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Kenya among States making big cuts in new HIV infections

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Kenya is among 18 nations worldwide that have cut HIV infections by between 25-50 per cent over the last seven years, a new UN report showed, signalling the success of safe-sex campaigns and improved use of antiretroviral therapy (ART), which helps to limit the risk of new infections by lowering viral loads.

Kenya’s performance tracks a trend in Eastern and Southern Africa regions where new HIV infections have dropped by a margin of about 30 per cent over the period, the largest reduction globally.

Contrastingly, HIV infections have increased in 50 countries worldwide, mostly in Eastern Europe and Central Asia with the UN warning that most countries are likely to miss a global target of lowering transmission of the disease by 2020.

The UN report notes that Kenya has made some remarkable progress in providing prevention services for adolescent girls, young women and their male partners in high prevalence counties. Stakeholders have also rolled out pre-exposure prophylaxis initiatives.

Pre-exposure prophylaxis, or PrEP, is, according to the Centre for Disease Control and Prevention, a way for people who do not have HIV but who are at substantial risk of getting it to prevent HIV infection by taking a pill every day.

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There are 40 per cent more people with access to treatment programmes, which has seen a drop in Aids related deaths while reducing the chances of new infections.

The latest report by UNAids backs the Economic Survey report released earlier this year by the Kenya National Bureau of Statistics (KNBS), which reported a drop in Aids related deaths to 8,758, from 9,471 in 2016, and 12,235 in 2014.

Voluntary medical male circumcision (VMMC) and sexual reproductive health services for men have also helped the country achieve targets in cutting new infections in priority regions such as Nyanza in Western Kenya.

“Data from Gem, an area within Siaya County show a steep drop in HIV incidence as access to ARVs and uptake of VMMC increased. HIV incidence among a cohort of adults (aged 15–64 years) fell from 1.11 per 100 person-years in 2011–2012 to 0.57 during 2012–2016 (1.09 to 0.66 among women and 1.14 to 0.38 among men),” said the UN report.

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Access to PrEP programmes has been lauded to be a major step in the fight against the killer virus. The report marks that Kenya is proceeding with a major roll-out of PrEP to priority populations, including adolescent girls and young women, and it expects to have half a million people on PrEP by 2022

While progress has been made in some areas, there are others that might slow down the country’s pace to eliminating new infections and Aids related illness deaths by 2030.

The report showed that only 56 per cent of infected mothers continue with treatment after birth, which puts their children or partners at risk. This is compared to 76 per cent of pregnant women who adhere to ARV regimens.

Young women are still vulnerable to new infections according to results of the study.

According to the study, one in five (19 per cent) of young women aged 15-24 years had been sexually assaulted or abused by an intimate partner in the previous 12 months, and almost one in four (24 per cent) had suffered sexual violence at the hands of a non-intimate partner.

The study recommended that this vulnerable group should be granted access to post-violence care.

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Another vulnerable group is sex-workers who lack access to the vital services.

“According to modelling studies from Canada and Kenya, elimination of violence by clients, police and strangers could avert 17–20 per cent of new HIV infections among female sex workers and their clients within the next decade,” the report said.

The report recommends that decriminalisation of sex work, based on the data they collected from Canada, India and Kenya, could reduce new infection by 33-46 per cent in the next decade.

Even with remarkable progress, more than 90 per cent of deaths worldwide from Aids-related illness within the age group of 10-19 years occurred in sub-Saharan Africa, including South Africa as a result of dropping out of medication.

“Studies in Kenya, Uganda and the United Republic of Tanzania indicate that young people aged 15–19 years are more likely to drop out of HIV care, both before and after starting ARV, compared with those aged 10–14 years or those older than 20 years,” said the report.

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Researchers further noted that patients who drop out of medication do so because of stigma and discrimination, disclosure issues, and travel and wait times at clinics.

Eastern and Southern Africa regions still account for 45 per cent of the world’s HIV infections and 53 per cent of people living with HIV globally.

The UN report warned that globally the pace of progress is not up to level with the targets set, which aim to end the Aids epidemic by 2030.

“Global new HIV infections have declined by just 18 per cent in the past seven years, from 2.2 million in 2010 to 1.8 million in 2017. Although this is nearly half the number of new infections compared to the peak in 1996 (3.4 million), the decline is not quick enough to reach the target of fewer than 500,000 people by 2020,” the UN report read.

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