By Mike Mwaniki
Nduta, a mother of two, has a problem that she encounters every time she visits her local health centre in search of reproductive health services.
Her husband of more than 15 years, John, usually gives excuses of not accompanying her to the clinic, despite repeated requests by doctors and nurses at the facility who are keen on testing him for HIV.
However, John—and most men who have never tested for HIV— can access self-testing kits from an electronic vending machine. The EVM ensures high privacy due to removal of direct human interaction.
This is an enhancement of access to the self-test kits by the public after following the introduction to the gadgets to the chemists, which others may shy away from.
HIV self-testing involves an individual collecting their sample and placing it into the kit and reading the results in a confidential way.
According UNAIDS, of the 1.5 million people living with HIV in Kenya, about 400,000 are unaware they are infected by the virus.
This has been partly associated with the people being uneasy to be tested in hospitals or buying the self-testing kits over ethe counters of chemists.
The EVM has, therefore, was launched on December, 1, 2020- the World Aids Day- to cater for those who need more privacy.
Division of National Aids and STIs Control Programme (NASCOP) Head, Dr Catherine Ngugi said:
“The machine will function just the way you can buy chocolate from a vending machine,” Dr Ngugi explained.
Dr Ngugi says the agency is working closely with different organisations to enhance HIV testing uptake.
“This is part of our efforts to scale-up the use of self-tests in the private sector and specifically, in workplace settings,” she said.
Among the partners are Farmers’ Choice Limited Kenya and OraSure Technologies Inc, which will implement a demonstration pilot of two self-test EVMs.
“Farmers’ Choice Limited has over 1,500 staff, a majority of whom are men. Self-tests will be dispensed at no cost to the personnel at the company,” she added.
The use of EVMs in HIV care and treatment programmes is not new.
“Condom vending machines have been implemented globally in locations such as public restrooms, petrol stations and campus halls of residence.
“They provide discretion, enhance privacy and in turn, reduce users’ feelings of embarrassment and fear or risk of stigma from health providers in the community,” Dr Ngugi explained.
They can, therefore, be of value to the overall health system by facilitating and increasing access to key commodities, providing opportunity for health programmes to focus more on quality of services.
Dr Ngugi hopes that the EVMs will reverse the dropping number of people testing for HIV caused by the Covid-19 pandemic, and the project, if successful, will be rolled out countrywide.
She also warned that the focus of information flow has moved from other killer diseases to almost solely Covid-19, and this could impact on how the disease is managed.
“As agenda-setters, the media can find a balance to report on Covid-19 as well as stories around HIV and other life-threatening diseases so that we do not negate the strides made prior to this pandemic,” she added.
Globally, Kenya has one of the largest HIV epidemics with about 1.5 million people living with HIV. Of these, about 1.4 million are adults and 106,807 are zero-14 years.
Overall, the national prevalence is 4.9 per cent. Data show a double prevalence among women than men at 6.6 per cent and 3.1 per cent respectively.
At the same time, of the estimated 106,807 children aged less than 15 years LHIV, only 68,681 are on ART.
The self-testing kit will be part of a series of safer and more effective treatment interventions, which also include phased approach of ART optimization and treatment to phase out Non-Nucleoside Reverse Transcriptase Inhibitors—a class of ARVs (NNRTIs), as well as full implementation of multi-month dispensing of three months or more of HIV treatment.
Dr Ngugi said: “Infants born to HIV infected mothers now have access to prompt HIV diagnosis and treatment. A national system has been in operation for the past decade.
“However, only about 70 per cent of infants have access to these HIV testing facilities.”
On this note, she challenged the media to interrogate this situation to ensure the remaining 30 per cent of the infants get the healthcare they require.