Transgender and drug addicts deserted in fight against HIV

AMW spent her formative life as a little boy in South Africa with her parents.  At 10, a gay inclination developed and she never looked back. 

“I discovered at 10 that I was living in a boy's body and I was actually feminine. I decided to transition and my parents were very supportive," she says.

Across Kenya, transgender individuals and people who inject drugs are falling through the cracks of the country’s HIV response.

A new report by the Kenya Legal & Ethical Issues Network on HIV and AIDS (Kelin) says these two groups receive the least HIV-related support among all key populations—placing them at severe risk for new infections and continued transmission.

While Kenya has made notable progress in reaching gays and sex workers with HIV services, the same cannot be said for transgender persons and PWIDs.

“The coverage with HIV services for the FSW programme against the above estimates stands at 115 per cent, for MSM at 151 per cent,” the report states. “But gaps exist in the coverage of PWIDs at 75 per cent and for transgender persons at 86 per cent.”

These figures translate to thousands being missed. Kenya has an estimated 197,096 female sex workers and 61,650 gays. In contrast, only 26,673 people who inject drugs and 4,305 transgender individuals are accounted for in the national response—and they are dangerously underserved.

“These figures reflect gaps in reaching PWIDs and transgender persons with HIV services,” the report says. “Such gaps continue to widen due to stigma and other harmful practices such as conversion therapy and violence on key populations.”

JHM started self-injecting drugs during his teenage years.

“You don’t think about infection when you’re sharing needles just to survive the day,” he says. “But when I tried to get clean needles or HIV testing, there were no services—or they treated me like a criminal.”

The stigma and structural discrimination that people like AMW and JHM experience, creates a deadly barrier to care. Beyond HIV testing, uptake of pre-exposure prophylaxis (Prep), diagnosis, treatment and access to condoms and lubricants remains erratic.

Kelin, which compiled the report ahead of the UN’s universal peer review process in September, is a coalition working at the intersection of health and human rights. They call attention not only to gaps in urban clinics but also to the near-complete absence of services in Kenya’s prisons—where HIV crisis is quietly festering.

“In prison settings, HIV prevalence remains higher at 12–15 per cent compared to 3.7 per cent in general population,” the report says.

Conditions in correctional facilities are dire. TB, another opportunistic infection, is three to five times more common in prisons. “Additionally, the high rate of HIV/TB co-infection in prisons complicates treatment,” it says.

Kelin says the impact of these disparities is cumulative and cruel. Without adequate coverage and inclusive policies, these overlooked communities become the forgotten front line of Kenya’s HIV battle.

It says these gaps cannot be closed through health services alone. They require legal reform, public education and most urgently, the dismantling of stigma that denies people care based on their identity or circumstances.

As AMW says, “We are human beings. We bleed the same. We deserve to live.”