UNAIDS Urges Caution Over Kenya Study Findings That HIV Prevalence Rates Are OverestimatedUNAIDS on Tuesday urged caution in interpreting a recent study that implied that Kenya's HIV prevalence rate has decreased or is overestimated, Agence France-Presse reports (Agence France-Presse, 1/13). Researchers administering the Kenyan survey, which was funded by the CDC, interviewed 8,561 Kenyan men and women to collect health information. In addition, 70% of the participants agreed to have blood samples taken for HIV testing. Researchers found that 6.7% of Kenyans are HIV-positive, compared with a previous estimate of 9.4% by the country's Ministry of Health. Among the CDC study participants, 8.7% of the women tested HIV-positive, compared with 4.5% of the men (Kaiser Daily HIV/AIDS Report, 1/9). UNAIDS in a statement said that the study should not be interpreted as a sign that the severity of Kenya's epidemic has been overestimated. Although the statement said that UNAIDS "welcome[s]" household studies, it questioned the dramatic differences in prevalence rates between men and women, Agence France-Presse reports. "Nowhere in any country in the world do you see a twofold difference between men and women in the population," Catherine Hankins, chief scientific adviser at UNAIDS, said, adding, "When you look at the prevalence among men, that just hits you right in the face -- there's something wrong there." Hankins said that the gender difference could be accounted for by the fact that 30% of the people surveyed refused to be tested for HIV. Many of the people who refused testing could be men who engage in risky sexual behavior and fear the stigma of testing HIV-positive, Hankins said.
Hankins said that similar surveys from four other African countries had been taken into account last year when the organization published its update on AIDS data. UNAIDS' own techniques in determining HIV prevalence, which rely on prenatal testing centers, have been a matter of debate among AIDS specialists, according to Agence France-Presse (Agence France-Presse, 1/13). The United Nations and the World Health Organization base their estimates of HIV and AIDS prevalence in Africa on anonymous screening of pregnant women in clinics, the results of which are extrapolated to an area's entire population. However, some experts say that estimates based on HIV prevalence among pregnant women are flawed because the women tested are all sexually active and have likely not used condoms. In addition, most of the data are taken from urban clinics where HIV rates are higher than in rural areas (Kaiser Daily HIV/AIDS Report, 1/9). The new survey estimates that 1.4 million adults in Kenya are HIV-positive; the 2002 UNAIDS estimate said that more than three million HIV-positive people live in the country, according to the Boston Globe. "More than one million people who are HIV-positive is a serious problem," Anthony MBewu, executive director of research for the South Africa Medical Research Council, said, adding, "Three million is a serious problem. Which number is correct, I don't know. But either way, it's serious" (Donnelly, Boston Globe, 1/15).