Share this article on:

Prevalence and Incidence of HIV Infection, Trends, and Risk Factors Among Persons Aged 15–64 Years in Kenya: Results From a Nationally Representative Study

Kimanga, Davies O. MBChB, MMed*; Ogola, Samuel MSc; Umuro, Mamo MSc; Ng'ang'a, Anne BDS, MSc*; Kimondo, Lucy MSc§; Murithi, Patrick BDS, MPH; Muttunga, James MSc; Waruiru, Wanjiru MBA, MPH#; Mohammed, Ibrahim MD, MPH*; Sharrif, Shahnaaz MD, MMed, MSc**; De Cock, Kevin M. MD, FRCP (UK), DTM&H††; Kim, Andrea A. PhD, MPH††for the KAIS Study Group

JAIDS Journal of Acquired Immune Deficiency Syndromes: May 1st, 2014 - Volume 66 - Issue - p S13–S26
doi: 10.1097/QAI.0000000000000124
Supplement Article

Background: Enhanced HIV surveillance using demographic, behavioral, and biologic data from national surveys can provide information to evaluate and respond to HIV epidemics efficiently.

Methods: From October 2012 to February 2013, we conducted a 2-stage cluster sampling survey of persons aged 18 months to 64 years in 9 geographic regions in Kenya. Participants answered questionnaires and provided blood for HIV testing. We estimated HIV prevalence, HIV incidence, described trends in HIV prevalence over the past 5 years, and identified factors associated with HIV infection. This analysis was restricted to persons aged 15–64 years.

Results: HIV prevalence was 5.6% [95% confidence interval (CI): 4.9 to 6.3] in 2012, a significant decrease from 2007, when HIV prevalence, excluding the North Eastern region, was 7.2% (95% CI: 6.6 to 7.9). HIV incidence was 0.5% (95% CI: 0.2 to 0.9) in 2012. Among women, factors associated with undiagnosed HIV infection included being aged 35–39 years, divorced or separated, from urban residences and Nyanza region, self-perceiving a moderate risk of HIV infection, condom use with the last partner in the previous 12 months, and reporting 4 or more lifetime number of partners. Among men, widowhood, condom use with the last partner in the previous 12 months, and lack of circumcision were associated with undiagnosed HIV infection.

Conclusions: HIV prevalence has declined in Kenya since 2007. With improved access to treatment, HIV prevalence has become more challenging to interpret without data on new infections and mortality. Correlates of undiagnosed HIV infection provide important information on where to prioritize prevention interventions to reduce transmission of HIV in the broader population.

*The National AIDS and Sexually Transmitted Infection (STI) Control Programme, Ministry of Health, Nairobi, Kenya;

Kenya National Bureau of Statistics, Nairobi, Kenya;

National Public Health Laboratory Services, Ministry of Health, Nairobi, Kenya;

§The National Council for Population and Development, Nairobi, Kenya;

National AIDS Control Council, Nairobi, Kenya;

Kenya Medical Research Institute, Nairobi, Kenya;

#Global Health Sciences, University of California, San Francisco, San Francisco, CA;

**Ministry of Health, Nairobi, Kenya; and

††Division of Global HIV/AIDS, Center for Global Health, US Centers for Disease Control and Prevention, Nairobi, Kenya.

Correspondence to: Davies O. Kimanga, MBChB, MMed, National AIDS and STI Control Programme, Department of Disease Prevention and Control, Ministry of Health, Kenyatta Hospital Grounds, 19361–00202, Nairobi, Kenya (e-mail: dkimanga@nascop.or.ke).

Kenya AIDS Indicator Survey (KAIS) 2012 was supported by the National AIDS and STI Control Programme (NASCOP), Kenya National Bureau of Statistics (KNBS), National Public Health Laboratory Services (NPHLS), National AIDS Control Council (NACC), National Council for Population and Development (NCPD), Kenya Medical Research Institute (KEMRI), US Centers for Disease Control and Prevention (CDC/Kenya, CDC/Atlanta), United States Agency for International Development (USAID/Kenya), University of California, San Francisco (UCSF), Joint United Nations Team on HIV/AIDS, Japan International Cooperation Agency (JICA), Elizabeth Glaser Paediatric AIDS Foundation (EGPAF), Liverpool Voluntary Counselling and Testing (LVCT), African Medical and Research Foundation (AMREF), World Bank, and Global Fund. This publication was made possible by support from the US President's Emergency Plan for AIDS Relief through cooperative agreements (PS001805, GH000069, and PS001814) from the US Centers for Disease Control and Prevention, Division of Global HIV/AIDS. This work was also funded in part by support from the Global Fund, World Bank, and the Joint United Nations Team for HIV/AIDS.

The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention and the Government of Kenya.

© 2014 by Lippincott Williams & Wilkins