Kenyans are not getting the HIV medicines

Thousands of uprooted Kenyans are not getting the HIV medicines they need to survive, and rising sexual attacks in camps stand to further spread the disease, public health experts say.

About 15,000 of the more than 250,000 people who have fled political, ethnic and revenge attacks in the month since Kenya's disputed presidential election are HIV-positive, according to Kenyan Health Ministry figures cited by UNAIDS.

Of that group, 2,550 were taking anti-retroviral therapy to suppress the virus that causes AIDS before escalating violence forced them out of their homes and cut off their access to the drugs that must be taken continuously to work.

An unknown additional number of HIV patients are marooned in their homes, missing treatments because local health clinics are closed, or because they are too afraid to risk the journey.

"We don't know where our patients are," Florence Muli-Musiime, deputy director-general of the Kenya-based African Medical and Research Foundation, said in a statement.

"We had a very good tracking system using our contacts in the community, but this has now broken down," she said.

Elisabeth Byrs, a spokeswoman for the U.N. Office for the Coordination of Humanitarian Affairs in Geneva, said Kenya's HIV crisis could become much more acute unless tensions calm soon.

"Without adequate nutrition, water and sanitation, and vital AIDS services, people living with HIV are at risk of succumbing to opportunistic infections and more rapid disease progression," she said.

Byrs also warned that HIV transmission risks were extremely high in camps where sexual attacks on women and children are on the rise. Many have been raped while going to the latrine at night, and few are seeking immediate medical care.

A preliminary report by the U.N. population fund and UNICEF have further found that desperate girls and women in Kenya have also been trading sex for food, protection and transportation, further increasing their exposure to the deadly virus.

Situation fluid

Of the estimated 934,000 Kenyans living with HIV, 165,000 were getting government-supported anti-retroviral treatment as of December 2007, said UNAIDS spokeswoman Jacqueline Makokha.

Interruptions of the combination drug therapy, or dilutions of the dose patients take, greatly increase the risk that traditional drugs will no longer suppress HIV. Alternative or "second-line" treatments are much more expensive.

Makokha said it was difficult to keep track of HIV patients in the chaos, which was sparked by accusations that the Dec. 27 election of President Mwai Kibaki in power was rigged.

"The situation is very fluid. People are moving in and out of camps in some areas, and in some areas new people are coming into camps," she said in a telephone interview from Nairobi.

Further complicating matters, health workers said possibly large numbers of people infected with tuberculosis -- a highly contagious disease that is especially deadly for HIV patients -- are also going undetected in Kenya's camps and cities.

"HIV patients are receiving sub-optimal treatment, and because tuberculosis is not diagnosed, it is not treated," said Ian Van Engelgem, a Medecins Sans Frontieres (Doctors Without Borders) physician in Nairobi's Kibera slum.

"It is a very explosive cocktail," he said by telephone.

Kenya's national HIV prevalence is five percent, although some areas including Nairobi and Nyanza provinces have rates as high as 10 percent, according to UN figures.