Characteristics and outcomes of individuals enrolled for HIV care in a rural clinic in Coastal Kenya

Despite the scale up of HIV/AIDS care and treatment services in sub-Saharan Africa (sSA), characteristics of individuals enrolled for care and the continuum of care remains less well described. This thesis aimed to describe the characteristics and outcomes of individuals enrolled for HIV/AIDS care in a rural HIV clinic in Coastal Kenya.
We set up a longitudinal surveillance at a HIV clinic located within Kilifi District Hospital, a rural secondary level public health facility in Coastal Kenya. Individuals enrolling for care between 2008 and 2013 were consented and followed up over time. Routine sociodemographic, clinical and laboratory data were collected at every individual clinic visit. Remnant blood samples from routine clinic diagnostics were also captured and archived for follow-up nested studies.
Our surveillance suggests that characteristics and outcomes of Individuals enrolled for HIV care in this setting are largely comparable to those from HIV programs in other parts of Kenya and sSA. Whilst women are disproportionately affected by the HIV epidemic, men have poorer HIV outcomes. Of concern is that individuals enroll for care when they are relatively healthy but drop out only to resume later when they are severely immunocompromised. This necessitates ART initiation followed with poor outcomes, including high early attrition, acquisition of drug resistance and subsequent treatment failure.
Continued surveillance is needed to understand the evolving nature of the HIV epidemic in this setting. Practical and sustainable multifaceted interventions aimed at improving retention, timely ART initiation and consequent treatment outcomes are warranted in this rural HIV clinic in Coastal Kenya.