Women still face highest risk as Kenya reduces new HIV infections
10 counties carry 60 pc of Kenya's HIV burden despite national progress.
What you need to know:
- Mother-to-child transmission continues to threaten the youngest.
- The data shows that 38 per cent of new HIV infections among children were linked to mothers dropping off antiretroviral therapy during breastfeeding (23 per cent) or pregnancy (15 per cent), or not receiving ART at all during pregnancy (22 per cent) or breastfeeding (12 per cent).
Kenya recorded 13,936 new HIV infections in 2026, marking a historic 56 per cent decline from the 32,027 new cases reported in 2020, according to Joint Aids Programme Review (JAPR) data from the National Syndemic Diseases Control Council (NSDCC).
The country is home to 1,481,853 people living with HIV, with approximately 1.4 million currently on treatment. Aids-related deaths fell to 19,434 in 2026, a seven per cent reduction from the 21,007 deaths recorded in 2024.
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Despite these gains, the data reveals persistent inequalities across gender, age and geography. National HIV prevalence stands at 3.22 per cent, but the burden is unevenly distributed, with women disproportionately affected. Forty-one per cent of new adult HIV infections occurred among adolescents and young people aged 15 to 24, with young women accounting for the majority of cases.
Just 10 of Kenya's 47 counties account for 60 per cent of all people living with HIV. These are Nairobi (189,640), Homa Bay (128,906), Kisumu (114,986), Siaya (96,304), Migori (80,105), Busia (63,668), Kakamega (56,230), Mombasa (55,048), Kiambu (52,446) and Nakuru (52,163).
“A comparative analysis of new HIV infections between 2021 and 2026 reveals that adolescents and young persons aged between 15 and 24 recorded the greatest percentage decline in new HIV infections, reducing BY 61.5 per cent (from 11,229 in 2021 to 4,322 in 2026). In comparison, children aged between zero and 14 years recorded the lowest decline of 34.7 per cent (from 5,201 in 2021 to 3,396 in 2026)," the report notes.
Mother-to-child transmission continues to threaten the youngest. The data shows that 38 per cent of new HIV infections among children were linked to mothers dropping off antiretroviral therapy during breastfeeding (23 per cent) or pregnancy (15 per cent), or not receiving ART at all during pregnancy (22 per cent) or breastfeeding (12 per cent). The report flags this as an urgent call to strengthen Prevention of Mother-to-Child Transmission programmes and ensure treatment continuity.
Children are also dying at a higher rate than adults. In 2026, 33 out of every 1,000 children aged zero to 14 died of Aids-related causes, compared to 12 out of every 1,000 adults aged 15 and above. Among adults, men recorded a noticeably higher fatality rate (18 per 1,000) compared to 10 per 1,000 among women.
On syphilis, 1.4 million people were screened in Kenya in 2025, with 9,057 testing positive. Counties recording high numbers of positive cases included Nairobi, Kakamega, Bungoma, Narok, Kajiado, Homa Bay, Uasin Gishu and Machakos.
Speaking at the launch of the 47 County Syndemic Operational Plans under the new Kenya Aids Strategic Framework, NSDCC Chief Executive Officer Douglas Bosire said the data "tell a story of both achievement and urgency."
On county distribution of new infections, Dr Bosire noted that the burden remains uneven. "Nairobi County leads with 1,516 new infections. Kisumu follows with 1,057. Homa Bay, with 985, and Migori, with 970, are the next highest. Wajir has the lowest burden at only 10 new infections. The top five counties account for a disproportionate share
of the national total," he said.
He identified several gaps the Kenya Aids Integration Strategic Framework (KAISF) must address. "Children account for 24 per cent of new HIV infections and 12 per cent of Aids deaths among those aged zero to 14 years. Adolescent girls, young women and key populations carry a disproportionate burden. Men continue to present late with advanced HIV disease. The highest Aids deaths occur among adults aged 45 to 49 years, signalling a bi-modal age pattern that demands urgent attention. Vertical transmission fell to 8.04 per cent in 2025 but remains above target," said Dr Bosire.
He also pointed to deep structural vulnerabilities, noting that over 60 per cent of HIV programme funding historically came from foreign donors, a dependency that became a crisis in 2025 when that support was suddenly withdrawn.
An executive order issued in January 2025 triggered the withdrawal of Pepfar and USAid support, sending shockwaves through Kenya's health system. A total of 2,127 facilities reported significant service disruptions, with rural facilities hit 3.2 times harder than urban centres. Staff walked out of 39.5 per cent of affected facilities, and the nurse-to-patient ratio worsened to 1:120.
"Kenya did not collapse. Counties kept facilities open. Health workers reported to duty even when salaries were uncertain. Communities held together," Dr Bosire said.
"Our 95-95-95 treatment gains were largely protected through emergency measures. 99.8 per cent of disrupted facilities integrated HIV, TB and malaria services to maintain continuity. The NSDCC worked with county governments, implementing partners and development partners to adapt supply chains, redirect commodities and protect the most vulnerable populations."
To guard against future funding shocks, the Ministry of Health is pursuing a programme science approach; moving away from separate, vertical donor pipelines for individual diseases towards a unified platform that screens for HIV, tuberculosis, syphilis and non-communicable diseases in a single system. This shift is driven partly by the scale of co-morbidities: over half of Kenyans living with HIV now have at least one non-communicable disease such as cardiovascular illness or diabetes. HIV-positive women face a six-times higher risk of cervical cancer, accounting for over 5,200 new cases annually. At the same time, tuberculosis claims 23,500 lives each year, with 20,000 of those deaths directly linked to HIV co-infection.
Under the Kenya Aids Integration Strategic Framework (KAISF) 2025–2030, patients will be able to receive treatment for HIV, tuberculosis, sexually transmitted infections and non-communicable diseases in a single facility visit. By merging previously separate supply chains, data registers and workforces, Kenya aims to eliminate the administrative duplication that left health infrastructure vulnerable to external shocks.
The model is being operationalised through 47 distinct county syndemic operational plans, transferring ownership and accountability to local governments. By 2030, each county commits to migrating facilities to integrated digital reporting, pooling commodity procurement to prevent stockouts, and retraining medical staff to treat the whole patient rather than a single condition. Backed by domestic funding and the Social Health Insurance Fund, the framework targets dropping annual child HIV infections below 200, cutting Aids-related deaths by half, and achieving 100 per cent domestic financing across the health sector.
Health Cabinet Secretary Aden Duale said integration was not a retreat from the epidemic. "Integration is not a shift away from HIV. Rather, it's a strategic approach to sustain and protect the gains we have made while delivering HIV investment to strengthen health systems, improve our service delivery and advance UHC," he said.
Representing the Council of Governors, Bungoma County Governor Kenneth Lusaka welcomed the transition but cautioned against an unfunded burden on counties. "Integration cannot become an unfunded mandate transferred to counties without corresponding alignment in financing, commodities, workforce support, health information systems and partner coordination," he said. He added that counties, which employ over 80 per cent of the health workforce and manage 95 per cent of primary health facilities, must also rationalise staffing to maintain a seventy-to-thirty ratio of medical professionals to support staff.
