Lower infection rate creates new challenges

New statistics showing a decline in Kenya's HIV prevalence demonstrate that the government's fight against the pandemic is having an impact, but they also present fresh challenges, health officials said this week.

Prof Alloys Orago, director of the National AIDS Control Council (NACC), noted that the rollout of the antiretroviral (ARV) treatment programme, with over 105,000 people on therapy, had significantly "averted deaths", making it more difficult to measure the impact of the pandemic.

"Kenya will have to shift from prevalence measurement to incidence [new infections] monitoring mechanisms to determine the impact of HIV/AIDS if the dramatic decline in prevalence witnessed over the past three years is sustained," he told IRIN/PlusNews after opening a two-day HIV/AIDS Programme Review conference in Nairobi on 14 August.

On 13 August, NACC reported that national prevalence had dropped from 5.9 percent in 2006 to 5.1 percent in 2007, with the possibility of reaching less than 5 percent in 2008.

The statistics, compiled by the National AIDS and Sexually Transmitted Infections Control Programme, showed that HIV/AIDS-related deaths, which stood at 116,000 in 2001, had dropped to below 83,000 in 2006.

"The success in scaling down infection rates is creating another challenge: that of the growing population of HIV patients who need care and support," Orago said.

Another worrisome issue was the continued feminisation of Kenya's HIV pandemic: in the 15 to 24 age group there are four infected women to each infected man.

"Men still dominate the instruments of power, while women are still left out of major decision-making," Orago said. "Even decisions about sex are still made by men, in spite of the high level of HIV awareness."

However, the decreased prevalence showed that the government's aggressive Total War against AIDS campaign was changing behaviour. "After the government declared HIV/AIDS a national disaster in 2003, HIV/AIDS ceased to be just a health issue," he said. "All sectors were co-opted into the campaign."

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Encouragingly, the new report points out that HIV prevalence was significantly lower in people aged 15 to 24: in 2003 it fell from 1.2 percent to 0.8 percent among males, while among females it dropped from 5.8 percent to 4.4 percent.

Orago attributed this decline to a behavioural shift by teens delaying their first sexual experience, as well as the increased distribution of male condoms.

Another effective strategy in the government's anti-AIDS campaign was "the use of infected patients ... to bring about behavioural change", he said, and the "visual evidence" of 'live witnesses', or infected people, to drive home anti-HIV messages had "contributed to the drop in the number of sexual partners".

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