By Sharon Atieno
Though Kenya is making tremendous progress in HIV self-testing, the youth, among other target populations, are still left behind. This is partly due to inaccessibility challenges.
Data from the Kenya Health Information System (KHIS) shows that between 2018 -2020, the number of people who self-tested has risen from 20,934 to 283,660. Of these, about 32,000 were young people aged 15-24 years.
Of the 34,597 newly infected people, aged 15 years and above 14,344 cases being among young adults aged 15-24 years, according to the 2020 HIV Estimates.
According to Mr. Peter Mogere, 2017 AIDS Vaccine Advocacy Coalition (AVAC) Fellow, the 15-24-year olds are the most affected yet access to the self-testing kits remains a challenge making it difficult for them to be linked to prevention or care management.
Speaking during a Media for Environment, Science, Health and Agriculture (MESHA) café, Mogere noted that poor attitudes towards the youth in health facilities makes them shun going to these centres to access such services.
He also said that the requirement that young people aged, 15-17 years, must be accompanied by adults to access the kits poses a big impediment to the group.
Mogere strongly recommends a review of the national self-testing guidelines to remove the requirement . However, this may not be legally attainable because people below the age of 18 years cannot make such a decision without consent of their parents or guardians.
He also said that assisted self-testing, whereby the person performing the self-test receives an in-person demonstration from a trained provider or peer before conducting the test, is also an option to avoid any anticipated harm to the group.
Dr. Jonah Onentiah, HIV Testing Services (HTS) Program Manager, National AIDS and STI Control Programme (NASCOP) unveiled that they are trying to find more innovative ways for the youth to do testing to enable them progress either to HIV prevention or care and management.
Dr. Onentiah added: “If we can be able to get the target population being able to test themselves and know their HIV Status then we can be able to know what public health measures to take either as a person or a group to reduce viral load.”
Reducing the viral load will make the HIV undetectable hence untransmittable (U=U) , he said referring to the U=U national campaign that was launched recently.
In 2017, Kenya rolled out self-testing; where one can test themselves using oral fluid or blood to know their HIV status. However, if the test turns positive, the client is encouraged to go to a health facility to get a confirmatory test. So far, Kenya has approved four HIV rapid test kits, Ora Quick, INSTI, Sure Check and Atomo.
Though there are several benefits attached to self-testing including privacy, convenience and autonomy, it is used as a complementary strategy to other testing services.
According to the Joint United Nations Programme on HIV/AIDS (UNAIDS) by 2020, 90% of all people living with HIV should know their status, 90% of those who know their status should be put on treatment and 90% of those on treatment should be virally suppressed.
However, a year down the line after the deadline, Kenya is at 83% of those with HIV knowing their status, 83% being put on treatment and 78% who are virally suppressed.
Mogere observes that those who are unidentified may be unknowingly spreading the virus to others. “Therefore, we need to have targeted diagnostic interventions and strategies that will ensure we reach these populations that are yet to be tested.”