Expanded Polling Booth Surveys as innovative surveillance tools to detect and monitor HIV and STBBI among key populations in Nairobi County, Kenya

In Kenya, HIV and other sexually transmitted and blood-borne infections (STBBI), including mpox, syphilis, chlamydia (Ct), gonorrhoea (Ng), and trichomoniasis (Tv) disproportionately impact key populations (KP)-e.g., female sex workers (FSW) and men who have sex with men (MSM). In many low- and middle-income countries, like Kenya, comprehensive systems for STBBI surveillance are meagre. Instead, countries rely on large, population-based surveys that are time- and resource-intensive, and thus can only be implemented every few years, leaving counties reliant on outdated epidemiologic data. There is a critical need for innovative, lower-cost, rapid, and flexible surveillance tools that retain required methodological rigor to collect up-to-date HIV/STBBI prevalence and incidence estimates that informs policy and programming at national and sub-national levels. Our team has pioneered the use of the expanded polling booth survey (ePBS) platform among KPs in Kenya. ePBS is an innovative, lower-cost, nimble, and community-led platform that can be used for surveillance to rapidly capture community-level prevalence of STBBI, employing a wide array of biomedical testing technologies, while also assessing HIV/STBBI program coverage among the most marginalized poulations, including KP. Recently, ePBS has been endorsed by The Global Fund and the Global HIV Prevention Coalition as a useful, lower-cost method for routinely measuring HIV/STBBI prevention program outcomes. The goal of this proposal is to implement the ePBS platform to assess prevalence of HIV, mpox, and other STBBI, and identify prevention programming needs of KP at elevated risk for STBBI in Nairobi County, Kenya. Building upon earlier work, our study will highlight the flexibility and adaptability of the ePBS as a modular platform that is conducive to testing new surveillance and biomedical technologies and tracking emerging epidemiological trends rapidly, rigorously, and at relatively low cost.