Nairobi — As MPs turned up for public screening for HIV/Aids last week, concerns were being raised that few people know their status despite awareness campaigns.

The number of people visiting Voluntary Counselling and Testing (VCT) centres has risen over the years, but it is still a small fraction.

Figures show only 1.9 million people have been tested in the last six years, against a population of more than 32 million.

The number could be slightly higher because some centres have not submitted their data.

With the coming of antiretroviral (ARVs), drugs knowledge of one's HIV status is hailed as the first step in controlling the crisis.

ARVs are drugs that keep the number of Aids-causing viruses low, thereby prolonging a patient's life by helping the body fight opportunistic diseases in the wake of reduced immunity.

The VCT concept was introduced in 2000 to influence behaviour change. Those found to be HIV positive do not have to resign themselves to fate. They can take care of themselves through eating healthy diets and ARVs, while people free of the virus are encouraged to avoid behaviours that can expose them to infection.

The National Aids and Sexually Transmitted Diseases Control Programme (Nascop) says attitudes are slowly changing for the better.

Nascop's national VCT coordinator, Ms Carol Ngare, says stigma and myths associated with the disease initially slowed down the programme, but the concept has weathered the storm.

People are not afraid

Visitors at VCT centres have shot up from 18,000 people in 2001 to 735,000 last year.

"People are not as afraid as they used to be. We get some being tested and then going back for another test after a few months," she told The Standard.

"We can't force people to go for testing. But we are encouraging them to overcome their fear."

Stigma has gone down in urban areas where literacy levels are high, but it was still rampant in villages, she said.

The Government is establishing more testing centres, including mobile ones in remote areas.

There are 869 centres, but their distribution is skewed, with North Eastern Province having just nine to serve nearly two million residents.

While infection rates are going down in most parts of the country, it is said to be rising in the province. Nascop and its partners hope to have at least three VCT centres in every division by 2010.

VCT centres overwhelmed

With just over 2,000 trained counsellors, staff shortage is bogging down the campaign. Last year, 235 were employed and the Government will absorb another 100 this year, but this is a drop in the ocean.

An average counselling session takes about 45 minutes, meaning each counsellor can only attend to a maximum of 10 people per day.

With this scenario, some centres in urban areas are overwhelmed and are turning away people.

Response at a six-day free counselling and testing exercise conducted by Nec Institute of Management in Nairobi indicates Kenyans are hungry to know their status.

Ms Nduku Kilonzo, director of policy and performance at Liverpool VCT centres, says the fall of the national HIV/Aids prevalence was an indication the efforts have not been in vain. The centre introduced the VCT concept as a pilot project in 1998 before it was rolled out countrywide in partnership with the Government.

The initiative, alongside others, has brought down prevalence from 14 per cent in 2003 to 5.7 per cent.

Kilonzo adds: "But it doesn't mean we can now sit and celebrate. It only shows that we need to be focused in what we are doing."

Disadvantaged people say anti-Aids campaign has ignored them. In Dandora, project manager of a support group for the deaf, Mr Joseph Airo, says the centres hardly help members.

"There are too few counsellors who speak sign language," Airo said. "You cannot enter into a testing room in the company of an interpreter because you need privacy."