World Aids Day will be marked on December 1. On that day, President Uhuru Kenyatta will also launch the national Universal Health Care plan. Dr Selepe Percival, Bliss Healthcare senior vice-president spoke to health writer Joe Kimondo on the fight against HIV/Aids and how UHC will help the cause. Here are excerpts
QUESTION: Currently, which is the most vulnerable category of the population and why?
A: The most vulnerable group is people between 15 to 24 years. This is attributed to early sexual debut and risky sexual behaviour among the youth.
Q: Is this a challenge to UHC given that the trend is not likely to abate?
A. It is a challenge but healthcare providers have put in place strategies to deal with the problem. We always urge the youth to stop engaging in risky behaviour. This campaign is live and is being carried out by the government in partnership with the private sector.
Q: What is your advice to the youth as far as testing and prevention are concerned?
A. I urge sexually active youth to go for testing to know their HIV status. This is because when you know your status early, it will help one avoid risky sexual behaviour or increase new transmissions. This also helps in the management of the disease.
Q: Sometimes back, there were reports that new HIV infections were being detected in married couples because of promiscuity. Has this been proved?
A. In certain populations the risk is elevated, including among unmarried youth and persons engaging in high-risk behaviour or casual sex.
Between 2007 and 2012, the proportion of persons reporting a recent partner of unknown HIV status reduced substantially from 77.9 to 46.4 per cent (Personal Communication, Kenya Ministry of Health).
However, condom use with partners of unknown HIV status in the past year remained low, with only 11.8 per cent of men and 3.8 per cent of women reporting that they used condoms with their partners. HIV prevalence was higher among urban residents (8.4 per cent) than rural residents (6.7 per cent).
Among married and co-habiting couples, 5.9 per cent were HIV sero-discordant, where one partner was HIV infected and the other was HIV uninfected.
Q: Introduction of Anti-Retroviral (ARVs) drugs was a big boost in the management of HIV/Aids. But there are claims the drugs are partly to blame for new infections because users look very healthy. What is your take on this?
A. Not really. New infections are caused by risky sexual behaviour. Behavioural adjustment conversely affects new infection rates. ARVs have improved management of the disease but no study has confirmed their contribution to new infections.
Q.How long can a person using ARV therapy live with the virus?
A. With proper use of ARVs, patients can lead normal life. HIV is now considered a chronic disease of which with medication, can be managed easily.
With the advent of new ARVs this is being realised more as most HIV symptoms, which include opportunistic infections and progression of stages of HIV, have greatly been sustained.
Q: President Uhuru Kenyatta launches UHC plan next week. In your estimation, what is the state of government and private health care providers preparedness to roll out the initiative?
A: Kenya still has high HIV infection rate, especially among the youth. This is of great concern to all healthcare providers. Among people aged between 15 and 64 years, HIV prevalence rate is estimated at 5.6 per cent, representing 1,192,000 persons living with the virus.
Out of the figure, 106,000 comprise new HIV infections in the last one year. Healthcare providers will have to put this and other health conditions into consideration. But Kenya has the capacity to roll out the programme.
For instance, we have more than 80 clinics across the country alone and there are many other providers who should be prepared to back up this programme.
Q:What is the expected workload in the management of HIV/Aids infections?
A: As of last year, statistics show that 1.5 million Kenyans were living with the virus out which 110,000 were children. There were about a million deaths from Aids-related infections in 2016, down from 1.9 million in 2005.
The global burden remains on management of opportunistic infections. At the moment, data on infection rate is quite clear and the government and private healthcare providers know what they are required to do.