92 The Global HIV Epidemics among Sex Workers
costing less than $1 USD per day. Access to these drugs could be improved, as even this modest cost is high for many Indians. Access to treatment could be incorporated into the extensive clinical and community infrastructure that has been established through the Indian Government, NGOs, and donors. Although community mobilization efforts have helped to create an enabling environment for sex workers to access HIV prevention services in India, persisting stigma and discrimination as well as laws that indirectly criminalize sex work continue to increase female sex workers’ risk for STIs and hinder their ability to access these services. There are currently no non-discrimination laws or regulations that specify protections for sex workers. Additionally, there are extensive gaps in research related to male and transgender sex workers.
Kenya Introduction Key Themes
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Though HIV prevalence in Kenya has been in decline in recent years since its peak in 2000, HIV prevalence among female sex workers remains extremely high at approximately 45%. The Kenyan Government has recognized the disproportionate burden of HIV among female sex workers and developed National Guidelines for HIV/STI Prevention among sex workers.
Criminalization, as well as, stigma discrimination and violence are barriers to access to HIV prevention, treatment, and care services among Kenyan sex workers.
Kenya has a population of 39 million people and remains the largest economy in East Africa with a GDP of nearly 30 billion USD as compared to approximately 21 billion in Tanzania and 16 billion in Uganda. Kenya is at the upper end of low-income countries as defined by the World Bank with a GDP per Capita of 738 USD and a purchasing power parity that has been steady at $1,600 USD. The United Nations (UN) human development index of Kenya has been slowly increasing by 0.5% per year from 0.404–0.470 equating to a current rank of 128/169 countries and above the average of Sub-Saharan African countries (Beyrer 2011). Historical Perspectives on and Trends of the HIV Epidemic and Response. The first case of HIV was estimated to have occurred in 1978 with the first AIDS case officially reported in 1984 (Kawewa 2005). The first and most clearly identified risk factor related to HIV infection at that time was sex work