Recent progress in the fight against HIV in Kenya is being overshadowed by a troubling rise in deaths among people living with the virus due to Advanced HIV Disease (AHD), stakeholders have reported. Medics and people living with HIV observe that risk factors contributing to AIDS deaths more than four decades ago are resurfacing.
The challenges contributing to these deaths include stigma, late screening, delayed initiation of treatment, non-adherence to medication, and HIV co-infections, issues that were significant during the height of the epidemic. In 2022 alone, estimates showed that 18,273 people died from AIDS-related conditions such as TB co-infection and malnutrition among children.
Despite significant advances in HIV prevention, as reported by the National STI Control Program (Nascop), challenges persist. Nascop’s data indicates that Kenya has made considerable progress, with 95 percent of all people living with HIV (PLHIV) diagnosed, 95 percent on treatment, and 90 percent virally suppressed. Among children, the figures are 85-85-74, respectively.
“Despite these successes, we continue to encounter preventable AIDS-related deaths,” said Dr. Lazarus Momanyi, Nascop’s Technical Advisor for HIV/AIDS. He noted that these deaths were often due to preventable conditions like TB infections and malnutrition, and questioned why people are still presenting as very sick and even dying despite widespread access to treatment.
Dr. Momanyi highlighted late diagnosis as a key issue. “Some people take too long to know their HIV status. By the time they are tested and find out they are living with the virus, their immunity has already declined, making them vulnerable to infections and even death,” he explained. He added that the challenge is particularly pronounced among men, where the target of identifying 95 percent of those living with HIV has not yet been met.
Dr. Momanyi was speaking at a one-day engagement with media and technical experts hosted by the National Empowerment Network of People Living with HIV/AIDS in Kenya (NEPHAK), where they discussed the ongoing issues faced by those with, and at risk of, AHD.
Dr. Momanyi also highlighted ongoing efforts to improve awareness of HIV status, such as the scaling up of HIV self-testing, which is now widely accessible. “Even for those who are aware of their status, some are not engaging with care immediately,” he noted.
According to the World Health Organization (WHO), Advanced HIV Disease (AHD) is defined as having a CD4 cell count of less than 200 cells/mm³ or experiencing a WHO stage 3 or 4 event. AHD includes individuals who have never been on Antiretroviral Therapy (ART), those who have interrupted their treatment and returned to care, and those on ART who experience treatment failure.
For children, all those under five years old with HIV are considered to have advanced HIV disease, although those who have been on ART for more than a year and are clinically stable are not classified as having AHD.
Nelson Otwoma, NEPHAK Executive Director, pointed out that there is a common misconception about AHD. Some people mistakenly believe it only affects those who have had HIV for a long time or confuse it with non-communicable diseases like hypertension or diabetes. In reality, AHD is primarily associated with unmanaged HIV, which leads to severe damage to the body.
