Georgetown: The elimination of mother-to-child transmission (eMTCT) of HIV has been recognized as a key factor in the recently launched HIVision2020 National Strategic Plan, which is designed to guide the Ministry of Health’s fight against the epidemic over the next eight years.
The Strategic Plan, which was launched just last week, seeks to emphasize that “eMTCT continues to be a gateway for HIV prevention, treatment, care and support services for affected families.” As such Programme Manager of the National AIDS Programme Secretariat, Dr Shanti Singh said that an effective eMTCT programme will facilitate universal access to testing, prophylaxis and treatment for all reproductive Guyanese male and female. She disclosed that this target will be supported with the provision of Antiretrovirals (ARVs) and other necessary interventions to protect infants from becoming infected with HIV. Moreover, Option B Plus, which caters to the administration of a triple combination Antiretroviral Therapy (ART) to all pregnant HIV-infected women will be rolled out nationally, ensuring eMTCT, while at the same time contributing to prevention. This disclosure was made by Dr Singh. And since Guyana already recognizes the effectiveness of condom use in preventing transmission, the Strategic Plan highlights this avenue as a HIV prevention intervention. As such, both male and female condoms will receive enhanced promotion with increased access to the Hinterland Regions and key populations at higher risk, Dr Singh disclosed. These ‘higher risk’ populations are defined in the Strategy as “those most likely to be exposed to HIV or to transmit it due to either the number of partners that they have or the type of higher risk sex that they engage in.” In Guyana’s context these key populations include people living with HIV, men who have sex with men, transgender persons, sex workers and their clients, prisoners, miners and loggers. This has therefore encouraged more HIV testing through the Voluntary Counselling and Testing (VCT) programmes, which according to Dr Singh, has remained another major crucial gateway to HIV prevention. This move, she said, is seen as one that could enable every Guyanese to know their HIV status. Equally important is the implementation of strategies and approaches that could ensure that the key populations at higher risk receive timely and regular counselling and testing in a confidential manner, Dr Singh said. Added to this, she disclosed that moves will be made to ensure that the gap between testing and entry into treatment would be strengthened, facilitating timely entry and access to ARVs for those persons testing positive. Further still, the Strategic Plan outlines that moves will be made towards renewed focus as it relates to integrating VCT with the prevention of mother to child transmission (PMTCT) utilizing the Provider Initiated Testing and Counselling (PITC) approach. However, with the expansion of VCT services, Dr Singh said that enhanced finding and treatment for sexually transmitted infections (STIs), with greater focus on key populations at higher risk especially in the hinterland and hard-to-reach communities, will be more robustly addressed. It is believed that efforts in this regard will be aptly aided by the Guyana Sexually Transmitted Infections Strategic and Monitoring and Evaluation Plan 2011-2020. And even as vigorous measures of intervention are put in place, Dr Singh alluded to the need to ensure the maintenance of a safe blood supply. This, she said, will be of paramount importance, since the prevention of HIV transmission through transfusion with contaminated blood is a key component of HIV prevention. The past five years have seen a steady increase in voluntary blood donation and according to Dr Singh, “all blood (100 per cent) is screened for infectious markers such as HIV and other STIs.” She noted the importance of the development of a Blood Banking Strategy to effectively roll out enhancement of regional recruitment, screening and testing processes of all blood collected from non-remunerated blood donors. This is essential, she noted, to ensure that adequate safe blood is available to all those in need while at the same time serving as a major priority on the prevention front. Added to this, it was disclosed that “reducing the risk of HIV transmission in medical settings with updated guidelines and standard operating procedures with universal precautions such as those for post-exposure prophylaxis will also see enhanced focus.” And in order to realize real results, Dr Singh disclosed that “every HIV prevention practitioner will be expected to contribute to the elimination of HIV, by ensuring that activities and services for HIV prevention meet national standards.” The recommended National HIV Prevention Guidelines will be the document providing direction in achieving and maintaining these standards, Dr Singh noted. “Aligned with the guiding principles, HIVision2020 takes into consideration that all biomedical interventions such as ART, Pre- Exposure Prophylaxis (PrEP) with ARVs, post-exposure prophylaxis (PEP), and treatment of sexually transmitted infections must have behavioural components,” Dr Singh stated. She also noted that although still unavailable, in the future microbicides and/or an HIV vaccine could become additional important interventions.
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