Countdown To Zero

Countdown To Zero

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Elimination of New HIV Infections Among Children by 2015 And Keeping Their Mothers Alive

Kenya (draft) Country Situation Adult HIV prevalence (ages 15-49) in Kenya, estimated 6.3% in 2009, has declined from 8.4% in 2001. Between 2009 and 2010, the number of new HIV infections among children in Kenya has declined 43%—from 23,200 to 13,200[3]. HIV prevalence among pregnant women was estimated at 5.6% in 2009, and in 2010, almost 87,000 pregnant women were estimated to be living with HIV in Kenya.

Background Statistics HIV prevalence - adults (ages 15-49)[1]*

6.3% [5.8%-6.5%]

2009

HIV prevalence - pregnant women (all ages)[2]* 5.6%

2009

Number of women living wih HIV delivering[3]

86,700

2011

Est. # children (ages 0-14) living with HIV[1]*

180,000 [98,000-260,000] 2009

Maternal mortality ratio[4]

360/100,000

2010

Est. annual births[5]

1,529,000

2010

Infant mortality rate[6]

55/1,000

2010

Under-5 mortality rate[7]

80/1,000

2010

The majority (92.5%) of health facilities in Kenya offer PMTCT services[8]. HIV testing among pregnant women increased from 31% in 2005 to 83% in 2010[9], and 67% of pregnant women with HIV received efficacious ARVs for PMTCT in 2011[3]. Kenya has adopted WHO 2010 Guidelines Option A regimen for prophylaxis, and a Multi-Sectoral National AIDS Strategic Plan (2009/2010 – 2012/2013) is in place, of which PMTCT is a component[10].

Reaching High Level Targets Global 2015 Targets • Reduce the number of new HIV infections among children by 90% • Reduce the number of HIV-associated deaths to women during pregnancy, delivery or puerperium by 50%

Figure 1: Number of new child HIV infections due to mother to child transmission, by scenario, Kenya

Child Targets • Reduce under-five deaths due to HIV by at least 50% • Provide antiretroviral therapy for all children with HIV

An estimated 27,400 children were newly infected with HIV in 2009. Modeling data from UNAIDS indicates that if all interventions are scaled up and Global Plan targets achieved (see Figure 1), there would be 4,600 new child infections in 2015—an 83% decline in the number of new child infections[11].

Base scenario: 2009 programme coverage maintained through 2015 Intervention scenario: 50% reduction in HIV incidence, eliminate unmet need for family planning, provide ARVs or ART to 90% of women in need

Source:[11] Joint United Nations Programme on HIV/AIDS, Unpublished estimates on PMTCT country targets, 2010

2009 Baseline [or last available data]

2010

2011

2012

2013

2014

2015

Number new paediatric HIV infections [3] Number HIV-associated maternal deaths[4] Percentage of under-5 deaths due to HIV ART coverage among children (ages 0-14)[3]

23,200 3,400 (2005) 9%[12] (2008) 19%

– 2,200 7%[4] –

13,200 – – 31%

– – – –

– – – –

– – – –

– – – –

Prong One

HIV incidence in women (ages 15-49)[3]

0.58%

–

0.52%

–

–

–

–

Prong Two

Percentage of married women with unmet need for family planning (ages 15-49)[13]

26%

–

–

–

–

–

–

26%

–

15%

–

–

–

–

Prong Three

Maternal ARV coverage (prophylaxis and ART coverage, excluding single-dose nevirapine)[3]

34%ª

–

67%

–

–

–

–

ART coverage among HIV+ pregnant women in need of treatment[3]

16%

–

67%

–

–

–

–

42%

–

61%

–

–

–

–

Child Targets

Overall Targets

Indicators

Prong Four

Global Plan Targets, Baseline and Current Status

Mother-to-child transmission rate[3] Breastfeeding ARV Coverage[3]

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Program Status According to PMTCT Prongs Primary prevention of HIV among women of childbearing age Preventing unintended pregnancies among women living with HIV

Global 2015 Targets • Reduce HIV incidence in women (ages 15-49) by 50% • Reduce unmet need for family planning among women to zero

Key Points

Background Statistics Young people (ages 15-24) HIV prevalence[1]*

Female: 4.1% [3.0-5.4%]

2009

Male:

2009

1.8% [1.3-2.4%]

Condom use at last sex among young people (ages 15-24) Female: 37%[11] with 2+ sexual partners in the last 12 months [13] Male: 67% Male partners of pregnant women attending ANC tested in last 12 months [14]*

Male:

Unintended pregnancies (ages 15-49)[13]

Female: 43%

2008/2009 2008/2009

4%

2010 2008/2009

Kenya has seen a very slight decline in HIV incidence in women (ages 15-49) between 2009 and 2011–from 0.58% to 0.52%[3]. Among young people (ages 15-24), HIV prevalence is over twice as high among young females (4.1%) than males (1.8%). Contraceptive prevalence is low, with less than half of married women in Kenya (46%) using any method in 2008-2009, and the rate of unintended pregnancies was 43% in 2008-2009[13].

Preventing HIV transmission from a woman living with HIV to her infant

Global 2015 Targets • Reduce overall mother-to-child transmission of HIV to