STIs in Kenya

Despite a high burden of disease, STI research and services remain underfunded, heavily dependent on HIV-linked financing, and vulnerable to shifting donor priorities and policy changes.

At-A-Glance 

• STIs are widespread yet underdiagnosed because of limited diagnostic capacity and continued reliance on syndromic management. 
• Kenya’s STI response is closely tied to HIV funding and programming, making research and service delivery vulnerable to donor cuts and policy shifts. 
• STIs risk being deprioritized within broader Universal Healthcare (UHC) and primary healthcare reforms unless explicit financing, surveillance, and service delivery protections are put in place. 

The Burden

• The 2018 Kenya Population-based HIV Impact Assessment (KENPHIA) found that within the last year, among men, 3.7% reported abnormal urethral discharge and 3.4% genital ulcers or sores; among symptomatic men, 38.8% received an STI diagnosis. Among women, 8.3% reported abnormal vaginal discharge and 4.0% genital ulcers or sores; among symptomatic women, 29.3% were diagnosed with an STI.  
• Studies among women receiving PrEP, MSM and transgender people show that up to one in four PrEP users or members of key populations have a curable bacterial STI.  
• A recent meta-analysis found an overall chlamydia prevalence of 5.8%, with prevalence among women older than 25 reaching 14.9%. 

Key Challenges

• Access to STI diagnostics remains limited, particularly at the primary care level. Syndromic management continues to miss many asymptomatic infections and contributes to antibiotic overuse. 
• STI research and programming are heavily dependent on external funders, especially HIV-related funding from the U.S. government, multilateral donors and philanthropy, making them vulnerable to service disruptions and research pauses. 
• Recent policy and funding shifts, including USAID-supported program closures, NIH collaboration restrictions and broader donor reprioritization, have created service gaps, particularly for adolescent girls and young women and other vulnerable groups. 
• Fiscal pressure and debt repayment are constraining domestic health research financing, while proposed increases in clinical trial review fees may further slow STI research and disproportionately burden smaller local institutions. 

Opportunities

• Integration of STI services into UHC reforms and embedding STI screening and treatment into PrEP, family planning, maternal and child health, and primary care platforms may be possible. 
• Dual HIV/syphilis rapid tests already exist. There is opportunity to scale them up, pilot near-patient CT/NG diagnostics and expand self-testing and pharmacy-based models that have already shown feasibility and acceptability. 
• There is also an opportunity to strengthen surveillance and antimicrobial resistance monitoring by expanding EGASP sentinel sites, improving STI reporting and building stronger national data systems. 
• Relationships exist, so there is opportunity for private pharmacies, insurers, manufacturers, and county governments to expand access, reduce stigma and improve supply for STI diagnostics and treatment. 

Advocacy Partners

In Kenya, government, research institutions, civil society and community partners are using advocacy to elevate STIs and drive stronger coordination, investment and evidence-based responses. The Kenya advocacy agenda was developed by Felix Mogaka and Mercy Nyakowa, with priorities centered on elevating STIs as a national health issue, strengthening diagnostics and data systems and ensuring community voices shape policy and practice.