Men more likely to transmit HIV than women, report finds Lower prevalence among men linked to failure to seek health services By ANGELA OKETCHMore by this Author 27/2/2020 Women are less likely to transmit HIV to their partners than men, according to a 2018 survey released last week. The study reveals that HIV prevalence among adults in Kenya stands at 4.9 per cent with that of women being at 6.6 per cent and men 3.1 per cent. But, when the numbers are broken down into different age groups, the prevalence among women aged 20-24 is five times (3.4 per cent) more than men at 0.6 per cent. Despite women leading in all the age groups, the 2018 Kenya Population-Based HIV Impact Assessment report by National Aids and STI Control Programme, shows women have the highest prevalence of viral load suppression at 74 per cent while men have lower prevalence at 65 per cent. This means that in every 10 HIV positive women, only three can transmit HIV to their partners while in men it is four. PREV NEXT According to the Centres for Disease Control and Prevention, if taken as prescribed, HIV medicine reduces the amount of HIV in the body (viral load) to a very low level, which keeps the immune system working and prevents illness. This is called viral suppression. HIV medicine can even make the viral load so low that a test cannot detect it. VIRAL LOAD The national prevalence of viral load suppression among all HIV-positive adults in Kenya is 71.6 per cent, according to the report. Dr Nduku Kilonzo, National Aids Control Council chief executive, said men were generally not good at seeking health services hence the lower in numbers in prevalence and women are more likely to go to the hospital for the tests. “With women, it is different. When they feel unwell, they go to the hospital and get treatment and that explains why the adherence rate is also high in women and lower in men,” she explains. Dr Kilonzo also said it is high time men start taking their health seriously and taking drugs. “If viral load suppression in men comes down to that in women, it will be easier to manage the virus and reduce the viral load to transmittable levels,” she says. Speaking during the launch of the report, Dr Kilonzo said sexually active young women were sleeping with older men, who were not taking their health life seriously. The report points to an ageing HIV-positive population, a fact that might call for the government to review the support services given to people with HIV. Prevalence in the age groups from 40-59 years is between 7.5 and 9.4 per cent, higher than all age categories under 40. Experts say this is majorly a consequence of the success of an aggressive antiretroviral therapy campaign that is enabling HIV positive people to live longer. Many people in this category are getting weaker and less economically active and thus are increasingly in need of a broader health and nutrition support framework that goes beyond the HIV medicine offered by the government, if the treatment is to continue being effective, the experts say. “This data shows the ever-widening gap that is now showing a significantly higher burden of the disease in women compared to men. The same worrying trend is also emerging in the sub-Saharan region as evidenced by other regional PHIA (Population-based HIV Impact Assessment) surveys,” said outgoing Health Cabinet Secretary Sicily Kariuki. She challenged the stakeholders to urgently re-examine and redesign current frameworks, strategic plans and implementation programs tackling HIV prevention. She said they must also address the underlying unequal cultural, social and economic status affecting women in the societies that allowed HIV to so disproportionately affect mothers, sisters and daughters. GENDER INEQUALITIES A recent paper by Drissa Sia, a lecturer at the London School of Hygiene and Tropical Medicine and colleagues, explored what lies behind gender inequalities in HIV/Aids. The authors were interested in understanding the distribution of HIV risk among men and women compared with the effects of risk factors. That is, whether gender inequalities in HIV prevalence are explained by differences in socio-economic and behavioural factors among women and men or differences in women and men’s abilities to reduce HIV risk. The authors explored this by analysing data from surveys in Kenya, Tanzania and Lesotho. The authors suggested that biological differences between men and women might account for this, as men can infect women more easily than women can infect them. There also might be more complex social and cultural factors that exacerbate women’s vulnerability to HIV infection, they found.