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At least 24 HIV-positive sex workers in Kenya have died after United States aid cuts disrupted access to treatment and other health services, according to health workers cited by AFP.
The deaths are among the consequences reported after the US reduced funding for HIV programmes in early 2025.
Health workers and rights groups fear the actual number of deaths could be higher.
They also warned that the disruption is contributing to rising HIV infections among sex workers, with possible consequences for the wider population.
The United States has long been a major donor to Kenya’s health system. However, the administration of President Donald Trump shifted support away from non-governmental organisations and introduced restrictions affecting programmes it opposed.
A July 2026 report by the Foundation for AIDS Research, amfAR, found that 73 per cent of US-funded organisations had been forced to stop services for key populations, including sex workers, LGBTQ communities and people who use drugs.
Clinics shut down
Kenya previously had specialised clinics providing HIV treatment, condoms and prevention services to sex workers.
The peer-led facilities also offered services in settings where patients faced less stigma and discrimination.
Many of the clinics have since closed because of funding cuts.
Kenyan authorities estimate that about 285,000 women are engaged in sex work, with an HIV prevalence rate of 27.5 per cent among them.
Experts fear that reduced access to treatment and prevention could reverse years of progress in controlling the disease.
UNAIDS Executive Director Winnie Byanyima described the disruption as one of the most serious setbacks to the global HIV response in recent years.
‘She stopped taking her medication’
One of the women identified in the report was Judy, a 36-year-old sex worker in Nairobi.
She was diagnosed with HIV in 2017 and had received support from the Bar Hostess Empowerment and Support Programme, an organisation serving sex workers.
According to her friend Diana, Judy received antiretroviral drugs, condoms and other assistance through the programme.
However, after US funding was withdrawn, BHESP lost its outreach teams.
Judy could not afford the transport to visit a clinic herself and eventually stopped taking her HIV medication.
Her health deteriorated rapidly.
“She had sores… Her skin was so rough,” Diana said.
BHESP confirmed the deaths of three HIV-positive sex workers from Mathare in recent months after they stopped treatment.
Daisy Kwala, the organisation’s programmes director, described the impact of the funding cuts in stark terms.
“The stop-work order from the US administration, for us, is a kill order,” she said.
BHESP operated two USAID-funded centres, but one closed in September 2025 and the other is scheduled to close by the end of September 2026.
The organisation said about 12,000 of the 14,500 sex workers previously treated at the two centres had stopped receiving services, including about 2,300 who were HIV-positive.
Rising infections
Kenya had recorded substantial progress in reducing new HIV infections.
Douglas Bosire, head of the National Syndemic Diseases Control Council, said new infections fell from about 110,000 in 2005 to 13,936 in 2025.
He warned that the gains could be reversed if sex workers were unable to access HIV services.
The Sex Workers Outreach Programme, which monitors about 45,000 sex workers in Nairobi, reported a 48 per cent increase in new HIV infections in the first half of 2026 compared with the same period in 2024.
Half of its clinics have closed because of the loss of USAID funding.
BHESP also reported a sharp increase in infection rates at its remaining centre in Roysambu.
Nurse Sharon Lagat said reduced access to regular monitoring meant some patients were arriving for treatment with more advanced infections and higher viral loads.
“They come for treatment late, and before they come, they will have transmitted more HIV to their customers in the community,” she said.
“These customers… are our parents, our husbands, our friends, so definitely at the end of the day, the virus will reach to our homes.”
Recent global health reporting has also warned that aid cuts are weakening HIV prevention programmes even where treatment services have remained relatively stable.
Concerns over condoms and prevention
Health officials have also raised concerns about shortages of condoms.
Bosire said the Kenyan Government could provide about 200 million of the 500 million condoms it needs each year for free distribution.
For sex workers living in poverty, buying condoms regularly can be difficult.
Kwala said some workers continued to see several clients a day despite the rising cost of prevention supplies.
The Coast Sex Workers Alliance reported 14 deaths among HIV-positive sex workers who lost access to treatment in Kenya’s coastal region.
In western Kenya, the Kisumu Sex Workers Alliance reported at least five deaths, while Survivors of Busia reported two more near the Ugandan border.
Dorothy Agalla, director of the Kisumu-based organisation, said none of the 25 USAID-funded sex worker clinics in western Kenya remained operational.
She said fewer than 1,000 of the 20,000 sex workers previously covered by the programme were now receiving care at public facilities.
Fear of returning to past crisis
Doctor Joshua Kimani, clinical and research director of the Sex Workers Outreach Programme, said he feared Kenya could return to the HIV crisis of the 1990s.
Kimani, who worked during the height of the epidemic, recalled 1998 as his “worst year”.
“I became ‘Dr Death’ because of telling people to go home, to die at home,” he said.
“I don’t want to go back there.”
He warned that increased infections among sex workers would eventually affect the wider population.
“We cannot treat ourselves out of this epidemic. We need prevention,” Kimani said.
The impact of the funding cuts has also been felt by families.
Cecilia, a sex worker, told AFP that her friend Beatrice stopped taking antiretroviral drugs after outreach workers stopped visiting her.
Beatrice died in August 2025. Her sister Rosemary, who was also a sex worker living with HIV, died a year later.
Cecilia appealed to President Donald Trump to restore the support previously available to sex workers.
Meanwhile, Frank Garcia, the Trump administration’s deputy assistant secretary for Africa, rejected claims that the US was responsible for the deaths.
“I completely push back on the narrative that… the most generous nation in the world with regard to AIDS research, AIDS funding, and AIDS distribution of life-saving methodologies, is in any way responsible for that,” he told AFP.
