HIV Incidence, Recent HIV Infection, and Associated Factors, Kenya, 2007–2018
Open Access
- 1 February 2023
- journal article
- research article
- Published by Mary Ann Liebert Inc in AIDS Research and Human Retroviruses
- Vol. 39 (2), 57-67
- https://doi.org/10.1089/aid.2022.0054
Abstract
Background: Nationally-representative surveys provide an opportunity to assess trends in recent HIV infection based on assays for recent HIV infection. Methods: We assessed HIV incidence in Kenya in 2018 and trends in recent HIV infection among adolescents and adults in Kenya using nationally representative household surveys conducted in 2007, 2012 and 2018. To assess trends, we defined a recent HIV infection testing algorithm (RITA) that classified as recently infected (<12 months) those HIV-positive participants that were recent on the HIV-1 limiting antigen (LAg)-avidity assay without evidence of antiretroviral use. We assessed factors associated with recent and long-term (≥12 months) HIV infection versus no infection using a multinomial logit model while accounting for complex survey design. Findings: Of 1,523 HIV-positive participants in 2018, 11 were classified as recent. Annual HIV incidence was 0.14% in 2018 (95% confidence interval [CI] 0.057–0.23), representing 35,900 (95% CI 16,300–55,600) new infections per year in Kenya among persons aged 15–64 years. The percentage of HIV infections that were determined to be recent was similar in 2007 and 2012 but fell significantly from 2012 to 2018 (adjusted odds ratio [aOR]=0.31, p<0.001). Compared to no HIV infection, being aged 25–34 versus 35–64 years (aOR=4.2, 95% CI 1.4–13), having more lifetime sex partners (aOR=5.2, 95% CI 1.6–17 for 2–3 partners and aOR=8.6, 95% CI 2.8–26 for ≥4 partners versus 0–1 partners), and never having tested for HIV (aOR=4.1, 95% CI 1.5–11) were independently associated with recent HIV infection. Interpretation: Though HIV remains a public health priority in Kenya, HIV incidence estimates and trends in recent HIV infection support a significant decrease in new HIV infections from 2012 to 2018, a period of rapid expansion in HIV diagnosis, prevention, and treatment.Keywords
This publication has 30 references indexed in Scilit:
- Identifying Risk Factors for Recent HIV Infection in Kenya Using a Recent Infection Testing Algorithm: Results from a Nationally Representative Population-Based SurveyPLOS ONE, 2016
- Recalibration of the Limiting Antigen Avidity EIA to Determine Mean Duration of Recent Infection in Divergent HIV-1 SubtypesPLOS ONE, 2015
- The Kenya AIDS Indicator Survey 2012JAIDS Journal of Acquired Immune Deficiency Syndromes, 2014
- Tenofovir, Emtricitabine Intracellular and Plasma, and Efavirenz Plasma Concentration Decay Following Drug Intake CessationJAIDS Journal of Acquired Immune Deficiency Syndromes, 2013
- A New General Biomarker-based Incidence EstimatorEpidemiology, 2012
- Beyond detuning: 10 years of progress and new challenges in the development and application of assays for HIV incidence estimationAIDS, 2010
- Estimates of HIV incidence from household-based prevalence surveysAIDS, 2010
- Estimating Incidence from Prevalence in Generalised HIV Epidemics: Methods and ValidationPLoS Medicine, 2008
- Sexual Risk Factors for HIV Infection in Early and Advanced HIV Epidemics in Sub-Saharan Africa: Systematic Overview of 68 Epidemiological StudiesPLOS ONE, 2007
- Quantification of antiretroviral drugs in dried blood spot samples by means of liquid chromatography/tandem mass spectrometryRapid Communications in Mass Spectrometry, 2005