HIV report reveals major testing gap as thousands remain unaware of status

A large number of Kenyans living with HIV are still moving through life without knowing their status, a new national assessment has shown, raising concern over missed testing opportunities and continued spread of infections across the country.

Data from Kenya's HIV Estimates 2026 by the National Syndemic Diseases Control Council shows that out of about 1.48 million people living with HIV, around 93 per cent have been diagnosed, leaving close to 100,000 people unaware they are infected.

The report notes that these undiagnosed cases remain a key driver of new infections because many continue normal routines, including work, relationships and family life, without access to treatment or knowledge of their condition.

Across all 47 counties, researchers found that the level of HIV prevalence strongly shapes new infection rates, but the biggest factor linked to rising cases is the number of people who have the virus but do not know it.

In areas where more people remain untested or undiagnosed, new infections are higher, pointing to gaps in access to testing and awareness campaigns.

“A person who does not know they have HIV cannot start treatment, cannot suppress their viral load, and cannot protect their partners,” the report states.

The findings also highlight a second challenge: people who test positive but do not begin antiretroviral treatment. Reasons include stigma, fear, denial, transport costs and delays between diagnosis and starting care.

According to the report, those who are not on treatment remain highly infectious, making it harder to control the spread of the virus even after diagnosis.

Children are among the most affected groups when it comes to treatment gaps.

Out of 12,912 children aged four years and below living with HIV, only 5,876 are on treatment, leaving more than half without medication. In the five to nine age group, 13,886 out of 21,779 are on ART, while among those aged 10 to 14, only 21,576 out of 34,640 are receiving treatment.

The report says this stage of life is often where responsibility for medication shifts from caregivers to the child, and many are lost in the process.

Among adolescents aged 15 to 19, treatment coverage improves to 88 per cent, though more than 5,000 are still not on ART. Adult coverage remains higher, ranging from 90 to 93 per cent for those aged 20 to 49, and rising to 95 per cent for those above 50 years.

The improvement among older adults is linked to frequent interaction with health services due to other illnesses and more regular testing.

Nine counties were identified as priority areas where the number of undiagnosed people is higher than expected. These include Marsabit, Wajir, Mandera, Garissa and Samburu, as well as Kilifi, Kericho, Nandi, Laikipia and Busia.

In the northern counties, low testing rates are linked to distance, stigma and cultural barriers, while in other regions, undiagnosed cases are reflected in rising infection numbers.

Men remain one of the most affected groups, with many diagnosed late or not starting treatment after testing positive. The report shows that one in 10 men who test positive never begins treatment.

The HIV care cascade for men stands at 90-88-80 compared to 96-96-92 for women. Men also record higher Aids-related deaths at more than 18 per 1,000 compared to 10.6 per 1,000 for women.

Only a small fraction of men, about three per cent, have accessed HIV testing through antenatal care services over the past decade.