Although West Pokot has one of the lowest HIV/Aids prevalence, long distance truck drivers threaten efforts by the County government to keep the virus at bay.
The County is home to the Great Northern Corridor road perennially patronized by long distance truck drivers who make stop-overs at Makutano, Ortum, Chepararia and Marich pass.
Female commercial sex workers are common in these trading centres and are contributing to an increase in the number of new HIV infections especially at Makutano town.
The commercial sex workers however defend themselves that this is their lifeline in what they describe as a marginalized County characterized by famine, drought , insecurity, food insecurity and few other alternative economic activities
“There is little else I can do. I live in a rented room here in Ortum. I am able to put food on the table and support my siblings back in the village”, says Jessica Puoruk from a village in Pokot Central some 60 km away.
She says she has a regular customer who returns to her whenever he makes a stopover but declines to confirm or deny whether she has any other relationships with other truck drivers whenever the regular “lover” is away.
Ms Puoruk however confirms that her regular lover does not use protection because “we trust each other” and rewards her handsomely for her services.
Reginah Longole, another commercial sex worker at Makutano trading centre has multiple lovers, all truck drivers who make stop-overs at the centre at different times. According to Ms Longole, some of her clients make brief stop-overs during the day before proceeding on their journeys. Most of her clients are not bothered about condoms and protection.
Amano Pauko, one of the trucks drivers routinely stops at the busy and popular Kainuk trading centre where he has maintained two regular “lovers” over the last three years he has been on this route.
“These are my women but I cannot vouch for their faithfulness when I am not around. They could be having other customers but they are always available whenever I am around and need their services”, said Amano who was on his way to southern Sudan to deliver cargo. He has other lovers in Lodwar and Kapenguria.
“This is normal for truck drivers. How else are we supposed to survive the many days , weeks and even months of stress on the roads?”, he asks but adds that his family in Pokot North is well taken care of.
There are fears among health officials in West Pokot that the projected reduction HIV prevalence to 1.5per cent from the previous 2.8 per cent prevalence may not be achieved .
Currently, the County is categorized under the HIV medium incidence cluster and is ranked at number 30 nationally, meaning there are 17 other counties with lower HIV prevalence than West Pokot.
Following renewed fears of increasing HIV infections, the County Government recently launched the West Pokot County HIV and Aids Strategic plan (WPCHASP) whose overall objectives includes the reduction of new HIV infections by 75 per cent besides bringing down Aids related mortality by 25 per cent.
Other objectives of the plan are to reduce HIV related stigma and discrimination by 50 per cent while increasing domestic financing of the HIV response to another 50 per cent.
Currently, the County has an estimated 8,603 People Living with HIV (PLHIV) but if the strategic plan succeeds in its objectives, it is expected that this figure will come down by year 2019 when the strategic plan goes full cycle (2015/2016-2018/2019).
Of the 8603 PLHIV in West Pokot, 1103 of them were children according to the Kenya Estimates Report ,2014.
The proportion of women living with HIV in West Pokot County is 3% and its significantly higher than that of men at 1.7%. Over the years, the women living in the county have been more vulnerable to HIV infection than the men.
Over 80 per cent of HIV-positive pregnant women in West Pokot do not deliver in a health facility and only 41 per cent of pregnant women attend the recommended four antenatal visits in West Pokot County
In the same pe riod, there were 576 new HIV infections among adults and 28 new infections among children.
Approximately 428 adults and 60 children died of Aids related conditions in the County according to the Kenya HIV Estimates report 2014.
Some of the key gaps and challenges identified in the County’s HIV response include unmet support for orphans and vulnerable children to ensure protection, care and treatment.
Other challenges are inadequate financing for HIV programmes, high stigma and discrimination for HIV infected persons and negative cultural practices such as FGM and wife inheritance.
The rest of the challenges are minimal engagement of male reproductive health programmes, few skilled health workers such as counselors and limited data on effective models for increasing adherence to care.
The county’s stigma index stands at 46 compared to the National HIV and Aids stigma and discrimination of 45 on a scale of 1-100.
Stigma is a key barrier to access HIV prevention, treatment and care services. It often leads to violation of the rights of PLHIV as well as key populations further inhabiting their access to HIV services.
Besides the County Government, other collaborating partners in the health sector include the World Vision, Action Again Hunger, Kenya Red Cross, Amref, Sikom and the leading partner on HIV and Aids- Ampath Plus, according to the County Director for Health Dr. Nobert Abuya.
West Pokot has a population of 512,690 people, 52 per cent of whom are aged 0-14 years.
This is due to high fertility rates among women as shown by the highest percentage household size of 4-6 members at 38%.