By Robai Ludenyi
Cuts to US-funded health programmes in Kenya are disrupting HIV treatment and prevention services for sex workers, with health organisations reporting more infections, clinic closures and deaths among people who have lost access to care.
The funding cuts followed the dismantling of several USAID programmes, which had supported HIV treatment, testing, condom distribution and outreach services for vulnerable groups across the country.
Health organisations say the effects have been particularly serious among sex workers, many of whom depended on specialised clinics and outreach teams for regular treatment and prevention services.
The Sex Workers Outreach Programme (SWOP), which monitors about 45,000 people in the profession, recorded a 48 per cent increase in new HIV infections during the first half of 2026 compared with the same period in 2024.
The organisation has also been forced to close half of its clinics after losing funding, reducing the number of facilities where sex workers can access HIV testing, treatment and other health services.
The Bar Hostess Empowerment and Support Programme (BHESP) has reported a similar situation. Its two USAID-funded centres previously served about 14,500 sex workers. Following the funding cuts, about 12,000 people have dropped out of its care, including around 2,300 people living with HIV.
Frontline health workers have also reported at least 24 confirmed deaths among HIV-positive sex workers who lost access to treatment. They fear the actual number could be higher because not all deaths are formally recorded or linked to the disruption of healthcare services.
As Kenya, we are still struggling with progress in fighting HIV. The country has about 285,000 women
engaged in sex work, with an estimated HIV prevalence of 27.5 per cent among them.
Health officials say Kenya has made significant progress in reducing new HIV infections. New infections
fell from about 110,000 in 2005 to 13,936 in 2025. However, reduced access to prevention and
treatment could threaten these gains.
Condom shortages are adding to the concern. Kenya requires about 500 million condoms each year for
free distribution, but the government currently has the budget to provide only about 200 million.
Many sex workers cannot afford to buy condoms regularly, increasing the risk of HIV transmission and
other sexually transmitted infections.
Stigma is another major challenge. Some sex workers avoid public health facilities because they fear discrimination or being judged because of their work. People living with HIV may also fear that their status could become known to their families or communities.
Douglas Bosire, head of the National Syndemic Diseases Control Council, has warned that the progress Kenya has made in reducing HIV infections could be reversed if vulnerable groups are left without reliable access to healthcare.
UNAIDS chief Winnie Byanyima has also warned that disruption of HIV services threatens years of progress in the fight against the disease. However, US officials have rejected claims that the United States is responsible for the reported deaths.
During a visit to Nairobi on September 9, US Deputy Assistant Secretary for Africa Frank Garcia defended the country's record in supporting HIV research and treatment.
With funding gaps continuing to affect specialised health programmes, organisations working with sex workers are calling for urgent action to restore treatment, testing and prevention services.