Is this the beginning of the end of HIV in Kenya?

By Gatonye Gathura

A third study in as many months by US agencies shows HIV to be on a significant retreat in Kenya.

The first study presented in March showed a drop in prevalence rates, the second reported a decline in new infections and the latest a decrease in HIV related deaths.

The fact that all have been reported by US agencies is significant because Americans are the main donors to HIV programmes in Kenya and major policy influencers.

The latest report by the US Army published on 20th April in JAIDS shows HIV deaths to have declined markedly in 2011-2015 within western Kenya.

Western Kenya is the epicenter of the HIV epidemic in Kenya.

The study was carried out in Kombewa in Kisumu County, Western Kenya where the CDC maintains a HIV study group comprising 141,956 individuals from 34,718 households.

The area serves as the study catchment area for both the US Army researchers and the US President’s Emergency Plan for Aids Relief (PEPFAR).

Though the report says deaths from HIV in the area are still high they however declined significantly in a four year period.

The deaths declined in all age groups apart from the over 65.

The report prepared by the US Army Medical Research Directorate-Kenya and the Walter Reed Army Institute of Research, US is the third such by American agencies showing declining; infections, prevalence and now HIV deaths.

In March a study by the US Centers for Disease Control and Prevention-Kenya (CDC-K) suggested HIV prevalence estimates in western Kenya and even nationally may be highly exaggerated.

The study was presented at the annual Conference on Retroviruses and Opportunistic Infections (CROI) in Boston, US by CDC-K director Kevin De Cock.

De Cock had presented data collected from Western Kenya which showed HIV prevalence rates to be much lower than cited in official estimates.

The study, also involving the National Aids Control Council showed official HIV estimates in some pockets of western Kenya to be 80 per cent over what they found on the ground.

Official estimates shows Nyanza to have the highest HIV prevalence rates in Kenya at 16.1 per cent compared to the  national average of about six per cent. The new study put HIV prevalence in Nyanza at 12.6 per cent.

Another study published in April by the CDC-Kenya and the Kenya Medical Research Institute showed new HIV infections to have dropped by more than a half in Siaya, western Kenya.

The study published in The Lancet HIV attributed the drop to accelerated use of antiretroviral drugs, male circumcision, the natural progression of the disease and previous overestimates.

In the new study the authors cautiously attribute the drop in HIV deaths to increased use of antiretroviral drugs and measures to reduce mother-to child infections.

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.

Reliable HIV statistics in Kenya are hard to come by, for example  NGOs driven data  estimates about 36,000 Aids related deaths in 2016 compared to the 8,758 reported in the Economic Survey 2018, published recently by the Kenya National Bureau of Statistics.

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