Mbili Pamoja Dissemination Report held on 21st August 2025

Facilitator-Felix Ochieng

Note taker-Patriciah Wambua

Venue-UNIM Boardroom-Lumumba

Date-21st August 2025

Attendees

The dissemination meeting was attended by two representatives from the Female Sex Workers Association, the Medical Superintendent of Lumumba Hospital, the Hospital Administrator, and the Nurse-in-Charge at Lumumba Hospital. Also present were a Key Population representative from the County Government, two staff members from the POWWER Study, a staff photographer, the Director of NRHS, and other departmental heads from the Kisumu County Government.

 Report

The dissemination meeting began with introductions of the Anza Mapema staff, followed by the Principal Investigators, the study objectives, and the importance of the study. Thereafter, the findings were presented to the participants.

When the differences in baseline characteristics by study site were discussed, the facilitator invited reflections on why rectal STIs appeared to be more prevalent in Nairobi than Kisumu. Participants shared several perspectives. One participant suggested “individuals in Kisumu were more likely to seek medical attention compared to those in Nairobi.” Another participant remarked, “both sites had drop-in centers, so service availability alone might not explain the difference.” Others added, “Kisumu seemed to have stronger programs supporting health-seeking behavior among MSM, which could contribute to better service uptake.” It was further noted that “PrEP uptake was higher in Kisumu, which links back to stronger MSM programming in the region.” Another participant shared the view that “higher levels of self-medication with antibiotics in Nairobi might influence STI patterns.” Educational attainment was also mentioned, with the observation that “Nairobi had more highly educated participants due to the presence of many institutions of higher learning.”

Discussion then shifted to the mode of data collection, where participants were asked why ACASI (Audio Computer-Assisted Self-Interviewing) appeared to elicit more sensitive information compared to CAPI (Computer-Assisted Personal Interviewing). One participant explained, “ACASI encouraged more honest responses since clients did not feel the need to give socially desirable answers. For example, when asked about condom use, they would provide truthful timelines in ACASI, unlike in face-to-face interviews where they might say what is expected.”

When reviewing factors associated with rectal STIs, one participant noted that “many individuals in Kisumu remained in the closet, unlike in Nairobi where MSM might be more open and thus have more frequent sexual encounters.” Regarding age differences, particularly among those aged 25–29, a participant suggested, “this age group tends to experiment more, engaging with multiple partners to explore different experiences.” Another added that “some were still having sex with women while exploring relationships with men, possibly because they had not fully come out.”

The discussion then turned to condom use, where participants reflected on why higher condom use was paradoxically associated with increased STIs. Responses included, “condom breakage,” “inconsistent use,” and “deliberate removal during intercourse when sexual pleasure was prioritized.” Some participants added that “condom use often declined once partners became familiar with each other.”

The conversation concluded with reflections on programmatic implications, with participants noting that “Nairobi might need to intensify its STI prevention efforts compared to Kisumu.”