The 2008 Kenya AIDS Indicator Survey (KAIS) presents a grim picture of the HIV prevalence rates in the country, with rate now standing at 7.8 per cent from 5.1 per cent announced last year.

But one of the most interesting findings of this study is the changing pattern of the HIV prevalence rates, with older men and women now at increasing danger than young people.

Prevalence among adults aged between 50 and 54 years was 8 percent compared to 4.1 per cent among young people of ages 15 to 24 years. In the past, it is the youth who have borne the brunt of the disease, with high infection rates being recorded among them. The whole attention has been on young people, with over 90 per cent of the interventions targeting them.

Meanwhile, the older population seems to have perceived itself to be at less risk of infection as no one was talking about them with such passion as the youth. Messages on condom use, abstinence and be faithful, and now circumcision, have largely been directed at young people. 

HIV experts now suspect that most of the older people are more at risk because they are not using condoms as is the case with the young people. Similarly, at this age, majority of the older men have created wealth and either keep mistresses or engage with multiple sexual partners. 

The other reason, the pundits claim, the attention on the youth appears to have portrayed them to be at a greater risk than older population. Nevertheless, the number of infections among young people remains high and a cause of concern to policy makers.

HIV prevalence among those aged between 15 and 49 years was 7.8 per cent, and among those aged 15-64 years was 7.4 per cent. The highest prevalence rate (11.7 per cent), was recorded among those aged between 30 and 34 years.

Prevalence among women aged 15 to 49 years remains high at 9.2 per cent compared to 5.8 per cent among men. This is an increase from 8.7 percent for females and 4.6 per cent for males captured in the 2003 Kenya Demographic and Health Survey (KDHS). 

Most at risk are women aged 25 to 44 years. Of those aged 30 to 34 years, for instance, prevalence rate was 13.7 per cent, more than double the rate among their counterparts in the age bracket of 15 to 24 years. Likewise, urban women had a high prevalence rate of 10.8 per cent against 8.2 per cent of those in the rural areas. 

Prevalence was also high among those currently widowed women and men (20.7 per cent), over 17.1 per cent among those divorced or separated, and 11.2 per cent among those in polygamous marriages.

Women and men with steady partners or in monogamous marriages however had low HIV prevalence rates, which may indicate they are practicing faithfulness values. 

At the moment, the number of widowed men and women has more than tripled since 2003. The HIV prevalence rate among this group implies the death partner must has been HIV positive, says the KAIS study. 

While the older population is increasingly entering the HIV risk bracket, the ratio between infected male and female almost the same than is the case among young people. For instance, among those aged 50 to 54 years, the prevalence was 8 percent among females and 8.1 percent among males. 

Besides the trends within and between age groups, the 2008 KAIS provides a geographical pattern of the disease. Nyanza province lead with prevalence of 15.4 per cent, followed by Nairobi (9.3 per cent), Coast (8.1 per cent), Rift Valley (7.4 per cent), Western (5.7 per cent), Eastern (4.9 per cent) Central (4.2 per cent), and North Eastern (1.3 per cent). 

Nyanza also leads with 17.7 percent of the females infected followed by Nairobi at 10.7 percent, with Central (4 per cent) and North Eastern (1 per cent), having the lowest rates. 

But Nairobi and Central province registered a marginal decrease in the HIV prevalence rate from what was recorded in the 2003 KDHS. Other provinces are experiencing increasing infection rates, with highest being recorded in Coast province (from 5.8 percent in 2003 to 8.1 per cent in 2007). 

Urban areas on the other hand have higher prevalence rates of 9.2 per cent compared to the 7.4 per cent in the rural areas. But prevalence rates in the rural areas seem to be on the upward trend, with 7 out of 10 HIV infected adults being rural residents.

Some of the reasons, scientists think, HIV positive people are either retreating to their rural areas from urban centres or more people in the rural areas are now getting infected as well as turning out to be tested.

Although the number of those going for HIV testing has increased from 13.7 per cent in 2003 to 35.6 per cent in 2007, women are almost twice the number of men who have been tested. Also worrying is a very small percentage of the HIV infected men using condoms when having sex.

The KAIS study also looked at the prevalence of herpes simplex virus-2 and syphilis and their co-infections with HIV. Prevalence ofsyphilis infection was higher in the rural areas than urban ones, with males being the most affected. 

This article was also published in the Nation  on July 30th 2008. (http://www.nation.co.ke )