Bill & Melinda Gates Foundation

"How to Put on a Condom": A Home Visit for HIV Testing

June 25, 2012

We trail along with two HIV home-visit health workers who work with the CDC Kenya (Centers for Disease Control) to visit with a family in a remote area in the Nyanza province. “Mama Christina” is the 80 year old grandmother living in one mud-walled, thatched roof home, her children and their families live in the others, all surrounding a big open field with emaciated cows feasting on the grass.

Christina asks one of the health workers why she needs to be tested for HIV again. She was just tested 3 years ago, she tells them, and she’s not sexually active. But, as the CDC health workers explain to her, there are other ways to contract HIV. As well, they say, they want to teach her how to protect against contracting HIV; in particular so that she has the knowledge to help her children and young grandchildren, when they are old enough, protect themselves.  

You have not lived until you've seen an 80 year old woman being taught how to put a condom on a large, wooden phallus. She patiently watches, asks some questions, and seems relieved when we’re done. She can now introduce us to all of the family members waiting to meet us outside.

A grandmother receives a condom demonstration. c/o Charlott Schoenwetter.

The CDC Kenya is located outside of the small city of Kisumu. Behind armed gates, lie multiple office buildings and research sites. The center is responsible for most of what goes on when it comes to HIV/AIDS research and other health-related issues in this country: what prevention and treatment methods work, monitoring the number of new HIV/AIDS cases, implementing those treatment and prevention methods (including voluntary medical male circumcision, distribution of condoms, and anti-retrovirals for treatment), and maternal and newborn health issues which are directly connected to HIV (like prevention of mother-to-child transmission). One-third of the total resources for HIV/AIDS that come to Kenya, actually come to the CDC (and USAID); half a billion dollars, in fact.

The CDC Kenya employs hundreds of Kenyan scientists, as well. In this area—the Nyanza province—the HIV rate is double that of the rest of the country, people are living longer with HIV and so need more treatment (500,000 people in Kenya are currently on treatment), and there are more new infections than there are resources; clearly, funding is desperately needed to keep up.

HIV testing of those who live in desperately poor circumstances in this rural region where people live far away from testing sites, with no money for transportation, is a big issue. So the CDC Kenya, in partnership with KEMRI (Kenya Medical Research Institute), conducts home-based testing. In fact, every two weeks they visit 25,000 people in the area to monitor their health circumstances.

After a round of greetings and photos with Christina's family, the delegation of bloggers from around the world with whom I'm traveling heads out leaving the health workers to visit with the other family members, provide HIV tests for the adults, talk about using condoms and continue working to prevent and treat HIV, home by home, person by person.

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