Brian, a 40-year-old resident of Kapseret, first noticed a burning sensation when passing urine. What began as mild discomfort soon turned into severe pain.
Last December, while his wife was upcountry, Brian had unprotected sex with a sex worker he met on the streets of Eldoret town. He says the trip had drained him financially, leaving him without money to purchase condoms. Embarrassed by his actions and fearful of disclosing the encounter to a doctor, he opted to self-medicate with antibiotics in a bid to ease the pain.
The symptoms worsened. Eventually, he sought treatment at Moi Teaching and Referral Hospital (MTRH), where he was diagnosed with gonorrhoea and placed on medication. He recovered after two weeks.
“I hated the experience. It was shameful to contract gonorrhoea from illicit sex. I became even more worried when my testicles swelled and there was pus discharge from my penis,” he recalls.
Although it was the first time he had contracted a sexually transmitted infection (STI), he admits it was not his first encounter with a sex worker.
“I know the sex worker. Sometimes I reach out to her when I am sexually starved. Initially, she would come with condoms, both male and female, which we used for protection. But on that occasion she did not have any. She said they had not been supplied,” says Brian.
His experience is not isolated. Health experts are raising alarm over a worrying rise in STIs, including HIV, amid an acute shortage of condoms across the country.
Sharon Lorna, a peer educator in Mombasa, says sex workers previously collected free condoms from dispensers placed in hospitals and other strategic locations. Today, many of those dispensers remain empty.
“For the safety of sex workers, we would normally pick condoms and distribute them in hotspot areas. Currently, we do not have adequate supplies, which increases the risk of infections,” Lorna says.
Lorna notes that sex workers are increasingly anxious.
She informs The Nairobian that current interactions with sex workers highlights their growing anxiety about STIs.
“Sex workers are seeking STI tests because they are having unprotected sex with their clients due to lack of condoms. Some of the clients they receive agree to buy condoms for safe sex, but others take advantage to have raw sex,” regrets Lorna.
Deducted cost
Limited access to condoms threatens to increase unprotected sex at a time when HIV remains a major public health concern.
Beatrice Sudi*, a sex worker in Mombasa, says she now buys condoms daily, an expense she previously did not incur. She once relied on free supplies from Voluntary Counselling and Testing (VCT) centres.
At the moment, supplies are inconsistent. Without condoms, Beatrice says her health safety is compromised.
“Some clients deduct the cost of condoms from my pay if they buy them. It hurts to lose income just because of a condom,” she says.
“I rely on sex work for a living, but without access to condoms our safety is compromised. Sometimes, the shortage forces people into unprotected sex,” she adds.
Her frustrations mirror concerns raised by fellow sex workers across the country exposed to HIV risks following disruptions in the supply of condoms and pre-exposure prophylaxis (PrEP), both critical HIV prevention tools.
VCT centres that were once consistently stocked with free condoms are struggling to meet demand, forcing many to purchase them privately.
A spot check by The Nairobian at several condom pick-up points found empty dispensers. Distribution to government and corporate offices has also largely stalled.
“I came to pick free condoms from the VCT box, but there are none, and I don’t have money to buy any,” complained George, a street family member living in Eldoret town.
Commercial condoms retail at between Sh50 and Sh1,000 depending on the brand and quality.
Kenya previously received about 180 million condoms annually, valued at roughly Sh25.4 billion, from international donors, including the Global Fund and UNFPA.
However, supply disruptions have since been reported.
Donor support
A Ministry of Health commodity status report released in November last year indicated shortages of both male and female condoms.
Data showed monthly consumption of about 31,067 female condoms and 1,065,891 male condoms. By November, however, KEMSA stores reportedly had no stock.
Kenya requires an estimated 450 million condoms annually but largely relies on donor support from the Global Fund, development partners, and NGOs.
An additional challenge is that condoms procured through certain donor programmes are restricted to HIV prevention initiatives and may not be distributed through family planning clinics.
A National AIDS and STI Control Program (NASCOP) official, speaking anonymously, said female condom procurement has been limited due to low uptake, while male condom supply remains constrained following reduced funding.
“Male condoms are available, but not in quantities sufficient to meet demand,” the official said, adding that distribution has also been affected by the closure of some drop-in centres after USAID halted certain operations in the country.
Some centres previously supported through humanitarian partners have shut down or been integrated into hospitals.
However, stigma prevents many individuals from picking condoms in hospitals, as compared to VCT boxes where they pick without arousing much attention.
“Once condoms are moved into hospitals, peer educators are needed for community distribution, but many of those programmes are no longer active,” the official noted.
But with the country attaining an improved economic status, Kenyans are staring at a crisis as donors gradually pull out of health support that had sustained the country for years.
Kenya is expected to be self sustainable by 2027, having moved from low-income to a middle-income country.
Data from the Ministry of Health indicates that free-to-user condoms in the country are fewer than before, due to reduced funding by donors.
Kenya has been receiving condoms worth Sh25.4 billion, annually. However, private sector condoms are available.
“Kenya has a low market share, about two per cent for condoms in private sector, which need to be increased,” said the NASCOP official.
The official acknowledged that use of condoms has had a great impact in reducing new HIV infections, STIs and pregnancy, hence need for 100 per cent condom policy.
The condom shortage is being felt at a time the country is grappling with a rise in HIV infections
Data from National Syndemic Disease Control Council (NSDCC) shows that 19,991 new infections were recorded in 2024, representing a 19 per cent increase from 16,752 cases in 2023.
Of the new infections, 4,349 were children aged zero to 14 years, while 32 per cent of all new HIV infections occurred among adolescents and young people aged 10 to 24 years.
Ten counties account for 60 per cent of all new infections in 2024.
The counties are Nairobi, Kisumu, Busia, Kakamega, Mombasa, Kiambu, Kajiado, Kericho, Kilifi and Kisii.
Meanwhile, the epidemic remains unevenly distributed across the country, with seven counties: Nairobi, Kisumu, Homa Bay, Migori, Siaya, Kiambu, and Mombasa, accounting for 50 per cent of all people living with HIV.
AIDS related deaths also increased from 20,997 in 2023 to 21,007 in 2024.
Consistent use
The country is reporting new HIV infections, barely four years from the set time-frame for eliminating HIV/AIDS.
NSDCC Chief Executive Officer Douglas Bosire expressed concern during the commemoration of World Aids Day, saying the numbers are worrying.
“Kenya has made significant progress on the HIV response, reducing new infections, lowering HIV/AIDS related deaths, and expanding access to prevention and treatment. Yet, even as we celebrate these gains, we stand at a crossroads,” Bosire said.
In the last five years, new HIV infections reduced by 52 per cent, from 41,416 in 2019 to 19,991 in 2024, with the lowest reduction among children at 36 per cent.
Last year, however, new HIV infections increased by 19 per cent, from 16,752 to 19,991 in 2024,” said Bosire.
The council therefore acknowledges importance of ensuring every sexually active person in Kenya has access to a sustained supply of quality condoms, correct knowledge, skills and motivation to use them correctly and consistently.
Correct and consistent condom use provides up to 95 per cent protection against HIV, other STIs and unintended pregnancy, according to the NSDCC.
Koigi Kamau, a professor at the University of Nairobi in the department of Obstetrics and Gynecology, observes that lack of condoms risks infections of more sexually transmitted diseases.
“People link illicit sex to transmission of HIV, but there are so many viruses and infections someone can acquire. The current trends are worrying,” says the researcher.
Common STIs within the Kenyan population, according to the Ministry of Health, include gonorrhoea, syphilis, chlamydia, herpes and mycoplasma genitalium.
Chlamydia and gonorrhoea often come to mind as they present physical symptoms such as painful urination, vaginal discharge in women, discharge from the penis in men, painful sexual intercourse in women, bleeding between periods and after sex in women and testicular pain in men.
Prof Koigi, also a fertility specialist, explains that chlamydia is caused by a specific strain of bacteria known as chlamydia trachomatis, whereas gonorrhoea is caused by the bacterium neisseria gonorrhoea.
Consequenses
“It is worrying that individuals are not able to conceive because of chlamydia. This is a severe disease that causes permanent damage to the reproductive system of a woman, resulting into infertility. It blocks the fallopian tubes,” he notes.
The researcher raises concerns particularly for female patients as repeated exposure to sexually transmitted infections can lead to tubal blockage and hence infertility.
Like gonorrhoea, the researcher notes that it has been mutating for several years, and medicine which could be used to treat the disease is no longer effective.
Gonorrhoea, he adds, mutates more than syphilis and in some countries, gonorrhoea has become one of the hardest STIs to treat.
Although syphilis and gonorrhoea have basic genetic makeup, they also have different adaptation mechanisms when medicines aimed at treating them are misused.
There are also other sexually transmitted infections, including trichomonas vaginalis trichomoniasis and vulvovaginal candidiasis that have no noticeable consequences.