Funding cuts impact HIV care for communities in Kenya

'Service uptake down'

"Service uptake has definitely gone down after the services were integrated into public health facilities," Ouma said.

Wendy Kigami Juja, a nurse attending to key populations at Oruba Dip Dispensary, said the former drop-in center provided HIV testing, antiretroviral therapy, PrEP, post-exposure prophylaxis, sexually transmitted infection treatment and referrals for survivors of gender-based violence.

Peer educators helped health workers reach people who might otherwise avoid health facilities. The center typically served 15 to 20 clients daily, with numbers sometimes reaching 20 to 30, depending on bookings and walk-ins.

"Once they realize there is a facility or there is a safe space where they can access these services, they come out clearly," she said.

After PEPFAR funding stopped, the center struggled to meet the operating costs, including rent. Its services were integrated into Oruba Dip Dispensary in June 2025, and outreach activities were discontinued.

Juja said condoms, lubricants, antiretroviral drugs and HIV prevention medicines continued to be supplied through other channels, including the Global Fund and the national government. However, reaching clients outside health facilities remained difficult.

She estimated that a consultation, urinalysis and treatment for a sexually transmitted infection could cost between $3.90 and $5.40, potentially discouraging people struggling to meet basic needs.

Without peer educators and outreach workers, health workers have also lost contact with some clients, particularly those in hard-to-reach areas.

The cuts have also affected programs supporting orphans and vulnerable children, including those living with HIV.