Kenya: Comprehensive AIDS Indicator Survey in Kenya Reveals Urgent Need to Scale up HIV Counseling and Testing (November 2009)

On September 24, 2009, the Government of Kenya launched the 2007 Kenya AIDS Indicator Survey (KAIS) report. Speaking during the official KAIS report launch, Dr. Kevin De Cock, Director of the U.S. Centers for Disease Control and Prevention (CDC) in Kenya, recognized the 2007 KAIS for being the first in a new era of HIV surveillance.

The survey, supported by the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) through CDC and the U.S. Agency for International Development (USAID), is the most comprehensive national surveillance effort implemented by the Kenyan Government to date. Nearly 18,000 adults aged 15-64 completed an individual interview, and 88 percent of them consented to giving a blood sample. The consent process included education and risk reduction counseling on HIV, genital herpes and syphilis, the infections tested for in KAIS.

Speaking on behalf of the Director of the Kenya National AIDS Control Council (NACC), Regina Ombam stated that HIV remains a serious challenge in Kenya and emphasized the need for universal access to HIV testing. According to the KAIS, among the estimated 1.4 million Kenyan adults aged 15-64 years living with HIV/AIDS in 2007, only one in six knew their status. Ombam noted that this number is largely due to the fact that most of these adults have never been tested for HIV and recommended that, in addition to traditional voluntary testing counseling and testing, HIV testing be normalized and made more accessible through approaches such as provider- initiated counseling and testing at all health facilities and home-based counseling and testing.

Speakers at the launch also recommended universal access to HIV prevention within Kenya, and particularly highlighted access to male circumcision. The KAIS found 3.9 percent of circumcised males were infected with HIV compared to 13.2 percent of uncircumcised males.

But emphasizing that male circumcision cannot prevent HIV alone, the report also called for knowing one's HIV status and that of their partners, contraceptive services for women who do not desire children, and primary prevention of sexually transmitted infections known to increase the risk of HIV. The importance of prevention among couples could not be overstated: 344,000 couples surveyed were HIV-discordant, meaning one partner is HIV-positive and the other is HIV-negative.

Comparing 2007 KAIS estimates to results from the 2003 Kenya Demographic and Health Survey, the overall prevalence of HIV among 15-49 year olds did not significantly change - 6. 7 percent in 2003 to 7.4 percent in 2007. A closer look at subpopulations, however, revealed important patterns. While urban HIV prevalence had stabilized or even declined, the burden of HIV in rural areas had increased. Since 2003, adults with no formal education and the poor faced increases in HIV prevalence compared to those with wealth or formal education, whose prevalence remained the same or had declined.

Dr. Ibrahim Mohamed, Head of the Kenya National AIDS/STI Control Programme, commented on the report emphasizing the need for comprehensive surveillance data to monitor the HIV epidemic and inform HIV policy and resource allocation.

An important activity for the people of Kenya, policymakers, and international stakeholders, the KAIS will play a crucial role in building an evidence base to guide the design and evaluation of the Kenya National HIV/AIDS Strategic Plan.

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