Health workers and HIV advocacy groups in Kenya are raising concerns over the impact of cuts to US foreign aid, with fears that disruption to treatment and prevention services is putting vulnerable communities at greater risk.
Among those affected is Cecilia, a sex worker who is mourning the death of her friend, Beatrice, who was also a sex worker living with HIV.
According to Cecilia, Beatrice stopped taking her antiretroviral medication after visits by a non-governmental organisation providing support services were discontinued. She was reportedly reluctant to seek treatment at a public health facility because of the stigma she feared she would face.
Grieving over her friend’s death, Cecilia appealed to US President Donald Trump to reconsider the cuts.
“It’s really sad, really, really sad. Due to Trump, things that happened during that season, my friend had no access to the medication. She was HIV positive. Please, if he can change his mind, if something can happen, please, people are dying. Not even Beatrice. Those are people near me,” she said.
At least 24 deaths among HIV-positive sex workers in Kenya have reportedly been recorded since US aid cuts disrupted services. The victims, like Beatrice, were said to have remained in relatively good health before the withdrawal of support.
Daisy Kwala, Programme Coordinator of the Bar Hostess Empowerment and Support Programme, warned that the reported deaths could represent only part of the impact.
She said the suspension of services had made it difficult for sex workers to access essential HIV prevention and treatment commodities, including condoms and antiretroviral drugs.
“With or without the stop-work order, sex work has not stopped. So with the stop-work order, the only difference is now the sex worker is not able to access commodities, they are not able to get condoms, they are not able to get their ARVs, and they are still selling sex there,” Kwala said.
She added that the disruption could increase the risk of new HIV infections because some sex workers living with HIV may continue working without access to treatment or affordable condoms.
“They will still sell the sex, they will still meet six to ten people in a day, and that puts the entire community at risk,” she said.
The concerns come as the United States seeks to reshape its engagement with Africa following cuts to foreign assistance. A senior US official responsible for African affairs visited Nairobi earlier this month, promoting a partnership centred on “trade, not aid”.
The official has rejected suggestions that the United States bears responsibility for deaths among sex workers following the reduction in aid.
The developments have nevertheless intensified debate in Kenya over the consequences of reduced international funding for HIV treatment, prevention and support programmes serving vulnerable populations.
