Odinga Manas Migot, Kuria Samuel, Muindi Oliver, Mwakazi Peter, Njraini Margret, Melon Memory, Kombo Bernadette, Kaosa Shem, Kioko Japtheth, Musimbi Janet, Musyoki Helgar, Bhattacharjee Parinita, Lorway Robert
Men Against AIDS Youth Group, Kisumu, Kenya.
Mamboleo Peer Empowerment Group, Kiambu, Kenya.
Gates Open Res. 2020 Oct 29;4:117. doi: 10.12688/gatesopenres.13152.2. eCollection 2020.
In comparison to European and American countries, Kenya has been less impacted by the COVID-19 pandemic in terms of reported cases and mortalities. However, everyday life has been dramatically affected by highly restrictive government-imposed measures such as stay-at-home curfews, prohibitions on mobility across national and county boundaries, and strict policing, especially of the urban poor, which has culminated in violence. This open letter highlights the effects of these measures on how three community-based organizations (CBOs) deliver HIV programs and services to highly stigmatized communities of men who have sex with men living in the counties of Kisumu, Kiambu and Mombasa. In particular, emphasis is placed on how HIV testing programs, which are supported by systematic peer outreach, are being disrupted at a time when global policymakers call for expanded HIV testing and treatment targets among key populations. While COVID 19 measures have greatly undermined local efforts to deliver health services to members and strengthen existing HIV testing programs, each of the three CBOs has taken innovative steps to adapt to the restrictions and to the COVID-19 pandemic itself. Although HIV testing in clinical spaces among those who were once regular and occasional program attendees dropped off noticeably in the early months of the COVID-19 lockdown, the program eventually began to rebound as outreach approaches shifted to virtual platforms and strategies. Importantly and unexpectedly, HIV self-testing kits proved to fill a major gap in clinic-based HIV testing at a time of crisis.
与欧美国家相比,肯尼亚在新冠疫情报告病例数和死亡人数方面受影响较小。然而,日常生活却受到政府实施的高度限制性措施的巨大影响,如居家宵禁、禁止跨国家和县界流动以及严格执法,尤其是针对城市贫困人口,这最终导致了暴力事件。这封公开信强调了这些措施对三个社区组织(CBO)向基苏木、基安布和蒙巴萨县与男性发生性关系的男性这一高度受歧视社区提供艾滋病毒项目和服务方式的影响。特别强调的是,在全球政策制定者呼吁扩大关键人群中艾滋病毒检测和治疗目标之际,由系统的同伴外展支持的艾滋病毒检测项目正受到干扰。虽然新冠疫情措施极大地破坏了当地为成员提供卫生服务和加强现有艾滋病毒检测项目的努力,但这三个社区组织都采取了创新措施来适应这些限制以及新冠疫情本身。尽管在新冠疫情封锁的最初几个月里,曾经定期和偶尔参加项目的人在临床场所进行的艾滋病毒检测明显减少,但随着外展方式转向虚拟平台和策略,该项目最终开始反弹。重要且出乎意料的是,在危机时刻,艾滋病毒自检试剂盒填补了基于诊所的艾滋病毒检测的一个重大空白。
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