{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T00:01:52Z","timestamp":1793145712388,"version":"4.5.0"},"reference-count":29,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,6,3]],"date-time":"2021-06-03T00:00:00Z","timestamp":1622678400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Amref Health Africa","award":["N\/A Internal Grant"],"award-info":[{"award-number":["N\/A Internal Grant"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The study sought to determine the impact of COVID-19 on HIV\/AIDS programming in the Kibera informal settlement and COVID-19 hotspot counties during the first wave of the pandemic. The study was conducted in two phases. The first phase entailed the analysis of HIV care and treatment secondary data (2018\u20132020) from the Kenya Health Information System. In the second phase, a prospective cohort study was conducted among people living with HIV in the Kibera informal settlement. A total of 176 participants aged 18 years and above accessing HIV services at selected healthcare facilities in Kibera were randomly sampled from facility electronic medical records and followed up for three months. Socio-demographics and contact details were abstracted from the records and telephone interviews were conducted with consenting participants. Results from the retrospective review of HIV program data indicated a 56% (p &lt; 0.000, 95% CI: 31.3%\u201362.8%) reduction in uptake of HIV services. Clients starting antiretroviral therapy (ART) reduced significantly by 48% (p &lt; 0.001, 95% CI: 35.4%\u201377%) in hotspot counties. However, pre-exposure prophylaxis uptake increased significantly by 24% (p &lt; 0.019, 95% CI: 4%\u201349%). In Kibera, 14% reported missing medications at the onset of the COVID-19 pandemic because of lack of food (38%) and government measures (11%), which affected ART access; 11% did not access health facilities due to fear of contracting COVID-19, government regulations and lack of personal protective equipment. Socioeconomic factors, food insecurity and government measures affected uptake of HIV\/AIDS services; hence, the need for scaling up measures to increase access to HIV\/AIDS services during the onset of pandemics.<\/jats:p>","DOI":"10.3390\/ijerph18116009","type":"journal-article","created":{"date-parts":[[2021,6,3]],"date-time":"2021-06-03T10:59:51Z","timestamp":1622717991000},"page":"6009","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Impact of the First Wave of the COVID-19 Pandemic on HIV\/AIDS Programming in Kenya: Evidence from Kibera Informal Settlement and COVID-19 Hotspot Counties"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7992-6532","authenticated-orcid":false,"given":"Samuel","family":"Muhula","sequence":"first","affiliation":[{"name":"Monitoring Evaluation and Research Unit, Amref Health Africa in Kenya, 30125-00100 Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3163-0633","authenticated-orcid":false,"given":"Yvonne","family":"Opanga","sequence":"additional","affiliation":[{"name":"Monitoring Evaluation and Research Unit, Amref Health Africa in Kenya, 30125-00100 Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Violet","family":"Oramisi","sequence":"additional","affiliation":[{"name":"Department of Strategic Health Programs, Division of National AIDS and STIs Control Programme, 19361-00202 Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Ngugi","sequence":"additional","affiliation":[{"name":"Department of Strategic Health Programs, Division of National AIDS and STIs Control Programme, 19361-00202 Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Ngunu","sequence":"additional","affiliation":[{"name":"Health Directorate, Nairobi Metropolitan Services, 49130 Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4671-3519","authenticated-orcid":false,"given":"Jane","family":"Carter","sequence":"additional","affiliation":[{"name":"Clinical and Diagnostics Programme, Amref Health Africa Headquarters, 27691-00506 Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7923-1271","authenticated-orcid":false,"given":"Enock","family":"Marita","sequence":"additional","affiliation":[{"name":"Monitoring Evaluation and Research Unit, Amref Health Africa in Kenya, 30125-00100 Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim","family":"Osur","sequence":"additional","affiliation":[{"name":"Office of the Vice Chancellor, Amref International University, 27691-00506 Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Memiah","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Prevention: Institute of Human Virology, University of Maryland Baltimore, Baltimore, MD 21201, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,6,3]]},"reference":[{"key":"ref_1","unstructured":"NASCOP (2020). Kenya Population Based HIV Impact Assessment (KENPHIA) 2018 Preliminary Report, NASCOP."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1089\/apc.2015.0259","article-title":"I knew I would be safer. Experiences of Kenyan HIV serodiscordant couples soon after pre-exposure prophylaxis (PrEP) initiation","volume":"30","author":"Ngure","year":"2016","journal-title":"AIDS Patient Care STDS"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1929","DOI":"10.1016\/S0140-6736(07)61696-1","article-title":"The burden and costs of chronic diseases in low-income and middle-income countries","volume":"370","author":"Abegunde","year":"2007","journal-title":"Lancet"},{"key":"ref_4","unstructured":"NACC (2020, May 18). Ministry of Health National AIDS Control Council. Ministry of Health. Available online: https:\/\/www.lvcthealth.org\/wp-content\/uploads\/2018\/11\/KARPR-Report_2018.pdf."},{"key":"ref_5","unstructured":"MOH-Kenya (2020). Ministry of Health\u2014Republic of Kenya. Coronavirus Dashboard."},{"key":"ref_6","unstructured":"WFP (2020). WFP Kenya COVID-19 Situation Report #1, 18 April 2020\u2014Kenya | ReliefWeb. Relief Web, WFP."},{"key":"ref_7","unstructured":"WHO (2020). WHO Coronavirus Disease (COVID-19) Dashboard Who.int, WHO."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Ssentongo, P., Ssentongo, A.E., Heilbrunn, E.S., Ba, D.M., and Chinchilli, V.M. (2020). Association of cardiovascular disease and 10 other pre-existing comorbidities with COVID-19 mortality: A systematic review and meta-analysis. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0238215"},{"key":"ref_9","unstructured":"Herrick, C. (2021, March 23). Syndemics of COVID-19 and \u201cPre-Existing Conditions\u201d|Somatosphere. Available online: http:\/\/somatosphere.net\/2020\/syndemics-of-covid-19-and-pre-existing-conditions.html\/."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.glohj.2020.04.003","article-title":"Vulnerability and everyday health risks of urban informal settlements in Sub-Saharan Africa","volume":"4","author":"Zerbo","year":"2020","journal-title":"Glob. Health J."},{"key":"ref_11","unstructured":"Keyobs-IFRA (2019). Kibera: The Biggest Slum in Africa?. Les Cahiers de l\u2019Afrique, 44, 3\u201334."},{"key":"ref_12","unstructured":"KNBS (2019). 2019 Kenya Population and Housing Census. Republic of Kenya."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1111\/j.1365-3156.2008.02193.x","article-title":"The impact of distance of residence from a peripheral health facility on pediatric health utilisation in rural western Kenya","volume":"14","author":"Feikin","year":"2009","journal-title":"Trop. Med. Int. Health"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Njuguna, H.N., Cosmas, L., Williamson, J., Nyachieo, D., Olack, B., Ochieng, J.B., Wamola, N., Oundo, J.O., Feikin, D.R., and Mintz, E.D. (2013). Use of Population-based Surveillance to Define the High Incidence of Shigellosis in an Urban Slum in Nairobi, Kenya. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0058437"},{"key":"ref_15","first-page":"197","article-title":"Understanding the grassroots dynamics in Nairobi: The dilemma of Kibera informal settlements","volume":"2","author":"Mutisya","year":"2011","journal-title":"Int. Trans. J. Eng. Manag. Appl. Sci. Technol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Quaife, M., Van Zandvoort, K., Gimma, A., Shah, K., McCreesh, N., Prem, K., Barasa, E., Mwanga, D., Kangwana, B., and Pinchoff, J. (2020). The impact of COVID-19 control measures on social contacts and transmission in Kenyan informal settlements. BMC Med., 18.","DOI":"10.1101\/2020.06.06.20122689"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2000543","DOI":"10.2807\/1560-7917.ES.2020.25.18.2000543","article-title":"Projected early spread of COVID-19 in Africa through 1 June 2020","volume":"25","author":"Pearson","year":"2020","journal-title":"Eurosurveillance"},{"key":"ref_18","unstructured":"Amref Health Africa (2018). Kibera Reach 90\u2014Tafuta na Google, Amref Health Africa."},{"key":"ref_19","unstructured":"Health Ministry of Health (2020). 33 Counties Now Have Cases of COVID-19 Nairobi, Saturday May 30, 2020."},{"key":"ref_20","unstructured":"National AIDS and STI Control Programme (NASCOP) (2018). KENPHIA 2018 PREL REP fin_alt2_USAID.indd 1. 2020, NASCOP."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Chenneville, T., Gabbidon, K., Hanson, P., and Holyfield, C. (2020). The impact of COVID-19 on HIV treatment and research: A call to action. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17124548"},{"key":"ref_22","unstructured":"USAID (2020). Meeting Targets and Maintaining Epidemic Control (EpiC) Project Mitigating the Impact of COVID-19 on HIV Programs: Practical Considerations for Community-Based Providers."},{"key":"ref_23","unstructured":"Owino, H. (2020). Into Their Own Hands: Kibera, Kenya\u2019s Largest Slum, Tames COVID-19, Pulitzer Center."},{"key":"ref_24","unstructured":"WHO (2020). WHO\/Europe | HIV\/AIDS\u2014Ensuring PLHIV Have Continued Access to Treatment during COVID-19 Pandemic, WHO."},{"key":"ref_25","unstructured":"MOH (2020). Updated Operational Guidance on Continuity of Healthcare Services in HIV Prevention Care and Treatment in the Context of the COVID 19 Pandemic."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1016\/j.jmii.2020.04.011","article-title":"Coronavirus Disease 2019 (COVID-19) in Kenya: Preparedness, response and transmissibility","volume":"53","author":"Aluga","year":"2020","journal-title":"J. Microbiol. Immunol. Infect."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"211","DOI":"10.12688\/wellcomeopenres.16222.1","article-title":"Infection prevention and control during the COVID-19 pandemic: Challenges and opportunities for Kenyan public hospitals","volume":"5","author":"Maina","year":"2020","journal-title":"Wellcome Open Res."},{"key":"ref_28","unstructured":"WHO (2020). WHO: Access to HIV Medicines Severely Impacted by COVID-19 as AIDS Response Stalls, World Health Organization."},{"key":"ref_29","unstructured":"UN-Habitat (2020). 35 Addressing the Vulnerable Urban Vulnerability Increasing Food Insecurity Likely Deterioration in Nutritional Status 36 Monitoring for Evidence-Based Response 38 Bibliography, UN-Habitat."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/11\/6009\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:10:31Z","timestamp":1760163031000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/11\/6009"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,3]]},"references-count":29,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,6]]}},"alternative-id":["ijerph18116009"],"URL":"https:\/\/doi.org\/10.3390\/ijerph18116009","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,3]]}}}