Many of new HIV infections in Kenya are being recorded in emerging hotspots mainly in central and coastal parts of the country.
The hotspots, it is suggested are being driven by the growing new roads, transport networks and new monies within devolved units.
For years, Nairobi, Homabay, Kisumu, Siaya, and Migori, have been the five traditional HIV hotspots collectively accounting for over 40 per cent of infected persons in Kenya
But a recent report by Kenya’s Ministry of Health, USAID and US-CDC says new hotspots have emerged in previously low risk areas.
To confront the new threat, the team suggests a retooling of the HIV control strategy with the aim of redistributing resources and efforts to the new areas.
“Achieving the “first 90” will become a reality if resources are redirected to areas with the highest potential for identifying new HIV-infected persons,” says the study published in the journal Frontiers in Public Health.
The new hotspots, the report says include Isiolo and Nanyuki which are situated along a major transport corridor to northern Kenya.
Meru is especially mentioned for its booming trade in miraa (Khat) with potential to attract high commercial sex activities.
Bigger clusters were identified at the coastal region in Mombasa, Malindi, Kwale, and Voi towns.
“We also identified clusters in Kajiado County along the Nairobi-Namanga major highway and toward the Kenya-Tanzania border,” says the study.
The study funded by the US President’s Emergency Plan for AIDS Relief (PEPFAR), suggests the new hotspots may be driven by infrastructural developments such as road construction or high-volume economic activities.
The team reports a link between rood and transport infrastructure expansion in Kenya and the emergence of the new HIV hotspots.
The road network and more connectedness the report says may be facilitating commercial sex work and is associated in the spread of HIV in rural areas.
Rurality of HIV
Good transportation networks are also associated with the growing spread of HIV in previously naïve areas hence the ‘increasing rurality’ of HIV.
In the last dozen years Kenya has seen increased construction of transport infrastructure including roads, railways and sea ports.
It has also seen increased connections to electricity, growth of university towns across the country and more young people engaging in petty trading.
Such trade include motorbike taxis called boda boda, sale of second hand clothes, as well as underage transactional sex.
Interrupting the virus
The study led by Anthony Waruru of CDC – Nairobi, had analysed data from about 3,900 HIV testing sites from across the country for a one year period.
For the period, the study recorded 192,608 new infections with significant numbers from previously low risk counties.
“We have established and demonstrated that clusters with a high number of HIV infected persons are in both high and low-burden counties,” says the study.
To control the epidemic, the researchers say it is absolutely crucial to interrupt the spread of the virus from the new hotspots to other areas.
They suggest control efforts and resources are re-directed to areas with budding HIV infections if the country is to achieve the United Nations’ “first 90.”
The first 90, but now 95, targets at having all persons living with HIV know their status by 2030.
However, it will be interesting to watch how PEPFAR, reacts to suggestions of opening new areas for more funding at a time it is categorical that the epidemic in Kenya is under control.
The Americans have been reducing their involvement in ‘soft’ HIV control activities in Kenya while retaining a firm grip on biomedicals.
By Gatonye Gathura
The report is available here: https://doi.org/10.3389/fpubh.2021.503555