US aid cuts are killing Kenyan sex workers

NAIROBI, Kenya — Under an unmarked block of concrete in a Nairobi cemetery lie the remains of Judy, an HIV-positive Kenyan sex worker, who died just hours before she was due to meet AFP last month — one more victim of US aid cuts. AFP has confirmed the deaths of at least 24 HIV-positive sex workers in Kenya who, like Judy, were in good health until aid was slashed by the United States in early 2025, according to frontline health staff. The real number of deaths is likely far higher, and NGOs say there is already a huge spike in HIV infections among sex workers that will likely spark a “catastrophic” rise in cases among the general population.

The US has long been the biggest donor to Kenya’s health system, but the Donald Trump Administration has restructured support away from NGOs, and passed rules to prevent them promoting issues it opposes. A July 2026 report by the Foundation for AIDS Research (amfAR) found that 73 per cent of US-funded organisations had been forced to end services to “key populations” — sex workers, LGBTQ communities, and drug users — despite them facing the highest risk of infection. Kenya had dozens of clinics catering specifically to sex workers, providing antiretroviral drugs, condoms, and other preventive treatments — peer-led places where they would not face questions and disapproval.

Kenyan authorities estimate there are 285,000 women engaged in sex work in the east African nation, with an HIV prevalence rate of 27.5 per cent. Experts fear a surge in infections if they are no longer targeted for health support. Decades of progress are being put at risk, UNAIDS chief Winnie Byanyima told AFP.

“This is the most serious disruption in the HIV response since the world came together to fight this disease,” she said. Stigma Nearly 1.5 million people, or 3.2 per cent of Kenya’s population, live with HIV. Judy, 36, was diagnosed in 2017, according to her friend Diana, also a sex worker.

She had learned to manage with the help of the Bar Hostess Empowerment and Support Programme (BHESP), an NGO supporting sex workers that delivered medication, condoms, and sometimes food to her in the Mathare slum of Nairobi where she lived. Like most in her profession in Kenya, Judy lived in extreme poverty, sometimes selling sex for 50 or 100 Kenyan shillings (40 or 80 cents) or in exchange for food for her four children.