The National AIDS Control Council recently released Kenya County profile book in which it reports on the HIV situation in all counties in Kenya. Several issues addressed in the report include gender based prevalence rates, new infections county and point of entry into the database used to dispense ART (Antiretroviral therapy). This post seeks to surmarise the details already addressed in the report and those not given enough focus.
County prevalence rates
Kenya has an average hiv prevalence rate of 6% and with about 1.6 million people living with HIV infection, it is one of the six HIV ‘high burden’ countries in Africa. The western part of the country through Homabay, Siaya and Kisumu are the most affected with HIV with rates of 25.7%, 23.7% and 19.3% respectively. The counties with the least infection rates are Wajir, Tana River and Marsabit with rates of 0.2%, 1% and 1.2%.
Gender based prevalence rates
Women in Kenya, with a hiv prevalence rate of 7.6% are more vulnerable to HIV infection compared to men, with a hiv prevalence rate of 5.6%.
It is telling that in most counties, the prevalence rate in women is higher than that of their male counterparts. As this number is based on the available statistics, it can be argued that men are afraid to seek help, collect ART as well as make visits to VCT.
ART coverage per county
The UNAIDS Gap report shows that as people find out their HIV-positive status they will seek life-saving treatment. In sub-Saharan Africa, almost 90% of people who tested positive for HIV went on to access antiretroviral therapy (ART). Research shows that in sub-Saharan Africa, 76% of people on ART have achieved viral suppression, whereby they are unlikely to transmit the virus to their sexual partners. The report also points to a 1% decrease in new hiv infections for every 10% coverage of of ART. The National Aids Control Council, in their report have ensured the supply of ART is able to cover beyond the number of people who are needing the drugs.
Adult ART Reception
Against the hiv prevalence per county, ART is being received by less adult individuals than expected in the top 5 counties (Homabay, Siaya, Kisumu, Migori, Kisii and Turkana) with high prevalence rates.
Notably, it is only in Uasin Gishu, Kisumu and Busia where more adults receive ART than expected. Aditionally, In Homabay, with the leading HIV prevalence rates, less people receive ART than expected. More needs to be done to ensure that ART is supplied and dispensed to counties (Nairobi, Ho with higher disparity in terms of expected and actual recipients.
Child ART reception
The report describes children as persons of age below 14 years.
Unlike in adults case, all counties have less child recipients of ART than expected.
sources of new infections
According to UNAID’s Gap Report, HIV prevalence is estimated to be 28 times higher among people who inject drugs, 12 times higher among sex workers, 19 times higher among gay men and other men who have sex with men and up to 49 times higher among transgender women than among the rest of the adult population. In sub-Saharan Africa, adolescent girls and young women account for one in four new HIV infections. The report looks at why certain populations are not accessing HIV services and outlines the urgent need to address their specific needs.
The data point to hetorosexual sex within union (44.1%) as the largest contributor of new infections. Casual heterosexual Sex (20.3%), MSM and Prison (15.2%) and Sex Workers and Clients (14.1%) help make the argument that the largest cause of new infections is primarily sexual contacts. It is however heartbreaking that a number of new infections is still within health centres. The health department through it’s practitioners should therefore triple their efforts to do away with such infections.
Distributution of new infections
As expected, more adults than children contribute to the number of hiv infections. Nonetheless, one is left to question the causes of the infections to children.
Point of Entry into the HIV program
#### Mother to child transmission
HIV is most often transmitted from a mother to her child during pregnancy, delivery, and breastfeeding. Breastfeeding is crucial for children’s survival, growth, and development. Providing antiretroviral medicines to mothers throughout the breastfeeding period is critical to significantly reducing mother-to-child transmission rates. Kenya has committed to eliminating new HIV infections among children by 2015, while keeping their mothers alive.
Assuming that all new infections arise from Mother to child transmission, the data shows that all counties are doing a stellar job in reducing the number of new child infections.
However more needs to be done to ensure that pregnant mothers not only attend the 4 recomended prenatal visits and deliver in hospitals.
HIV related mortality
The high burden of HIV and AIDS in Kenya accounts for an estimated 29 per cent of annual adult deaths, 20 per cent of maternal mortality, and 15 per cent of deaths of children under the age of five.