Nguru Karugu is a public health consultant on LGBTI healthcare needs with 20 years experience working with vulnerable groups including LGBTI, MSM, incarcerated and injection drug users.
Nguru, as everyone calls him, worked with LGBTI and substance abusers at the height of the HIV epidemic in the South Bronx, USA in the late 1980’s and early 1990’s prior to the introduction of ARV’s.
Presently Nguru is a consultant with various regional entities including the Open Society Institute East Africa (OSIEA) where he is managing their LGBTI Initiative Portfolio. Nguru also serves on the Peer Grants Committee of UHAI which provides grants to LGBTI and sex worker groups in the East African region.
He spoke to Melissa Wainaina of Behind the Mask and the following are excerpts of the interview:
What are the key components the Kenyan LGBTI movement needs to pay keen attention to in seeking a holistic well being?
Stigma and discrimination have been proven to have an effect on one’s sense of wellness and wellbeing. The lived reality of many LGBTI persons is informed by the illegality of same-sex sexual conduct.
The struggle to come to terms of who one is under an environment which is hateful and oppressive is bound to have effect on one’s wellbeing. Therefore mental health is a major issue for the LGBTI community.
Where studies have been conducted, LGBTI communities have been found to have higher suicide rates than the general population. Substance use and abuse have also been found to affect this community in higher levels than the general community.
Besides these, other medical concerns like HIV/Aids, STI, various cancers (breast, cervical etc.) afflict the community. Due to stigma, discrimination and ignorance, accessing appropriate services within existing health sites tends to be difficult to impossible for the community and that further exacerbates the presenting medical issue.
HIV/ Aids is a huge issue in general, but it has a special significance within LGBTI communities. Why is this the case? How can we combat new infections and ensure treatment for those who test positive?
HIV/Aids is a huge issue for Kenya at large. The government’s response over the years was not necessarily informed by concrete data until 2008, when two key studies, the Modes of Transmission Study (MOT) and the Kenya Aids Indicator Survey (KAIS) conducted by the government with key stakeholders provided for the first time a clear picture of the HIV epidemic in Kenya.
Of significance was the indication that while HIV incidence was at about 7 per cent for the general population, it was at a staggering 33 per cent for some marginalized communities (MSM, IDU and sex workers). This made it clear that Kenya was experiencing a mixed HIV epidemic with characteristics of both a ‘generalized’ epidemic among the mainstream population and a ‘concentrated’ epidemic among specific most at risk populations (MARPS).
The data around MARPS remains incomplete, and while the modes of transmission study, 2008 indicated that MSM (Men who have sex with Men) and IDU (intravenous drug users) combined account for perhaps 15 per cent of new infections, the model for Nairobi places these groups contribution at 26 per cent and in Mombasa at 31 per cent, almost a third of new infections.
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