Following a study in 2009 by National Aids
Control Council and UNAIDS, it was identified that the epidemic was changing and that transmission between discordant couples, where one partner is positive and one partner is negative, accounted for
the majority of new infections. As a result, prevention for positive people is to be a central element of Kenya’s new approach to prevention which will, among other approaches, include couple-based
testing and encourage partner disclosure and condom use.
HIV testing. HIV testing has widely expanded across Kenya since the beginning of the millennium. In 2000 there were only three voluntary counselling and testing (VCT) sites nationwide; by 2007 there were almost 1000. HIV testing and counselling facilities increased to 4,438 in 2010. Alongside voluntary testing, provider initiated counselling and testing (PCT) has expanded and is now available in 73 percent of health facilities. PCT is when individuals are offered a HIV test whenever they go to a health facility, rather than patients having to ask for a test.
Condom use. The Kenyan government has only actively promoted condom use since 2001, when an estimated 12.8 percent of its population were infected with HIV. That year, the government announced its intention to import 300 million condoms. Since then, condom distribution has been radically scaled up; 10 million were distributed in 2004 and 124.5 million in 2008.
Education and awareness. HIV and AIDS education is an essential part of HIV prevention. In Kenya AIDS education is part of the curriculum in both primary and secondary schools, and for a number of years Kenya has delivered educational campaigns to raise nationwide awareness of the issue. As a result, awareness about HIV and AIDS in Kenya is high. In Kenya’s national, population-based survey, nearly all adults aged 15-64 had heard about AIDS, 90 percent knew that a healthy-looking person could be infected with HIV, and most knew how to reduce their chances of becoming infected with the virus. Awareness of the need to use condoms was high with 75 percent of women and 81 percent of men in this age group aware that condoms reduce the risk of HIV infection.
Preventing mother-to-child transmission (PMTCT). Since 2000 PMTCT efforts in Kenya have rapidly expanded. There are now more than 3,397 health facilities offering PMTCT services. In 2010 an estimated 83 percent of pregnant women were tested for HIV and 43 percent of pregnant women living with HIV received the most effective antiretroviral regimen for preventing the transmission of HIV to their babies. Whilst only half of HIV-exposed infants received ARVs for PMTCT in 2009, testing of HIV-exposed infants improved in 2010 with 64 percent tested by 2 months of age.
Harm reduction and needle exchange services. HIV transmission through injecting drug use is a growing problem, particularly in the capital and in coastal areas. HIV prevalence among injecting drug users (IDUs) reached 21 percent in 2010 and in Nairobi around 1 in 3 IDUs are infected with HIV. Even where IDUs in Kenya know how HIV can be transmitted, needle sharing and unprotected sex is commonplace. Up to 4 percent of all new infections are as a result of injecting drug use. Although Kenyan drug laws and government policy have hindered the prevention of new infections among IDUs, there has been a recent change of view in the Kenyan government. This follows a similar turnaround by the American initiative PEPFAR (the largest foreign funder of HIV and AIDS programs in Kenya), which now supports a variety of harm reduction approaches to HIV prevention among IDUs.