KAIS 2007 1 - Kenya National AIDS & STI Control Programme ...

Overall, national ARV coverage was estimated to be 40.5%. That is, of all adults eligible to take ARVbased on a CD4 eligibility criterion of less than 250 cells/μl, only 40.5% were doing so. Coverage ofARV based on a criterion of less than 350 cells/μL was estimated at 28.6%.ARV coverage (based on CD4 less than 250 cells/μL) did not differ by sex, education level orresidential setting, but was marginally different when stratified by age group, and significantlydifferent by marital status. ARV coverage stimates for these groups are presented in Appendix B.10.Among adults who were aware of their HIV infection and eligible for ARVs (based on a CD4 countless than 250 cells/μl), ARV access was high with 91.6% reporting they were taking daily ARVs.Among persons with CD4 cell counts less than 350 cells/μL who were aware of their HIV‐infectedstatus, access to ARV was still relatively high and not significantly different at 81.8%.The vast majority (93.8%) of adults not on treatment but eligible (CD4 less than 250 cells/μL) were notaware of their infection because either they had never been tested for HIV or they incorrectly believedthey were HIV‐uninfected based on their last HIV test. ARV initiation requires that people infectedwith HIV know their status and receive medical evaluation to determine if they are eligible to initiateARV. Therefore, to improve care and ARV coverage, HIV testing must be scaled up and encouraged.Once diagnosed, HIV‐infected adults should be referred to medical services for clinical evaluation andCD4 testing.Only a small percent of eligible (based on CD4 cell counts less than 250 cells/ μL), infected adults(3.7%) were aware of their infection but were not taking ARV. Although the 2007 KAIS did not collectexplicit reasons for not taking ARV, all untreated respondents who knew they were infected,regardless of their CD4 count, had heard of ʺspecial drugsʺ for people with AIDS, and 57.7%specifically stated they knew of antiretroviral drugs. It is possible that some adults eligible for but nottaking ARV had recent declines in CD4 count since their last clinical assessment and did not know thatthey were now eligible. This highlights the need for close patient monitoring.KAIS 2007 190