As Guyana ups its efforts to reduce new HIV infections, the Ministry of Public Health will be rolling out an initiative that will see HIV prevention products and services being offered at “hot spots” frequented by persons considered to be more vulnerable to HIV infection.
In a statement published as an ad in the Sunday Stabroek, Deputy Chief Medical Officer Dr Karen Campbell said that the pilot “Social Contracting” initiative will be implemented in Region Four. It aims to reach those persons considered more vulnerable to HIV infection or key populations, which include Female Sex workers (FSW), Men who have Sex with Men (MSM), and transgender women.
Campbell explained that the Social Contracting initiative will see a number of non-governmental organisations (NGOs), contracted by the Ministry of Public Health, reaching out to the key populations with HIV prevention products and services.
“This strategy will have trained NGO staff doing outreaches to “Hot Spots” which are places frequented by key populations. The NGOs will provide on-site HIV testing, sexual risk reduction counselling, condoms and referral for other health and social services,” she said.
“It is anticipated that this strategy will help reach an additional 1,821 FSW, 1,653 MSM and 315 transgender women with HIV and STI prevention services thereby helping Guyana reach its goal in reducing the number of new infections,” the health official added.
Campbell recalled that in 2017, Guyana had an estimated HIV prevalence of 1.7 per cent, up from 1.4 per cent in 2014. This apparent increase in HIV prevalence is not due to an increase in the rates of HIV infection but rather to persons infected with HIV living longer due to treatment with Highly Active Anti-Retroviral Therapy (HAART), she said.
Guyana has seen a steady decrease in new infections since 2016, Campbell observed. She said that Dr Rhonda Moore, Programme Mana-ger of the National AIDS Programme Secretariat, says this can be attributed to new initiatives, such as ‘Treat All,’ pregnant women who test positive during pregnancy receiving HAART to prevent their unborn infants from becoming infected, the establishment of a ‘Loss to Follow up’ programme, and to the extended hours of clinic at the National Care and Treatment Centre (NCTC).
The ‘Treat All’ initiative started officially in May, 2018. Under this initiative, patients start treatment as early as five days after enrollment at a treatment site. Prior to ‘Treat All’, patients were not placed on anti-retroviral treatment until their immune system had started to decline. With the ‘Treat All’ initiative, persons who test positive are started on treatment after being counselled and deemed ready. Once a person living with HIV adheres to their treatment, they can suppress the virus from multiplying, Campbell said.
She pointed out that keeping the viral load low reduces the risk of spreading HIV through unprotected sex. In 2018, the estimated number of persons living with HIV in Guyana was 8,369. Of these, 5,557, inclusive of children, were on treatment.
Campbell further noted that as part of the Prevention of Mother to Child Transmission policy of the Public Health Ministry, all pregnant women are required to have an HIV test during the course of their pregnancy.
“Any woman found to be HIV infected is placed on treatment to protect her unborn child from becoming infected and to preserve her immune system. Male partners of pregnant women are also tested so they too can be placed on treatment if positive. Under the Prevention of Mother to Child initiative, pregnant women are also required to be tested for sexually transmitted infections (STIs). Once placed on HAART during pregnancy, a woman stays on treatment for the rest of her life,” she said.
Campbell also observed that the ‘Loss to Follow up’ initiative was revamp-ed in 2017, with support from the United States’ Centers for Disease Control. The programme tracks patients who missed clinic appointments from 2002 to 2016. Social workers from the Ministry of Public Health call or visit patients who defaulted to encourage them to return for treatment. 80 per cent of the defaulters targeted successfully returned, Campbell revealed.
She also noted that the NCTC in Region 4 initiated extended clinic hours in June, 2018, in order to facilitate attendance from working men and women. “The clinic now opens late on Mondays, Wednesdays, Fridays and Saturdays from 4:30 to 8:30 pm. This welcomed initiative has seen an additional 356 persons accessing care and treatment at the NCTC,” she said.
