HIV in Kenya.
Kenya is experiencing a mixed and geographically heterogeneous HIV epidemic whose characteristics are those of both a ‘generalized’ epidemic among the mainstream population, and a ‘concentrated’ epidemic among specific key populations. The pattern emerging is of highly variable epidemiological dynamics, geographically with respect to modes of transmission, and with substantial age and sex differentials. The national HIV prevalence among the general population aged 15-64 years is estimated at 7.1%, and a total of 1.4 million adults are living with HIV. There are large differences across provinces in the estimated number of HIV infected adults (Figure 2).
Figure 2: Kenya AIDS indicator survey
There has been massive scale-up of treatment and care in the last few years. Slightly more than half (52%) of those in need of treatment, however, are being reached at present, with coverage for children much less at about 15%; and only 30,000 of those on ART receive nutritional support. Up to 300,000 Kenyans still at the risk of dying because they lack access to treatment. Worse, 70% of PLHIV live in rural areas but services are concentrated in urban/peri-urban areas. These are concerns for NEPHAK.
Tuberculosis (TB) remains the leading cause of sickness and death among PLHIV in Kenya.Despite 80% of TB patients being offered HIV testing and 80% of TB facilities providing HIV testing to patients, only 27% of TB patients who are HIV+ are on ART. The challenge seems to be in diagnosis and treatment of TB. The country is lacking tools that can provide accurate and timely diagnosis of TB among PLHIV. TB treatment drugs are available free in public health facilities but the management of multi-drug resistant (MDR-TB) TB is a challenge.
The socio-economic and cultural impacts of HIV have deepened and PLHIV and their families are more vulnerable. A national cash transfer programme has been scaled up to cover 37 districts, benefiting some 16,000 households in 2007/08, significantly up from 7,500 households in 2006/07. An OVC Policy has been developed and the National Plan of Action revised. With the unveiling of the new constitution providing for the social protection of the vulnerable, there seem to be a strong basis for expanded HIV and AIDS programming.
The HIV epidemic affects all sectors of the economy and is equally a developmental as it is an epidemiological challenge, encompassing identification and development of a series of appropriate sectoral responses and their application at the local level. Kenya has seen great success in its HIV response. AIDS related deaths have fallen by one third since 2002 and HIV prevalence has consistently declined over the past few years.
