Georgetown: National AIDS Programme Secretariat (NAPS) Director, Dr Shanti Singh said that a new report has indicated that HIV/AIDS is on the decline in Guyana.
The Health Ministry through NAPS recently hosted a consensus meeting at the Regency Suites Hotel that brought together officials representing various in-country partners involved in the multi-sectoral national response to HIV. Partners included Government Ministries; United Nations agencies; the President’s Emergency Plan for AIDS Relief (PEPFAR); the Pan Caribbean Partnership against HIV & AIDS (PANCAP); Civil Society Organisations; various categories of health care workers; and Persons Living With HIV (PLHIV).
Dr Singh, underscored that the most recent estimate has revealed an HIV prevalence of 1.4 per cent (2013) which shows a steady decline from the 2.4 per cent reported in 2004. Work on modelling of new national estimates for 2014 with projections for future years is ongoing and will be finalised by May 10, with support from technical experts from UNAIDS.
The NAPS Programme Director stated that there were 751 new cases of HIV reported during 2014 while the number of AIDS cases reported was 105. Most affected was the productive age group 25-49 which comprises 61.7 per cent of the reported cases. The proportion of all deaths attributable to HIV/AIDS has declined from 9.5 per cent in 2002 to 4.8 per cent in 2012. The estimated male to female ratio for HIV cases was 1.09 in 2014 while that for AIDS was 1.4. The rate of TB-HIV co-infection has steadily declined from 31 per cent in 2012 to 22 per cent in 2014.
In addition, it was pointed out that Prevention of Mother To Child Transmission (PMTCT) services was provided at 188 health care facilities and this included routine HIV testing for all pregnant women, which revealed a 1.9 per cent prevalence of HIV among this population during 2014.
Dr Singh noted that at the end of 2014, there was a total of 5041 PLHIV enrolled at the 22 HIV care and treatment sites countrywide of which 4295 were on Antiretroviral Therapy (ART). The survivability of patients on ART after 12, 24, 36, and 60 months were reported at 81.2 per cent, 75 per cent, 72.4 per cent, and 63 per cent respectively. Care and support services included home based care provided to 716 patients, PLHIV peer support, and the provision of a total of 3689 food hampers to 937 PLHIV.
Training, assessment
“During 2014, more than 5218 healthcare workers and other individuals were trained in a wide range of subject areas in the effort to increase knowledge and build capacity to support the HIV response,” she said.
Among the major achievements, was the Biological and Behavioural Surveillance Survey (BBSS) conducted among key affected populations (sex workers; men who have sex with men (MSM); transgenders; miners; and loggers). The survey revealed a reduced HIV prevalence among female sex workers from 26.6 per cent in 2005 to 5.5 per cent in 2014, among MSM from 21.2 per cent in 2005 to 4.9 per cent in 2014 and among miners from 6.5 per cent in 2000 to one per cent in 2014. Male sex workers, transgenders, and loggers who were being surveyed for the first time showed a prevalence of 5.1 per cent, 8.4 per cent and 1.3 per cent respectively.
HIV testing was done at 62 fixed sites and a number of mobile sites with a total of 54,816 tests done during 2014. Testing was also done among prisoners and TB patients and blood donors were routinely screened for HIV.
Post-exposure prophylaxis (PEP) against HIV was provided to 52 persons who had needle stick injuries and 17 persons who were victims of sexual assault. This latter figure, Dr Singh noted, was an indication that not all assault victims were coming forward to be treated. There was also a disparity in the numbers of males and females presenting for treatment of Sexually Transmitted Infections with only 18 per cent of the 5127 reported STI cases being male.
Transitioning programme
In relation to transitioning from donor-funded support to Government, Dr Singh highlighted that this has already commenced and is moving ahead, with already significant staff transitioning to Government. Other areas of transitioning included the absorption of 25 per cent PEPFAR supported Antiretrovirals (ARVs) in 2014 and the commencement of the transitioning of the Global Fund Supported ARVS in 2015. All laboratory supplies in support of the HIV treatment programme, CD4 test, Viral Load, and DNA PCR have been fully transitioned.
During the consensus meeting, NAPS’ Monitoring and Evaluation lead Fiona Persaud spoke about the generation of estimates that formed an important part of the Global AIDS Response Progress Reporting (GARPR). This generation was done through Spectrum, specially designed software that allows for modelling of the HIV epidemic after certain essential country data is inputted. HIV indicators for which draft estimates were developed at a recently-held workshop included the HIV population in country, HIV prevalence, the number of persons requiring ART, MTCT rates, and mortality due to HIV.
Whilst listing the successes of the national HIV response, Dr Singh advised that the programme was, however, not without its challenges. She stated that one of the main challenges identified was the interruptions in some service delivery due to the transitioning of human resources from donor-funded to country-funded in the move towards sustainability.
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