Siaya, Homa Bay top counties with highest HIV/Aids prevalence

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Siaya County is leading with the highest number of adults infected with HIV in the country, narrowly overtaking Homa Bay, a new report shows.

The document prepared by two government agencies leading the fight against the scourge notes that Siaya recorded a prevalence of 21 per cent followed by Homa Bay at 20.7. Kisumu County was third at 16.3 per cent while Migori and Busia came fourth and fifth with 13. 3 per cent and 7.7 per cent respectively.

Other counties above the national prevalence rate of 4.9 per cent include Nairobi at 6.1 per cent and Vihiga at 4.5 per cent.

The national adult HIV incidence rate was estimated at 4.9 per cent with the prevalence higher among women (5.2 per cent) than men (4.5 per cent).

In Homa Bay, the prevalence was also higher in women at 22.1 per cent than men at 19 per cent while Siaya recorded 22.4 per cent incidence in women and 19.4 per cent in men.

The data from the report released on Friday by the National Aids Control Council (Nacc) in Embu County revealed that the prevalence in Homa Bay has reduced from 29 per cent in 2016 to 20.9 per cent in 2017.

This, the experts said, could be attributed to concerted efforts from the national government, the county and other stakeholders in finding solutions to curb the spread of HIV/Aids in the region.

With the worrying figures, Homa Bay government introduced a Multisectoral Aids Strategic Plan (2014/2015-2018/2019) which addressed the main drivers of HIV/Aids including cultural and sexual attitude and behaviour and the fishing industry networks in the eight sub-counties.

“The people in the county have been very responsive and we have created awareness and distributed condoms to residents, especially those in the fishing industry in all the beaches in the county. We have also created awareness and door-to-door advocacy on the need for protection,” said Prof Richard Muga, county health minister.

He said the concentration of partners in the county has also led to the significant milestone.

According to the 2018 Kenya Aids Response Progress Report, other counties that recorded lower adult HIV prevalence included Wajir at 0.1 per cent, Mandera (0.2 per cent), Garissa (0.8 per cent), Baringo (1.3 per cent) and Marsabit (1.4 per cent).

However, the council said there was a decline in HIV prevalence among both men and women at both national and county levels.

“Trends in HIV Incidence and New HIV Infections Kenya has continued to see a sharp decline in HIV incidence among adults aged 15-49 from 0.35 per cent in 2010 to 0.19 per cent in 2017 possibly due to the scale up of various prevention and treatment programmes,” says the report.

From the report, the annual new HIV infections in 2017 were 52,800 across all ages; 44,800 among adults aged 15 and above and 8,000 among children aged 14 and below.

It also revealed that the new HIV infections among all ages reduced from 77,200 in 2010 to 52,800 in 2017 — a 32 per cent decline — at the national level, in spite of population growth.

In adults aged 15 and above, the new infections declined from 63,700 in 2010 to 44,800 in 2017, a 30 per cent reduction. Among children, new infections declined from 13,500 in 2010 to 8,000 in 2017, a 41 per cent drop over the period.

Among young people aged 15-24, new infections declined from 28,800 in 2010 to 17,700 in 2017, a 39 per cent decrease over the period.

Nacc says the improvement is a result of better campaigns following the increase in total expenditure to Sh121 billion in 2016/2017 from Sh73 billion in 2015/2016.

According to the Kenya HIV Estimates Report 2018, Nairobi had the highest number of new infections among young people between 15 and 24 years at 2,587 followed by Homa Bay (1,852), Siaya (1,641), Kisumu (1,630) and Migori (1,143).

Generally, in all groups, Nairobi led in the number of new infections contributing 7,159; Homa Bay (4,558); Kisumu (4,012); Siaya (4,039); and Migori (2,814).

Together, these counties contributed about 43 per cent of the estimated total new infections and 38 per cent of the new infections among children in 2017.

The counties also recorded the highest number of patients on anti-retroviral (ART) drugs.

Nairobi leads with 140, 000, followed by Kisumu (101,527), Homa Bay (100,667), Siaya (80, 000) and Migori (65,820).

There are 184,719 HIV-positive youth (15-24 years) and this age group accounts for 17,667 of the total new infections, and 2,830 HIV-related deaths.

Fewer deaths indicate that more youth are being tested, treated and retained on antiretroviral therapy.

Initiation and retention on ART is vital to achieving viral suppression (reduced viral load that is undetectable and can therefore not be transmitted) among HIV-infected patients.

Currently, nearly one million Kenyans (76 per cent coverage) are on ART, including 53,067 mothers to prevent mother-to-child transmission (PMTCT).

The number of HIV-related deaths are nearly half the number of new infections at 28,214.

According to Dr Dismas Oketch of the Kenya Medical Research Institute, this can be attributed to patients who seek treatment late and lack of adherence to treatment.

“The number of defaulters is becoming a concern. That’s why new infections are decreasing, but HIV-related deaths continue to rise,” said Dr Oketch, adding that this could also be explained by treatment failure or infection with drug-resistant strains.

Moreover, HIV-related deaths are not always accurately estimated because a HIV-positive person can die of other infections, but be deemed to have died of HIV-related causes.

Newer strategies like pre-exposure prophylaxis (PrEP) initiatives have also helped the fight against the virus.

More than 53,291 Kenyans are receiving PrEP, and Kenya expects to have half a million people on PrEP by 2022.

Other HIV control measures such as condom distribution, voluntary male circumcision of 233,879 men, HIV education and awareness, safe sex messages and distribution of 189,000 needles and syringes to drug users have also helped.

“Despite progress by Kenya in advancing towards national targets as reflected in the 2018 HIV estimates report, much remains to be done to halt and reverse HIV.

“In absolute terms, a large proportion of Kenya’s population is infected with or affected by HIV,” said Dr Nduku Kilonzo, Nacc chief executive officer.

She said the spread of the epidemic must be halted, with zero new infections the principal target for epidemic control.

The vision of eliminating the impact of the AIDS epidemic can be realised through scale-up of evidence-based interventions such as PrEP and voluntary medical male circumcision, which can help programme planners better target interventions where they are most needed.

“Data presented through Kenya HIV Estimates Report 2018 should act as a primary step to catalyse continued action,” she said.