As World AIDS Day approaches on December 1, Kenya remains at the forefront of the global battle against HIV/AIDS. Despite significant progress, the disease continues to pose a substantial public health challenge, particularly for women.
According to Kenya’s Ministry of Health, over 1.3 million people in the country are living with HIV, with women comprising the majority—880,000 cases.
For a 50-year-old sex worker in Nairobi’s Dandora neighborhood, the fight against HIV/AIDS is a personal battle. A single mother of four, she turned to sex work out of financial desperation. While the profession provides her daily bread, it also exposes her to the risk of HIV infection. Until recently, she relied on daily oral Pre-Exposure Prophylaxis (PrEP) tablets for protection. Now, she’s among the women transitioning to the Dapivirine Vaginal Ring (DPV-VR), a new method recently approved by Kenya’s Ministry of Health.
The dapivirine vaginal ring offers a monthly prevention option, releasing an anti-HIV drug directly into the body over 30 days. During a visit to her local health clinic, the woman received comprehensive guidance on its use. While the ring is still in a pilot phase, she has embraced it as a discreet and effective method to reduce her risk.
“I’ve had partners I couldn’t trust, but they helped me provide for my children,” she shares. “I learned about the vaginal ring from a friend. I used oral PrEP before, but it lacked privacy and caused side effects. The ring is a better option for me.” Like many others, she wishes to remain anonymous due to the social stigma surrounding sex work, which, while not criminalized in Kenya, is often met with judgment.
The World Health Organization (WHO) endorsed the dapivirine vaginal ring in January 2021 as an additional prevention choice for women at substantial risk of HIV infection. Following this endorsement, Kenya approved its use in 2022, launching a pilot study in June 2023 to evaluate its implementation. The full rollout is slated for 2025, making the ring accessible to women at no cost.
For women involved in the pilot, the ring’s discreetness and ease of use are standout features. “When you have daily PrEP pills, it’s hard to keep them private. Visitors might see them and assume you’re on antiretrovirals,” explains another Nairobi-based sex worker. “The ring, on the other hand, is hidden. No one knows I’m using it, and I can’t forget it like I sometimes forgot to take pills.”
Jennifer Gacheru, a clinical officer with the Bar Hostess Empowerment and Support Programme (BHESP), has seen firsthand how the vaginal ring is changing lives. “Many women prefer the ring because it avoids the side effects of oral PrEP and doesn’t require daily attention,” she notes. However, she highlights a limitation: the ring is only effective for vaginal intercourse and doesn’t protect against other sexually transmitted infections (STIs) or pregnancy.
For comprehensive protection, experts recommend combining the ring with condoms. “The ring is a valuable option for women who cannot negotiate safer sex or condom use with their partners,” says Jonah Onentiah, leader of the HIV Prevention Team at the National AIDS and STIs Control Programme (NASCOP). “When used effectively, its efficacy in preventing HIV increases from 27% to 75%.”
Users are advised to wait 24 hours after inserting the ring before engaging in sexual activity to ensure the medication is properly released. Despite its limitations, the ring represents a significant advancement in HIV prevention. It has already been approved for use in several African countries, including Botswana, South Africa, Rwanda, Uganda, Zimbabwe, Lesotho, and Eswatini.
Kenya’s rollout of the ring in 2025 is eagerly anticipated, especially given the stark statistics. In 2023 alone, 9,100 women in Kenya were newly infected with HIV, compared to 4,100 men. Globally, women and girls account for 44% of all new HIV infections, according to UNAIDS.
While the ring is a game-changer, experts caution against relying on it as a standalone solution. Comprehensive education, continued innovation, and access to diverse prevention tools remain essential in the fight against HIV/AIDS. For Kenya’s women, the dapivirine vaginal ring represents not just a new method of protection but a beacon of hope in the ongoing battle to safeguard their health and futures.
