KENYA: Targeting older people in HIV prevention

Older Kenyans, often neglected by HIV programmes that assume they are no longer sexually active and therefore not at risk, are slowly becoming more visible in the fight against the pandemic.

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The NGO, HelpAge Kenya, is training older people to talk to their peers about how HIV is spread, teach them to use condoms, seek HIV testing and treatment and live a healthy life even while HIV-positive.

“When you have an old man aged 65 openly talking about his HIV status, his peers begin to reflect and realize that they too can get infected,” said Erastus Maina, programme officer at HelpAge Kenya. “Many of them still view HIV as a disease for the young and the restless, forgetting many of them are getting into sexual relationships with young people.”

According to the 2007 Kenya AIDS Indicator Survey, Kenyans aged between 50 and 64 years have an HIV prevalence of 5 percent; an estimated 3.4 percent are infected with syphilis, higher than any other age group.

Maina noted that older people had been relegated to the role of carers of children orphaned through HIV, with scant attention paid to the fact that many continued to lead active sexual lives. Older men often engage in relationships with much younger women while continuing to have sex with their older wives.

“Odd one out”

When Douglas Nasirembe, 66, first fell ill four years ago, the idea that he could be HIV-positive did not cross his mind, even though he had inherited two widows several years earlier.

“I used to be sick and then it would disappear and come back again… I just thought it was one of those diseases that come with being old and poor,” he told IRIN/PlusNews at his home in the western Kenyan town of Kakamega.

Nasirembe was eventually diagnosed with HIV and convinced to start taking antiretroviral drugs. “I just thought how shameful it would be for me to line up with young people for ARVs… I just knew I was going to be the odd one out,” he said.

“I decided to discuss that with the doctor, and he said I could get the medicine from him, I would not line up at the counter,” he added.

Nasirembe knows what a condom is, but has never used one. “I can’t go where they are teaching young people how to use condoms… they will look at me and say the old man is still doing this thing,” he said.

HelpAge Kenya has so far trained 313 peer educators in Kenya’s Central Province targeting older people. Together with the National AIDS and Sexually transmitted infections Control Programme, NASCOP, they are also developing a home-based care manual focusing on the care of HIV-infected older persons.

Nasiremebe says he would be comfortable talking to his peers about HIV.

According to Nyanza Provincial AIDS and sexually transmitted infections coordinator Charles Okal, older people’s low HIV risk perception meant they missed out not only on HIV prevention messages, but also on treatment.

“HIV programmes should be friendly to them so that they don’t miss out; when they believe they are not at risk, it means many of them miss out on treatment and care as a result of late diagnosis,” he said.
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[This report does not necessarily reflect the views of the United Nations]