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04 Ntaganira 5th Sahara Hiv Prevention 2009

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04 Ntaganira 5th Sahara Hiv Prevention 2009

  1. 1. Acceleration of HIV Prevention: Where are we? I.Ntaganira, Regional adviser HIV Prevention, WHO Regional Office for Africa 5th SAHARA Conference, 30 November-3 December 2009
  2. 2. Outline • Background information; • Actions taken; • Progress made • Issues and challenges • Way forward 5th SAHARA Conference, 30 November-3 December 2009
  3. 3. Resolution AFR/RC55/R6 • Adoption by the 56th Session of the Regional Committee; • Calling the 46 Member States to accelerate HIV prevention; • Declaring 2006 the Year to launch acceleration of HIV prevention 5th SAHARA Conference, 30 November-3 December 2009
  4. 4. Brazzaville, November 2005 5th SAHARA Conference, 30 November-3 December 2009
  5. 5. Addis Ababa, 11 April 2006 5th SAHARA Conference, 30 November-3 December 2009
  6. 6. Country actions • 2006: Launch of acceleration of HIV prevention in all countries; • Appointment of HIV prevention focal persons and establishment of HIV prevention task forces; • Development of HIV prevention road maps; • multisectoral HIV/AIDS strategies and plans (stronger component on HIV prevention); • Resource mobilization (GFATM proposals with stronger focus on HIV prevention) 5th SAHARA Conference, 30 November-3 December 2009
  7. 7. Other actions • Establishment of HIV prevention units within UN agencies • Establishment of UN interagency technical teams on HIV prevention; • Organization of regional think tank meetings with setting up of regional targets for HIV prevention; • Organization of national summits on HIV prevention; • Regional efforts to mobilize financial resources 5th SAHARA Conference, 30 November-3 December 2009
  8. 8. Progress made 5th SAHARA Conference, 30 November-3 December 2009
  9. 9. Prevention of Mother-to-Child Transmission of HIV 2008: 600,000 HIV positive pregnant women received ARV for PMTCT 5th SAHARA Conference, 30 November-3 December 2009
  10. 10. Ensuring Individuals know their HIV status 2007-2008 Total number of health facilities providing HTC increased by 50% More than 17 millions people aged 15 and above received HTC 5th SAHARA Conference, 30 services November-3 December 2009
  11. 11. Male Circumcision for HIV prevention: Botswana, Burundi, Kenya, Lesotho, Malawi, Mozambique, Namibia, Rwanda, South Africa, Swaziland, Zambia, Zimbabwe, Uganda, United Republic of Tanzania, 5th SAHARA Conference, 30 November-3 December 2009
  12. 12. Trends in the Prevalence of Syphilis among ANC Women in Selected Countries in Southern Africa Malawi South Africa Swaziland Lesotho Zimbabwe 15 % 10 5 0 94 95 96 97 98 99 00 01 02 03 04 05 06 07 19 19 19 19 19 19 20 20 20 20 20 20 20 20 Source: WHO/AFRO, From national surveillance reporting 5th SAHARA Conference, 30 November-3 December 2009
  13. 13. Number of people receiving antiretroviral therapy in low- and middle-income countries, by region, 2002–2008 5th SAHARA Conference, 30 November-3 December 2009 Towards Universal Access – Scaling up priority HIV/AIDS interventions in the health sector. WHO/UNAIDS/UNICEF, Sep 2009
  14. 14. Issues and Challenges 5th SAHARA Conference, 30 November-3 December 2009
  15. 15. Knowledge of HIV status among HIV- infected persons *Sources: most recent DHS/AIS ►Large unmet desire for 100 HIV testing among HIV- infected Kenyans(79%) ►Knowledge of partner 80 status among HIV-infected Ugandans (9%) 60 Percent 40 23 20 20 16 0 Kenya 5th SAHARA Conference, 30 Malawi Uganda November-3 December 2009
  16. 16. HIV status of spouses of HIV-infected persons in Kenya, DHS, 2003 HIV DISCORDANT: One partner positive, one CONCORDANT POSITIVE: partner negative: 50% Both partners HIV-infected: 50% ►In Kenya, 50% of married HIV+ persons have an th 5 SAHARA Conference, 30 HIV-negative spouse December 2009 November-3
  17. 17. Sexual behavior of people living with HIV Kenya, Malawi, Uganda (%) Kenya Malawi Uganda Sexually active (last yr) 84 85 77 Of sexually active: One partner (last yr) 88 92 86 Used condom last sex 10 10 17 Used condom last sex 3 6 - with spouse 5th SAHARA Conference, 30 November-3 December 2009
  18. 18. Knowledge about HIV/AIDS Country Comprehensive Heard of correct HIV/AIDS (15- knowledge (15- 49 year old) 49 year old) Male female Male Female Benin 31.4% 13.8% 98.7% 94.2% Ethiopia 30% 15.8% 96.5% 89.9% Cameroon 32.2% 22.5% 99.2% 97.8% Swaziland 51.4% 51.9% 99.3% 99.8% 5th SAHARA Conference, 30 November-3 December 2009
  19. 19. ART: Challenges • Patients often tested at late stage of the disease; • Patient retention on antiretroviral therapy • 75% at 12 months and • 67% at 24 months • Late initiation of treatment – Botswana, average 67 cells per mm3 and 80 % of patients at stages 3 and 4; – Province of Cape Town ( 23 % started treatment with CD4 lower than 50 cells per mm3) 5th SAHARA Conference, 30 November-3 December 2009
  20. 20. Way forward: Going to scale • District based programming; • Scale up HIV prevention along side treatment and care; • Implementation of combination HIV prevention which are known to be working (enabling people living with HIV to know their status; PMTCT, ART, Male circumcision); • Invest more financial in HIV prevention while addressing health systems bottlenecks; 5th SAHARA Conference, 30 November-3 December 2009

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