Kenya’s AIDS Report to UN Summit Shows Disparity in Prevalence Among Sexes

By Ben Omondi

NAIROBI----Kenya’s report submitted to the United Nations General Assembly Special Session on HIV/AIDS (UNGASS 2010) shows that the country has different prevalence rates for males and females as well as variations in prevalence among age groups.

The report, prepared by the National Aids Control Council (NACC), notes that HIV prevalence has been declining in the last two decades, with national estimates indicating that while in the 1997/98 period, prevalence among adults (15-49 years) was 10 per cent, the rates had declined to 6.7 per cent, according to the 2003 Kenya Demographic and Health Survey (KDHS 2003) and 7.1 per cent as per the 2007 Kenya AIDS Indicator Survey (KAIS 2007).

On prevalence according to sex and age, the report notes that women have a prevalence rate almost two times higher than men; at 8.4 per cent for women against 5.4 per cent for men according to the 2007 KAIS and women 8 per cent compared to 4.3 per cent for men (KDHS 2008/9).

Young women (aged between 15 to 24 years) have a prevalence rate four times higher than that of young men in the same age group (5.6 per cent for women against 1.4 per cent for men) according to the 2007 Aids Indicator Survey and 4.5 per cent women against 1.1 per cent for men as per the 2008/9 KDHS.

On prevalence according to provinces and regions, the UNGASS report shows that there exists significant difference in HIV prevalence across provinces as well as between provinces and urban centres.

The prevalence among adults aged between 15 to 64 years in rural areas was estimated to be about 6.7 per cent compared to 8.4 per cent for adults in the same age group living in urban areas.

According to the 2008/9 KDHS, 7.2 per cent of adults aged between 15 to 49 years in urban areas were infected, compared with only 6 per cent of those in the same age group living in rural areas.

The report however notes that given that the vast majority of people (75 per cent) reside in rural areas, the absolute number of HIV infections is higher in rural than urban areas as an estimated1 million adults in rural areas are infected with HIV, compared to 0.4 million adults in urban areas.

The report shows that HIV prevalence also varies by sex, with women in the 15 to 49 year age group residing in urban areas recording a higher prevalence rate than those in rural areas (10.4 per cent and 7.2 per cent respectively). Among men, prevalence rate in urban is marginally lower than rural areas (3.7 per cent and 4.5 per cent respectively).

To regions, the report also notes disparities, with North Eastern Kenya having the country’s lowest prevalence rate of 0.9 per cent and Nyanza recording the highest prevalence of 13.9 per cent.

The report further shows that a key characteristic of HIV epidemic in the country is the risk of infections among people in unions, with 2008/9 KDHS finding significant variation of prevalence by marital status, the highest being among widowed respondents (44.4 per cent) and the lowest among who had never been married at 2.4 per cent. Also crucial to note is the fact that about 14.3 per cent of the respondents in the survey who were cohabiting or married were found to be HIV positive.

HIV prevalence is also twice as high among respondents in polygamous unions (12.9 per cent) compared to respondents in non-polygamous unions at 6.1 per cent. Among those in polygamous relationships and unions, prevalence is higher among men (15.7 per cent) compared to 11.8 per cent for women.

In non-polygamous unions however, HIV prevalence is marginally higher among women than men (6 per cent and 5.3 per cent respectively). The report notes that this differs significantly among women who are not currently in union (9.8 per cent) compared to men in the same category whose prevalence rate is 2.7 per cent, thereby emphasizing the need to prioritise interventions for people in married unions as key vulnerable populations.

To most-at-risk populations (MARPs), the report notes that this group - which includes female sex workers and their clients, men who have sex with men (MSM) and injecting drug use (IDU) - plays a significant role in driving the HIV epidemic in the country, with the Mode of Transmission (MoT) study conducted in 2008 indicating that sex workers and their clients contribute about 14 per cent of new infections.

Others in the group and their contribution to new HIV infections is as follows: heterosexual sex within union/regular partnership (44.1 per cent); casual heterosexual sex (20.3 per cent); men having sex with men (MSM) and prison (15.2 per cent); sex workers (14.1 per cent); injecting drug use (3.8 per cent) with 2.5 per cent of new HIV infections being health facility-related.

On prevalence rates among children, the report picks data from the 2010 Kenya National AIDS Estimates which shows that the cumulative number of children infected was estimated to be about 184,052 by 2009, with about 22,259 children estimated to have been infected during the same year.