Nairobi (AFP) – Under an unfinished concrete slab in a Nairobi cemetery lies Judy, a 36-year-old HIV-positive Kenyan prostitute. Sick after being deprived of her antiretroviral drugs by brutal cuts in American aid, she died on August 7, a few hours before a planned meeting with the AFP.

Published on: 02/10/2026 - 08:42

AFP was able to confirm with sex worker organizations the deaths in Kenya of at least 24 of them, who, like Judy, were HIV positive but in good health at the beginning of 2025, when the administration of Donald Trump announced the freeze of American humanitarian aid.

These cuts caused the closure of many clinics dedicated to prostitutes, where they received condoms, pre-exposure prophylaxis (PrEP) or antiretroviral drugs. Treatments preventing them from being infected or reducing the viral load of HIV-positive people to the point of making them non-contaminating.

The United States, historically the main bilateral donor of the Kenyan health system, signed a five-year health agreement with Kenya in December, worth $2.5 billion, of which $1.6 was financed by Washington and the rest by Nairobi.

But in the right moral line of the Trump administration, which this year adopted rules prohibiting NGOs that it supports from promoting social issues that it opposes, the American-Kenyan "cooperation framework" has not brought any major progress for prostitutes, whose clinics have not reopened.

A global trend: In July 2026, a report from the Foundation for AIDS Research (amfAR) revealed that 73% of U.S.-funded organizations had permanently ended services for “key populations” — sex workers, LGBT communities and drug users — even though they are most at risk of infection.

Several experts interviewed by AFP fear a future "catastrophe" in Kenya: an explosion of HIV contamination, already observed among the country's many sex workers.

Kenyan authorities estimate their number at 285,000, of whom 27.5% are HIV positive.

Stopping treatment for prostitutes can only have disastrous consequences for the population, according to experts and a dozen prostitutes interviewed by AFP. Many clients refuse - or cannot afford - condoms and then have unprotected sex with other partners.

"Risk"

Questioned by AFP, UNAIDS director Winnie Byanyima regrets the closure in Kenya of numerous structures welcoming populations at risk. Places run by their peers, emphasizing prevention, where these communities go without fear of being judged.

These reception centers and clinics represent a “huge part of the response to HIV”, she notes, warning that the cuts by the United States, followed by other major donors, “put at risk” decades of fight against AIDS.

As the phenomenon is recent, Kenyan statistics do not currently reflect an increase in infections in the population.

Douglas Bosire, president of the NSDCC, a government agency supervising the HIV/AIDS strategy, on the contrary, recalls the “great progress” recently made in Kenya.

In 2025, some 14,000 new contaminations were recorded there, compared to around 20,000 in 2024, a drop of 27%, he welcomes. Deaths from AIDS-related illnesses fell by 8%, from 21,000 to around 19,500 deaths over one year, he noted to AFP.

But he recognizes "a risk that these gains will be reversed" if populations most at risk are not better targeted in Kenya, where nearly 1.5 million people, or 3.2% of the population, live with HIV.

Judy was diagnosed with HIV in 2017, according to her friend Diana, also a prostitute.

A status that she had learned to fight thanks to the Bar Hostesses Empowerment and Support Program (BHESP), an NGO which delivered her medicines, condoms and sometimes a little food in the Mathare slum, where she lived.

Judy's situation, like that of many Kenyan prostitutes, was extremely precarious. Sometimes selling for 50 or 100 Kenyan shillings (30 or 60 euro cents), sometimes for food for her four children, she could not afford transport to a BHESP clinic.

However, when the NGO lost subsidies from the American federal aid agency USAID, almost dismantled under Donald Trump, BHESP's field teams were dismissed. And Judy found herself deprived of vital support.

Because if antiretrovirals are available in Kenyan public hospitals and if the authorities want them to receive treatment there, the sex workers met by AFP refuse to set foot there because they feel stigmatized there, even more so if they are HIV positive - another factor of discrimination in Kenya.

The fear is also great of coming across a neighbor or acquaintance, who learns of their viral status and reveals it, making their children in turn outcasts, they confide.

Advanced stage

To avoid this, Judy therefore “stopped taking her medication”, despite the danger involved, Diana remembers. His immune system went haywire. Judy has become considerably thinner and weaker.

"She had sores on her body. Her skin was rough," says Diana, very moved, when met by AFP on the day of her friend's death, died, she says, of tuberculosis, an illness associated with AIDS.

Judy is one of three HIV-positive prostitutes in Mathare who have died in recent months because they were no longer taking their treatment, according to initial information collected by BHESP. Several others would have died, for the same reasons, in neighboring slums, notably in Korogocho, says Diana.

“The order to suspend missions, issued by the American administration, is for us an order to kill” prostitutes, denounces Daisy Kwala, program director for BHESP. This NGO had to close, in September 2025, one of its two centers financed by USAID.

The second, in an anonymous building in Roysambu, a suburb of Nairobi, is still functioning at a minimum, but will cease all activity, due to lack of money, at the end of September.

Of the 14,500 prostitutes treated in these two clinics, some 12,000 disappeared from BHESP's radar, of whom 2,300 were HIV positive. Destitute, incapable - like Judy - of coming for treatment on their own, the NGO does not know how many died, seriously ill, or were infected.

New contaminations have exploded where American aid has disappeared.

In the second quarter of 2024, when Joe Biden was still in the White House, nine contaminations were detected for 6,685 prostitutes tested in the Roysambu BHESP center which, over the same period this year, identified 45 among 2,439 women checked.

That is to say a 14-fold increase in the number of infections, at a constant population.

Conversely, no new contamination has been recorded over the last two years in the two other BHESP structures supported by the Global Fund against Infectious Diseases, according to the NGO.

Another problem is that while previously the prostitutes, monitored regularly thanks to American aid, discovered their HIV status at an early stage, they are now at a more advanced stage in the disease when they come to the Roysambu center, observes Sharon Lagat, a nurse at this structure.

“They have oral fungus, skin rashes, symptoms of sexually transmitted infections,” she lists, all diseases favored by the immunodeficiency caused by HIV.

“Out of control”

“As they come late, they transmit HIV more to clients,” regrets the nurse. However, “these customers are our husbands, our friends. In the end, the virus will definitely reach our homes.”

The Sex Workers Outreach Program (SWOP), an NGO following 45,000 prostitutes and prostitutes in Nairobi, half of whose clinics closed with the cessation of US funds, also observed a 48% increase in new infections in the first half of 2026, compared to the first six months of 2024.

Its clinical and research director, Dr Joshua Kimani, says he fears "a return to the situation of the 1990s", when infections were "out of control".

Veteran of a fight against the virus that he started in 1992, this recognized epidemiologist remembers 1998 as his “worst year”. “I became Doctor Death,” he says, “because I told people to go home and die there. I don’t want to go through that again.”

And Dr. Kimani observes: When, after the dark years of AIDS in Kenya, "we started to see a decline in viral load and deaths among sex workers, the same thing followed in the rest of the population. So if you start seeing deaths among prostitutes, it will repeat itself throughout the community."

In such a context, all the sex workers interviewed by AFP deplored the lack of free condoms. Many of them are too poor to buy a box of three, which costs 100 shillings, sometimes more than the price of a pass.

But today, HIV-positive prostitutes “who no longer receive their antiretroviral drugs, who cannot afford condoms, continue to work,” notes Daisy Kwala. “They continue to sell their bodies, six to ten times a day.”

Until they get too sick.

On the Kenyan coast, 14 prostitutes have already died after stopping treatment, estimates the Coastal Sex Workers Alliance.

At least five others died in western Kenya, where the HIV/AIDS prevalence rate, among the highest in the country, already exceeded 10% of the population until now, notes the Kisumu Sex Workers Alliance.

None of the 25 clinics dedicated to prostitutes existing in four counties in this region, all financed by USAID, have survived, protests its president Dorothy Agalla.

Less than a thousand of the approximately 20,000 working there are now treated in public structures, she observes.

“Worst era”

“We are living in the worst times” regarding the fight against HIV/AIDS, says Ms. Agalla. “We are going back, but we do not know where we are going”, while at the beginning of the epidemic “we started (the fight) but we had a goal”.

Caroline Kemunto, president of Survivors of Busia, an NGO for sex workers in this other region of the west, bordering Uganda, lists two deaths among her members, HIV-positive and who were no longer receiving treatment.

In Mathare, near Nairobi, Cecilia Joseph mourns her friend Beatrice. A prostitute like her, Beatrice, 43, stopped taking her antiretrovirals when the visits from BHESP members stopped, refusing to go and collect some at the nearby dispensary, to prevent her and her two children from being stigmatized, relates Cecilia Joseph.

“When she started to deteriorate (...), a large rash appeared around her stomach, looking like a burn,” her friend recalls. "Then the headaches came. And poof. She was gone."

Beatrice “died in her bed” on August 24, 2025, from a kidney infection, assures Cecilia Joseph. Beatrice's sister, Rosemary, followed her a year later. Aged 29, according to Ms. Joseph, she was also a sex worker and HIV positive and was no longer taking her treatment due to American cuts.

Cecilia Joseph implores President Trump to “rectify” the measures taken by his administration, before relying “on God”, so that he “gives us what we had before”. “We would be so happy,” she whispers.

Questioned by AFP about these deaths, the Trump administration's deputy secretary for Africa, Frank Garcia, preferred to get annoyed on September 9 during a visit to Nairobi, in particular to promote the USA/Kenya health agreement.

"I totally reject," he said, "the narrative that any change coming from the most generous country in the world when it comes to AIDS research, AIDS funding and the dissemination of life-saving treatment methods is in any way responsible for this."

© 2026 AFP

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