Freebie approach looks to entice Kenyans into HIV tests (Feature)

By Michael Logan Sep 29, 2008, 2:08 GMT

Nairobi - In the small rural village of Eshisiru in Western Kenya, hundreds of women in colourful dresses, many of them surrounded by a gaggle of children, queue patiently in the midday sun.

These women are not waiting to draw water from a borehole or to buy food.

Instead, they are waiting to be tested for HIV - something that campaigners say is virtually unheard of in Africa.

The concept behind the programme that has brought people out in such numbers is very simple: Giving away a long-lasting insecticide- treated mosquito net, a water filter and condoms in exchange for taking the test.

'The response has been overwhelming,' says Peter Cleary, communications director of Vestergaard Frandsen, the private company providing the free pack and funding the testing. 'Over 10,000 people showed up on the first day; on the second day we had almost as many.'

The project, run in cooperation with the Kenyan Ministry of Health and other non-governmental organizations, aims to test 43,000 sexually active people aged 15-49 across Lurambi District.

At the moment, less than 20 per cent of Kenyans know their HIV status and there are an estimated 1.2 million HIV-infected Kenyans who do not know they carry the virus.

You don't have to be a health worker to deduce a person ignorant of his or her status is more likely to spread the disease, and most of the people taking the test acknowledge this.

'It is important to be tested because if people know their status they are going to change their behaviour,' says 30-year-old Sarah Mukoshi, who queued for over two hours before receiving her pack.

However, those involved in running the project - many of whom have taken part in previous, less successful testing campaigns for various diseases - are in no doubt the real reason people have turned out is the freebies.

'They are all saying they came to be tested, but you have to ask yourself why there is such a difference in turnout now,' says Louis da Gama of Global Health Advocates.

Even experienced campaigners like da Gama are surprised by the demand, but the desire to get a hold of a free mosquito net is perfectly understandable given that malaria is one of the top killers in Africa.

Around 90 per cent of the 1 million deaths from malaria each year occur in Africa, largely due to the lack of preventative measures.

In Kenya, only 52 per cent of all children sleep under a mosquito net. The figure for pregnant women is 37 per cent.

Considering that according to World Health Organization figures, diarrhoea accounts for up to 7.7 per cent of all deaths in Africa, the water filter also is a major draw.

So attractive is the free pack that even frail old men and women, not exactly a high risk group for HIV/AIDS, have been showing up to be tested.

Part of the apparent success is also down to holding the testing in a central location, thus encouraging everyone to come at the same time and overcoming the stigma of individual testing.

'Because people are coming in big numbers, nobody is embarrassed,' says Christine Amboya, 23, as she is queuing together with her neighbours.

For those who do test positive, counselling is immediately available to help deal with the blow of being diagnosed HIV positive.

'Most people come expecting to be negative because they don't feel sick and are still able to work,' says Beatrice Awino, manager of the Eshisiru testing site.

'They are distraught when they find out they are positive.'

Also important is the fact that machines are located at many of the sites to test people's CD4 count - the marker which determines the need to begin anti-retroviral treatment.

At Eshisiru alone, 40 people tested positive out of 650 in the first two days - slightly below the estimated national infection rate.

Of those 40 people, eight had to be put on to anti-retrovirals - made available in advance by the Kenyan Ministry of Health - immediately.

However, as successful as the testing programme appears to be in the early stages, it still has to be rolled out across Kenya to help the East African nation meet its goal of having 80 per cent of all adults know their HIV status by 2010.

Vestergaard Frandsen is only funding the initial 43,000 tests, but from the level of interest being shown in the project, the money to take the project nationwide should not be long in coming.