The Lost Shield: PrEP Shortage Leaves Vulnerable Kenyans Exposed

Nairobi, Kenya – A critical shortage of pre-exposure prophylaxis (PrEP)—a frontline preventive medicine against HIV—is squeezing access for sero-discordant couples and sex workers, increasing their vulnerability to infection.

Personal Stories Illuminate the Crisis

• Mary Auma (alias), married to an HIV-positive husband for five years, has remained HIV-negative thanks to daily PrEP. But the recent spike in unavailability at local health facilities has forced her to ration doses amid fear of infection.

• Her husband, John Ooko, voiced concerns that condoms are not always reliable, especially when trying to expand their family, and pleaded with the government to restore consistent PrEP access.

  “We’ve tried using condoms… our son is now seven months old. How is that possible without PrEP?” Ooko lamented. 

• Nancy Atieno, a sex worker based in Homa Bay Town, said access to the drug has dramatically declined in recent months.

  “It’s become increasingly difficult to access the drugs… I’ve had to turn down clients who want unprotected sex… that affects my earnings… Unprotected sex pays better… That’s how HIV spreads.” 

Official Data Reflects Alarming Decline

According to recent data from the Kenya Health Information System, PrEP initiations dropped by 49%, falling from 55,876 (Jan–Mar 2024) to 28,648 (Jan–Mar this year). Analysts link this steep decline to funding cuts following the reduction of support from USAID. 

Health Experts Sound the Alarm

• Justus Ochola from Homa Bay County’s Health Department warned the shortage could reverse gains against HIV infection, particularly among key populations like sex workers and discordant couples, and could eventually cascade into the wider community. He urged county governments to allocate emergency budgets for PrEP procurement. 

Broader Context and Implications

• Kenya has been a regional leader in integrating PrEP into its national HIV prevention strategy since 2016–2017, focusing on key populations such as discordant couples and sex workers. However, demand-outstripping supply and funding instability have repeatedly hampered progress. 

• Research in Kenya highlights significant awareness–uptake gaps and high rates of PrEP discontinuation among vulnerable groups—issues compounded by systemic barriers like stigma, stockouts, and access challenges. 

Summary Table