Kenya cuts new HIV infections but AIDS deaths barely drop
New infections fell from 32,027 to 13,936, while the gap between deaths and new infections has widened significantly.
What you need to know:
- The country has achieved a 56 per cent reduction in new infections against a 75 per cent target.
- However, it has managed only a 0.3 per cent reduction in AIDS deaths against a 50 per cent target.
- The gap between those two numbers, experts say, is a diagnosis.
Kenya has cut new HIV infections by 56 per cent over the past five years, between 2020 and 2026. New infections fell from 32,027 to 13,936, while the gap between deaths and new infections has widened significantly.
According to the Kenya HIV Estimates 2026, presented by the National Syndemic Disease Control Council (NSDCC) this month, AIDS-related deaths declined by just 0.3 per cent over the same period, from 19,486 to 19,434. This means nearly 20,000 people are still dying every year from a disease for which effective prevention and treatment drugs are widely available.
The country has achieved a 56 per cent reduction in new infections against a 75 per cent target. However, it has managed only a 0.3 per cent reduction in AIDS deaths against a 50 per cent target. The gap between those two numbers, experts say, is a diagnosis.
The report indicates that deaths are a consequence of a system that keeps people alive just long enough to diagnose them, then loses them at every subsequent step. From 2023, deaths overtook new infections. The 2025 surplus, 19,434 deaths against 13,936 new infections, is the largest recorded, signalling unfinished treatment and survival work rather than a failure of prevention, according to the report.
The deaths are not distributed evenly. Nairobi leads the country with 2,491 AIDS-related deaths, followed by Homa Bay at 1,693 and Kisumu at 1,510. The top five counties alone account for 43 per cent of all AIDS-related deaths nationally.
These are the same counties that carry the heaviest treatment burden, because the volume of people in need of services has outpaced the systems designed to deliver them.
According to the NSDCC, 10 counties together account for well over half of all national deaths, dominated by Nairobi and the Lake region. Nairobi alone, with 2,491 deaths, represents 12.8 per cent of the national total and carries the largest absolute HIV burden in the country.
It is followed by Homa Bay with 1,693 deaths, Kisumu 1,510, Siaya 1,265, Migori 1,052, Busia 836, Kakamega 738, Mombasa 723, Kiambu 689, and Nakuru with 685 deaths.
At the other end of the scale, the bottom 10 counties record far fewer absolute deaths: Wajir reports only eight deaths nationally, Mandera 16, Marsabit and Garissa 29 each, Samburu 39, Isiolo 70, West Pokot 76, and Elgeyo Marakwet 92. However, these counties have some of the highest Mother-to-Child Transmission rates in Kenya, with Wajir at 30.9 per cent, Samburu at 21.9 per cent, and Marsabit at 21.2 per cent.
"Low absolute deaths reflect low HIV prevalence in populations that are predominantly Muslim and have lower overall HIV exposure, not better treatment outcomes. When people in these counties do acquire HIV, their care cascade is among the worst in the country, driven by stigma so severe that men avoid testing entirely," the report notes.
In Mandera, Wajir and Garissa, HIV stigma is documented to be so severe that men are avoiding testing altogether. The data shows male deaths exceeding 18 per 1,000, compared to under 10.6 per 1,000 for women. In these counties, a diagnosis is more likely to come when a person is already critically ill. Treatment begins late. Death follows quickly.
Deaths by age
The peak death toll was recorded in the 45–49 age group, with 2,559 deaths, the single highest of any age bracket. It is followed by 50–54 years at 2,413 deaths and 40–44 years at 2,017 deaths. Together, adults aged 35–59 years account for 53 per cent of all 19,434 deaths.
"These are not people who missed the era of antiretroviral treatment. They were diagnosed, most of them enrolled on antiretroviral drugs, and the programme lost them along the way. Either they dropped their medication and were never followed up, or adherence was a problem," said Nelson Otwoma, Director and Head of Programs at the National Empowerment Network of People Living with HIV and AIDS in Kenya.
Otwoma said that to reduce deaths, as long as one is enrolled on drugs, programmes should ensure that patients remain on treatment to keep them alive for years and also reduce their chances of transmission.
"We are failing them. Once they are enrolled, we should ensure that they stay put on drugs," Otwoma said.
He added: "People are starting antiretroviral therapy and stopping. Others lack transport to clinic, drug stockouts, fear of stigma if seen collecting medication, work schedules incompatible with facility hours. Again, people are not being identified. Those who are identified are not being linked to care.
Those who are linked are not being retained. The pipeline from diagnosis to suppression is leaking at multiple points simultaneously."
By age and gender, men above 55 years died in higher numbers, while in the 50–54 age bracket, the numbers nearly equalise (1,207 men, 1,206 women). Case fatality exceeds 18 per 1,000 in men, compared to under 10.6 per 1,000 for women.
Among children, the 0–4 years age group accounts for 1,507 deaths, the largest child group, driven almost entirely by mother-to-child transmission and poor paediatric Antiretroviral Therapy (ART) coverage. Only 46 per cent of children aged 0–4 are on treatment.
The data shows that children are dying at more than twice the adult rate. The child case fatality rate rose from 28.9 per 1,000 in 2020 to 42.8 per 1,000 in 2024, before easing to 32.7 per 1,000 in 2025. The adult rate stands at 13.8 per 1,000.
Nairobi recorded 241 child AIDS deaths, Homa Bay recorded 231, and Kisumu recorded 174. The top five counties for paediatric deaths account for 47 per cent of all AIDS deaths among children aged 0 to 14. These are children in the most resourced parts of the country dying from a preventable disease.
In the 15–19 age group, 662 deaths were recorded. In the 20–24 bracket, 1,159 deaths were recorded. Among adolescents and young women in this age range, ART coverage stands at 77 per cent, compared to more than 90 per cent for older adults.
Deaths today reflect infections and treatment failures from five to ten years ago. The prevention gains now being recorded will not translate into lower mortality for years. The system is treating a legacy of exposure from an earlier, higher-burden era.
