For 22-year-old Jerop Limo, who has lived with HIV since childhood, the fear of running out of life-saving medication now outweighs the virus itself.
Like many Kenyans living with HIV, she has begun rationing her antiretroviral (ARV) medication — taking pills every other day instead of daily — to stretch her supply. “People are scared,” she says. “They don’t know when or if they’ll get their next refill.”
Across Kenya, health workers and HIV advocates are reporting a worrying trend: a rise in the number of patients defaulting on treatment, driven by anxiety over future access to ARVs. The concern stems largely from the uncertainty following funding cuts by the United States under former President Donald Trump’s administration. Though some support remains, the psychological impact of the cuts has lingered.
Nelson Otwoma, Executive Director of the National Empowerment Network of People Living with HIV/AIDS in Kenya (Nephak), says rumours of impending drug shortages have taken root in many communities. “There’s a perception that without U.S. funding, ARVs will not be available. That anxiety is leading people to skip doses or stop treatment altogether,” he told The Standard.
Some hospitals have already reduced the quantity of ARVs issued to patients, providing only a one-month supply instead of the usual three to six months. This has added to the panic. “You go to a clinic and come out with less than you expected. You start fearing the worst,” said Limo.
Kenya has made significant strides in its HIV response, cutting new infections by over 67 percent since 2010. Today, more than 1.3 million Kenyans are on treatment. But this progress is at risk. Missed medication doesn’t just allow the virus to rebound; it raises the chances of co-infections like tuberculosis — the leading cause of death among people with HIV.
“For mothers, missing treatment could mean passing HIV to their babies during pregnancy or breastfeeding,” said Limo. “We are likely to see more cases of meningitis, TB, and even avoidable deaths.”
Young people are particularly vulnerable. With youth-friendly health centres closed following the withdrawal of USAID support, many now have nowhere to turn. “Stigma in general outpatient clinics is real,” said Limo. “Some young people simply don’t want to be seen queuing for HIV care.”
Health experts warn that a recent government decision to integrate HIV services into general outpatient units is exacerbating the problem. While well-intended, the move has disrupted specialised support that HIV patients relied on — including trained personnel and peer counsellors. Many of the 41,000 staff supported under the PEPFAR programme have been laid off, leaving gaps in care.
Worse still, patients are now being asked to pay consultation fees at public facilities — a cost many cannot afford.
“We’re not against integration,” said Otwoma. “But it must be done with input from the people it affects. We need clear guidelines, and we must protect young people, mothers, and other vulnerable groups from falling through the cracks.”
For now, campaigners like Limo are urging those on treatment to stay the course — even when the future feels uncertain. “If you have the medicine, take it,” she says. “Skipping it won’t solve anything — it will only make things worse.”
As Kenya fights to protect the gains made over two decades of HIV response, the call is clear: don’t let fear undo the progress.
