CIHEB Kenya’s Commitment to Health and Dignity for PWIDs on MAT in Nairobi County

Nairobi County accounts for over half of Kenya’s population of People Who Inject Drugs (PWIDs) enrolled in Medically Assisted Therapy (MAT), making it a critical epicenter in the national HIV response. CIHEB Kenya, in partnership with Mathari and Ngara MAT Clinics, is implementing a fully integrated harm reduction program tailored to the unique needs of this population.

This initiative is the first in Nairobi County to integrate HIV care, non-communicable disease (NCD) screening, mental health support, and gender-based violence (GBV) services within MAT clinics delivered through an innovative model that combines digital health platforms (IQ Care), peer-led adherence strategies, and community-driven referral systems. Informed by ongoing client feedback and community engagement, this model is already demonstrating exceptional outcomes, including a projected 30% increase in viral load suppression rates among PWIDs on MAT.

Anchored in PEPFAR guidance, Kenya’s AIDS Strategic Framework IV, and national health policies, the program provides a seamless continuum of care and social support to over 1,500 PWIDs positioning it as a model of excellence for high-impact, rights-based HIV programming in Kenya.

To enhance health outcomes and reduce HIV transmission among PWIDs on MAT in Nairobi County through the implementation of integrated, evidence-based harm reduction services that are person-centered, sustainable, and scalable.

CIHEB Kenya’s program has successfully reached over 1,500 PWIDs with HIV combination prevention packages, contributing to a measurable decline in new HIV infections among MAT clients. In alignment with the UNAIDS 95-95-95 targets, the program has achieved significant milestones. There has been a 100% uptake of CD4 and CrAg testing among newly diagnosed clients, enabling early detection and prompt management of opportunistic infections. The program has also ensured 100% viral load monitoring, with over 95% of clients achieving viral suppression, an essential milestone in reducing HIV transmission and improving long-term health outcomes.

Appointment adherence remains high, with less than 5% of clients missing appointments and less than 1% experiencing treatment interruptions, reflecting strong engagement and adherence. Routine screening for non-communicable diseases and mental health conditions has been fully integrated into care, ensuring holistic, patient-centered services for all eligible clients. For HIV-negative clients, the program has maintained continuous PrEP initiation and follow-up, while providing comprehensive reproductive health support, including cervical cancer screening, for women of reproductive age. Additionally, the full-scale rollout of the IQ Care system across all service delivery points has significantly improved service coordination, data use, and real-time clinical decision-making.

Strategic activities have been central to the success of this program. Quality improvement efforts have included quarterly joint review meetings with civil society organizations, clinical mentorship, peer supervision, and continuing medical education (CME) for healthcare workers. Client support has been enhanced through strengthened psychosocial support groups, the integration of mental health services, active defaulter tracing, and individualized case management.

The program has invested in extensive capacity building by training providers on MAT service delivery, mental health care, stigma reduction, gender-based violence (GBV) response, and trauma-informed care. Service integration efforts have co-located HIV testing, PrEP, family planning and condom distribution, GBV care, and maternal health services such as antenatal care (ANC) and Operation Triple Zero (OTZ) programming for pregnant PWIDs.

To ensure clients receive holistic support, referral and linkage systems connect them to DREAMS, orphans and vulnerable children (OVC) programs, and other socio-economic empowerment platforms. Monitoring and evaluation are conducted through real-time IQ Care based reporting, enabling continuous data-driven decision-making supported by structured feedback loops. Community engagement is embedded in service delivery through client feedback mechanisms, peer-led advisory panels, and participatory planning forums to ensure programming remains responsive, inclusive, and client-centered.

To ensure clients receive holistic support, referral and linkage systems connect them to DREAMS, orphans and vulnerable children (OVC) programs, and other socio-economic empowerment platforms. Monitoring and evaluation are conducted through real-time IQ Care based reporting, enabling continuous data-driven decision-making supported by structured feedback loops. Community engagement is embedded in service delivery through client feedback mechanisms, peer-led advisory panels, and participatory planning forums to ensure programming remains responsive, inclusive, and client-centered.