Expanded polling booth surveys monitor HIV programme outcomes among female sex workers and men who have sex with men in Nairobi, Kenya
6 affiliations
- 1Institute for Global Public Health, University of Manitoba
- 2Partners for Health and Development in Africa
- 3Sex Workers Outreach Project (SWOP) Clinic
- 4Grant Management Division, The Global Fund
- 5Ministry of Health
- 6University of California
Abstract
Introduction: Nairobi County has the largest HIV prevention programme for female sex workers (FSW) and men who have sex with men (MSM) in Kenya. Routine monitoring of programme outcomes is critical for tracking progress toward programme targets. Monitoring approaches need to be rapid, affordable, and sufficiently robust to capture programme outcomes while meaningfully involving communities.
Methods: We conducted a cross-sectional outcome assessment among FSW and MSM (71% reporting sex work) in Nairobi County from April–July 2023 using an expanded polling booth survey (ePBS). The ePBS combined anonymous group-level polling booth survey (PBS) with an individual biobehavioural survey (BBS) to assess behavioural, structural and biological outcomes. Weighted descriptive analyses summarised programme outcomes.
Results: The target sample size for the study was 769 FSW and 420 MSM. Overall, 759 FSW (response rate 98.6%) and 398 MSM (response rate 94.7%) participated in 64 PBS sessions; 758 FSW completed the BBS, while 398 MSM completed the behavioural component and 396 completed the biological component. Condom use at last sex was reported by 80.8% of FSW with paying clients and by 72.7 and 68.9% of MSM with non-regular partners and paying clients, respectively. Recent peer educator contact was reported by 68.8% of FSW and 65.8% of MSM. Healthcare-related stigma was reported by 8.0% of FSW and 7.5% of MSM, and recent forced sex by 10.7% of FSW and 6.5% of MSM. HIV prevalence was 14.0% among FSW and 18.6% among MSM. Among participants living with HIV, 85.9% of FSW and 80.4% of MSM were virally suppressed. Among those reporting current oral PrEP use, tenofovir was detected in urine among 48.3% of FSW and 52.6% of MSM.
Conclusion: FSW and MSM in Nairobi remain priority populations for the HIV response. The findings suggest persistent gaps across behavioural, structural and biomedical outcomes that need to be addressed. The ePBS approach offers a practical and scalable method for generating actionable outcome data that can complement routine monitoring systems and support adaptive HIV programming. As countries face increasing pressure to optimise HIV programmes within constrained funding environments, approaches that generate timely and actionable outcome data will become increasingly important.
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BibTeX
@article{bhattacharjee2026expanded,
title = {{Expanded polling booth surveys monitor HIV programme outcomes among female sex workers and men who have sex with men in Nairobi, Kenya}},
author = {Parinita Bhattacharjee and Shajy Isac and Joshua Kimani and Faran Emmanuel and Rhoda Kabuti and Antony Kinyua and Virginia Njeri Ndukuyu and Helgar Musyoki and Anthony Kiplagat and Peter Arimi and Souradet Y. Shaw and Monica Gandhi and James Blanchard and Marissa L. Becker and Leigh M. McClarty},
journal = {Frontiers in Public Health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.1969489},
url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1969489/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Expanded polling booth surveys monitor HIV programme outcomes among female sex workers and men who have sex with men in Nairobi, Kenya
AU - Parinita Bhattacharjee
AU - Shajy Isac
AU - Joshua Kimani
AU - Faran Emmanuel
AU - Rhoda Kabuti
AU - Antony Kinyua
AU - Virginia Njeri Ndukuyu
AU - Helgar Musyoki
AU - Anthony Kiplagat
AU - Peter Arimi
AU - Souradet Y. Shaw
AU - Monica Gandhi
AU - James Blanchard
AU - Marissa L. Becker
AU - Leigh M. McClarty
PY - 2026
DA - 2026/10/27
JO - Frontiers in Public Health
DO - 10.3389/fpubh.2026.1969489
UR - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1969489/full
AB - Introduction: Nairobi County has the largest HIV prevention programme for female sex workers (FSW) and men who have sex with men (MSM) in Kenya. Routine monitoring of programme outcomes is critical for tracking progress toward programme targets. Monitoring approaches need to be rapid, affordable, and sufficiently robust to capture programme outcomes while meaningfully involving communities. Methods: We conducted a cross-sectional outcome assessment among FSW and MSM (71% reporting sex work) in Nairobi County from April–July 2023 using an expanded polling booth survey (ePBS). The ePBS combined anonymous group-level polling booth survey (PBS) with an individual biobehavioural survey (BBS) to assess behavioural, structural and biological outcomes. Weighted descriptive analyses summarised programme outcomes. Results: The target sample size for the study was 769 FSW and 420 MSM. Overall, 759 FSW (response rate 98.6%) and 398 MSM (response rate 94.7%) participated in 64 PBS sessions; 758 FSW completed the BBS, while 398 MSM completed the behavioural component and 396 completed the biological component. Condom use at last sex was reported by 80.8% of FSW with paying clients and by 72.7 and 68.9% of MSM with non-regular partners and paying clients, respectively. Recent peer educator contact was reported by 68.8% of FSW and 65.8% of MSM. Healthcare-related stigma was reported by 8.0% of FSW and 7.5% of MSM, and recent forced sex by 10.7% of FSW and 6.5% of MSM. HIV prevalence was 14.0% among FSW and 18.6% among MSM. Among participants living with HIV, 85.9% of FSW and 80.4% of MSM were virally suppressed. Among those reporting current oral PrEP use, tenofovir was detected in urine among 48.3% of FSW and 52.6% of MSM. Conclusion: FSW and MSM in Nairobi remain priority populations for the HIV response. The findings suggest persistent gaps across behavioural, structural and biomedical outcomes that need to be addressed. The ePBS approach offers a practical and scalable method for generating actionable outcome data that can complement routine monitoring systems and support adaptive HIV programming. As countries face increasing pressure to optimise HIV programmes within constrained funding environments, approaches that generate timely and actionable outcome data will become increasingly important.
SN - 2296-2565
ER -