A couple’s struggle for survival as HIV drugs disappear
Boniface Mukuha, 28, and his wife Medrine Kemunto, 28, during the interview at their home in Kibra, Nairobi on March 12, 2025.
What you need to know:
- For years, PrEP and ARVs kept their discordant relationship safe. Now, with USAID funding halted, a Kibra couple fears what happens next when their supply runs out.
Five years ago, in the heart of Kibra, Boniface Mukuha, 28, met Medrine Kemunto, 28, in a cybercafé—an unassuming setting for what would become an extraordinary love story. She had just completed her Kenya Certificate of Secondary Education exams, and he, a young man born with HIV, was navigating the complexities of life in one of Nairobi’s most densely populated neighborhoods.
Boniface Mukuha and his wife Medrine Kemunto during the interview.
What began as a casual encounter quickly deepened into something undeniable. Their relationship unfolded in quiet corners of the slum, away from prying eyes. They sought refuge in late-night walks, stolen moments, and whispered conversations, careful to keep their growing bond away from scrutiny.
But when their love could no longer remain in the shadows, they faced a wave of rejection. Medrine’s family and community struggled to understand her choice. Why, they asked, would a young woman with her whole future ahead of her commit to a man whose HIV status was common knowledge? The questions were laced with fear, stigma, and the weight of generations of misunderstanding.
Still, against the odds, they chose each other. Their love, tested by societal expectations and the burden of prejudice, became a quiet rebellion—a testament to the power of human connection in a world that too often defines people by their circumstances rather than their hearts.
“You see, the lack of information and awareness in Kibra about Undetectable = Untransmittable (U=U), an informational campaign about how effective HIV medications are in preventing sexual transmission of HIV was the genesis of it all. As a discordant couple, we are living proof that U=U actually works,” Medrine starts off while explaining that she knew of her husband’s HIV status from his friends and the society around her before Boniface even opened up about it.
But how did everyone get to know about Boniface’s status?
According to his wife, living in a densely populated slum like Kibra means everyone knows everyone’s business and also when people line up at the clinics for antiretroviral therapy (ARVs), everyone ends up knowing who goes for the pills.
When Boniface finally worked up the courage to disclose his HIV status to his wife, she responded not with fear, but with an embrace.
“I have been waiting for you to tell me yourself. I know, and I love you even more. Nothing can change that,” she told him. “Always remember, HIV is not a death sentence if you religiously take your medication.”
She, however, discloses that she would at first develop cold feet after a health worker at a health centre in Kibra South shockingly went off at her for choosing to love her man in that state and even getting pregnant for him.
“When I arrived at the clinic, I was quick to let the person who was attending to me know that my man and I are a discordant couple,” Medrine tells Healthy Nation. “She didn’t want to hear any of it and in fact, she wanted to get my husband arrested because someone had misinformed her that the pre-exposure prophylaxis (PrEP) - medicine people at risk for HIV take to prevent getting the virus from sex or injection drug use - could harm the baby.”
Medrine adds that a second opinion they sought with her husband from a doctor confirmed that nothing would happen to the baby, thereby putting her mind at ease.
“My daughter is now five years old, hearty and healthy, clear evidence that PrEP does not harm a baby during pregnancy but instead is effective in ensuring the baby doesn’t contract the virus,” the mother to one assures.
For years, their love story has defied stigma, fueled by trust and adherence to medical treatment. But now, an abrupt disruption in US funding for HIV programmes threatens their future. The lifesaving medication that has safeguarded their health and relationship has become scarce. Even condoms, once freely available, are difficult to find.
The crisis comes despite US Secretary of State Marco Rubio approving an emergency humanitarian waiver to President Donald Trump’s foreign aid suspension earlier this year. The waiver was meant to ensure continued access to critical treatment for diseases such as HIV/Aids, malaria, and tuberculosis in 55 countries, including Kenya.
“When I saw the announcement by President Trump on the news, it hit me so bad, I got so scared and very depressed and still ask myself how our life as a couple is going to be without the vital HIV medication,” Medrine says as tears race down her cheeks. “Our entire existence depends on those pills, which we were getting at no cost from an Amref clinic in Kibra that was shut down after the funding was withdrawn.”What concerns her more is the fact that they have fired so many people who used to hold crucial roles in HIV work in the community. “For example, there’s a lady who worked at that Amref clinic who has helped me to navigate this journey and settle in my marriage. Last week I went to look for PrEP from her only to find the place closed and when I called, she told me she’s out of a job because of the Trump order,” she says. “This broke my heart because she’s the one I have been confiding in.”
For Boniface, he says he was shocked and humbled that her beloved wife was not surprised by his positive HIV status. He was deeply moved by his wife’s reaction. “My wife is a gem and my solid rock,” he says. “She has been very supportive since day one and even reminds me about taking medication and clinic visits.”
His fears before meeting her had been justified. “Before her, I tried dating three other women. Whenever I came clean about my HIV status, they would immediately flee, which made me feel like I was destined to be alone forever. Losing her is what I fear most in this life.”
He recalls his childhood struggles with the virus, growing up under the care of an aunt who ensured he took his ARVs but never explained why. “I came to learn about HIV status in primary school in 2005 on my own, and it finally made sense why I had been taking pills all my life.” Thanks to his adherence to treatment, his viral load remains undetectable—a crucial indicator of health for people living with HIV.
A viral load gives you an idea of how much of the HIV virus is in your body and the test measures the number of HIV copies in a milliliter of blood. This means that test results help your doctor follow what's happening with your infection, how well your treatment is working, and guide treatment choices. Also, HIV viral load predicts how fast the disease will progress, while other tests, like the CD4 count, indicate how much damage the virus has already caused.
Dr Godfrey Mutakha, a consultant obstetrician and gynecologist at Masinde Muliro University of Science and Technology, explains that maintaining an undetectable viral load means the immune system is healthy and the risk of transmission is nearly eliminated.
“A low viral load that can’t be detected means less than 20 copies and is always the goal of HIV treatment, although this doesn’t mean you’re cured,” Dr Mutakha explains. “Unfortunately, the virus still survives in various cells in the body, but maintaining an undetectable viral load is compatible with a normal, or near-normal life span.”
Boniface says convincing his wife that medication could protect her from the virus was another challenge. “Most people around here, for lack of information, believed that having sex was the only way to contract HIV. So, I made sure to furnish her with all the information I could about U=U—undetectable equals untransmittable.”
He also arranged for her to speak with medical experts. “I’m a champion of ending HIV in my community. Doctors Without Borders picked me up and trained me as a peer educator,” says Boniface.
Medrine has remained HIV-negative. But with treatment access threatened, they face an uncertain future.
“That announcement and the subsequent shutdown of USAID-funded programmes hit me so hard,” Boniface says. “I have seen my best friend, who defaulted on ARVs, die right before my eyes. Now, I am imagining that there is someone somewhere who has immense power, who can just wake up and deny me the pill that my life depends on. Maybe he doesn’t know how that pill has changed my life for the better. It hurts so bad.”
Even condoms, once freely distributed through USAID programmes, have vanished from clinics. “The prices of condoms in Kenya have gone up,” says Boniface. “A three-pack that used to cost Sh150 now goes for Sh600. Considering my wife and I are not gainfully employed, we find it so hard to afford them.”
While the US has placed a three-month pause on President Trump’s funding halt, Boniface’s medication supply will barely last a month. “What are we going to do when the timeframe given comes to an end?” He wonders.
Faced with the prospect of running out of medication, he is contemplating an agonising decision. “I am seeing a situation where I will be compelled to let my wife go if this continues because I love her too much and would never want to infect her with the virus,” he says. “My moral conscience would kill me if I did.”
The Ministry of Health has acknowledged that the recent US decision to impose a 90-day pause on foreign development assistance has significantly disrupted healthcare service delivery in Kenya.
It notes that despite Kenya’s progress in the fight against HIV—where 95 per cent of the 1.378 million people living with HIV know their status, antiretroviral therapy coverage has risen from 41 per cent in 2013 to 97 per cent in 2023, and viral suppression has improved from 85 per cent in 2019 to 94 per cent in 2023.
“The country must take decisive action to safeguard these achievements,” said Health CS Deborah Barasa.
“As a government, we acknowledge the vital role those international partnerships have played in supporting our HIV response.
This funding has been instrumental in ensuring access to life-saving anti-retroviral treatment, HIV prevention, essential diagnostic tools for millions of Kenyans living with HIV, as well as in other programmes such as the malaria and TB ,” said Ms Barasa.
Addressing delegates in Nairobi last week during a high-level meeting on mitigation measures to address the impact of funding cuts on Kenya’s HIV response, the CS added that the US decision highlights the urgent need for Kenya to take decisive actions to safeguard the progress made in controlling HIV and other infections as well as strengthening healthcare systems.
The CS revealed that bilateral discussions had been initiated with US representatives to better understand the executive order and advocate for advance notice of such decisions in the future.
Kenya, according to the ministry, needs Sh13.5 billion to sustain its HIV response, including Sh7.4 billion to bridge the commodity gap following the US President's Emergency Plan for AIDS Relief’s withdrawal, Sh5.8 billion to maintain 11,059 healthcare workers, Sh50 million for a human resources audit, and Sh140 million to integrate HIV programs into the digital health superhighway.
llidigu@ke.nationmedia.com
