Kenya: HIV and New Medical Frontiers

By Arianna Azzolini

The lack of knowledge among the grassroots people causes the marginalization of many HIV infected Kenyans and their relatives by their community, forcing some to see their condition as a death sentence.

It was for this reason that a public forum was held in Nairobi on July 28 to discuss the effects of such discrimination and stigmatization, organized by the Kenya Alliance of Residents Association (KARA).

Dr. Teresa Mwendwa is a lecturer at the University Of Nairobi School Of Medicine and is working with HIV infected people and their families in the Korogocho slum. Speaking at the forum, she focused on the fact that in the past years and in the present days as well, human rights of the HIV infected and affected have often been violated.

Kenya’s HIV and AIDS Prevention and Control Act was passed in Parliament in 2006, but it has not been fully enforced yet. The Act provides legislation on the rights of people living with HIV and aims to mitigate the effects of the epidemic on the population.

In Sub-Saharan Africa, 98% of the HIV population gets infected through sexual relationships, and usually men tend to infect women. Three out of five infected people are women. Three medical researches conducted in 2007 also showed that male circumcision reduces female-to-male transmission by 50–60 per cent. This was in fact encouraged by the Kenyan government and nowadays it is becoming a common practice even among tribes that did not circumcise traditionally, such as the Luo.

The main modes of transmission are mainly from the male sperm, which contains the highest concentration of the HIV virus, to virginal fluids, breast milk, blood transfusion and finally from intravenous injection of drugs using shared needles.

It can take up to fifteen years before an infected person shows symptoms, so there are actually many people unknowingly living a normal life with HIV. According to the last report from the National AIDS and STD Control Programme (NASCOP), 84 % of Kenyans infected by HIV are not aware of their condition.

Dr. Mwendwa believes it is mainly the stigma that causes the loss of appetite, the weakening of the immune system going down and other opportunistic infections which bring serious medical problems much sooner. According to her, the immune system would also be better strengthened if the sexual life of these people continues because even rejection itself lowers their immune system.

In the past years some Kenyans believed that it was possible to reverse their sero-status by having sex with young virgin girls. Fortunately, due to awareness programmes and community activities, these kinds of beliefs, which violated human rights and dignity, are fortunately being dispelled. In Sierra Leone, the stigma made the government pass a law that prohibited women infected with HIV from getting pregnant. Hopefully this human rights violation made by the government itself should not spread out to other African countries. For a fact, the baby inside the uterus is always HIV negative, and the infection can only take place during birth or during breast feeding, but even that does not certainly mean the baby will turn out positive. UNICEF is committed in taking a lead role towards the elimination of mother-to-child transmission by giving access to antiretroviral drugs to as many infected pregnant women as possible.

Each year, over 350,000 new HIV infections occur among children in sub-Saharan Africa as a result of mother-to-child transmission, but only 45 % of the pregnant women in the region receive antiretroviral drugs to prevent the transmission to their children.

Every year, Kenya experiences 100,000 new HIV infections. The Kenya National Commission on Human Rights is challenging the government to implement the HIV and AIDS prevention and control Act as soon as possible, but meanwhile it seems there are new medical frontiers on the matter of regulating HIV transmission.

There is a new programme in Kenya called Post-Exposure Prophylaxis (PEP), which allows people to reverse the infection by accessing antiretroviral drugs a maximum 72 hours after the infection. This treatment is especially addressed to victims of rape and healthcare workers exposed to HIV through needle stick injuries at work: it is not possible to take it after every sexual act.

PEP prevents HIV from completely entering the system, thus reducing the chances of infection by 80% or more. San Francisco started a pioneer PEP program in 1998 and it reached Kenya in 2001. This programme has the potential to be very effective if awareness about it could be increased. Nowadays still, the lack of information among the grass roots people does not allow the programme to make a significant impact.

Another new frontier towards preventing HIV transmission is “the gel of hope”: a new research by the Centre for the AIDS Programme of Research in South Africa (CAPRISA) presented at the 18th International AIDS Conference 2010 in Vienna which was tested among 889 women. By using microbicide vaginal gel applied by women 12 hours before or after sex, the infection rate is reduced by 50 % after one year, and in cases of prolonged use, by 39% after two years. This appears to be a small but significant sign of hope in the fight to win the HIV battle in Africa.

Various efforts are being made to find solutions, but the number of people living with HIV in Kenya is officially believed to be between 1.5 and two million people. There is still a huge need for information and awareness especially among the lowly educated class in order to end stigmatization and to fight for an AIDS-free generation in Kenya.