It is estimated that more than 33 million people in the world today are currently living with the human immunodeficiency virus (HIV). It is also estimated that more than 30 million people have died from HIV-related complications since the earliest cases were detected in the early 1980s. While it is trite truth that huge progress has been made to increase access to HIV treatment in the past twenty and more years, and that new HIV infections have significantly declined in some regions, the pandemic nevertheless continues to wreck havoc in many more areas and efforts to control it seem distant. The number of newly infected people each year in most scenarios far outnumbers those who gain access to treatment by an estimated two to one ratio.
It is reported that Kenya has the fourth largest HIV epidemic in the world. In 2012, out of a population of about 40 million, an estimated 1.6 million individuals were living with HIV and there were approximately 98,000 new infections. The HIV & AIDS epidemic in Kenya has since been often referred to as being generalized. In essence this means that it affects all sections of the society including children, youth, adults, women and men alike. According to a Kenya AIDS Response Progress Report, a concentrated certain group of Kenyans are more susceptible to contracting the virus due to their vulnerability to HIV transmission.
These groups can be categorized as follows;
- Men who have sex with men (MSM)
- Persons who inject drugs (PWIDs)
- Sex Workers
- Women and young girls
HIV prevalence among MSM in Kenya is almost three times more than the general population. Condom use among this group is reportedly fairly low. It is important to note that sexual relations between men remain illegal in Kenya and can carry a prison sentence of about 21 years if found guilty. Homosexuality is thus largely considered taboo and repugnant to the cultural values and moral code of the Kenyan Nation. This stance leads to high levels of stigma and discrimination towards MSM as well as towards other members of the lesbian, gay, bi-sexual and transgender community in Kenya. This often acts as a huge barrier and deterrent for these individuals to seek HIV treatment and testing.
I will not belabor with the jurisprudential arguments on the law and morality and how these two are either distinct or analogous hypotheses. However what I would like to direct your attention to the Kenyan Constitution in specific to Article 43(1) which guarantees every individual the highest attainable standard of health…which is important to the realization of the right to life. Articles 26,27 and 28 in my mind also suggest that everyone has a right to life and that everyone shall be subjected to equality and freedom from discrimination in every sphere including access to medical care and treatment irrespective of sexual orientation or preference.
Granted, the Kenyan Government has made significant contributions to addressing the HIV & AIDS pandemic but a correlation and consistency remains to be seen in theory and in practice. One of the greatest strides taken was in 2006 with the enactment of the HIV and AIDS Prevention and Control ACT 2006 which establishes the first ever tribunal (only one in the world) to handle legal issues relating to HIV, including discrimination against people living with HIV and protecting the confidentiality of medical records. Since its establishment in January 2012, the tribunal has received 400 complaints, admitted 14 cases and delivered two judgments.
Although the HIV prevalence among the general Kenyan population has fallen with rigorous campaigns around testing at VCT centers, sensitization and education campaigns as well as free ARVs medications provided at Government clinics, women and young girls unfortunately continue to be disproportionately affected by the epidemic. In 2012, Government statistics report that 6.9 % of women in Kenya were living with HIV compared with 4.2 % of men. Young women aged 15- 24 in Sub-Saharan Africa are almost three times more likely to be living with HIV than men of the same age. This can be attributed to discrimination that women and girls face in terms of access to education, employment, healthcare to name but a few. As a result, men will often always dominate sexual relations with women not being able to practice safe sex even when they know and understand the risks.
In the wake of the recently publicized partnership between the Bill & Melinda Gates Foundation, the Nike Foundation and the U.S President’s Emergency Plan for AIDS Relief (PEPFAR) on a $ 210 Million initiative to reduce new infections in adolescent girls and young women, governments in Sub-Saharan countries should also accelerate efforts in prevention initiatives targeted at the most vulnerable groups as identified. More people should be encouraged to know their status and thus be able to access treatment, care and support regardless of other collateral factors. The Kenyan Government should also work on overcoming social, cultural and legal barriers that hinder access, treatment and testing of all its citizenry. Leaders should also start thinking of sustainable ways to scale up and fund existing prevention and treatment efforts to curb HIV & AIDS.