1. HIV AND AIDS
DR. GORDON AMBAYO

2. WHAT IS HIV?? “Human Immunodeficiency Virus”
A unique type of virus (a retrovirus)
Invades the helper T cells (CD4 cells) in the body of the host (defense mechanism of a person)
Has caused a global epidemic.
Preventable, manageable but not curable.

3. WHAT IS AIDS ??? “Acquired Immunodeficiency Syndrome”
HIV is the virus that causes AIDS
Disease limits the body’s ability to fight infection due to markedly reduced helper T cells.
Patients have a very weak immune system (defense mechanism)
Patients predisposed to multiple opportunistic infections leading to death.

4. “The viral genome”
Icosahedral (20 sided), enveloped virus of the lentivirus subfamily of retroviruses.
Retroviruses transcribe RNA to DNA.
Two viral strands of RNA found in core surrounded by protein outer coat.
Outer envelope contains a lipid matrix within which specific viral glycoproteins are imbedded.
These knob-like structures responsible for binding to target cell.

5. HIV TRANSMISSION How is HIV virus transmitted?
How is it not transmitted?

6. Through Bodily Fluids
Blood products
Semen
Vaginal fluids

7. IntraVenous Drug Abuse
Sharing Needles
Without sterilization Increases the chances of contracting HIV
Unsterilized blades

8. Through Sex
Unprotected Intercourse
Oral
Anal

9. Mother-to-Baby
Before Birth
During Birth

10. Global estimates for adults; 2012
People living with HIV million (32.2–38.8)
New HIV infections in million [(1.9–2.7) million]. The trend have been declining over the years
Deaths due to AIDS in million [1.4–1.9 million]
Source: 2013 UNAIDS reports

11. Regional estimates for adults; 2012
People living with HIV million [22.1–24.8 million]
in sub-Saharan Africa
New HIV infections in million [1.6 million–2 million] in sub-Saharan Africa
Deaths due to AIDS in million [1.1 million–1.3 million] in sub-Saharan Africa
Source: 2013 UNAIDS reports

12. HIV IN KENYA 101,560 New infects in Kenya in 2014.
21% of new adult infections occur among young women aged years.
191,840 children were living with HIV in 2014
63% of men and 80% of women know their HIV status
5.6% of Kenyans are HIV positive.
1.6 million Kenyans are living with HIV

13. 65% 0f new infections occur in 9 out of 47 counties.
COUNTY
NEW HIV INFECTIONS
PEOPLE LIVING
WITH HIV IN
HIV PREVALENCE (%)
Homa Bay
15,003
150000
27.1
Kisumu
12,645
113,000
18.7
Siaya
12,059
100400
17.8
Migori
8,292
68,700
13.4
Kisii
5,975
73,300
4.9
Nakuru
4,326
57,800
5.6
Turkana
3,141
51,200
9.9

14. 65% 0f new infections occur in 9 out of 47 counties.
COUNTY
NEW HIV INFECTIONS
PREVALENCE (%)
Nyamira
2.507
16,600
6.9
Bomet
1,965
18,700
3.5

15. HIV IN KENYA HIV prevalence in Kenya is 5.6%
Women infection is 8% Men 4%

16. POPULATION AT HIGHES RISK
Injection drug users 53%
Commercial sex workers ( Prostitutes) 27%.
Men who have sex with men 18.2%

17. HIV prevalence among university students
Overall prevalence of HIV in six universities- 0.51%
Prevalence UON- 0.46%
HIV Prevalence by Sex-Males(0.58%) & Females (0.40%)
Source :HIV&AIDS Baseline Sero-behavioural Study in Six Universities in Kenya (2009)
By IUCEA - Inter-University Council for East Africa EALP & East African Lake Basin Project
HIV Prevalence by Year of Study
Prevalence (%)
1st year
0.24%
2nd year
0.47%
3rd year
0.81%
4th year
0.75%

18. Proportion of those abstaining by year of study and sex (source : HIV&AIDS Baseline Sero-behavioural Study in Six Kenyan Universities by EALP/IUCEA 2009)

19. HIV PREVALENCE BY COUNTY
ADULT PREVALENCE (%)
ADULT PREVALENCE
HOMA BAY
27.1
BUSIA
7.1
KISUMU
18.7
NYAMIRA
6.9
SIAYA
17.8
TAITA TAVETA
6.4
MIGORI
13.4
KWALE
6.2
MOMBASA
11.1
VIHIGA 6
TURKANA
9.9
NAKURU
5.6
KISII
8.9
MAKUENI
NAIROBI
8.6
KAKAMEGA
TRANS NZOIA
7.2
MURANGA
5.2

20. HIV PREVALENCE BY COUNTY
ADULT HIV PREVALENCE
ADULT HIV PREVALENCE
THARAKA NITHI
5.1
MACHAKOS
4.7
SAMBURU
NYERI
4.4
KAJIADO 5
KIAMBU
UASIN GISHU
4.9
KERICHO
NAROK
BARINGO
4.2
NANDI
4.8
LAIKIPIA
4.1
KITUI
KIRINYAGA 4

21. HIV PREVALENCE BY COUNTY
ADULT HIV PREVALENCE
NYANDARUA
3.9
GARISA
2.6
ISOLO
3.8
WEST POKOT
2.4
ELGEYO
TANA RIVER 2
KILIFI
3.7
MANDERA
1.3
EMBU
LAMU
BUNGOMA
3.5
MARSABIT 1
BOMET
WAJIR
0.2
MERU
3.3

22. PREVENTION
ABC – Abstinence, being faithful and condom use are key to HIV prevention.

23. Abstinence It is the most effective method of not acquiring HIV/AIDS.
Refraining from unprotected sex: oral, anal, or vaginal.
Refraining from intravenous drug use

24. Monogamous relationship
A mutually monogamous (only one sex partner) relationship with a person who is not infected with HIV
HIV testing before intercourse is necessary to prove your partner is not infected

25. MULTIPLE SEXUAL PARTNERSHIPS
The percentage of Kenyans having multiple sexual partners in the previous 12 months has increased in the last 10 years.
Having multiple sexual partners puts one at risk of HIV.

26. MULTIPLE SEXUAL PARTNERS

27. MULTIPLE SEXUAL PARTNERSHIPS
YEAR
% OF MALE
CONDOM USE %
% OF FEMALE
CONDOM USE %
2003
11.6
31.6
1.7
12.2
2008/2009
9.3
37.0
1.2
31.8
2012
14.7
38.8
2.5

28. MALE CIRCUMCISION
Kenya initiated voluntary medical male circumcision in Since then the program has scaled up from 8,000 in 2008 to 190,000 VMMCs in 2013.

29. FEMALE SEX WORKERS
% REPORTING USE OF CONDOMS IN MOST RECENT SEXUAL INTERCOURSE
86.2
% WHO HAVE RECEIVED hiv TEST IN THE LAST 3 MONTHS
68.0
PERCENTAGE WHO ARE HIV POSITIVE
29.3

30. MEN WHO HAVE SEX WITH MEN
% WHO USED A CONDOM IN THE LAST SEXUAL INTERCOURSE
68.8
% TESTED FOR HIV IN THE LAST 12 MONTHS AND KNOW THEIR RESULTS
74.0
% WHO ARE LIVING WITH HIV
18.2

31. Impacts of HIV/AIDS Includes the following
Individuals and families consequences (increased morbidity, orphans, discrimination, school/college drop outs etc
Demographic consequences( increased mortality, reduced fertility and migration
Reduced life expectancy
Impact of HIV on the workforce (increased absentees)
Impacts on the country's economy (poor economic growth)

32. HIV Transmission Heterosexual risk networks
Sexual HIV Transmission
HIV Transmission via Blood
Heterosexual risk networks
Regular sexual partners if HIV+
MSM networks
HIV+ MTCT
IDU networks
medical procedures
Other- B/F

33. HIV Preventive programs
Primary
Secondary
Tertiary

34. PRIMARY PREVENTION: Five ways to protect yourself?
Abstinence
Monogamous Relationship
Protected Sex
Sterile needles
New shaving/cutting blades

35. Major Types of HIV Preventive Interventions
Behavior change interventions
Behavior change communication (BCC): multiple media
VCT
Peer education programs
Social/structural programs
100% condom use
Economic empowerment of women
Harm reduction e.g. access to safe injections
Biomedical interventions
Anti-retroviral
PMTCT
HAART
Post exposure prophylaxis
Treatment of STIs
Voluntary Male Medical circumcision
Screening donor blood
Vaccines?
Microbicides?

36. Effects of HIV preventive programming
Reduced stigma and discrimination
Increased productivity
Reduced morbidity
Improve quality of life
Improved life expectancy
Reduced mortality among others