Stigma is highest contributor to new HIV infections in ASAL counties

Douglas Bosire speaks to media about worrying trend of HIV infections and deaths. [Mercy Kahenda, Standard]

Stigma is a major contributor to new HIV infections in arid and semi-arid counties, with at least 51 people dying in Kenya every day because of AIDS-related complications, according to a new report.

Among counties recording high infections of the viral disease include Samburu, Turkana and Mandera at 4.3, 2.9, and 0.3 per cent against 3.7 per cent national prevalence, according to a new HIV status report.

In Mandera, the rate of mother-to-child HIV infection stands at 38.8 per cent, against 8.6 per cent nationally.

Counties of Narok, Samburu and Wajir also record high mother-child transmission at 21.1, 25.7 and 29.6 per cent respectively.

The newly-released data by the National Syndemic Disease Control Council (NSDCC) reveals that the counties are reporting more infections in comparison to those which were hard hit by the pandemic in the 1990s, like Western and Nyanza.

Douglas Bosire, officer in charge of County Support Programmes, NSDCC said because of the high stigma in the counties, there is a low rate of testing and uptake of Antiretroviral (ARV) treatment.

“We are seeing low-burden counties with a rise of new infections instead of reducing. This is because of high stigma levels and forms of discrimination,” said Bosire.

Unlike the arid- and semi-arid counties, there is more programming, engagement, awareness and sensitisation in counties that were hard hit by the virus, more so Nyanza and Western region.

Data reveals that Kisumu, Siaya, Migori and Homa Bay were the worst-hit counties, where new infections have gradually reduced.

Ten years ago, at least one in three people in the worst-hit counties were HIV positive, data that currently stands at 15 per cent out of 100 (two out of 100).

Infections in the counties he said were highly attributed to cultural practices, and failure to undertake male circumcision that stops HIV infections by 60 per cent.

“Stigma levels in the Nyanza region are low because it is easy for someone to receive ARVs and test for HIV.

People in Nyanza come out, get tested and enrol for ARV and other treatment, the majority of people know their HIV status,” said Bosire.

He added, “Stigma is high in other counties. It is worrying that where we have stigma, people will not come out to test, and collect drugs”.

Despite having been hardly hit, Siaya has reduced mother-child HIV transmission to 4.3 per cent, being the only county in Kenya that has hit World Health Organisation (WHO) mother-child transmission of below five per cent.

The county has also suppressed HIV viral loads of 95 per cent.

Among interventions in place to increase uptake of ARV and testing in the affected counties is the engagement of key community gatekeepers like opinion leaders, clergies and traditional leaders.

In August this year, the NSDCC signed a commitment with religious leaders to lay their role in ending HIV infections, including addressing stigma at their places of worship.

“Cultural and traditional leaders in every village have been trained about HIV/AIDS, and we are looking unto them to discuss HIV/AIDS whenever they converge because this disease affects everyone,” added Bosire.

Since 1985, AIDS has killed about 2 million Kenyans, according to data.

At least 4 out of 100 people in Kenya have HIV, with 51 dying every day of AIDS-related complications, which translates to two people every hour.

The prevalence of HIV infection has however reduced from 6.4 per cent in 2010, to 4 per cent.

Japheth Kioko, the head of monitoring and evaluation at NSDCC said though the rate of infection has gradually reduced over the years, the country is recording low rates of HIV reduction in children.

According to data, in 2022 Kenya had a total of 22,154 infections in all ages, 17,680 adult infections, whereas 4, 464 children aged between zero and 14 years were infected with HIV.

At least 41 per cent of HIV infections in Kenya occur among adolescents and young people aged between 15 and 24 years.

Kioko said the low reduction of HIV in children highly depends on their mothers.

“We have mothers who are not taking ARVS during pregnancy. This is an important intervention to reducing transmission to less than five per cent,” said Kioko.

He added, “Paediatric Antiviral Treatment (ART) largely depend on mothers. This is mother-baby care. We have plans of targeting paediatrics, especially scaling up facility delivery and outcome of postnatal care”.

Nationally, treatment and suppression gaps widen among Adolescents and Young persons with one out of three not being on treatment, and not suppressed, as per the May 2023 HIV Status report.