• Between 2014 and 2018, the percentage of new infections per year among the population at risk decreased from 1.9 to 0.7 per cent
• At least 95 per cent of people receiving ART had completely suppressed the virus ( up 11 per cent from 2012).
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A large ‘test and treat’ campaign in western Kenya has reduced new HIV infections by more than 50 per cent, results show.
The strategy, which involves intensifying HIV testing and placing all positive people on treatment, confirms that virally suppressed people cannot infect others with HIV through sex.
Researchers suggest the strategy could be the fastest way to control the epidemic in Kenya.
The approach was rolled out in Ndhiwa subcounty, Homa Bay county, between 2014 and 2018.
The Ministry of Health and health lobbies Médecins Sans Frontières/ Doctors Without Borders (MSF), and Elisabeth Glaser Pediatric Aids Foundation, boosted testing through extensive community engagement, door-to-door campaigns, and household testing.
Additionally, the teams worked to increase access to anti-retroviral therapy and follow-up care for HIV-positive people.
“Between 2014 and 2018, the prevalence rate dropped from 24 to 17 per cent, and the percentage of new infections per year among the population at risk decreased from 1.9 to 0.7 per cent,” according to results of the study, titled Ndhiwa HIV Impact on Population Survey 2.
The region has had one of Kenya’s highest HIV prevalence for many years.
Results show 93 per cent of Ndhiwa population knew their HIV status in 2018 (up from 59 per cent according to a 2012 survey) and 97 per cent of HIV-positive people were receiving ART treatment (up from 68 per cent).
At least 95 per cent of people receiving ART had completely suppressed the virus (up 11 per cent from 2012).
“The underlying principle is that, when your treatment is successful, the virus has been suppressed and you are unable to pass it to other people. When applied to large numbers of people, HIV treatment equals HIV prevention,” said Dr Mohammed Musoke, MSF medical coordinator in Kenya.
Musoke said starting 2014, MSF and its partners also improved the turnaround of laboratory tests thanks to a network of boda boda riders who collected blood samples in local health centres and transported them to the nearest laboratory facility.
“The investment in a laboratory system was a key part of the process, as medical staff rely on these tests to know what to treat, how to treat it and whether the treatment is actually working,” Musoke said.
Kenya adopted the WHO recommendation to systematically ‘test and treat’ in 2016, and this is among the few local studies demonstrating that the approach is highly effective.
The NHIPS 2 study also confirms that the 2020 targets set by UNAids to bring the global HIV epidemic under control had been met and exceeded two years earlier in Ndhiwa.
The ‘90-90-90’ UN target—in which 90 per cent of HIV-positive people know their status, 90 per cent are on treatment, and 90 per cent have a suppressed viral load—helps reduce the rates of new infections.
MSF says the approach is cost-effective but relies on many partners on the ground and a major investment, without which the gains might be lost.