Our understanding of disease and health has been transformed in the 31 years that HIV has been with us in Kenya. Many of us who were alive when the media first brought the story of HIV into our homes still think of Aids as a terrible disease, but younger adults increasingly view it as a medical condition for which you take a pill.
While some of us have never known a world without HIV, scientists and Aids activists now say an HIV free world is within reach. A look at Kenya’s HIV and Aids data reveals on one hand that this possibility is not farfetched but on the other hand evidence shows that the goal will only be reached with a more concerted response to HIV, including increased awareness and scale up of prevention and treatment services.
According to the National Aids Control Council’s Kenya HIV Estimates 2014, the national HIV prevalence for those aged 15 and over now stands at six per cent, a decline from a peak of 11 per cent in the mid-1990s. It sounds like great news until you drill deeper into the data which reveals a continued decline of HIV prevalence among the adult population from the late 1990s to 2008. But HIV prevalence has since stabilized, meaning the downward trend has not continued. With the current national HIV prevalence still too high, the slowdown in the rate of improvement in the last four years should be of concern to all.
The data also shows that the country’s HIV epidemic is not as generalised as previously thought. Hyper-epidemics persist in parts of the country and among certain groups. For instance, the county of Homa Bay had an HIV prevalence of about 26 per cent in 2013, the highest in the country, according to the 2014 estimates. It was followed by the county of Siaya with 23.7 In other words, in the two worst hit counties, one in four residents is living with HIV. By contrast, the county of Wajir has an HIV prevalence of 0.2, the lowest in the country, followed by Tana River with 1.00 per cent. Overall, 10 counties have a prevalence above the national average with four of them having hyper-epidemics – prevalence of above 15 per cent. The HIV incidence figures further show that we are not wining against HIV, that is there are still too many new infections. According to the 2014 estimates, one in four of new HIV infections among children occurred in five of the 47 counties: Homa Bay, Kisumu, Siaya, Migori and Kisii.
Data from the Kenya Aids Indicator Survey 2012, reveals that HIV prevalence among sex workers and other groups at higher risk of HIV are several times higher than prevalence in the general population. The wide variations in HIV prevalence among different regions and different groups direct to sustained prevention campaigns in areas where prevalence continues to decline or remains low and stepping up of efforts in high prevalence areas and among groups at higher risk of HIV.
To achieve the national and international HIV and Aids targets Kenya will need to redouble its efforts to address contributing factors including poverty, domestic violence, gender inequality and stigma.
“Progress, but there are still some major gaps,” said Dr Nduku Kilonzo, Director of the National Aids Control Council (NACC) during the launch of 30 years of HIV, a digital and photographic exhibition held at the National Museums of Kenya in November and December 2014. “We want to look forward to zero new infections and zero deaths from HIV related illnesses, but it can only happen if there is zero stigma and discrimination.”
In absolute numbers, today, about 1.6 million Kenyans are living with HIV, including 1.4 million adults and 191,840 children (0-14 years). These numbers can be daunting if we forget how far Kenya has come since the peak of the mid-1990s.
One of the great successes in the response towards HIV has been the prevention of mother-to-child transmission of HIV program which has expanded rapidly in the past few years. In 2013, about 55,000 women living with HIV received ARV prophylaxis to prevent transmission to their new born children. This represents about 70 per cent of need. As a result of the scale up of the program since 2004, about 73,000 child HIV infections have been averted, according to the 2014 estimates report. Further, annual Aids related deaths have reduced since 2003 despite the fact that more people are living with HIV thanks to increased access to treatment services. According to the report, more than 58,000 people died of Aids related causes in 2013 compared to about 167,000 in 2003. NACC estimates that the scale up of anti-retroviral therapy (ART) since 2009 has saved over 380,000 lives in the country. That is, without ART, 380 000 people or more would have died of Aids related illnesses.
Dorothy Otieno is a data journalism specialist