Huge drop in HIV infections reported in Siaya, western Kenya

By Gatonye Gathura

New HIV infections have dropped by more than a half in Siaya, western Kenya, the epicenter of the epidemic in the country.

A large study published on Monday by the US Centers for Disease Control and Prevention-Kenya (CDC-K) and the Kenya Medical Research Institute (Kemri) also shows HIV prevalence to have dropped by a third in some age groups.

The drop is attributed to accelerated use of antiretroviral drugs, male circumcision, the natural progression of the disease and previous overestimates.

“We are very excited about this development though still a lot of work remains to be done,” says Dr Kevin de Cock, head of CDC-Kenya and senior author of the study.

The highest drop in new infections was recorded among people; both males and females aged 15-34. In this age group the study shows HIV prevalence to have declined by a third since 2011.

“HIV prevalence in study participants aged 15–34 years and new infections in all adults has declined strongly in the region,” says the new study.

The study which was published in The Lancet HIV attributes the drop to three factors:  a dramatic increase of ARVs coverage since 2011, high rates of male circumcision and the natural progression of the disease.

In Siaya County, the report says the number of individuals on ART increased from 2096 in 2006, to 70 261 in 2016.

The Kenya Demographic Health Surveys shows male circumcision in western Kenya to have increased from 45 per cent in 2008 to 72 per cent in 2014

“In the period in which ARVs and male circumcision coverage increased we observed a decline in new HIV infections —by half—in those aged 15–64 years,” says the study.

The study, like in an earlier one presented by Dr De Cock at an international conference on retroviruses in Boston, US, last month raised the issue of accuracy of the high HIV prevalence rates in western Kenya.

Official data put HIV prevalence in Siaya at 25 per cent but recent on the ground studies by CDC, Kemri and the Ministry of Health suggested this could be highly exaggerated.

“These discrepancies suggest the need to review the HIV estimates at county level because they might be too high,” says the new study.

The country will be undertaking the Kenya Population-based HIV Impact Assessment – KENPHIA, later this year which experts say could record a dramatic drop in prevalence rates.

This, CDC has suggested is mainly attributable to more effective data collection and estimation methodologies.

Announcing the proposed survey last year former Cabinet Secretary for Health Dr Cleopa Mailu had expressed optimism that results will reflect a declining epidemic.

“The new data suggest that we are on the right track and that as we increase knowledge of HIV status, use of ARVs and uptake of male circumcision, we do see a meaningful reduction in new HIV infections,” says Dr De Cock.

The study also involving the University of Amsterdam, The Netherlands had engaged about 30,000 people aged 15 – 64 in Gem, Siaya County from 2011-2016.

Dr De Cock, said the US government through the President’s Emergency Plan for Aids Relief (PEPFAR) will continue supporting the scale-up of ARVs and male circumcision to further reduce HIV infections in Kenya.

 

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