By Kepher Otieno - Reporter
Kenya, 2 July 2026 - Siaya County is grappling with a troubling resurgence in new HIV infections despite introducing long-acting injectable HIV prevention medicines that health officials had hoped would accelerate progress toward ending the epidemic.
The county, which has one of Kenya's highest HIV burdens, is reporting an increase in new infections even as public health authorities expand access to innovative prevention tools and integrate HIV services into mainstream healthcare to cushion the sector against declining donor support.
Siaya County HIV Coordinator Silvia Imbuye said the latest HIV estimates paint a worrying picture, underscoring the need for stronger community uptake of preventive interventions.
"As per the 2026 HIV estimates, we have not realised a positive improvement. Previously, new HIV infections stood at 40%, but the latest report puts them at 47%," Imbuye said during a training session for health supervisors on integrated service delivery in Siaya Town.
The figures highlight the challenge facing health authorities as they attempt to reverse fresh infections while sustaining gains made over the past decade.
Central to the county's strategy is the rollout of long-acting injectable HIV prevention, an alternative to daily oral medication designed for people who struggle with adherence, face stigma or have limited access to health facilities.
The injectable option, administered at extended intervals depending on the regimen, is expected to improve compliance by reducing the need for daily pills and lowering the risk of missed doses.
Health experts have described the innovation as one of the most significant advances in HIV prevention in recent years, particularly for high-risk populations where consistent use of oral pre-exposure prophylaxis (PrEP) has remained a challenge.
Imbuye urged residents, especially those at high risk of HIV infection, to embrace injectable prevention as part of broader efforts to curb transmission.
"This strategic initiative marks a significant step toward our goal of ending HIV/AIDS by 2030, making that vision increasingly attainable," she said.
She stressed, however, that injectable prevention was not intended to replace existing biomedical interventions but to complement oral PrEP, post-exposure prophylaxis (PEP), voluntary medical male circumcision and condom promotion.
County health officials are also expressing concern over the rise in mother-to-child transmission of HIV.
According to Imbuye, the transmission rate has increased to 6.7% from 6.2%, reversing earlier progress.
She urged expectant mothers to attend antenatal clinics as early as possible to enable timely screening for HIV, syphilis and hepatitis.
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"Early testing allows us to begin prevention and treatment immediately, greatly reducing the risk of transmitting these infections to the baby," she said.
The county is simultaneously intensifying awareness campaigns targeting adolescents and young people, who remain among the populations most vulnerable to new infections.
Imbuye said health teams would continue taking HIV education and testing services to public events and community outreach programmes.
"We will not tire until new HIV infections are reduced significantly. We are ready to reach our target populations wherever they are," she said.
Beyond community mobilisation, Siaya is restructuring how HIV services are delivered in response to shrinking donor funding that has historically sustained stand-alone HIV clinics.
The county government has launched a capacity-building programme to train sub-county health managers on integrated service delivery covering HIV, sexually transmitted infections and viral hepatitis.
The training is intended to prepare public health facilities to provide comprehensive services under one roof while maintaining quality of care as external funding declines.
"We are training our health teams on integrated service delivery manuals for the prevention, management and treatment of HIV, sexually transmitted infections and viral hepatitis. Once the training is complete, we shall fully roll out the integrated model," Imbuye said.
She added that service integration would improve efficiency, strengthen continuity of care and help preserve the gains made against HIV despite tightening financial resources.
Health officials are also urging county departments to fully implement the Public Service Workplace HIV Policy to reduce stigma, protect employees and maintain workplace productivity.
Nationally, Kenya has made substantial progress in combating HIV, with the vast majority of people diagnosed with the virus now linked to treatment. New infections and AIDS-related deaths have declined sharply over the past decade, reflecting sustained investment in prevention, testing and access to antiretroviral therapy.
Yet Siaya's latest data illustrates that the epidemic remains uneven across the country. As donor financing contracts and counties assume greater responsibility for HIV programmes, sustaining those gains will increasingly depend on stronger local health systems, wider uptake of biomedical innovations and continued community engagement among populations most at risk.