Why women remain at the center of the HIV epidemic in the coastal city

 

TURNING THE TIDE

By SHARON OTISO

Women and HIV in Mombasa: The Hidden Burden

Why women remain at the center of the HIV epidemic in the coastal city

In Mombasa, where the rhythm of coastal life blends tourism, trade, and culture, a quieter crisis continues to affect thousands of women. HIV remains a major public health concern  and women are bearing the greatest burden.

Mombasa's vibrant coastline and economic activities mask an ongoing health challenge

According to the National Syndemic Diseases Control Council, HIV prevalence among women in Mombasa stands at approximately 6.2 percent, more than double that of men at 2.6 percent. This disparity reflects not only biological vulnerability but also deep-rooted social and economic inequalities that continue to shape women’s lives.

“Women in Mombasa remain disproportionately affected by HIV.”

The Gender Gap Driving Infections

Experts point to a combination of factors that make women more vulnerable to HIV infection. Biologically, women are at a higher risk of contracting HIV during unprotected sex. But beyond biology, structural inequalities play a larger role.

Mombasa’s nightlife can expose vulnerable groups to risky survival choices

In many cases, women  particularly young women have limited power to negotiate safe sex or insist on condom use. Cultural norms and gender dynamics often place men in control of sexual decision-making, leaving women exposed.

Economic hardship further compounds the problem. In some coastal communities, transactional sex  where relationships are driven by financial support increases the risk of HIV exposure.

Young Women at Greater Risk

Economic hardship increases HIV vulnerability among young women

Adolescent girls and young women aged 15 to 24 are among the most affected. Limited access to education, unemployment, and poverty create conditions that heighten vulnerability.

Health experts warn that without targeted interventions, this group could continue to drive new infections in the region. Early pregnancies, school dropouts, and lack of access to reproductive health services further increase the risk.

Organizations such as the World Health Organization emphasize the importance of investing in young women’s health, education, and economic empowerment as a strategy to reduce HIV infections.

Access to Treatment — Progress and Gaps

Mombasa has made significant strides in expanding access to antiretroviral therapy (ART), with most people living with HIV now receiving treatment. For women, this has translated into improved life expectancy and better quality of life.

Young expectant woman during counselling.

Prevention of mother-to-child transmission (PMTCT) programs has also been a major success, ensuring that many babies are born HIV-free even when their mothers are living with the virus.

However, gaps remain. Some women still face barriers such as stigma, lack of financial independence, and limited access to healthcare facilities, particularly in informal settlements.

Stigma and Silence

Stigma continues to be one of the most powerful drivers of the epidemic among women. Fear of discrimination often prevents women from seeking testing or disclosing their HIV status.

In some cases, women risk violence, abandonment, or social isolation if they are found to be HIV positive. This silence not only affects individuals but also contributes to the continued spread of the virus.

Health advocates stress the need for community-based solutions that address stigma and support women living with HIV.

A Path Forward

Addressing HIV among women in Mombasa requires a multi-faceted approach. Experts highlight the need for:

• Economic empowerment programs

• Access to education and reproductive health services

• Gender-sensitive healthcare systems

• Stronger community awareness campaigns

By tackling the root causes of vulnerability, Mombasa can make meaningful progress in reducing HIV infections among women.

“Ending HIV means addressing inequality as much as infection.”