As Kenya observes World AIDS Day, recent reports highlight both successes and challenges in the country’s ongoing battle against the HIV/AIDS epidemic. With a recorded decline in new infections and increased access to antiretroviral drugs, Kenya has made significant strides in recent years. However, emerging issues, such as HIV transmissions through injection drug use, threaten progress.
Success in HIV Prevention
Kenya has been a pioneer in implementing comprehensive strategies to combat HIV/AIDS. In 2016, the country became one of the first in Africa to provide antiretroviral pre-exposure prophylaxis (PrEP) for key populations, including female sex workers. This initiative has proven effective, with an estimated 400,000 Kenyans now using PrEP, contributing to a remarkable 44% drop in new HIV infections between 2016 and 2022.
Caroline, a sex worker in Nairobi, emphasized the positive impact of PrEP on her life, stating, “I decided to take PrEP because I don’t know their status.” The government’s commitment to making these preventive measures accessible appears to be yielding tangible results.
Rising Challenge: Injection Drug Use
Despite the progress, recent data from the National Syndemic Disease Control Council (NSDCC) reveals a concerning trend. Approximately 26,000 Kenyans engage in injectable drug use, ranking the country sixth globally in AIDS-related deaths. Dr. Ruth Masha, CEO of NSDCC, highlighted the challenges posed by the criminalization of drug use, leading to a lack of health services for this population.
Dr. Masha emphasized harm reduction as a key intervention for reducing HIV transmission associated with injection drug use. She stated, “One of the challenges we are experiencing is HIV being transmitted in drug use practices by people who inject drugs. This practice is criminalized, and for them to come out, they need to get to a space where there is a legal framework to be able to access treatment.”
Regional Disparities and Lack of Programs
The NSDCC data further highlighted regional disparities in drug use, with Kwale county leading in the number of people injecting drugs, followed by Nairobi, Kilifi, Nakuru, and Kisii. However, despite the prevalence of drug use, the majority of counties lack programs to address this issue. Dr. Masha expressed concern, stating, “Twenty counties have no programs for people who inject drugs, and 18 counties reached less than 50 percent of people who inject drugs in their respective counties in 2022.”
Women at the Forefront of New Infections
Disturbingly, the NSDCC data indicates that women account for the majority of new HIV/AIDS infections in Kenya. Out of 22,154 new infections recorded in 2022, 12,558 were women. This highlights the need for targeted interventions to address the specific vulnerabilities faced by women in the country.
The overall decrease in new infections, from 34,540 in 2021 to 22,154 in 2022, is a positive sign. Nairobi leads in the number of new infections, followed by Kisumu, Homa Bay, Nakuru, Siaya, and Migori. Wajir reported the least number of new infections.
Government Commitment and Universal Health Coverage
Health Cabinet Secretary Susan Nakhumicha shared a positive outlook, revealing that out of the 1.4 million Kenyans living with HIV, 96 percent are on treatment. She emphasized the role of the new Social Health Authority (SHA) in the government’s comprehensive plan to combat HIV/AIDS. Nakhumicha stated, “In the Social Health Authority, we have no limitations or exclusions. If a child is born with a congenital disease, the child will be covered under the SHC.”
Condom Shortage Threatens Progress
While Kenya aims to eliminate HIV/AIDS by 2030, the AIDS Healthcare Foundation (AHF) Kenya warns of potential setbacks due to a shortage of free condoms. Dr. Samuel Kinyanjui, AHF Kenya Country Program Director, noted that some donors have scaled down or withdrawn funding for free condoms, contributing to a rise in new HIV infections.
Kinyanjui highlighted the economic burden of taxing condoms and urged the government to view HIV prevention as an investment. He said, “For any one person who gets infected with HIV, the government will need to spend between 25,000-30,000 shillings a year, for the lifetime of that individual.”
Conclusion: A Call for Collective Action
As Kenya commemorates World AIDS Day, the nation reflects on both achievements and challenges in the fight against HIV/AIDS. While successes in PrEP implementation and increased treatment rates are commendable, emerging issues like injection drug use and condom shortages demand urgent attention. The government’s commitment to Universal Health Coverage and the Social Health Authority signals progress, but collective action from communities, authorities, and international partners remains crucial to achieving the ambitious goal of ending AIDS in Kenya by 2030.