Recent wins in the fight against HIV in Kenya are once again being overshadowed by rising deaths among people living with the virus from Advanced HIV Disease (AHD), stakeholders have said. Medics and people living with HIV say they have seen risk factors that contributed to Aids deaths more than four decades ago are creeping back.
The challenges are listed as; stigma, late screening, delayed engagement with treatment, non-adherence to medication and HIV co-infections, and other problems that contributed to Aids deaths during the peak of the epidemic.
In 2022 alone, estimates indicated that 18,273 people died as a result of Aids-related conditions that included TB co-infection and malnutrition among children. Major strides According to the National STI Control Program (Nascop), Kenya has made major strides in HIV prevention, indicating that 95 per cent of all people living with HIV (PLHIV) have been diagnosed, 95 per cent put on treatment and 90 per cent virally suppressed, while among children the performance is 85-85-74.
“Despite this good success though, we are still seeing some challenges, and one of them is that we are still seeing occurrences that we consider to be preventable Aids-related deaths. “In the year 2022 as our estimates indicate, we had 18, 273 people who died because of AIDS-related modalities,” said Dr Lazarus Momanyi, Nascop’s Technical Advisor for HIV/Aids.
He explained further that these are people who died because of things like TB infections, and malnutrition among children that are preventable deaths because the country, or as a health system, can be able to prevent them. “So one of the key questions we’ve been trying to ask ourselves is, what is the cause or why are people still presenting very sick, and even dying in the era of wide access to treatment?” he asked, further highlighting that one of the key contributors is late diagnosis.
Technical expert Dr Momanyi was speaking during a one-day engagement with media and technical experts to discuss the plight of people with; and at risk of AHD.
The meeting was hosted by the National Empowerment Network of People Living with HIV/Aids in Kenya (NEPHAK).
He said that some people were taking too long to know their HIV status, and by the time they got to be tested, and know that they were living with the virus, their immunity had already declined and they were coming in when they were already at risk of all these infections and even death
. “Particularly, we have seen the challenge of late diagnosis especially in men that we have not been able to reach a target of identifying 95 per cent of them who are living with HIV,” he said.
However, according to Dr Momanyi there are efforts to ensure that people can know their status, including scaling up HIV self-testing, which is now widely accessible
“The other thing that you’ve seen is that even people who know their status, some of them are not engaging to care immediately,” he noted.
The World Health Organisation- WHO definition of AHD, is a person’s CD4 cell count of less than 200 cells/mm3 or WHO stage 3 or 4 event. It includes both Antiretroviral Therapy (ART) inexperienced individuals and those who interrupt treatment and return to care, those on ART with treatment failure.
Younger children All children younger than five years old with HIV are considered as having advanced HIV disease, although those on ART for more than 1 year, and are clinically stable are not considered to have AHD.
Nelson Otwoma, NEPHAK 0045ecutive Director, noted that people confuse AHD since they believe it only affects those individuals who had HIV for a long or confuse it with non-communicable diseases such as hypertension or diabetes.
However, AHD is mainly linked with conditions where HIV is unmanaged which leads to severe damage to the body.
