Report raises concern over rate of men dying of AIDs complications

Despite a gradual reduction in new HIV infections in Kenya, more men and boys continue to succumb to HIV/AIDS-related complications.

The deaths are reported at a time when the country has intensified efforts to eliminate AIDS as a public health threat by 2030.

The latest report by the National Syndemic Disease Control Council (NSDCC) reveals that at least 1,378,457 Kenyans are living with HIV, with men accounting for 35 per cent (487,710) compared to 890,747 women.

In 2023, Kenya recorded 20,480 AIDS-related deaths, an increase from 18,473 in 2022. Of these, 8,490 were men, while 9,382 were women.

“Although more women and girls live with HIV than men, the proportion of men dying from AIDS-related causes remains alarming,” said Caroline Kinoti, NSDCC Deputy Director for Health Promotion and Capacity Development, in an interview with The Standard.

Kinoti attributed the higher mortality rate among men to poor healthcare-seeking behaviour.

Unlike women, who often interact with healthcare systems during pregnancy or other reproductive health needs, men are less likely to seek routine care or HIV testing services.

“Men generally avoid seeking healthcare unless they are seriously ill. Even when infected with HIV, they may live with the virus for a long time without being diagnosed or starting treatment, increasing the risk of transmitting the virus if their viral load is high,” Kinoti explained.

Dr Japheth Kioko, a statistician in NSDCC’s Monitoring and Evaluation Division, highlighted several gaps in HIV care for men, including low testing rates, delayed initiation of antiretroviral therapy (ART), and poor treatment adherence.

“Kenya has exceeded its treatment target, with 97 per cent of people living with HIV on ART and 94 per cent achieving viral suppression,” said Kioko. “However, men are lagging behind. For instance, 91 per cent of men are on ART compared to 100 per cent of women.”

Out of the 1,378,457 Kenyans living with HIV, 1,336,681 are on treatment, leaving a gap of over 41,000 people.

According to Kioko, those not on treatment are more likely to transmit the virus to others.

“It is our responsibility to bring everyone living with HIV into treatment. While overall progress is impressive, challenges remain, especially among men, boys and young people aged 20 to 24,” Kioko said.

Kenya has made significant strides in reducing new HIV infections over the past decade. In 2013, the country reported over 100,000 new infections annually. By 2023, it had dropped to 16,752—a reduction of 83 per cent.

“While this reduction in new infections is commendable, we are still not where we need to be. Our target was a 75 per cent reduction in new infections by 2025,” said Kinoti.

The report indicates that 4,072 new infections in 2023 were among men aged 15 and above, compared to 8,937 among women in the same age group. Additionally, 3,743 children aged 0 to 14 were newly infected.

Over the last 10 years, new HIV infections in Kenya have declined by 83 per cent across all populations, from 101,448 in 2013 to 16,752 in 2023—equivalent to 46 infections every day.

The reduction of new HIV transmissions in children between 2013 and 2023 is 71 per cent, while the reduction among adults stands at 85 per cent.

“Reduction is slower among children. Adults seem to experience faster declines in new infections compared to children,” said Kioko, noting that transmission among children is largely due to vertical (mother-to-child) transmission.

New infections among adults are mainly occurring in adolescents and young people aged 15 to 24 years.

Nine counties accounted for the highest number of new HIV infections: Nairobi, Kisumu, Nakuru, Migori, Homa Bay, Uasin Gishu, Siaya, Mombasa, and Kakamega.

HIV prevalence in Kenya stands at 3.3 per cent, with significant geographic disparities.

Kisumu County has the highest prevalence at 11.7 per cent, followed by Homa Bay, Migori, Siaya and Busia. Wajir County has the lowest prevalence at 0.1 per cent.

Young people aged 15 to 24 account for a significant proportion of new infections, with boys and men aged 15 to 45 particularly affected.

To address these disparities, the NSDCC, in collaboration with the Ministry of Health, has organised a marathon to mark World AIDS Day on December 1.

Themed “It Is a Race Against Time: Promoting Health and Wellbeing of Men and Boys,” the event will take place at Nyayo Stadium. It aims to engage men and boys in championing HIV prevention, testing, treatment, and viral suppression.

“Men and boys are disproportionately affected by HIV-related deaths. By empowering them to take charge of their health, we can close the gaps in testing, treatment, and prevention,” Kinoti said.