- The new count also found the country has 16,063 individuals who identify as people who inject drugs, and 10,951 transgender people.
- This is the country’s second major estimate of the national count of sex workers and gay people. The first was conducted in 2012.
Image: FELIX KIPKEMOI
More than 167,000 Kenyans identify as female sex workers, and about 32,000 as men who have sex with men, a new estimate of the country’s key population indicates.
Key Population (KP) refers to people who are disproportionately affected by HIV compared to the general population.
The new count also found the country has 16,063 individuals who identify as people who inject drugs, and 10,951 transgender people.
This is the country’s second major estimate of the national count of sex workers and gay people. The first was conducted in 2012.
It is also the first estimate of transgender people.
Transgender describes people whose gender identity is different from the gender they were thought to be when they were born.
The current analysis was conducted by researchers from the National Aids and STI Control Programme, the Key Population Consortium of Kenya and Partners for Health and Development in Africa.
Others are Global Health Program of the University of California San Francisco, and the Institute for Global Public Health, University of Manitoba, Canada.
One of the most significant findings was the noticeable increase in the estimated numbers of some KPs since the last study in 2012.
“Comparing the size estimates of KPs from 2012, we have noticed a 26 per cent increase in the overall estimated number of Female Sex Workers (FSW) (133,675 to 167,940) and a 76 per cent increase in Men who have Sex with Men (MSM) (18,460 to 32,580), while the number of People Who Inject Drugs (PWID) has decreased from 18,327 to 16,063,” the researchers said.
The data suggest that these increases might be due to both a genuine rise in these populations and improvements in the mapping and estimation techniques.
The decrease in PWID was attributed to the expansion of medically assisted therapy programmes in recent years.
Their final version of their study – “Programmatic mapping and estimating the population size of FSW, MSM, PWID and transgender populations in Kenya”— was published in the Gates Open Research journal.
Estimating the size of the key population is important so that policy makers can better reach them with targeted HIV prevention strategies.
HIV prevalence is high with 18.9 per cent PWID, 29.5 per cent of FSW and 18.2 per cent of MSM being HIV positive.
The study, conducted between January and March 2018, covered 34 counties.
The researchers said they employed a mixed-methods approach. First documenting all known venues where these key populations congregate and then validating these locations to confirm their activity.
Additionally, the study found a substantial proportion of underage children in the key population.
An estimated nine per cent of FSWs and MSM and 11 per cent of PWIDs were under 18 years of age.
The populations were also concentrated in a few counties.
"Eighteen counties collectively accounted for 80 per cent of all FSWs, while eight counties accounted for 80 per cent of MSM," the study revealed.
For instance, of FSWs, Nairobi had 24 per cent, followed by Nakuru (11 per cent) and Mombasa (five per cent).
Among MSM, Nairobi county accounted for 31 per cent of the total estimate.
Both Kilifi and Mombasa comprised of nine per cent each of the total estimated MSM in Kenya.
Nearly 85 per cent of the total PWIDs were from four counties, with Nairobi having the largest proportion (31 per cent) followed by Kilifi and Mombasa, which had 27 per cent and 16 per cent of the estimated PWID respectively.
Of transgender women, Nairobi county has the largest share (25 per cent) followed by Bungoma (12 per cent), Mombasa (10 per cent) and Kilifi (eight per cent) counties.
Despite its strengths, the study faced several limitations. "The estimates are not based on physical counts but rather on reports from respondents, which could lead to underestimation," the researchers cautioned.
Moreover, they noted that individuals who primarily use virtual sites to find partners might not have been fully captured, particularly among MSM.
"A virtual mapping exercise indicated that 75 per cent of MSM who use online platforms also visit physical venues, suggesting our estimates could be 20-25 per cent higher," they added.
The findings also pointed to the need for more nuanced interventions.
"We observed significant mixing of key populations at venues, such as transgender people using the same locations as FSWs and MSM," the team noted.