The alarming rise in advanced HIV cases in Kenya, particularly among men, has raised concerns within the country’s health sector. Recent data from the National Aids and STI Control Programme (Nascop) indicates that 40% of individuals with newly acquired HIV infections are presenting with advanced stages of the disease, formerly known as AIDS. This worrying trend highlights the need for immediate interventions to combat the disease’s progression and reduce the number of related deaths.
One of the primary causes of advanced HIV disease is late diagnosis, often when a person’s immune system is already severely compromised. This late detection is often due to a failure to seek treatment early or interruptions in the treatment process. These delays in accessing care lead to the development of serious opportunistic infections, such as meningitis, tuberculosis (TB), malnutrition, and various cancers, all of which contribute to the death toll. According to Dr. Lazarous Momanyi, a technical advisor at Nascop, many of these individuals present at clinical stages 3 and 4, when their immune systems are already severely weakened by these infections.
In 2022 alone, HIV/AIDS-related complications claimed the lives of 18,473 people in Kenya, including children who were particularly vulnerable. These deaths were primarily caused by infections like TB, diarrhea, and malnutrition. Dr. Momanyi emphasizes that many of these fatalities could have been avoided with early intervention. He posed a critical question: “Why are we seeing such high mortality rates in an era where treatment and testing are widely available?”
Children are especially at risk of developing advanced HIV disease if they are not put on treatment at birth. The failure of some mothers to suppress their viral load before and during pregnancy, combined with home deliveries and a lack of early HIV testing, has resulted in many children acquiring the virus and deteriorating rapidly. Dr. Momanyi explains that without timely treatment, half of the children born with HIV die before their first birthday, and 70% do not survive beyond their second birthday. This grim reality underscores the urgent need for improved maternal and child healthcare services.
Despite the availability of free HIV testing and treatment in Kenya, the National Empowerment Network of People Living with HIV/AIDS in Kenya (Nephak) has noted a troubling trend of people delaying testing and treatment, particularly men. Nephak chairperson, Nelson Otwoma, expressed concern that people are not taking advantage of the free services available, often waiting until it is too late to seek care. He highlighted the need for increased awareness and urged individuals to regularly test for HIV and adhere to treatment protocols to avoid the progression of the disease.
Interrupted treatment is also a significant issue, with 113,000 people in Kenya discontinuing their HIV medication in 2023. This lapse in treatment not only compromises their health but also increases the risk of transmitting the virus to others. To address this challenge, the Ministry of Health has emphasized the importance of preventing mother-to-child transmission and is working toward reducing the transmission rate to below 5%, as recommended by the World Health Organization (WHO). Currently, only Siaya County has met this target, while regions in northeastern Kenya lag behind with rates as high as 20%.
The stigma surrounding HIV also plays a critical role in the spread of the disease. Many individuals, especially men, are reluctant to disclose their HIV status to their partners, leading to further infections. Dr. Momanyi also noted that some people, influenced by strong religious convictions, withdraw from their HIV medication in favor of prayers for healing. Unfortunately, these individuals often return to hospitals in a deteriorated state, with their health irreversibly compromised.
Nascop, in collaboration with the Ministry of Health and other partners, is working to build literacy among healthcare providers and caregivers to better understand advanced HIV. They are also revamping diagnostic centers and mapping out specialized treatment facilities. Additionally, initiatives such as pre-exposure prophylaxis (PrEP) for high-risk individuals and the “Operation Triple Zero” (OTZ) program aim to promote treatment adherence and reduce HIV transmission. The OTZ program focuses on the U=U (undetectable equals untransmittable) strategy, which ensures that individuals with suppressed viral loads cannot transmit the virus to their partners.
As Kenya strives to eliminate mother-to-child transmission by 2027 and reduce advanced HIV cases, there is hope that a combination of innovative approaches, increased community engagement, and international support will help the country achieve its goals.
