15th International AIDS Conference Bangkok, Thailand - July 11-16, 2004

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. MoOrD1031)

Ngongo BP, Marum EM, Omondi JO, Taegtmeyer MT
Liverpool VCT and Care Kenya, NAIROBI, Kenya

ISSUES: Recent dramatic increases in access to VCT services in Kenya have led to a demand for an accessible deaf-friendly VCT service. The Deaf community in Kenya comprises an estimated 950,000 people with no unified sign language and few agreed signs for many words related to HIV awareness. The number who had accessed VCT was in single figures. Low levels of awareness of HIV, lack of trust in lay interpreters and the multiplicity of sign languages used in Kenya were key factors in this low uptake.

DESCRIPTION: This paper analyses the multi-sectoral collaboration process of planning, implementing and monitoring of Africa's first VCT site and mobile VCT outreaches run by the Deaf for the Deaf. The development of Deaf specific counselors and community mobilisers training courses, VCT service delivery, supervision and quality assurance mechanisms are highlighted. The deaf - friendly VCT site opened in 2003 was also a referral point for STI and HIV care. This paper will be presented in a mixture of Kenyan Sign language and English with interpretation of both.

LESSONS LEARNED: Ownership of VCT services by the Deaf community has made this unique project a success. Client flow at the VCT site is around 200 clients per month and Deaf from all over Kenya have requested mobile services. Supervision and quality assurance mechanisms are integral to the service and this has further increased client confidence. Clients value not having to share their issues with a third party. A combination of stand-alone site with mobile outreach to Deaf institutions has proven cost-effective however referral to other health care remains challenging.

RECOMMENDATIONS: This project is replicable in other countries. Involving the Deaf directly in service provision makes the service accessible and acceptable. In addition the government strategy and planning must take into account the vulnerability of the Deaf to HIV when designing national HIV prevention and care interventions

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