The HIV burden in Kenya is extremely high among adolescents and young people. The Kenya HIV Estimates 2018 by National AIDS Control Programme (NASCOP) indicate that 105,230 adolescents are living with HIV; this is approximately equivalent of 80 public high schools.
Among these, 20,663 are on antiretroviral therapy but only 6,700 have had their viral load suppressed. Statistics point out that there are 8,177 new infections per year and 2,072 annual AIDS related death among youths.
“While AIDS related deaths have halved in children since 2010, they have only fallen by 5% in adolescents. AIDS, in other words, is far from over especially for young people,” Linda-Gail Bekker, International AIDS Society President.
According to Statistics, half of the 15 to 19 year olds who are living with HIV in the world live in just six countries: South Africa, Nigeria, Kenya, India, Mozambique and Tanzania.
In the 2018 conference on HIV/AIDS titled, Turning the tide: Preventing New HIV Infection and Optimizing treatment Outcomes several issues emerged as hindrances to the progress of HIV treatment and prevention among youths. The conference provided a platform for different youths from different backgrounds and organizations to air their issues in regards to HIV/AIDS.
Stigma and discrimination is a major issue when it comes to dealing with HIV among the youth. Youths living with HIV often feel discriminated against even in school set ups. “Life in boarding school was hard for me, I did not tell anyone about my status for fear of being discriminated and stigmatized. I could not take my medicine in public, so I would wake up in the middle of the night when everyone was asleep and take them,” states James*, a minor living with HIV/AIDS. In schools, HIV is usually portrayed as a killer disease and often associated with sexual immorality.
At the health centres it is difficult for youths to approach health workers on issues to do with safe sex practices such as contraceptives and other sexual issues, this in return hinders them from getting information related to HIV as well. “When you go to the health facility especially public ones to just enquire about these services such as condoms and other family planning measures, most of the health workers look down upon you, this they do through their facial expressions or verbally,” states Anne , an adolescent mother. “That hostility is enough to make you change your mind,” she adds.
The society in general has a lot of myths and misconceptions about people living with HIV/AIDS and this makes it even harder for youths to disclose their status or even go for HIV testing at the health facilities. The fear of the public judging them and after that segregating them is a nightmare for them.
Lack of inclusion in policy making concerning the youth is a barrier that cannot fail to be mentioned. Adults design different programs for the youth but exclude them when coming up with these things. ” If you are making decisions concerning the youths involve them in the round table, let them say which things are going to work for them,” Dr. Rose Wafula, United Nations Children’s Fund (UNICEF). “Let’s go beyond talking about them, engage young people and let them voice their positions,” she adds.
Low financial empowerment among youths is a hindrance to dealing effectively with HIV/AIDS in Kenya especially in informal settlements or families grappling with loss of breadwinners. “I had just lost my dad, and going back to school became a problem as we couldn’t get access to his pension money. I had to look for other means to pay my school fees and support myself. That was the genesis of me becoming a commercial sex worker,” says Hellen, a youth commercial sex worker.
“At that time, I had no idea about safe sex practices,” she adds. Many youths in their quest to become economically empowered, give in to such lifestyles; even the male ones have sugar mums, whereby they render sexual services to older women in order to get money. In most of these cases, the one with the upper hand is the one with money; hence they give in to their demands regardless of caring about their sexual health.”
The internet also plays a big role in hindering the fight against HIV/AIDS among the youth. Through the social media platforms, youths are able to gain information which might not be necessarily true concerning their sexual health. Youths listen to youths, so when they hear other youths on social media platforms sharing their experiences (no youth ones to tarnish their image), it arouses their curiosity and makes them desire to have such encounters.
There is the problem of nutrition for youths living with HIV in arid and semi-arid areas. “Turkana is a dry area, being that pastoralism is our main economic activity, it becomes difficult to eat healthily, some just have access to one meal a day,” Gladys, an adolescent from Turkana laments. Food insecurity makes it hard to adhere to treatment, lack of adherence results in high viral load and finally death.
The adolescent’s cascade of care in Kenya is in line with the global agenda of ending AIDS by 2030 through the adoption of 90-90-90, which means 90% knowing their HIV/AIDS status, 90% of those infected to receive anti-retroviral therapy and 90% to achieve viral suppression. According to statistics the current coverage stands at 36-96-66, 36% know their HIV, 96% of the infected are on anti-retroviral therapy yet 66% have been virally suppressed. There is need for change in order to battle with HIV among the youth, not just in terms of lowering the new infections but also managing HIV and reducing the rate of mortality.