Alarm raised over rising number of ARV defaulters

People Living with HIV protest in Kisumu

People Living with HIV protest in Kisumu in April last year over the shortage of ARVs. A new study shows that the country has recorded 67, 731 cases of antiretroviral defaulters, with adults aged 25 years and above leading with 47,672 cases.

Photo credit: File I Nation Media Group

What you need to know:

  • More adults living with HIV are defaulting on their drugs than teenagers, a trend that is worrying healthcare providers.
  • The category of 20 to 24 years has registered 6,711 defaulters, while the newborn to four years group has recorded 3,090 cases. 
  • The ages 10 to 14 group recorded the lowest number of defaulters, with 1,674. However, the number is still worrying experts.


More adults living with HIV are defaulting on their drugs than teenagers, a trend that is worrying healthcare providers.

According to data released by the National Syndemic Diseases Control Council, between January and August this year, the country recorded 67, 731 cases of antiretroviral defaulters, with adults aged 25 years and above leading with 47,672 cases.

The category of 20 to 24 years has registered 6,711 defaulters, while the newborn to four years group has recorded 3,090 cases. 

The five to nine years group has 2,468 defaulters, with teenagers between 15 and 19 years recording 2,000 cases.

The ages 10 to 14 group recorded the lowest number of defaulters, with 1,674. However, the number is still worrying experts.

Defaulters are defined as clients on antiretroviral therapy (ART) with a missed appointment of more than 30 days.

The data reported and captured through the electronic medical records covered 81 per cent of the total number of clients on ART. 

As of August 2022, 1,287,331 Kenyans were on ART.

Counties' data

According to the data, Nairobi county is leading in the number of defaulters with 9,668 followed by Kakamega 6,793, Migori 5,410, Kisumu 3,378, Mombasa 2,941, Uasin Gishu 2,676, Busia 2,554, Homa Bay 2,326, Nakuru 2,194, and Vihiga with 2,174.

Among the counties with the least number of defaulters are Kirinyaga with 127, Samburu 163, Nyandarua 199, Baringo 224, Laikipia 285, Elgeyo Marakwet 288, Taita-Taveta 322, Nyeri 368, and Tharaka Nithi and Kwale recording 448 defaulters each.

Dr Jacob Bulimo, the Elizabeth Glaser Paediatric Aids Foundation senior technical lead for HIV care and treatment, said defaulting is dangerous since it can lead to drug resistance. Such patients do not respond at all to treatment.

“This can be costly. When one stops taking treatment, the virus becomes resistant to the drug. As a result, even if one resumes the drugs later, they might not work,” Dr Bulimo said.

He said the drugs slow down the damage that the virus does to the immune system and allow people to live long, productive lives.

“These drugs are tremendously valuable in giving an excellent quality of life and should be taken religiously without any defaulting,” he said.

According to Dr Bulimo, the reasons that contribute to defaulting include economic aspects, with some patients lacking resources to pay for their transport to collect the drugs, lack of food security to ensure a regular nutritious diet, and the burden of some side effects.

“The drugs are for a lifetime; once you start taking them then you should not stop. If the drugs are stopped, or not taken at the right time each day, the HIV virus takes advantage of this and starts to make copies of itself again. Sometimes the copies change a little bit, and the ARV drugs will not be as effective against them,” he said.

Poorer viral suppression among children is at least partly attributable to a lack of child-specific and child-friendly treatment options, which leads to inefficiency, side effects, non-adherence to treatment, and dropping out of care.

Children are, therefore, not given drugs in the right proportion and others vomit after taking the drugs, while others have caregivers who are not well educated about the dosage.

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