Since its first known case 35 years ago, Guyana has made significant strides in combating and preventing HIV here and is on track to achieve the target of 95% of all HIV-positive individuals being diagnosed by 2030, Minister of Health Dr. Frank Anthony says.
Lauding the support from a number of local, regional and international groups and countries, the Minister of Health said that the recent self-testing initiative along with the acquisition of a HIV viral load machine will further boost the fight against the virus which was once seen as a death sentence but could now be managed with a growing suite of medications.
“When we heard of our first case of HIV 35 years ago, for a lot of people at that time, it was a sense of hopelessness …when we [in Guyana] heard, we didn’t have diagnostics. It was a big challenge. So 35 years ago to where we are today, we have really made a transformation with how we have been managing this disease,” Anthony said on Sunday in his address to this country’s inaugural HIV/STI conference, in observance of World AIDS Day on December 1st.
HIV causes the Acquired Immune Deficiency Syndrome (AIDS) disease.
“When you look at what we have accomplished, because we have also had a lot of good partnerships …with the US and PEPFAR… it just shows, we have had a lot of dedication; a lot of work done to have seen this transformation,” he added.
The viral load machine will be placed at the National Public Health Reference Lab where health personnel will be trained in its use.
Anthony later told Stabroek News that while Guyana has tested and collected data on at- risk groups identified, it has not been able to gather information on how they were responding to their ARVs (anti-retrovirals) treatment because this country still did not have a viral load testing machine.
A viral load test measures how much human immunodeficiency virus (HIV) is in the blood. Viral load is first measured when one is diagnosed with the HIV infection. This first measurement serves as the baseline. Future viral load measurements will be compared with the baseline and the initial test can be used to not only diagnose an HIV infection but monitor a patient’s response to treatment, the minister explained.
“While the rest of the developed world have had viral load testing machines, we did not have one dedicated to this. So what we did in this year’s budget was, we have bought that machine. We are expecting it, one of the Roche brands, later in this month or early next year. Once we get that, it will be set up at the lab and every HIV patient will be able to access those tests, free of cost,” he said.
“That will be a big boost to our programme. Our statistics for viral load testing right now is like 28%. So now we will be able to monitor and I am sure our numbers will increase significantly. If you give the patients ARVs, you have to make sure they are working and the only way is to see in their system their viral load. Why is this important? It is because if you are virally suppressed you can’t transfer the HIV. Once you drink the medicines you won’t be able to transmit. With this machine and testing and I am sure we can work to get to that target by 2025,” he added.
Anthony explained that the ’95-95-95’ statistics data he was referring to was the target set in 2014, by the Joint United Nations Programme on HIV/ AIDS (UNAIDS) . The aim was to diagnose 95% of all HIV-positive individuals, provide antiretroviral therapy (ART) for 95% of those diagnosed and achieve viral suppression for 95% of those treated by 2030.
According to UNAIDS reports, while significant progress has been made in controlling the HIV epidemic in the past 20 years, many countries are still falling behind the targets set.
In Guyana, according to the Heath Minister, while the 28% of persons who are virally suppressed is low, this country is set to achieve the other 95% targets by 2030 because currently 94% of at-risk persons knows their status and about 73% who tested positive are on treatment.
Big boost
A big boost in persons testing and going for treatment has been credited to the self-testing initiative that was launched last year. “We recognized that self-testing would have been a big boost and we introduced that last year. We started with a programme where they did counselling then the test at a testing site. What we are now doing is making the tests, which are just like pregnancy tests, available and persons can take home the test and do it from the comfort and privacy of their own homes,” he said.
“Self-testing also helps potential partners who may want to know the status of the other person. But they must remember there is a window period and depending on the sensitivity of the test, that window can differ. So sometimes after you test you should (test) again,” he said.
Anthony noted that although self-testing also started in the United States over a decade ago and Guyana is only now doing it, that still shows that government is committed to bridging the health care divide and will continue to pour resources into the sector. “Anyone who feels they are at risk or have any doubt, just come in and get a kit and use at home…Self-testing is good to have in country and hopefully more and more people will use self-testing,” he said.
Counselling is still offered to persons and support mechanisms, via phone or in person are alternatives.
Guyana’s Artistes in Direct Support (AIDS), a non-profit organisation which educates at-risk people about HIV and AIDS through the creative arts, was singled out for their tireless efforts over the decades.
Hailed also was the United States’ President’s Emergency Plan for AIDS Relief (PEPFAR) which Anthony said was with Guyana through the years, and when children couldn’t access treatment, that US programme assisted in ensuring children had access to anti-retrovirals.
The PAHO/WHO, which continuously gives technical and other support was also thanked, among others.
“The big picture is that all the little things we do must add up to end AIDS by 2030. So if we can pool our resources and work steadfastly to achieve this goal, then we can…,” Anthony said.
