Burden of HIV Infection Among Children Aged 18 Months to 14 Years in Kenya

Abstract

Backgrounds In Kenya, mathematical models estimate that there are approximately 220,000 children aged less than 15 years infected with HIV. We analyzed data from the second Kenya AIDS Indicator Survey (KAIS 2012) to estimate the prevalence of HIV infection among children aged 18 months to 14 years. Methods KAIS 2012 was a nationally representative 2-stage cluster sample household survey. We studied children aged 18 months to 14 years whose parents or guardians answered questions pertaining to their children by interview. Blood specimens were collected for HIV serology and viral load measurement. Results We identified 5162 children who were eligible for the study. Blood was obtained for 3681 (71.3%) children. Among child participants, 16.4% had been tested for HIV infection in the past, and among children with parents or guardians who self-reported HIV-positive status, 52.9% had been tested for HIV infection. Twenty-eight (0.9%) children tested HIV-positive in the survey. Of these, 11 had been previously diagnosed with HIV infection before the survey. All 11 children were in HIV care and receiving cotrimoxazole; 8 were on antiretorivral therapy (ART). Among those on ART, 4 were virologically suppressed. Conclusions HIV causes a substantial burden of disease in the Kenyan pediatric population. Although most children who had been diagnosed with HIV before the survey were engaged in care and treatment, they represented less than half of HIV-infected children identified in the survey. Future efforts should focus on identifying infected children and getting them into care and on suppressive ART as early as possible.

Kenya AIDS Indicator Surveys 2007 and 2012

“…19 Among adults and adolescents aged 15–64 years, the prevalence of HIV was 5.6%, representing an estimated 1,192,000 persons living with HIV, 106,000 of which were new HIV infections. 20 This estimate was significantly lower than that reported in 2007 when the prevalence of HIV, excluding North Eastern region, was 7.2% ( P = 0.002).…”

“…Only 11 of 28 HIV-infected children in KAIS 2012 had been diagnosed previously, and although all children with previous diagnosis were accessing care, only 8 were receiving ART, and of those, only half had achieved viral suppression. 19 …”

Implementation of repeat HIV testing during pregnancy in southwestern Kenya: progress and missed opportunities

“…The MTCT rate was estimated in 2012 to be 15%, accounting for 13,000 new childhood infections in Kenya annually 9, 10. In 2012, the Kenya Ministry of Health adopted international guidelines recommending that repeat HIV testing be offered three months after an initial negative HIV test result in early pregnancy 11.…”

Why Are Orphaned Adolescents More Likely to Be HIV Positive? Distinguishing Between Maternal and Sexual HIV Transmission Using 17 Nationally Representative Data Sets in Africa

“…However, recent research has found that HIV infection progresses slowly among some infants and a substantial proportion of HIV positive survive to adolescence and beyond. 13,14 Moreover, recent research in Kenya 15 and Ethiopia 16 has found substantial HIV prevalence for older children (under age 15), the majority of whom were presumably not infected through sexual transmission due to low rates of sexual activity for these age groups. In addition, an intervention to reduce HIV among Zimbabwean adolescents had no impact on orphan HIV disparities, leading the authors to suggest that excess risk among orphans is likely due to maternal transmission.…”

“…16 As a result, many of these HIV positive children are undiagnosed and not linked to treatment. 15,16 As these “missing children” mature into adolescents, they may alter the future course of the HIV epidemic. The goal of this study is to clarify the etiology of orphan HIV disparities, and in doing so provide essential guidance for our response.…”