Adapting HIV care in Western Kenya to prevent the spread of COVID-19

The COVID-19 pandemic has impacted all facets of healthcare. With the pandemic, the Kenyan government set new restrictions to promote social distancing. The majority of people living with HIV in Kenya access care through the public health system provided by the Ministry of Health—the same public health system responsible for front-line COVID-19 response. If people living with HIV may avoid health facilities out of fear, or the facilities become overwhelmed due to COVID, it could lead to more disease and deaths. 

In a new article, the Family AIDS Care & Education Services (FACES) team, a program of the Bixby Center, details a strategy they developed in collaboration with the Ministry of Health to help reduce congestion at HIV care and treatment clinics during the pandemic. Their interventions, which were implemented at 60 Ministry of Health facilities in Kisumu County, Kenya, included:

  • Providing multi-month refills of antiretroviral treatment (ART),
  • Screening all patients at arrival for COVID-19 symptoms,
  • Spacing patients within health facilities,
  • Providing handwashing stations and sanitizers at service points,
  • Conducting daily health talks on COVID-19, and
  • Scaling up community distribution of ART.

The FACES team found that 84% of eligible patients picked up multi-month supplies of ART and subsequently saw a 50% decrease in daily clinical attendance, showing that decongestion of HIV clinics if feasible within a short time span by using existing resources. This decongestion of the health facilities allowed them to focus on patients requiring in-person visits and cope with challenges from COVID-19.

As the pandemic continues, the health system is likely to redefine care for all patients who experience chronic illness, including those living with HIV. The pandemic is likely to affect those in the lowest socio-economic classes disproportionately, a significant proportion of patients supported by FACES. Programs like FACES will continue to create innovative interventions to ensure patients continue to access quality care.