NAIROBI, KENYA – Mary Nyambura says she discovered she was HIV-positive 11 years ago, after a group of men raped her because she was a lesbian. Since then, she has battled the dual stigma attached to HIV and homosexuality while living in Nairobi, the capital, with her partner and their family.
Nyambura and her partner, Caroline Akoth, craft and sell caps and doormats for a living. A rainbow-colored doormat stands out among their creations, and Nyambura explains its significance cheerfully.
“This is our identity and pride as the gay and lesbian community,” says Nyambura, a volunteer for Minority Women in Action, an advocacy group.
But despite her pride, Nyambura says that she has battled discrimination from other lesbians because of her HIV status.
“Most girls fled the moment I told them about my status,” she says. “One of them really insulted me and accused me of planning to infect her with HIV.”
Nyambura says that Akoth accepted her despite her HIV status. Akoth accompanies Nyambura to obtain antiretroviral therapy at a government-run hospital every month.
But there, Nyambura battles further discrimination – this time for her sexuality. Nyambura says the staff does not know how to approach the couple.
“Since health officers insist that I take my partner with me, I normally ask Carol to accompany me,” Nyambura says. “When I introduce her as my partner, they look at us as though we are creatures from another planet. The health workers even call their colleagues to come and just look at us.”
Although the government’s National AIDS Control Council offers free therapy at these hospitals, the visits frustrate Nyambura. She says the staff is uneducated on how to prevent HIV transmission between two women.
“They absolutely have no idea how to handle me. I once asked a health officer if she knew about dental dams, and she said she had never seen one,” she says of the rectangular sheet of latex that can be used as contraception.
Most health officers also tell Nyambura that she cannot infect her partner, she says.
“But I think it is possible for me to infect her, through the shared toys, for example,” she says. “I’ve met two HIV-positive women who told me they had never been with men.”
Akoth says that the staff is insensitive to she and Nyambura’s relationship.
“Some of the questions they ask her are even more ridiculous,” Akoth says. “They keep asking how many men she has slept with, and I normally tell them to ask how many women she has slept with. And I’ve noticed they do not take the challenge kindly.”
Nyambura says that Kenya has excluded lesbians from its fight against HIV and AIDS.
An estimated 6.2 percent of Kenya’s adult population is living with HIV – or about 1.6 million people, according to 2012 data from the Joint United Nations Programme on HIV/AIDS. Adult women make up approximately half of all cases of HIV and AIDS in Kenya.
But there are no specific statistics on the number of lesbian women living with HIV in Kenya, says Lilian Langat, the program officer for key populations at the NACC. Although the council offers programming for men who have sex with men, the council does not offer support designed specifically for the lesbian population.
“To start such a program, we need evidence to show that such a group exists,” Langat says. “We know they are there, but we do not have any numbers.”
The lack of data on the number of HIV-positive lesbians also prevents nongovernmental organizations from offering specific support to this group.
Artists For Recognition and Acceptance, or AFRA-Kenya, is an organization that encourages lesbian, bisexual and transgender women to express themselves artistically. The organization filmed a documentary about Nyambura’s life last year and featured it at the 2012 OUT Film Festival in Nairobi.
But AFRA-Kenya has no programs that cater to lesbians living with HIV, says Kate Kamunde, the organization’s founder. Although the group has 50 members, Nyambura is the only woman who has declared her HIV status.
“HIV-positive women might be there, but they have not come out,” Kamunde says.
To develop a program for HIV-positive women, the organization must first be able to establish that there is a need for such a program, she says.
In the absence of a formal program, AFRA-Kenya advocates for the health of its members at government-run hospitals. For example, when a woman who had been raped reported that hospital staff had treated her poorly after learning she was a lesbian, members of AFRA-Kenya demanded that hospital staff treat her with respect, says Irene, an organization volunteer who declined to give her surname because she has not shared her sexuality with her family.
Langat says that the NACC has not received any complaints about discrimination toward gay and lesbian patients in public hospitals, so the council cannot address the alleged behavior.
“It could be happening, but we don’t have any information about it,” she says.
If these patients are unhappy with treatment, Langat recommends they visit gay-friendly clinics such as Liverpool VCT, Care and Treatment. LVCT is a nonprofit organization that provides counseling and testing services at centers throughout Kenya.
Mitchell, a gay man who declined to publish his surname to keep his sexuality private, says he visits these clinics because the staff does not discriminate based on sexual orientation. Like the NACC, though, LVCT offers specific services for gay men but not for lesbians.
As a program officer at the National Empowerment Network of People Living with HIV/AIDS in Kenya, a nonprofit support group, Mitchell says he recognizes the need for more lesbian-specific programming.
He leads the group’s programs for lesbian, gay, bisexual, transgender and intersex Kenyans, and he is developing advocacy programs that will press the NACC to include lesbians in its strategic plans. He is also organizing workshops for health officials at government-run hospitals that will sensitize them on how to care for gay and lesbian patients.
“I know the doctors and nurses come from a very homophobic society and may have a negative attitude towards gays and lesbians,” he says. “That’s why we need to educate them.”
Mitchell is optimistic that these efforts will reduce the frustrations that lesbians such as Nyambura and Akoth face when they visit government-run hospitals.
“Change might be slow in coming, but it will happen,” he says.
Meanwhile, Langat advises lesbian couples to protect themselves from HIV transmission by cleaning their sex toys and buying dental dams to avoid exchanging bodily fluids.
