200,000 women skipped HIV tests during pregnancy, raising transmission risk

Overall number of babies born with HIV in Kenya has been reducing, NSDCC report indicates

by JOHN MUCHANGI

Health16 April 2025 - 14:10

In Summary

At least 3,742 babies (7.3 per cent of all livebirths by women with HIV) contracted the virus in 2023, according to the report.

A large number of women are not being tested for HIV during pregnancy, which partly contributes to the high number of babies born with the virus, data shows.

Joab Khasewa, an officer with the National Syndemic Diseases Control Council (NSDCC), explained that in 2023, about 200,000 pregnant women were not tested for HIV because they did not attend antenatal clinics and gave birth at home, while others attended clinics but declined to be tested.

“More than 200,000 pregnant women missed an HIV test due to non-attendance at their first antenatal clinic, becoming a major challenge to eliminating mother-to-child transmission of HIV,” he said.

Khasewa spoke during a media sensitisation meeting organised by the council in Mombasa on April 9.

The data comes from the HIV Situation in Kenya report, released by the NSDCC in 2024.

HIV can pass down from the mother to the child during pregnancy, labour and delivery, or breastfeeding.

At least 3,742 babies (7.3 per cent of all livebirths by women with HIV) contracted the virus in 2023, according to the report.

The council said this number is too high and such infections must be reduced to below five per cent of all babies born to mothers with HIV.

Khasewa said early testing allows for early identification of HIV-positive mothers, which leads to timely care and interventions.

“Mothers with HIV can begin ART as soon as possible, leading to a rapid reduction in viral load and a decrease in the risk of transmission to the baby,” he said.

The Guidelines for Prevention of Mother to Child Transmission (PMTCT) of HIV/AIDS in Kenya indicate that all pregnant women of unknown HIV status should be offered opt-out testing at the first ANC visit.

Repeat HIV testing (after three months) in the third trimester should be offered to all women whose first antenatal test was performed before 28 weeks gestation.

“The test is not forced. Women are counselled and offered the test but if they decline they cannot be forced,” he said.

The guidelines foresee such a situation. It advises that “women who decline HIV testing at the first antenatal visit should have follow up counseling at subsequent visits, and offered HIV testing.”

Still, they cannot be forced.

The 200,000 is part of all pregnancies in Kenya, which are about 2 million every year, with at least 500,000 resulting in abortion.

However, it is still a large number considering that Kenya had about 1.2 million live births in 2023.

Of the 3,742 babies who contracted HIV in 2023, 684 were infected during pregnancy after the mother stopped taking ARVs, the NSDCC report shows.

Some 727 were infected during breastfeeding when the parent stopped taking ARVs.

NSDCC also noted 151 women were not HIV positive when they got pregnant but were infected within the nine months, leading to infections to their babies.

Another 434 mothers had tested negative to HIV throughout their pregnancy but were infected unknowingly during breastfeeding and passed on the virus to their babies.

Overall, transmission of HIV to babies in Kenya has been reducing in the last five years.

In 2018, an estimated 13,000 new HIV infections occurred among children.

That represented 12.3 per cent of all babies born to HIV positive mothers that year.

Such infections can be eliminated if pregnant women are tested for HIV and those living with the virus receive treatment, and their babies are put on the drugs right after birth.

People with HIV who adhere to antiretroviral therapy can achieve extremely low viral loads.

However, these can increase if a person cannot adhere to the regimen.

The data showed in 2023, five counties had a mother-to-child transmission, currently known as vertical transmission, rate higher than 20 per cent.

These are Wajir (33.5 per cent), Mandera, (26.9 per cent), Samburu (26.8 per cent), West Pokot (21.2 per cent), and Isiolo (20.9 per cent).

Seven counties had rates lower than the national average, with Migori, Kisumu, Murang’a, Kirinyaga, Nyeri, Siaya and Nairobi achieving the lowest mother-to-child transmission rate of less than seven per cent.

Women living with HIV who do not receive ARV medicine have a 15-45 per cent chance of transmitting the virus to their children during pregnancy, labour, delivery or breastfeeding.

That risk drops to less than five per cent if treatment is given to both mother and child.

Kenya’s goal is to get to less than five per cent and be certified to have eliminated the vertical of HIV.

In high-income countries, almost universal early ART coverage amongst HIV-positive pregnant women and avoiding breastfeeding have reduced MTCT risk to less than one per cent.