Experience from a pilot point-of-care CD4 enumeration programme in Kenya

Kenya is a HIV ‘high burden’ county in Africa with both a generalised and a concentrated epidemic within its population of 47 million.1 HIV prevalence reached a peak of 10.5% in 1995–1996, but declined to approximately 6.0% in 2013.2 The number of people living with HIV is estimated to have increased from about 1.2 million in 2009 to 1.4 million in 2013.3 This number is projected to continue increasing due to improved survival attributable to antiretroviral therapy programmes. The total number of new HIV infections is estimated to have declined by about 15.0% over the last five years from about 116 000 in 2009 to around 100 000 in 2013.3 Over the last five years, the number of annual AIDS-related deaths has declined, from about 85 000 in 2009 to 58 000 in 2013. The prevalence of HIV in infants has also been declining, with numbers dropping from around 14.4% in 2007 to 8.8% in 2015. This decline is partly due to a robust prevention of mother-to-child transmission programme. It is estimated that 100 000 infants are born to HIV-positive mothers every year. Approximately 60 000 children are on treatment for HIV. However, only 50.0% of infants receive a timely virologic test and antiretroviral therapy coverage is suboptimal, which can be attributed to limited access to diagnosis