On Tuesday, UNAIDS warned against interpreting a recent survey's results as a sign that the HIV/AIDS crisis in Kenya has been overestimated.

The Kenya Demographic and Health Survey is carried out every five years. In September, it asked people, for the first time, whether they would be tested for HIV. The survey was administered to representative households across the country. About 70 percent of respondents -- 6,000 people -- agreed to take the test, while 30 percent refused. The tests were carried out and validated by officials from CDC. Preliminary results show Kenya with an infection rate of 6.7 percent, compared to UNAIDS' much higher estimate of 9.4 percent.

UNAIDS' main data source for estimating HIV prevalence is antenatal clinics, where women are routinely tested. The agency said it welcomed household studies and incorporated data from similar surveys in four other African nations in its December 2003 update on the global epidemic. Using these and other data, UNAIDS downgraded its estimate of global HIV cases to 40 million from the previous 42 million.

But UNAIDS' statement questioned the Kenyan study's reported gender differences for HIV infection: 8.7 percent of women, but 4.5 percent of men. "Nowhere, in any country in the world, do you see a twofold difference between men and women in the population," said UNAIDS Chief Scientific Advisor Catherine Hankins. The likely reason for the difference, she said, was the 30 percent of people who refused testing. Many of these people, Hankins suggested, could be men who have engaged in risky behavior and shunned the test for fear of stigma.

The advantage of UNAIDS' reliance on data from antenatal clinics is that 100 percent of women there are tested for HIV, providing a good country-to-country comparative tool. But the clinics are found in urban, not rural, areas, and the prevalence data collected through them do not reflect infection among gays, prostitutes, or injection drug users.

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