8The Ministry of Health through National AIDS and STI Control Programme (NASCOP) will sharpen data collection methods to understand prevalence of HIV prevalence, awareness, prevalence and treatment among citizens with disabilities.
Speaking during a workshop to sensitize journalists on new developments in HIV/AIDS prevention and treatment, NASCOP’s Strategic Information Lead Dr. Lily Nyagah said the agency recognized the disability gap in the HIV data and that plans are underway to close the gap.
“Going forward, NASCOP has decided to be more intention on disability inclusion in our work and the first place where we have placed primary effort is on disability disaggregated data so that we can understand how to improve our services to this vulnerable population,” said Dr. Nyagah.
Dr. Nyagah said although data from Kenya Health Information System (KHIS) does not capture disability, primary data tools at health facilities capture disability.
She was responding to a question from Health Business reporter who sought to know what NASCOP was doing to ensure that it had data at the national level to inform planning HIV response for persons with disabilities.
During the workshop, it emerged that Ministry of Health through NASCOP had rolled out the piloting phase of the implementation of the three test HIV testing algorithm transitioning from a two-test algorithm. The transition is expected improve the quality and timeliness of HIV testing results and treatment.
Head of NASCOP Dr. Rose Wafula, said the transitioning to a three-assay HIV testing algorithm which will now require three consecutive reactive tests to provide an HIV positive diagnosis is expected to limit the risk of misdiagnosis given the now low number of individuals living with HIV in Kenya who do not know their status.
Dr. Wafula explained that the three test HIV testing algorithm which will include an initial rapid test (RDT) and two confirmatory tests -3-test algorithm- is expected to ensure 99 percent positive predictive value (PPV) is achieved changing the way people used to be diagnosed with HIV.
She added that the adoption of the 3-test HIV testing algorithm will ensure that the risk of a misdiagnosis (false negative or false positive) is reduced to an absolute minimum.
“With the evolution of global HIV epidemiology, HIV testing approaches must also evolve to maintain accuracy and efficiency in population-level diagnosis, NASCOP is also pushing for newer and better tools guided by scientific evidence for HIV response,” Dr. Wafula said, adding that the three-test HIV testing algorithm rollout begins the first week of July in the Kenya’s ASAL counties and it will be strategically and seamlessly done to avoid interruption of ongoing services.
She added that, Kenyans testing for HIV will now have their blood samples tested on three different test kits that work in slightly different ways. In the three-test strategy, you can only be told you have HIV after three consecutive reactive (positive) tests.
“If you are told that you are HIV positive or negative after the three tests, you can be confident that is the case,” Dr. Wafula said.
She explained that World Health Organization (WHO) had recommended a shift to three-test algorithm for countries with a HIV prevalence of less than 5percent. Kenya’s prevalence standing at 4.3percent.
She said the three test algorithm will ensure quality services as the country move towards ending AIDs in 2030 and ending HIV among children by 2027 and achieve the UNAIDS 95-95-95 targets.
According to WHO false HIV test results can happen, although they are rare. This is why more than one test is needed to diagnose HIV. To avoid situations where people are misdiagnosed with HIV, WHO is encouraging countries with HIV prevalence below 5percent such as Kenya to increase the number of tests that are used to confirm an HIV diagnosis. By making this change, countries will be able to ensure HIV testing remains accurate, even as prevalence continues to decline.
A false-positive diagnosis has important consequences for individuals (the psychosocial impact of an HIV diagnosis, the health implications of unnecessary ART, public health consequences (the substantial costs of lifelong ART and related services for misdiagnosed people) and damage to the reputation of and trust in the HIV program.
Kenya conducted a thorough review of the current two -test HIV testing algorithm through a taskforce formed in March 2022 compromising of Ministry of Health officials, researchers and technical partners and the evidence from the technical taskforce recommended adoption of the 3-test algorithm based on its sensitivity and specificity.
The taskforce was charged with reviewing performance reports of the current HIV testing algorithm and available evidence to adapt the three-test algorithm as per WHO recommendation. It was also to contextualize the adaption process and advice on the implementation.
The task force found evidence indicating the two-test algorithm was not optimal for HIV testing in the country after looking at latest data from the Kenya Population -based HIV Impact Assessment (KENPHIA).
