NRHS Programmes

Sexual and Reproductive Health

Since its conception, NRHS has been at the forefront of provision of sexual and reproductive health services in the region. These services have ranged from family planning, management of sexually transmitted infections (STI), and HIV testing and counselling. As part of its Partners in Reproductive Health (PIRH) programme, NRHS offers screening, diagnosis and treatment of STIs both as a syndromic approach and an aetiological approach. These are offered on a walk-in basis to any client seeking services, free of charge.

Diverse and Non-Judgmental Care: Key Pops, Gender and Sexual Orientation Inclusive

At NRHS we are proud of our diverse and non-judgmental sexual and reproductive care services. We provide care to adolescents, men and women engaged in sex work, men who have sex with men, and transgender persons. Our clinicians have received specialized training in providing comprehensive, specialized, and non-judgmental care that maintains the highest standards of confidentiality. Everyone is welcome at NRHS.

HIV Testing and Counselling Services:

Riding on the Anza Mapema programme for Key Population and the PIRH programme for general population, we use a mix of different modalities to offer HIV testing and counselling. These modalities included fixed site testing both at Anza Mapema Centre of Excellence and UNIM Research and Training Centre as well as outreaches which included targeted, Social Network Strategy (SNS) and Partner Notification Services (PNS).

STI Services:

Our free STI services augment the Ministry of Health syndromic management guidelines. Clients are provided free clinical examination from our expert clinicians, who have many years training in clinical and research setting for diagnosing and treating ulcerative and non-ulcerative STIs. Based on best practices and critical evaluation, we conduct standardized and focused genital examinations, combined with careful history taking, to provide effective STI management. The medications and clinical examination services are provided free of charge with same day service to walk-in clients.

Laboratory Services:

The UNIM Research and Training Centre Laboratory supports etiologic testing for STIs, including:

  • Neisseria gonorrhoeae (molecular and culture-based testing)
  • Antimicrobial resistance testing via disc diffusion and E-Test
  • Chlamydia trachomatis (molecular testing)
  • Trichomonas vaginalis (microscopy, rapid immunochromatographic assay)
  • Bacterial vaginosis (wet mount and Gram stain with Nugent scoring)
  • pallidum (syphilis; RPR and antigen specific testing)
  • HSV-2 antibody testing

 

To support these assays, our BSL2 lab uses in-house equipment including: incubators, temperature-controlled centrifuges, GeneXpert machine, ELISA, light microscopy, hood, -80 and -20 freezers, autoclave, among many other durable and consumable supplies.

 

Our lab work in STIs and BV has been validated and undergone rigorous peer review, with over 30 publications in this area.

 

We are well suited to serve as a reference lab as fee for service, contractually for your clinical or research studies, or as co-investigators with extensive expertise in STI testing, treatment, and prevention.

 

 

References for STI Research Studies Completed by NRHS

  1. Wahome E, Otieno FO, Kimani J, Boyd A, Okall D, Nzioka J, Gichuru E, van der Elst E, Mehta SD, Bailey RC, Graham SM, Sanders EJ; for the Tatu Pamoja (three-site) study group (2024). Impact of coronavirus disease 2019-related clinic closures on HIV incidence in young adult MSM and transgender women in Kenya. 2024 Mar 1;38(3):407-413. https://doi.org/10.1097/QAD.0000000000003782. Epub 2023 Nov 27. PMID: 37939103 
  2. Nduva, George; Otieno, Frederick; Kimani, Joshua; Sein, Yiakon; Arimide, Dawit; McKinnon, Lyle; Cholette, Francois; Lawrence, Morris; Majiwa, Maxwell; Masika, Moses; Mutua, Gaudensia; Anzala, Omu; Graham, Susan; Gelmon, Larry; Price, Matt; Smith, Adrian; Bailey, Robert; Medstrand, Patrik; Sanders, Eduard J.; Esbjörnsson, Joakim; Hassan, Amin S.(2023) Temporal trends and transmission dynamics of pre-treatment HIV-1 drug resistance within and between risk groups in Kenya, 1986-2020.  Journal of Antimicrobial Chemotherapy JAC-2023-0800.R1 https://doi.org/10.1101/2023.03.21.23287487
  3. Samenjo KT, Ramanathan A, Gwer SO, Bailey RC, Otieno FO, Koksal E, Sprecher B, Price RA, Bakker C, Diehl JC (2023). Design of a syringe extension device (Chloe SED®) for low-resource settings in sub-Saharan Africa: a circular economy approach. Front Med Technol. 2023 Sep 1;5:1183179. https://doi:10.3389/fmedt.2023.1183179 PMID: 37727273; PMCID: PMC10505716.
  4. Supriya D. Mehta, Fredrick O. Otieno, Joshua Kimani, Elizabeth Wahome, Duncan Okal, Abhishikta Roy, Elise van der Elst, Susan M. Graham, Eduard J. Sanders& Robert C. Bailey  (2023). Transgender women in Kenya experience greater stigma, depressive symptoms, alcohol and drug use and risky sexual practices than cis-gendered men who have sex with men. BMC Public Health 23, 1493. https://doi.org/10.1186/s12889-023-16348-6
  5. Mehta, Supriya D., Walter Agingu, Garazi Zulaika, Elizabeth Nyothach, Runa Bhaumik, Stefan J. Green, Anna Maria van Eijk, Fredrick O. Otieno, Penelope A. Phillips-Howard, and John Schneider (2023). “Vaginal Microbial Network Analysis Reveals Novel Taxa Relationships among Adolescent and Young Women with Incident Sexually Transmitted Infection Compared with Those Remaining Persistently Negative over a 30-Month Period” Microorganisms11, no. 8: 2035. https://doi.org/10.3390/microorganisms11082035
  6. Supriya D. Mehta, Garazi Zulaika, Walter Agingu, Elizabeth Nyothach, Runa Bhaumik, Stefan J. Green, Anna Maria van Eijk, Daniel Kwaro, Fredrick Otieno, Penelope Phillips-Howard (2023) Analysis of bacterial vaginosis, the vaginal microbiome, and sexually transmitted infections following the provision of menstrual cups in Kenyan schools: Results of a nested study within a cluster randomized controlled trial. PLoS Med 20(7): e1004258. https://doi.org/10.1371/journal.pmed.1004258
  7. Susan M. Graham, Duncan O. Okall, Supriya D. Mehta, Eve Obondi, George Ng’ety, Elijah Ochieng, Laura Jadwin-Cakmak,  Rivet Amico, Gary W. Harper, Robert C. Bailey&  Fredrick O. Otieno (2022). Challenges with PrEP Uptake and Adherence Among Gay, Bisexual, and Other Men Who Have Sex with Men in Kisumu, Kenya. AIDS Behav 27, 1234–1247 (2023). https://doi.org/10.1007/s10461-022-03860-w
  8. Mehta SD, Nandi D, Agingu W, Green SJ, Otieno FO, Bhaumik DK and Bailey RC (2022). Longitudinal Changes in the Composition of the Penile Microbiome Are Associated With Circumcision Status, HIV and HSV-2 Status, Sexual Practices, and Female Partner Microbiome Composition.  Cell. Infect. Microbiol.12:916437. https://doi:10.3389/fcimb.2022.916437
  9. Robert C. Bailey, Makobu Kimani, Rhoda Kabuti, Edwin Gumbe, George Otieno, Joshua Kimani, Duncan Okall, Eduard J. Sanders, and Fredrick O. Otieno (2022) URCHOICE: Preferences for Pre-Exposure Prophylaxis (PrEP) Options for HIV Prevention Among Kenyan men who have sex with men and Transgender Women in Nairobi, Kisumu and the Coast. AIDS and Behavior https://doi.org/10.1007/s10461-022-03741-2
  10. George M. Nduva, Frederick Otieno, Joshua Kimani, Elizabeth Wahome, Lyle R. McKinnon, Francois Cholette, Maxwell Majiwa, Moses Masika, Gaudensia Mutua, Omu Anzala, Susan M. Graham, Larry Gelmon, Matt A. Price, Adrian D. Smith, Robert C. Bailey, Guy Baele, Philippe Lemey, Amin S. Hassan, Eduard J. Sanders, and Joakim Esbj¨ornsson (2022) Quantifying rates of HIV-1 flow between risk groups and geographic locations in Kenya: A country-wide phylogenetic study. Virus Evolution, 2022, 8(1), 1–14 https://doi.org/10.1093/ve/veac016
  11. Mehta SD, Nandi D, Agingu W, Green SJ, Otieno FO, Bhaumik DK, Bailey RC. Longitudinal changes in the composition of the penile microbiome are associated with circumcision status, HIV, and HSV-2 status, sexual practices, and female partner microbiome composition. Front Cell Infect Microbiol 2022;12:916437. PMCID: PMC9294230. DOI: 10.3389/fcimb.2022.916437
  12. Mehta SD, Zulaika G, Otieno F, Nyothach E, Agingu W, Bhaumik R, Green SJ, van Eijk AM, Kwaro D, Phillips-Howard PA. High prevalence of Lactobacillus crispatus dominated vaginal microbiome among Kenyan secondary school girls: Negative effects of poor quality menstrual hygiene management and sexual activity. Front Cell Infect Microbiol 2021;11:716537. PMCID: PMC8490761.
  13. Mehta SD, Okal D, Otieno F, Green SJ, Huibner S, Bailey RC, Bhaumik DK, Landay A, Kaul R. Schistosomiasis is associated with rectal mucosal inflammation among Kenyan men who have sex with men. Int J STD AIDS 2021;32(8):694-703.
  14. Kunzweiler C, Bailey R, Okall D, Graham SM, Mehta SD, Otieno-Nyunya B, Djomand G, Otieno F. Factors associated with retention among HIV-negative Kenyan gay, bisexual, and other men who have sex with men enrolled in the Anza Mapema J Int AIDS Soc 2020;23(Suppl 6):e25598. PMCID: PMC7527767.
  15. Mehta SD, Agingu W, Nordgren RK, Green SJ, Bhaumik DK, Bailey RC, Otieno F. Characteristics of women and their male sex partners predict clinical pathologic state among a prospective cohort of Kenyan women with non-optimal vaginal microbiota. Sex Transm Dis 2020;47(12):840-850. PMCID: PMC7668344.
  16. Mehta SD, Nandi D, Agingu W, Green SJ, Bhaumik DK, Bailey RC, Otieno F. Vaginal and penile microbiome associations with HSV-2 in women and their male sex partners. J Infect Dis 2022;226(4):644-654. PMCID: PMC9441199. DOI: 10.1093/infdis/jiaa529
  17. Mehta SD, Okall D, Graham SM, N’gety G, Bailey RC, Otieno F. Behavior change and sexually transmitted incidence in relation to PrEP use among men who have sex with men in Kenya. AIDS Behav 2021;25:2219-2229. DOI: 10.1007/s10461-020-03150-3
  18. Mehta SD, Zhao D, Green SJ, Agingu W, Otieno F, Bhaumik R, Bhaumik D, Bailey RC. The microbiome composition of a man’s penis predicts incident Bacterial vaginosis in his female sex partner with high accuracy. Front Cell Infect Microbiology 2020;10:433.
  19. Mehta SD, Nannini DR, Otieno F, Green SJ, Agingu W, Landay A, Zheng Y, Hou L. Host genetic factors associated with the vaginal microbiome in Kenyan women. mSystems 2020;5:e00502-20.
  20. Mason V, Otieno F, Odhiambo F, Sappenfield OR, Mehta SD. Association of partner support and partner communication with provider prescribed contraceptive method use among heterosexual couples in Kisumu, Kenya. African Journal of Reproductive Health 2020;24(2):40-47.
  21. Otieno FO, Ng’ety G, Okall D, Aketch C, Obondi E, Graham S, Otieno-Nyunya B, Djomand G, Bailey RC, Mehta SD. Incidence of gonorrhea and chlamydia among a prospective cohort of men who have sex with men in Kisumu, Kenya. Sex Transm Infect 2020;96(7):521-527.
  22. Nacht C, Agingu W, Otieno F, Odhiambo F, Mehta SD. Antimicrobial resistance patterns in Neisseria gonorrhoeae among male clients of a sexually transmitted infections clinic in Kisumu, Kenya. Int J STD AIDS 2020;31(1):46-52.
  23. Quilter LAS, Obondi E, Kunzweiler C, Okall D, Bailey RC, Djomand G, Otieno-Nyunya B, Otieno F, Graham SM. Prevalence and correlates of a risk score to identify asymptomatic anorectal gonorrhea and chlamydia infection among men who have sex with men in Kisumu, Kenya. Sex Transm Infect 2019;95:201-211. PMCID: PMC6428609. DOI: 10.1136/sextrans-2018-053613
  24. Mehta SD, Nordgren RK, Agingu W, Otieno F, Ochieng W, Odhiambo F, Bailey RC. Sexual quality of life and association with HIV and STIs among a cohort of heterosexual couples in Kenya. Journal of Sexual Medicine 2018;15(10):1446–1455.
  25. Mehta SD, Pradhan A, Green SJ, Naqib A, Odoyo-June E, Gaydos C, Landay A, Bailey RC. Microbial diversity of genital ulcers among HSV-2 seropositive women. Sci Rep 2017;7(1):15475.
  26. Mehta SD, Moses S, Agot K, Maclean I, Odoyo-June E, Li H, Bailey RC. Medical male circumcision and HSV-2 acquisition: Post-trial surveillance in Kisumu, Kenya. J Infect Dis 2013;208:1869-76. PMID: 23901089.
  27. Mehta SD, Green S, Maclean I, Hu H, Bailey RC, Gillevet PM, Spear GT. Microbial diversity of genital ulcer disease in men enrolled in a randomized trial of male circumcision in Kisumu, Kenya. PLoS One 2012;7(7):e38991. PMID: 22848346.
  28. Lagace-Wiens PRS, Duncan S, Kimani J, Ndinya-Achola JO, Thiong’o A, Shafi J, McClelland S, Maclean I, Saunders EJ, Moses S, Zhanel G, Maraguri N, Mehta SD. Emergence of fluoroquinolone resistance in Neisseria gonorrhoeae isolates from four clinics in three regions of Kenya. Sex Transm Dis 2012;39:332-4.
  29. Mehta SD, Moses S, Parker CB, Agot K, Maclean I, Bailey RC. Circumcision status and incident HSV-2 infection, genital ulcer disease, and HIV infection. AIDS 2012;26:1141-9. PMID: 22382150.
  30. Mehta SD, Gaydos C, Maclean I, Odoyo-June E, Moses S, Agunda L, Quinn N, Bailey RC. Medical male circumcision and urogenital Mycoplasma genitalium among men in Kisumu, Kenya. Sex Transm Dis 2012;39:276-80. PMID: 22421693.
  31. Mehta SD, Maclean I, Ndinya-Achola JO, Moses S, Martin I, Ronald A, Agunda L, Murugu R, Bailey RC, Melendez J, Zenilman JM. Emergence of quinolone-resistance and cephalosporin MIC creep in Neisseria gonorrhoeae in a cohort of young men in Kisumu, Kenya: 2002 – 2009. Antimicrob Agents Chemother 2011;55:3882-8.
  32. Pultorak E, Odoyo-June E, Hayombe J, Opiyo F, Odongo W, Ogollah JA, Moses S, Bailey RC, Mehta SD. Factors associated with repeat visits among clients attending a clinic for sexually transmitted infections in Kisumu, Kenya. Int J STD AIDS 2011 Nov;22:640-4.
  33. Mehta SD, Moses S, Agot K, Parker CB, Ndinya-Achola JO, Maclean I, Bailey RC. Adult male circumcision does not reduce risk of incident Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis: Results from a randomized controlled trial in Kenya. J Infect Dis 2009;200:370-378.
  34. Smith JS, Bailey RC, Westreich DJ, Maclean I, Agot K, Ndinya-Achola JO, Hogrefe W, Morrow RA, Moses S. Herpes simplex virus type 2 antibody detection performance in Kisumu, Kenya, using the Herpeselect ELISA, Kalon ELISA, Western blot and inhibition testing. Sex Transm Infect 2009;85:92-6. PMCID: PMC2857340. DOI: 10.1136/sti.2008.031815
  35. Mehta SD, Moses S, Agot K, Agingu W, Parker C, Ndinya-Achola JO, Bailey RC. Herpes simplex virus type 2 infection among young uncircumcised men in Kisumu, Kenya. Sex Transm Infect 2008;84:42-48.
  36. Mehta SD, Moses S, Ndinya-Achola JO, Agot K, Maclean I, Bailey RC. Identification of novel risks for non-ulcerative sexually transmitted infections among young men in Kisumu, Kenya. Sex Transm Dis 2007;34:892-899.
  37. Pultorak E, Odoyo-June E, Hayombe J, Opiyo F, Odongo W, Ogollah JA, Moses S, Bailey RC, Mehta SD. Factors associated with repeat visits among clients attending a clinic for sexually transmitted infections in Kisumu, Kenya. Int J STD AIDS 2011;22:640-4. PMCID: PMC3663590. DOI: 10.1258/ijsa.2011.010483