You need not die from cervical cancer


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Mrs Irene Mburu, a nurse at KNH demonstrates how samples for cancer testing are collected. PHOTO/FILE

Every sexually active woman should have a pap smear every year to rule out or detect cervical cancer early. Cervical cancer is a malignant disease of the cervix. The cervix is the lowest part of the uterus (womb) that connects it to the birth canal. Cancer of the cervix occurs when abnormal cells in the cervix grow out of control. It is the second most frequent cancer in women in Kenya, and the second most frequent cancer in women between 15 and 44 years.

Symptoms of cervical cancer; Symptoms may go unnoticed because they mimic many other ailments and women may pass them off as ovulation pains. Many times, however, cervical cancer has no symptoms and when they do occur, the cancer is at an advanced stage.

The most common symptoms include;

  • Abnormal vaginal bleeding, or changes in menstrual cycle.
  • Bleeding during sexual intercourse.
  • Pain during intercourse.
  • Foul-smelling vaginal discharge tinged with blood.
  • Symptoms of advanced disease may include loss of appetite, weight loss, fatigue, and lower abdominal pains.

Diagnosis of cervical cancer may be made using the following methods;

  • Pap smear: Cells from the surface of the cervix are viewed under a microscope to find out if they are abnormal.
  • Colposcopy: This procedure directly visualises the vagina and cervix for abnormal areas with signs of disease, after which curettage may be carried out.
  • Curettage: Involves collecting tissue samples from the cervix to check for signs of cancer.
  • Biopsy: If abnormal cells are found on a pap smear, a sample of tissues is taken and examined by a specialist pathologist.

Treatment modalities depend on the stage of the cancer, size of the tumour, the patient’s desire to have children, as well as age. Treatment may include radiation therapy and surgery. Surgery, which targets the removal of cancerous cervical cells, is based on the above factors and can be local (on or around the cervix), or widespread (occasionally including the uterus) depending on the degree of disease and spread. Chances of full recovery are dependent on the stage of the cancer, the type of cancer, and the size of the tumour, thus the emphasis to prevent where possible and ensure that cancer is diagnosed in its early stages.

Prevention of cancer of the cervix;

Vaccination against the HPV virus, which is associated with cervical cancer. There are several types of this virus and the type associated with cervical cancer is sexually transmitted. It may remain in the body for years before turning cervical cells cancerous. The HPV vaccine is targeted at girls and women before they are sexually active, and before they get infected with the HPV virus. If already sexually active, the vaccine only protects against new HPV infections.
The importance of a pap smear cannot be overemphasised. A pap smear done annually helps detect changes in the cervical cells before they turn cancerous.

Posted Monday, March 3, 2014
Source : Daily Nation

Checkups that could save your life


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It is important to have a wellness checkup at least once a year because illness can be managed effectively if detected early. The World Health Organisation describes health as “…a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity.” Wellness is an “approach to health that emphasises the prevention of illness and prolonging life, as opposed to emphasising treating diseases”. The prevalence of non-infectious diseases in Kenya ranges between 2.7 per cent in rural groups and 10.7 per cent in urban areas. Diseases like hypertension, diabetes, and cancer have become more common. In 2003, a survey by the Ministry of Health indicated that these diseases contributed to 53 per cent of hospital admissions, while WHO reports that non-communicable diseases cause 60 per cent of all deaths. Of note is that most of these diseases are preventable through healthy living.

WHO further identifies the major risk factors for these diseases as;

  • Overweight
  • Smoking
  • High blood cholesterol
  • High blood pressure
  • High blood sugar
  • Alcohol consumption
  • Inadequate or lack of a healthy and nutritious diet
  • Lack of exercise

It is more difficult and more costly to regain full health once chronic illnesses have set in as irreversible cellular changes may have already taken place. It is these processes that progress to illnesses such as cancers. Wellness checkups are a group of tests and examinations targeting the most common diseases in a particular risk group. The most important reason for carrying out a wellness checkup at least once a year is because most illnesses, such as cancers, can be managed effectively if detected early and to combat present risk factors and avoid progression to full blown disease. Tests required as part of a wellness checkup depend on one’s age, past medical history, and family social history. These include;

A full physical examination; It is the first step in establishing how healthy you are, even without any lab or radiological investigations.

The Body Mass Index (BMI); is a measure of one’s weight in relation to height. Excessive weight is a major contributor to heart disease, diabetes, and cancer.

Electrocardiogram (ECG); is a tracing of the electric activity of the heart and can pick up abnormalities indicating heart disease.

Clinical breast examination; is useful for picking up breast abnormalities such as lumps that may suggest cancer. A complete blood count is a panel of blood tests that includes haemoglobin, level which is the oxygen-carrying capacity of blood, as well as screens for infections and blood abnormalities such as blood cancers. Tests on the liver measure the functioning of the organ. Abnormal levels indicate conditions such as inflammation of the liver tissue, pancreatic disease, and liver damage as a result of alcohol consumption.

Kidney tests; measure kidney function, which may be affected by chronic diseases such as diabetes and hypertension.

Cholesterol levels; abnormal levels of the different types of cholesterol increase the risk of heart and blood vessel disease.

Thyroid function tests; evaluate the thyroid’s status, an organ that regulates the body’s metabolism and most bodily functions.

Prostate Specific Antigen; is a screening test for cancer of the prostate in men and other disorders of this gland.

Fasting blood sugar test; is the simplest method of screening individuals for diabetes. An elevated fasting blood sugar denotes overt diabetes or glucose intolerance.

A urine analysis; is a simple test useful not only for screening of infections in the urinary tract, but also in the kidney.

Stool microscopy; is useful for detecting abnormalities in the gut such as bacterial and parasitic infections.

The Pap smear; checks for changes in the cells of the cervix (the lower part of the womb that opens into the birth canal) which may indicate the presence of an infection, abnormal cells, or cancer in women.

These medical checkups are based on an individual’s risk factors and the tests done must be individualised. In addition, there are five key areas of health which one must focus on to remain in good health. This is because living healthy requires the right attitude and a change in lifestyle to see results.

Posted Tuesday, Dec 20,2011

Source : Daily Nation

Causes – Refugees


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AWHEEC in partnership with Loving Hut ( had put together a toys drive benefiting the refugee kids for different holidays throughout the year. Loving Hut manager, Tammy had demonstrated laudable effort to ensure that lots of toys were collected. As a result, refugee kids from Africa and Asia received lots of toys, many of whom getting their first toy ever.

Visit Loving Hut Facebook page

Stigma surrounding breast cancer stalls prevention efforts in Ghana


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ACCRA (IPS) – Mary Mingle thought she had a boil on her breast, so she bought some medication and tried to treat it at home. Two months later, bothered by persistent pain, she went to the doctor. There were eleven lumps in her breasts. She had first stage cancer, and her breasts, along with her uterus, would have to be removed. ”The doctor encouraged me,” she says. “The earlier I got them removed, the better. Otherwise, I would lose my life.” Now, years after her surgery, only five people in her personal life know about her double mastectomy: her three children, her sister, and her husband. She’s been carrying her secret for about 20 years, hiding it from her extended family with a padded bra because she is afraid she will be stigmatised. She also hides it from her church, for the same reason. ”I don’t want them to be aware,” she says, her voice a tiny whisper. Health officials in Ghana say breast cancer is a growing problem compounded by untrained medical practitioners, a lack of equipment, and unhealthy, sometimes fatal, cultural beliefs.

Historically, breast cancer has received scant attention in this West African country. International donors and institutions have been focused on communicable diseases like malaria and HIV/AIDS. Despite the fact that, according to Ghana Health Services (GHS), non-communicable diseases are the leading causes of death. ”It’s only now that attention is being drawn to it,” says Dr. Kofi Nyarko, head of the GHS cancer control programme. There aren’t any solid statistics yet. In the capital of Accra, the Korle Bu Teaching Hospital, one of two full service cancer facilities in the country, is building an in-hospital registry of cases. In Kumasi, the country’s second biggest city in Ashanti Region, Komfo Anokye Teaching Hospital is also working on a database. According to Dr. Verne Vanderpuye, a clinical oncologist at Korle Bu, the hospital gets about 3,000 breast cancer referrals a year. ”The main problem is that people don’t come early,” she says. “In an untreated case, when it’s moved beyond the breast, the average lifespan is one-and-a-half to two years. It will move from the breast, to the lymphs, to the lungs, to the liver, to the bones, and to the brain.”

Nyarko says the hospitals have gathered enough information for officials to know that breast cancer is becoming more prevalent, and its victims are younger and younger. ”It’s no longer a disease for the old,” he adds. About three years ago, a focus on non-communicable disease began to take shape. In 2008, in collaboration with the World Health Organization (WHO), the Ministry of Health set up a national Cancer Steering Committee. The following year, Nyarko became the government’s cancer chief. Working with WHO, GHS has identified cost effective treatment and detection strategies. Radiology equipment is scarce in Ghana – there are 10 mammogram machines in the whole country, six of which are in private institutions – so there will be a focus on clinical examinations, with mammograms for follow ups. It is a strategy that will require training. ”You need human resources,” Nyarko says. “You need infrastructure. You need certain equipment in place. You need all these things and money for training. The fact that you are a doctor or you are a nurse does not mean you can examine someone and say, ‘You are free (of cancer).’ You need to be trained.”

Nyarko expects a comprehensive national strategy will be launched by the end of the year. In addition to increased clinical examinations, the government would also like to build a full service hospital in Tamale, the biggest city in Ghana’s relatively undeveloped Northern Region. There is also a big emphasis on prevention and awareness, with a series of posters and leaflets produced in partnership with the Geneva-based Union for International Cancer Control. Aside from promoting exercise and fresh food diets, the campaign is also meant to chip away at Ghana’s cultural oppression of breast cancer victims. ”People think that cancer is a call to death, but we are telling them that cancer can be cured,” Nyarko says. “We are aware that awareness is very low, even amongst the social elite. So we are working on that.” It is not uncommon for victims to be shunned by their husbands or families. And in a country where women do a good deal of work, both around the house and in markets, husbands are reluctant to lose their wives to months of treatment. Furthermore, chemotherapy is not covered by health insurance and can cost almost 2,000 dollars in just two weeks.

According to the World Bank, Ghana’s 24 million people live on an average of 1,283 dollars a year. The Jubilee oil find in the country’s Western Region is expected to help push GDP growth to 13.4 per cent in 2011, but there is no guarantee that will influence the average annual income. ”There’s also the fact that you could lose your breast,” says Vanderpuye. “We have a polygamous society, whether we like it or not. They might say you are not a whole woman.” Like many African countries, Ghana is hugely religious. Many pastors tell their flocks that cancer is a spiritual illness, and that the answer is prayer, not surgery. As a result, some women do not go to the hospital until the tumours have spread. And then they die. ”They say the surgery kills, but they wait so long that the cancer spreads, so it appears surgery kills,” says Gladys Boateng, a breast cancer survivor and the founder of Reach for Recovery. Civil society groups like Reach for Recovery also play a role in spreading awareness. Formed after Boateng survived her own bout with breast cancer, the group has reached 3,000 sufferers in the past eight years. Survivors give back to the group, visiting women in hospitals and helping with screening missions in remote or rural areas.

But even advocates keep secrets. Boateng will not discuss her husband’s reaction to her ordeal. She just offers a tight smile and declines comment. Nyarko, who has been watching international dollars lean heavily toward infectious diseases, is predicting a continued sea change in donor awareness. He is ready – all he needs are resources. ”It’s just now that there’s an emphasis on non-communicable diseases,” he stresses. “You know the right thing to do. You know the right thing to say. But you do not have the resources.”

Source : Newstime Africa
Published On: Fri, Oct 28th

Rising infection rates among women reflect imbalances in gender relations


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On October 12 and 13, more than 200 women living with HIV and Aids from all over Kenya gathered to demand a political response to the issues that continue to affect women and girls.

This meeting came as a result of years of notable silence especially from top leaders on issues of HIV and Aids especially as it affects women and girls.

The last few years have seen this country bogged down under the weight of many issues ranging from the post-election violence, the new Constitution, its implementation, the ICC, to the high cost of living, drought and hunger, next year’s elections, corruption and now war. As a result, issues to do with HIV have been forgotten.

This meeting came at a time when high infection rates among women aged 15-49 remain a somber reminder that we must never forget that in our midst lives a virus that has no cure yet, and which continues to infect so many as to have a prevalence of 8.8 per cent for women and 5.5 per cent for men.

It is worth noting that for sections of the population, especially widows and divorced women, the prevalence is as high as 17 per cent and 22 per cent respectively.

The need to champion women’s leadership to contain Aids is an issue that must be given priority.

This conference was meant to be a reminder about the importance of a gender focus in HIV and Aids control.

We need to see some clear agenda-setting on issues involving HIV and Aids and their effect on women, especially by those seeking to lead this country.

None has so far appeared to be concerned about this reality, yet they are all looking for women’s votes.

A sobering reality is that around the world, the highest infection rates continue to be in those cultures where women have little power to negotiate for safer sex.

Women’s vulnerability is driven by cultural norms, which restrict power in all areas of their lives.

In which ways can the State empower women? There is need for special education forums targeting them so that they can take charge of their sexual, social and economic needs.

All HIV and Aids messages should be positive and not moralistic as this helps to reduce stigma.

Any message on prevention that tends to have moral undertones only makes those infected feel ashamed while the uninfected avoid being associated with the problem.

I have in mind messages that continue to give advice like “be safe, stay faithful, love carefully, wacha mpango wa kando” etc.

The message to the infected is that they loved carelessly and they had mipango ya kando, yet we know that the majority of women and girls infected with HIV got it from partners they trusted.

More positive messages focusing on the basic facts of prevention, treatment and care can make people see the need for positive living.

Prevention efforts should also consider the reality. The continued emphasis on male condom use, abstinence, circumcision, remaining faithful to one partner and so on, leave women confused as they fail to address the social, economic and power relations between men and women.

Men should be provided with information about the gender dimension of HIV and Aids given that they have more control on sexual matters.

It is only if they are fully educated that problems like rape, wife inheritance, early marriages and gender violence will be reduced.

Medical personnel need retraining to change their attitudes towards people infected with HIV.

Research evidence indicates that they tend to be more hostile to women and girls with a sex-related complications.

Women and girls (especially those with disabilities) generally feel a special anxiety, vulnerability, and fear of being labelled immoral if discovered to have sex-related problems.

For women infected with HIV, these feelings are even deeper as they fear being treated with contempt.

Such responses will help us analyse stereotypes and explore ways of reducing gender inequalities, not just in relation to HIV, but in all other aspects of life.

Prof Kamau lectures at St Paul’s University and is author of the book: ‘‘Aids, Sexuality and Gender: Experiences of Women in Kenyan Universities (Zapf Chancery, 2009)

Source : Daily Nation
Posted Wednesday, November 9 2011 at 20:00

President Obama names Olopade to National Cancer Advisory Board


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President Barack Obama on Feb. 24 announced his intent to appoint Olufunmilayo Falusi Olopade, the Walter L. Palmer Distinguished Service Professor of Medicine and Human Genetics, Associate Dean for Global Health, and Director of the Center for Clinical Cancer Genetics at the University of Chicago, as one of five new members of the National Cancer Advisory Board.

Members of board advise the Secretary of Health and Human Services and the Director of the National Cancer Institute with respect to the activities of the Institute, including reviewing and recommending support grants and cooperative agreements following technical and scientific peer review.

“These dedicated individuals bring a wealth of experience and talent to their new roles,” said Obama. “I am proud to have them serve in this administration. I look forward to working with them in the months and years to come.”

A recipient of numerous professional honors and awards, including the MacArthur Foundation Fellowship, ASCO Young Investigator Award, James S. McDonnell Foundation Scholar Award and the Doris Duke Distinguished Clinical Scientist Award, Olopade is a member of the Institute of Medicine of the National Academies and a fellow of the American Academy of Arts and Sciences. She is a frequent lecturer in the United States and abroad and has been honored many times for her contributions to medicine.

Her research focuses on the interactions between genetics and environment in the onset of breast cancer, especially the genetic basis of breast cancer in young women of African ancestry in the U.S. and West Africa, and on the prevention and early detection of breast and ovarian cancer in women at high risk.

She is also a practicing physician and director of the University’s Cancer Risk Clinic. In her clinical work, Olopade is an authority on cancer risk and prevention, and on individualized treatment based on risk factors and quality of life.

She also works with doctors in her native Nigeria, and with government officials and drug companies across Africa, to improve education and treatment.

Olopade studied medicine in her Nigeria, where she earned an M.B.B.S. with distinctions in Pathology and Pediatrics from the University of Ibadan. After completing an internship in medicine, surgery, pediatrics and OB/GYN at the University College Hospital in Ibadan and serving as a medical officer at the Nigerian Navy Hospital in Lagos, she completed her residency and chief residency at Cook County Hospital in Chicago. Following that, she completed a post–doctoral fellowship in hematology and oncology at the University of Chicago. She joined the faculty at the University in 1991.

Also named to the board were: Marcia Cruz–Correa, University of Puerto Rico; Kevin J. Cullen, of the University of Maryland; Jonathan M. Samet, of the University of Southern California; and Bill Sellers, of the Novartis Institutes of BioMedical Research.

By John Easton
MARCH 2, 2011

Source : UChicago News

Study shows women of African ancestry diagnosed with more virulent form of breast cancer


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A study comparing, for the first time, breast cancers in women from Nigeria, Sénégal and North America has revealed that women of African ancestry are more likely to be diagnosed with a more virulent form of the disease than women of European ancestry.

Researchers from the University, working with colleagues at the University of Calabar in Nigeria and the University of North Carolina, found that breast cancers in African women produce a different pattern of gene expression. Tumors from African women—from three locations in Nigeria and one in Sénégal—are more likely to originate from a different group of cells within the breast and often do not present the molecular targets that form the basis of many standard therapies.

“We have known for a long time that breast cancer is not one disease and that it may be somehow different in Africa,” said study author Funmi Olopade, Professor in Medicine and Director of the Center for Clinical Cancer Genetics at Chicago. “But there was no real sense of how much of that was biology and how much was environment. Now we have clear evidence that nature plays an important role. These tumors are biologically quite different in ways that make this a worse disease.” Olopade added that breast cancer strikes fewer women in Africa, “but it hits earlier and harder.”

“The discovery means we have to rethink how soon and how often we screen for breast cancer in women at risk for the most aggressive type of breast cancer, as well as how we prevent it and how we treat it,” she added. “The guidelines were developed based on our deep knowledge of breast cancer in older women of European ancestry, but our results mean that much of the U.S. and European data simply do not apply to the types of breast cancer we most commonly see in African women.”

The researchers studied the pattern of gene expression—a measure of which genes were turned on and active—in breast cancer tissue from 378 women in Nigeria and Sénégal. They compared the results with a database of breast cancer tissue from 930 Canadian women, compiled by Charles Perou and colleagues in North Carolina and British Columbia.

They found three significant differences. First, breast cancers in African women were more likely to arise from basal-like cells, rather than the inner milk-secreting luminal cells, which are the most common source of breast cancers for U.S. and European women. Tumors that arise from basal cells have a worse prognosis, regardless of race.

Second, breast cancers in African women often lacked estrogen receptors. These tumors do not depend on estrogen and thus will not respond to drugs, such as tamoxifen, which prevent estrogen from reaching the cancer cells.

Third, cancers from African women were slightly less likely to respond to the drug Herceptin, which was recently approved for metastatic breast cancer.

In America, most breast cancer occurs after menopause, usually in the late 50s or 60s. In Africa, it most often strikes women in their 40s.

Studies suggest that the rate and genetic profiles of breast cancers in African-American women are likely to fall somewhere in between, with a slightly lower lifetime incidence of breast cancer than Caucasians but earlier onset and worse prognosis.

Most of the screening guidelines in this country are based on studies that primarily looked at Caucasians, said Olopade. “We need to reconsider how to screen for a disease that is less common but starts sooner and moves faster. An annual mammogram beginning at 50 is not the best route to early detection in African women, who get the disease and die from it in their 40s, and it also needs to be adjusted in African Americans and high-risk women in all racial/ethnic groups.”

Olopade is one of four principal investigators in a large-scale, multi-year, cross-disciplinary effort based at the University to sort out the genetic and environmental factors that contribute to breast cancer. The investigators will now look at the genes, lifestyle, socioeconomic status and social interactions of women in the United States and Africa and their relationship to breast cancer.

She combines expertise in cancer risk and genetics with a close African connection. Olopade grew up in Nigeria, retains close ties with cancer specialists there, and returns frequently to teach, to conduct research and to visit. She worked with Nigerian researcher Francis Ikpatt, who is completing a three-year postdoctoral fellowship in Olopade’s laboratory, to gather the tumor samples from three regions of Nigeria, and later from Sénégal. The gene expression analysis was performed in Olopade’s laboratory.

“We now have the world’s largest collection of tumor samples from Africa,” said Olopade. “Francis did most of that over the course of one year. That should give you some idea of how neglected this continent is by cancer researchers.”

The Breast Cancer Research Foundation and the National Women’s Cancer Research Alliance Entertainment Industry Fund funded the study, which was presented Monday, April 18, at the 96th annual meeting of the American Association for Cancer Research.

By John Easton
Medical Center Public Affairs

Also contributing were Jinhua Xu and Audrey Kramtsov from Chicago; Roland Ndoma-Egba of the University of Calabar in Nigeria; Kayode Adelusola from the Obafemi Awolowo University Teaching Hospital of Ile-Ife, Nigeria; Jean Marie Dangou from Institut Pasteur, Dakar, Sénégal; Sani Malami from Usman Danfodio University Teaching Hospital, Sokoto, Nigeria; Adeyinka Falusi from the University of Ibadan, Nigeria; and Perou of the University of North Carolina.

Funmi Olopade

Source : Chicago Chronicle

2011 Nobel Prize Award


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A combination of three recent photos shows (from L) Yemen’s Arab Spring activist Tawakkul Karman, Liberian President Ellen Johnson Sirleaf and Liberian “peace warrior” Leymah Gbowee who won the 2011 Nobel Peace Prize the jury announced on October 7, 2011. The three prize winners share the 2011 award “for their non-violent struggle for the safety of women and for women’s rights to full participation in peace-building work,” Norwegian Nobel Committee president Thorbjoern Jagland said in his announcement. 

State rolls out plan to fight high HIV infection rates among women


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File | NATION A woman tests a client for HIV at a Voluntary Counselling and Testing Centre. The government’s new plan, Mainstreaming Gender in HIV Responses in Kenya, requires all stakeholders to address the specific needs of women at risk of infection.

A woman tests a client for HIV at a Voluntary Counselling and Testing Centre. The government’s new plan, Mainstreaming Gender in HIV Responses in Kenya, requires all stakeholders to address the specific needs of women at risk of infection.

Concerned about the high number of women being infected with HIV compared to men, the government has, for the first time in 12 years since HIV was declared a national disaster, launched an aggressive action plan that will see massive resources allocated to programmes targeting women.

The new strategy is aimed at, among other things, cutting the number of new HIV infections among women, which have reached worrying levels and continue to rise. This new intervention will involve providing women, especially young girls and other vulnerable groups, with skills on how to prevent HIV infection.

Those who run HIV programmes are from now on expected to ensure gender equality in care and treatment and to provide the National Aids Control Council (NACC) with concrete results in achieving the targets on reducing HIV infection in women.

The government is also focusing on increased access to antiretroviral drugs to reduce chances of HIV-negative women living with HIV-positive partners – discordant couples – from getting infected.

Viral load

Several studies have shown that a fall in viral load occasioned by taking antiretroviral drugs significantly reduces the chances of a person who is HIV-positive transmitting the virus to another person.

“Women are the backbone of our society in areas such as agriculture, health and education, yet HIV is hitting them harder than men,” says NACC Deputy Director, Coordination and Support, Dr Sobbie Mulindi.

“This means failure to have a specific plan to address their situation is going to land this country in a mess and make it difficult to realise some of the targets of Vision 2030 under the Social and Economic pillars.”

It is becoming clearer to HIV experts and governments that the gender dimension of the disease must be tackled.

Released this week, the plan – Mainstreaming Gender in HIV Responses in Kenya – is a response to recent findings that show that despite the many interventions to tackle HIV/Aids in the country in the past 12 years, the number of women infected or living with HIV is increasing at a faster rate than that of male counterparts.

Most recent studies show HIV prevalence among women aged 15 to 49 years stands at 8.8 per cent compared to 5.5 per cent for men in the same age group.

Hardest hit are widows and divorced women, with an HIV prevalence of 17 per cent and 21 per cent, respectively, notes the government plan.

In Nyanza, which leads with the highest HIV prevalence at 14.9 per cent, one in every two widows is infected with HIV, according to the Kenya Aids Indicator Survey.

Statistics further show that 44 per cent of new infections are occurring between couples in stable relationships, 20 per cent among men and women who engage in casual sex, and 14 per cent among sex workers and their clients, with women bearing the brunt of new infections.

Adolescent girls who are domestic workers, unemployed or have only a primary education are also identified as being among the most vulnerable to the disease. Young women between 15 and 24 are said to be four times more likely to be infected with HIV than men.

Source : Daily Nation