US cash cuts leave sex workers high and dry

HIV services for sex workers, gay men and people who inject drugs are the most affected by the US’s withdrawal of funding, the World Health Organization says.

In Kenya, HIV prevalence among these key populations is significantly higher than the general population, according to the Kenya HIV Modes Of Transmission Study Report, 2024.

The prevalence stands at about 29.3 per cent for FSW and 18.2 per cent for MSM and PWID, while the national average is considerably lower at around 3.3 per cent.

The WHO said in a statement that most of the outreach services to these populations was supported by US funding and through the Global Fund.

That is because they remain illegal and do not benefit from domestic financing in countries such as Kenya.

WHO said early reports indicate that, globally, prevention and treatment services for key populations are the most affected by the suspension of US funding.

“These disruptions are resulting in staffing shortages, supply chain interruptions and increased barriers to access, leaving key populations – including gay men and other men who have sex with men, sex workers, people who inject drugs, people in prisons and trans and gender diverse individuals – vulnerable to infection and death, as well as increased stigma and discrimination.”

US grants to hundreds of African organisations providing HIV services were terminated last Thursday with immediate effect.

The order affected many projects that are supported by the US President’s Emergency Plan for AIDS Relief (Pepfar) and others that receive some US support.

WHO said prevention, testing and treatment services for HIV, viral hepatitis and sexually transmitted infections have driven unprecedented progress in improving population health over the past two decades, averting millions of new HIV infections and AIDS-related deaths.

“Foreign aid investments in the global HIV response, such as the Pepfar and the Global Fund on Aids, TB and Malaria, have been pivotal to this success, also contributing significantly to progress towards elimination of hepatitis B and C and STI control,” WHO said.

“However, abrupt disruptions to foreign aid and service delivery threaten these gains, putting millions of people at risk – especially people living with HIV and key and vulnerable populations.”

Many essential evidence-based prevention interventions, including HIV pre-exposure prophylaxis, harm reduction services for people who inject drugs and community-led programmes have been permanently halted.