Alarm as HIV patients default on ARVs after closure of special clinics

A growing number of people living with HIV are defaulting on ARV medication following the closure of specialized clinics for key populations.

The National Empowerment Network of People Living with HIV/AIDS in Kenya (NEPHAK) warns that adolescents are the most affected, with stigma driving many away from treatment.

While some counties have integrated HIV services into general healthcare, patients say critical support remains missing, leaving them uncertain about their future.

Citizen TV visited Lumumba Sub-County Hospital in Kisumu, where the outpatient clinic buzzed with activity, a testament to the high demand for medical services.

In the pharmacy, a small corner is now dedicated to antiretroviral medication, a visible reminder of the hospital’s efforts to integrate HIV services following a freeze in external funding.

Despite this shift, patients say vital free services once offered at the Comprehensive Care Clinic are now missing, leaving many struggling to access essential care.

"Kuna test zenye ziko very expensive kama liver test, kidney test, na some of them unapataa zinachukua kama Ksh.10,000 and above ili ufanyiwe. Sasa a normal one hakuna vile ataweza kuafford, so si mtu anaona tu kifo mbele yake," an unnamed person living with HIV said.

Adolescents, once catered to in youth-friendly centers, have been the hardest hit, struggling to navigate HIV care in less supportive and overcrowded outpatient settings.

"Telling people who were used to getting medication at a special clinic to now go join with everyone is a huge challenge. Some of them are adolescents and young people, and because of stigma, they will not talk. The issue we have right now is not so many people are talking - even the people who have missed medication," said Nelson Otwoma, Executive Director, NEPHAK.

Kisumu County once had over 3,000 health workers under U.S.-funded programs, according to the National Syndemic Diseases Control Council.

However, with funding cuts, the integration of HIV services has left a critical gap—specialized clinic staff were not absorbed, leaving patients in the hands of overstretched general practitioners. Now, many fear the quality of HIV care is at risk.

"Ulikuwa second line, sasa unarudisha first line without being explained to, na wengi wao hawajakuwa trained. Na unajua wamepewa mpaka gadgets wa-fill ambazo hao hawaelewi nini inaendelea. Wanasema unaweza fill the wrong thing, but bora county inataka information, sisi tunawapatia tu," an unnamed person living with HIV said.

Lumumba Sub-County Hospital Superintendent Pamela Olilo added: "This is not the time that when a client comes to the outpatient because they have another condition, they do not have to go back to the CCC. The clinician here is able to see them."

U.S. Secretary of State Marco Rubio announced on Tuesday the cancellation of 83% of the programs funded by USAID.

In a tweet, Rubio, however, said that the remaining projects would be administered under the State Department. It is, however, not clear which specific programs will be funded.

As national and county governments strategize to sustain HIV services, those living with the virus are pushing for a seat at the table.