While the prevalence of HIV in adults increased marginally, from 1.1% in 2001 to 1.3% in 2012, the National AIDS Programme Secretariat (NAPS) believes that it is because infected persons are living longer lives.
“The rise in the prevalence is a good indication… the 1.3% shows us that and is really an indication that people with HIV are not dying,” Programme Manager of NAPS Dr Shanti Singh yesterday told a stakeholder dissemination meeting at the Cara Lodge, in Georgetown, where the HIV estimates for 2012 were presented.
“If you started out with 1,000 people in your treatment programme today and then you calculate the prevalence hold that number … tomorrow your number of HIV persons may go up to 1,200. That means two things—either, one, 200 new infections came in or two, 250 came but 50 people died,” Singh said, while explaining how the calculations are made.
“What will happen over time is that your prevalence will go up because you have new infections coming into the pool and the amount of new infections coming into the pool is greater than the amount of people dying of AIDS. It means that your pool is larger and which would you want? More people living longer and an increase in the number or more people dying and the constant number?” she added.
Singh pointed out that it was in 1998 when voluntary testing and counseling commenced and from then through 2008 there has been a mixed trend in HIV diagnoses, with increases in some years and reductions in others. She said that there was a peak in 2006, recording more than 1,200 infections but from 2009 through 2012, there has been a continuing reduction in new cases both for HIV as well as AIDS.
Estimated annual AIDS deaths have been reduced to less than 100 in 2012 compared to less than 500 in 2011.
The decrease can also be attributed to the fact that the Guyanese populace has universal access to free treatment of the disease.
“In Guyana’s case, we have reported universal access to treatment. This has also translated to improved quality of life and increased life expectancy at the time of HIV diagnosis. Importantly, with a robust treatment programme, patients will achieve and sustain virologic suppression and this, as demonstrated in the HPTN, is treatment as prevention. Ultimately, less AIDS-related deaths are reported,” she asserted.
Singh also noted that what remains clear was that the epidemic continues to affect the productive sector of society, that is, persons between 20 and 49 years old. This evidence, she said, should be a clear indicator for decision makers and health personnel that efforts targeting the workforce must be ongoing.
“This prioritisation has led to the excellent work done by the Ministry of Labour in partnership with the International Labour Organisation and with the Guyana Business Coalition on HIV and AIDS. At the end of 2012, a total of 649 cases were reported within the combined age group of 20 to 49. This accounts for almost 80% of all cases reported in 2012,” she said.
In terms of geographic distribution, Region 4 continues to account for the majority of the cases and still continues to be disproportionately affected as it was from the inception of the epidemic. At the end of 2012, Region 4 accounted for 63.3% of all newly reported cases to the Ministry of Health, again disproportionately affected as this region accounts for 41.3% of the population based on the 2002 census.
Region 3 was the district listed with the second highest percentage of reported HIV cases at 15. 9%.
The number of persons that will be newly affected by HIV this year is estimated at less than 500, with miners, loggers and both male and female sex workers at higher risk. Male sex workers, however, continue to be a challenge as while the numbers have been reduced for female sex workers, males have increased.
“The national programme continues to respond and monitor the key populations at higher risk. In our context, the FCSW [Female Commercial Sex Workers] and MSM [Men who have Sex with Men] continue to be prioritised as the prevalence among those populations remains high. Some progress is noted among the FCSW, with reducing prevalence from 26.6% to 16.6%. For the MSM population a lesser decrease is noted,” Singh explained.
NAPS hopes that donors will continue to give so that their fight can continue until a cure is found and the virus is eradicated.
