The Global Aids Program (GAP) is a comprehensive national HIV/AIDS program carried out in many parts of Kenya including Nyanza province. Nyanza Province has one of the highest HIV prevalence rates - 15.3% (Kenya AIDS Indicator Survey, 2007). GAP activities are funded through the United States President’s Emergency Plan for AIDS Relief (PEPFAR).

GAP works closely with the Kenyan Ministry of Health (MOH) in implementing its programs. Through this collaboration, the Project has trained health workers in the area as well as supporting renovations, equipment and furniture purchases in health facilities.

Project Sites
In Nyanza, GAP carries out its activities in Kisumu, Nyando, Gucha, Kisii, Nyamira, Bondo and Siaya Districts.

GAP Activities

Counseling and Testing
GAP provides Counseling and Testing support (CT) targeting more than 200,000 people in Nyanza province. CT helps identify HIV positive individuals who can benefit from prevention, care and treatment services through:
• Home-Based Counseling and Testing (HBCT);
• Provider-initiated HIV Testing and Counseling (PITC).

HIV Research /GAP Nyanza Laboratory
KEMRI/CDC has two laboratory facilities which support both HIV research and GAP activities. These laboratories have been awarded both the ISO-15189 accreditation by the South African National Accreditation Scheme (SANAS) and also certified by the Kenya Medical Laboratory Technology and Technician Board (KMLTTB).
• These labs carry out:
• CD4 testing, chemistry and hematology
• Quality assurance
• Infant diagnosis (EID)
• Providing technical support to the MOH

Prevention of Mother to Child Transmission (PMTCT)
The PMTCT program started in 2001 at the Provincial General Hospital and then upscaled to a total 248 sites in the province. Recently the program transitioned these sites to the University of Nairobi. These sites offer:
• CT to mothers in antenatal, maternity and postnatal clinics
• Anti Retroviral treatment for pregnant women with HIV
• Follow up of HIV exposed infants and HIV positive women
• Formation of breast feeding support groups
• Men Only clinics to encourage male involvement
• Sensitization of traditional birth attendants and community health workers on HIV/AIDS

Tuberculosis/HIV Program
The TB/HIV program in collaboration with the Division of Leprosy Tuberculosis and Lung Disease (DLTLD) and other partners seek to reduce the burden of HIV among TB patients and the burden of TB in HIV infected people.
By the end of December 2007, there were 346 TB treatment sites in Nyanza province. Through volunteer TB ambassadors, the program provides TB education and identifies and refers TB suspects and also finds treatment defaulters.

Uniformed Services Program
This is a comprehensive HIV program that focuses on prevention, care, treatment and support to Non- Military uniformed services including the Prisons, Police, Kenya Wildlife service (KWS) Administration Police (AP) and National Youth Service (NYS). The program aims to assist the uniform services develop HIV policies, be informed on risk reduction, develop behavior change communication skills, build their capacity and provide care and support for the infected.

GAP Data
The GAP Data program supports other HIV/AIDS programs in KEMRI/CDC through data management and analysis. It does this through timely collection, verification, analysis and reporting of data. GAP Data manages data from 248 PMTCT sites, 35 VCT sites, 70 care and treatment sites and PITC Sites.

Care and Treatment
The main goal of GAP Care and Treatment is to improve accessibility and ensure provision of quality care and treatment to HIV/AIDS clients. This project supports 46 Patient Support Centres (PSCs) out of which 28 are ART sites. The project also supports renovations in PSCs, establishment of client support groups as well as capacity building of people living with HIV/AIDS through nutrition, basic counseling skills and income generating activities.