UN Integrated Regional Information System - November 5, 2008

"To the young men here, it is important to use a condom if you want to engage in sex. I am HIV-positive and I knew my status by going to a VCT [voluntary counselling and testing centre], and now I use drugs that make me appear this healthy," Lydia Nyambura shouted in Kiswahili, holding up a packet of condoms.

Nyambura and her colleague, Dora Auma, belong to a local group of HIV-positive widows who have joined together informally to tell the people most at risk in the places where they are most at risk how they can avoid becoming infected. "People are dying here of HIV like flies; we have resolved to reach out to them everywhere that they can be found," Auma told IRIN/PlusNews.

"Alcohol makes some of these people do the unthinkable," Nyambura said. "It is not uncommon to find people in the evening staring at drunkards making love in these dark alleys."

Korogocho is one of the city's largest slums, with a population of about 120,000 people living in a single square kilometre; more than half of Nairobi's three million people live in informal urban settlements.

According to a recent study on disease among the children aged five and older living in these areas, HIV/AIDS and tuberculosis account for about 50 percent of deaths.

"Desperate living conditions and lack of livelihood opportunities could predispose residents to risky health-related behaviours, such as high alcohol consumption, unsafe sex, smoking and other substance abuse," the study commented.

Patrons of Korogocho's taverns say the women's advice is generally well-received, although it is difficult to see an immediate impact. "Yes, they have helped me change my attitude, and I know others have too, but from what still goes on here, there is still a lot to be done," said Peter Odero, a regular visitor at his neighbourhood pub.

Mary Okuon, a rehabilitated alcoholic who was counselled by the widows, said entrenched sexism made the women's task more difficult. "Men tend to dismiss them because they think women cannot tell them what to do."

Cooperation with owners key

The leader of the group, Margaret Anyango, said most bar owners welcomed them and their messages, provided they did not disrupt the business of selling alcohol; some bars have even gone so far as to paint HIV messages on their walls.

"Most bar owners, and even their patrons, are very welcoming. You see, we are not telling anybody to stop drinking; we are only advocating responsibility in the way people carry themselves around," she said.

"It would be a different scenario if we were throwing people out of bars or drinking dens - we do not even go to these places with the police, because it is a sure way of failing."

Recognising that poverty was the underlying problem, a year ago the group started providing food to local women to help them stop engaging in dangerous sex work.

"Just talking to these people alone would be counterproductive, because these things that they do are out of frustration and helplessness, so we decided to collect food from our members to give to them," Anyango said.

The group also works with the Kenya Network of Women with AIDS, a national NGO that provides some local residents with food and pays for HIV-positive patients' treatment at a local hospital.

Local government officials in Korogocho blamed widespread poverty for the widespread substance abuse and crime in the area. "Young people, and especially those who are jobless, engage in drug abuse as a pastime," Rispa Abukka, a local chief, told IRIN/PlusNews. "The rampant crime experienced here ... is a clear manifestation of the deep rooted nature of the problem."

Kenya's HIV prevalence is 7.8 percent, with urban populations generally having a higher level than their rural counterparts, but a recent survey in Korogocho found an infection rate of about 14 percent.

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