Engagement in HIV Care Among Kenyan Adults and Adolescents: Results From a National Population-Based Survey

BACKGROUND: Increasing access to care and treatment for HIV-infected persons is a goal in Kenyas response to the HIV epidemic. Using data from the second Kenya AIDS Indicator Survey (KAIS 2012) we describe coverage of services received among adults and adolescents who were enrolled in HIV care. METHODS: KAIS 2012 was a population-based survey that collected information from persons aged 15-64 years that included self-reported HIV status and for persons reporting HIV infection use of HIV care and antiretroviral therapy (ART). Blood specimens were collected and tested for HIV. HIV-positive specimens were tested for CD4 counts and viral load. RESULTS: Among 363 persons who reported HIV infection 93.4% [95% confidence interval (CI): 87.2 to 99.6] had ever received HIV care. Among those receiving HIV care 96.3% (95% CI: 94.1 to 98.4) were using cotrimoxazole prophylaxis and 74.6% (95% CI: 69.0 to 80.2) were receiving ART. A lower proportion of persons in care and not on ART reported using cotrimoxazole (89.5% 95% CI: 82.5 to 96.5 compared with 98.6% 95% CI: 97.1 to 100) and had a CD4 count measurement done (72.9% 95% CI: 64.0 to 81.9 compared with 90.0% 95% CI: 82.8 to 97.3) than persons in care and on ART respectively. Among persons in care and not on ART 23.2% (95% CI: 6.8 to 39.7) had CD4 counts microliter. Viral suppression was observed in 75.3% (95% CI: 68.7 to 81.9) of persons on ART. CONCLUSIONS: Linkage and retention in care are high among persons with known HIV infection. However improvements in care for the pre-ART population are needed. Viral suppression rates were comparable to developed settings.