All info below is from the AVERT country paper on Kenya.
Kenya has the fourth-largest HIV epidemic in the world. In 2012, an estimated 1.6 million people were living with HIV, and roughly 57,000 people died from AIDS-related illnesses. 1 Moreover, there are now 1.1 million orphans due to the epidemic. 2
The first case of HIV in Kenya was detected in 1984, and by the mid 1990s it was one of the major causes of mortality in the country putting huge demands on the healthcare system as well as the economy. HIV prevalence peaked at 10.5 percent in 1996. By 2012, this had fallen to 6.1 percent due mainly to the rapid scaling up of antiretroviral treatment (ART). 3
However, in recent years, a number of studies have identified concentrated epidemics among certain groups who are particularly vulnerable to HIV transmission.
People who inject drugs (PWID) and HIV in Kenya
In 2011, an estimated 18.3 percent of people who inject drugs (PWID) in Kenya were living with HIV. 9 The majority of PWID are concentrated in specific geographical areas such as Nairobi and Mombasa. 10
One study found that 3.8 percent of new HIV infections occur among PWID. In the capital Nairobi, this rises to 5.8 percent. 11 Condom use and safe injecting practices are very low among this group (29.8 percent and 51.6 percent respectively) and predominantly responsible for high rates of HIV transmission. 12
Sex workers and HIV in Kenya
Female sex workers (FSW) have the highest reported HIV prevalence of any group in Kenya. In 2011, an estimated 29.3 percent of FSW were living with HIV. 13 By comparison, data from the Sex Workers Outreach Program (SWOP 2011) showed an HIV prevalence of 30 percent among FSW and 40 percent among male sex workers on enrollment. 14
The 2009 Modes of Transmission Study (MOT) reported that 14 percent of new HIV infections occurred among FSW and their clients. However, FSW are reportedly better at protecting themselves from HIV transmission compared to groups such as MSM and PWID. 86 percent of FSW have reported using a condom with their most recent client. 15
Women and HIV in Kenya
Although HIV prevalence among the general population has fallen in Kenya, women continue to be disproportionately affected by the epidemic. In 2012, 6.9 percent of women were living with HIV compared with 4.2 percent of men. 16 Young women (aged 15-24) are almost three times as likely to be living with HIV than men of the same age (3 percent and 1.1 percent respectively). However, HIV prevalence among young women has almost halved since 2003, showing that progress is being made. 17
Like in many parts of sub-Saharan Africa, women and girls in Kenya face discrimination in terms of access to education, employment and healthcare. As a result, men often dominate sexual relationships with women not always able to practice safer sex even when they know the risks.
Young women in Kenya are three times as likely to be exposed to sexual violence than young men. 18 They are forced into early marriage and often unable to negotiate safe sex. 19 Young women also have a lower level of HIV knowledge than young men in Kenya. One study found that only 47.5 percent of young women could correctly identify ways of preventing sexual transmission of HIV and reject misconceptions about HIV transmission compared to 54.9 percent of young men. 20
HIV testing and counseling (HTC) in Kenya
In recent years, HIV testing and counseling (HTC) has been a major feature of the HIV response in Kenya. The country has adopted a number of strategies including provider initiated testing and counseling (PCT), outreach testing and counseling, home-based testing and counseling (HBT) as well as the integration of HTC in antenatal care, sexually transmitted infections (STI) and sexual and reproductive health services. 21
As a result, there has been progress in terms of the number of people getting tested for HIV. In 2000, there were just 3 voluntary counseling and testing (VCT) sites in Kenya; by 2010 there were over 4,000. In 2008, 860,000 people were being tested annually for HIV, by 2013; this had increased to 6.4 million. 22
Though annual testing rates have increased, there remains a significant disparity between men and women. In 2008/9, 22.8 percent of men and 29.3 percent of women aged 15-49 reported having an HIV test in the previous 12 months. 23 In 2012, 35.8 percent of men had a HIV test in the previous year compared with 47.3 percent of women. 24 As a result, there has been a concerted effort to increase testing rates among Kenyan men with community-based testing programs proving successful in particular. 25
Like HTC coverage among the general population, testing rates among pregnant women have risen substantially. From 2009 to 2013, the percentage of pregnant women tested for HIV increased from 68 percent to 92 percent. 26
As a result, in 2012, nearly half of all Kenyans living with HIV were aware of their status (47 percent) - up from 16 percent in 2007. 27 However, an unacceptable number of people in Kenya still do not know their HIV status.
Learn more at AVERT- HIV/AIDS in Kenya.