Kenya’s fight against epidemic — the hits and misses

Kenya has battled HIV/Aids for nearly 40 years now since the first case was reported in 1984. The epidemic has been a part of the country’s psyche since then, with multiple interventions by the government and other stakeholders to bring the number of infections down. 

The country has registered both hits and misses in the resilient fight to control the virus. 

As the world celebrates the World Aids Day this Thursday, we look at some of the notable wins and where the battle is being lost. 

Hits

1.Kenya smashed UNAids 95-95-95 targets

In 2014, ambitious new targets were set by the Joint United Nations Programme on HIV/AIDS (UNAIDS). The target included HIV treatment and testing known as 95-95-95 to end the Aids epidemic by 2030.

The programme would also seek to prevent nearly 28 million new HIV infections and 21 million Aids-related deaths.  As of 2020, more than 95 per cent of people in Kenya knew their status while more than 89 per cent of all people with HIV were on treatment, according to UNAIDS. Of these patients, 94 per cent had suppressed viral loads, making the country one of three African countries to hit this target.

2. Keeping more girls in school
Kenya’s current Aids strategy promotes interventions that keep girls in school.  According to experts, this significantly reduces their vulnerability to HIV as it helps girls’ to gain control over their sexual and reproductive health and rights.

3.Kenya has made it more cheaper and possible to test for HIV
The availability of modern self-testing kits , which are now available from vending machines in some areas, has allowed individuals to test themselves.

These facilities have been expanded in communities as opposed to just health clinics, boosting access. Testing services have also been integrated into other centers such as vaccination centers and TB clinics, thus revolutionising the country’s testing capacity and rate.

4.Intensified HIV awareness campaigns 
Millions of Kenyans are now informed about HIV/Aids. The population has an understanding on how to protect themselves thanks to multiple awareness campaigns.

There is information freely available on government websites besides media advertisements. This is an improvement from some years back when knowledge in HIV/Aids was scanty. According to experts, however, knowledge of one’s HIV status is lower in men than in women.

5.The rise of antiretroviral therapy (ART), medical circumcision and discordant couples.
Experts observe that between 2004 and 2019, the scale up of ART treatment averted more than 733,600 Aids-related deaths in Kenya.

They also estimate that at least two thirds of couples with HIV in the country are discordant. This means that one of the partners has HIV while the other does not. Apart from leading the way in approving medical male circumcision in Sub-Saharan Africa, Kenya was among the first country to approve the use of oral PrEP.

Misses

1. ARV defaulters
According to the National Syndemic Diseases Control Council, between January and August this year, 63,711 Kenyans had defaulted on antiretroviral therapy. Nairobi is home to the highest number of defaulters at 9,688 followed by Migori County at 5,410 cases. Meanwhile, the government is working to find ways to encourage defaulters to keep taking their medication.

2. Lack of proper HIV funding mechanism
According to the government in its latest HIV policy document, Kenya transitioned to a lower middle-income country. This consequently raised the expectation on counterpart financing and narrowing interest rates.

HIV accounts for 29 per cent of mortality in the country. While the global resource envelope for HIV response shrinks, experts argue that an increase in domestic resources will be imperative to bridge the funding gap to sustain more than 1.5 million Kenyans on lifelong treatment.

3. Ever rising HIV infections in young people
In Kenya, adolescents and young people make up to 42 per cent of the new adult HIV infections each year. Adolescent girls and young women making up 30 per cent of all new infections. Doctors fear that young people are engaging in premarital sex, worse without protection.

This is despite sustained campaigns to promote abstinence in schools and the media. 

4.Never ending HIV stigma
Forty years on, discrimination against persons living with HIV is still common in Kenya. In school, academic materials still juxtapose images of coffins with information about HIV.

Young people who spoke to Healthy Nation say this negative portrayal inspires hopelessness as opposed to efforts to defeat the virus.  Indeed, findings of the People Living with HIV Stigma Index 2021 show that 62 percent of people delayed taking a HIV test because they were worried about the reactions of those around them.

An additional 47 percent of people with HIV stopped or interrupted treatment because they were scared and did not want people to find out they were positive.

5. Discrimination of sex workers
According to experts, Kenya’s legal environment fuels stigma and discrimination against some groups, especially those involved in commercial sex.

Although sex work is not technically criminalised, a number of laws applied for sex workers portray them as ‘‘dirty and sinful’’. This discrimination against sex workers complicates the fight against the virus by locking out this critical group.

“ There are some laws that relate to sex work which are archaic and use very vague language such as the Penal Code provisions, which are open to wide interpretation and abuse, and their implementation negatively and disproportionately affects sex workers,” Kenya Sex Workers Alliance explains in their official report while pointing out Sections 153 and 154 of the Kenyan Penal Code—part of its provisions on “offences against morality”—make living on the earnings of sex work a felony.

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