HIV Incidence, Recent HIV Infection, and Associated Factors, Kenya, 2007-2018.

Area of Science:

• Epidemiology
• Public Health
• Infectious Diseases

Background:

• Nationally representative surveys are crucial for monitoring human immunodeficiency virus (HIV) infection trends.
• Assays for recent HIV infection, like the HIV-1 limiting antigen (LAg)-avidity assay, help estimate incidence.
• Understanding trends in recent HIV infection is vital for public health strategies in Kenya.

Purpose of the Study:

• To assess HIV incidence in Kenya in 2018.
• To analyze trends in recent HIV infection among Kenyan adolescents and adults from 2007 to 2018.
• To identify factors associated with recent HIV infection.

Main Methods:

• Utilized nationally representative household surveys from 2007, 2012, and 2018.
• Defined a recent HIV infection testing algorithm (RITA) using the LAg-avidity assay and antiretroviral use data.
• Employed a multinomial logit model to assess factors associated with recent, long-term, or no HIV infection, accounting for complex survey design.

Main Results:

• In 2018, annual HIV incidence was 0.14% (35,900 new infections) in persons aged 15-64 years.
• The proportion of recent HIV infections significantly decreased from 2012 to 2018 (aOR=0.31, p<.001).
• Factors associated with recent HIV infection included younger age (25-34 years), higher numbers of lifetime sex partners, and never having tested for HIV.

Conclusions:

• HIV incidence estimates and declining recent infection trends indicate a significant reduction in new HIV infections in Kenya between 2012 and 2018.
• This decrease coincided with expanded HIV diagnosis, prevention, and treatment services.
• Despite progress, HIV remains a public health priority requiring continued monitoring and intervention.