13,000 living with virus
Guyana has been recognised for boosting its Prevention of Mother-to-Child Transmission Programme (PMTCT) which has resulted in the reduction of the number of mothers transmitting the HIV virus to their infants, according to the UNAIDS AIDS Global Report 2008.
Guyana’s 94 PMTCT sites in eight regions were also mentioned while it was stated that in a 2006 survey it was found that 80% of pregnant women accepted PMTCT services when offered. Jamaica and Barbados were also mentioned for the scaling up of their PMTCT programmes.
However, the report released yesterday noted that there is a high prevalence of the virus among female sex workers with an estimated one-third of them living with the virus. The report disclosed that there has been a prevalence rate of 31% among sex workers in Guyana with a 9% prevalence in Jamaica.
Asked yesterday about the report, Minister of Health Dr Leslie Ramsammy said he is generally happy with what was stated on Guyana but said he wished up-to-date data was used to come up with Guyana’s HIV/AIDS picture. The minister pointed out that the report gave a prevalence rate for the virus in Guyana as a round 1.7% while in fact the prevalence rate in the country is between 1 and 1.12%. In the past, Guyana had a prevalence rate as high as 3.5%. Further the minister said the report indicated that Guyana has about 49% coverage in its PMTCT programme when in fact the country has 80% coverage.
He noted that the report showed that globally the epidemic has stabilized. However, while Guyana is also in this category, the minister said that the number of infected persons would not decrease as the health authorities are in the process of finding persons and placing them on treatment. The only way the number would decrease is if persons die and the minister said that they are in the business of keeping persons alive and Guyana now has to be careful not to have a large number of new infections.
“So I am generally satisfied with the report but I hope that next time they use more up-to-date figures, but I am not going to quarrel as long as it shows Guyana’s trend,” the minister said.
13,000 Guyanese infected
According to the report, there are some 13,000 Guyanese living with the virus while 6,800 are living with it in Suriname, making the two countries the most affected in the region.
UNAIDS publishes a new AIDS report every two years and usually draws upon and publishes the best available data from countries. It also provides an overview and commentary on the epidemic and the international response.
In the Caribbean the report found that AIDS is the leading cause of death in the 25 to 44 age group while the region has the highest HIV prevalence in the Americas with some 230,000 persons living with the virus.
The Caribbean picture of the epidemic occurs in the context of high levels of poverty and unemployment, gender and other inequalities, and considerable stigma, all of which the report said can fuel the spread of the virus and hinder efforts to control the disease.
And the epidemic is mainly transmitted through unprotected heterosexual intercourse in the Caribbean but unprotected sex between men was also listed as a significant factor in the spreading of the virus in several countries.
According to the report as many as one in eight (12%) reported HIV infections in the region occurred through unprotected sex between men. Unprotected sex between men is the main mode of HIV transmission in Cuba, where men account for more than 80% of all reported HIV cases. But on the positive side, in Cuba all pregnant women are tested for HIV and if positive they receive antiretroviral drugs to reduce the risk of transmission to their babies.
While the epidemic appears to have stabilised in the Caribbean, the report pointed out that this has occurred at a high level with the region reporting 20,000 new infections.
The report said that some 14,000 persons have died in the region from the virus, but it did not state over what period.
Among the countries in the Caribbean that are most infected are Haiti and the Dominican Republic with about three-quarters of the 230,000 of the infected persons in the Caribbean living in the two countries. However, the two countries were cited as having a declining number of cases in urban areas.
Further, the report revealed that recent epidemiological trends in HIV surveillance systems “are still inadequate in several Caribbean countries” but available information indicates that most of the epidemics in the region appear to have stabilized, while a few have declined in urban areas.
And Haiti which has the biggest epidemic in the Caribbean also had some more good news as, according to the report, HIV prevalence among pregnant women attending antenatal clinics declined from 5.9% in 1996 to 3.1% in 2004 and subsequently remained stable in 2007.
“Although positive behaviour changes appear to be at least partly responsible for the decline, significant levels of high-risk behaviour have been documented in Haiti’s rural areas and among young people…” the report said.
Meanwhile, the report said that HIV prevalence has declined in the Dominican Republic, since surveys have indicated that more sex workers are protecting themselves against HIV infection especially in the main urban and tourist centres.
And in contrast to the other countries in the region, injecting drugs is the key factor in the transmission of the virus in Bermuda and Puerto Rico. The report said that very high HIV prevalence is still being found among people who inject drugs in Puerto Rico, where the rate of infection, 26 in every 100,000, is twice that in the US mainland where more than two-thirds of HIV infections have been among men.
Globally, the report said, an estimated 33 million people were living with HIV in 2002 with 2.7 million new infections and two million AIDS-related deaths last year.
While it was stated that the rate of new infections has fallen in several countries, globally the favourable trends are at least partially offset by increases in new infections in other countries.
Also on the global front, women account for half of all infections with this percentage remaining stable for the past several years. Meanwhile, there is an estimated 370,000 children, younger than 15, who became infected with the virus in 2007 globally. The total number of children living with the virus has increased from 1.6 million in 2001 to two million in 2007 with almost 90% of them living in sub-Saharan Africa.
