Introduction

The annual HIV incidence in Kenya is 0.39 per 1000 among adults (15–64 years) in 2024. The national HIV prevalence among adults is 3.3% in 2024, twice as high among women, at 4.5%, compared to men, at 2.2%. Kenya has a devolved governance system comprising the national government and 47 county governments that are autonomous and responsible for managing health facilities and pharmacies, and for promoting and providing health care services for HIV infection, tuberculosis, malaria, and reproductive, maternal, neonatal, child, and adolescent health.

In 2014, the government of Kenya committed to prioritise and scale up HIV prevention interventions with the development of the Kenya HIV Prevention Revolution Roadmap 2030. It also set an ambitious target of reducing HIV incidence by 75% with the development and launch of the Kenya AIDS Strategic Framework 2014/15–2018/19. However, the country was not able to achieve its HIV prevention targets by 2019, so it has reprioritised reducing new HIV infections as one of the objectives of the Kenya AIDS Strategic Framework II, 2019/20–2024/25. The country also developed a Multisectoral HIV Prevention Acceleration Plan 2023–2030 to fast track achievement of the HIV prevention targets.

Although the national government provides policy and strategic direction, as health is a devolved programme, the counties’ role in designing and implementing HIV prevention programmes is critical. To this end, the National Syndemic Diseases Control Council (NSDCC) and the National AIDS and STI Control Programme (NASCOP) in partnership with University of Manitoba conducted a subnational epidemic appraisal in 2020-21 to inform the national HIV prevention strategy.

The appraisal was framed around three questions:

  1. Which geographies should Kenya prioritise for HIV prevention to achieve the country’s goal of reducing HIV incidence by 75%?
  2. Which populations should Kenya prioritise in these geographies?
  3. What programmes and services should be strengthened and/or scaled up in these geographies and populations?

The epidemic appraisal included the following three components:

  1. Analysis of HIV prevalence and incidence to identify high burden counties for geographic prioritisation.
  2. Analysis of population size and HIV prevalence to define epidemic typology and prioritise populations for preventive interventions.
  3. Analysis of routine programme monitoring data to assess programme coverage.

In the toolkit attached, we present the data and the analysis which was used for the subnational epidemic appraisal in Kenya. This epidemic appraisal is based entirely on secondary data, so the compilation of the required latest data from different sources is an important first step. The appraisal uses Microsoft Excel for all analysis, so the data are compiled in two Excel Workbooks.

Toolkit_ Subcounty Excel Workbook

Toolkit_County Excel Workbook

Epidemic Appraisal Toolkit