The document discusses acceleration of HIV prevention efforts in Africa. It outlines actions taken since 2006 to boost prevention, including establishing task forces and roadmaps. Progress is shown in several areas like PMTCT coverage increasing to 600,000 mothers in 2008. However, challenges remain like low rates of knowledge of HIV status and high rates of new infections among married couples. The way forward emphasizes scaling up proven prevention methods alongside treatment at the district level through combination approaches.

1. Acceleration of HIV Prevention:
Where are we?
I.Ntaganira, Regional adviser HIV Prevention,
WHO Regional Office for Africa
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November-3 December 2009

2. Outline
• Background information;
• Actions taken;
• Progress made
• Issues and challenges
• Way forward
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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
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4. Brazzaville, November 2005
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5. Addis Ababa, 11 April 2006
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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)
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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
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8. Progress made
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9. Prevention of Mother-to-Child Transmission of
HIV
2008: 600,000
HIV positive
pregnant
women
received ARV
for PMTCT
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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
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11. Male Circumcision for HIV prevention:
Botswana, Burundi,
Kenya, Lesotho,
Malawi,
Mozambique,
Namibia, Rwanda,
South Africa,
Swaziland, Zambia,
Zimbabwe, Uganda,
United Republic of
Tanzania,
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November-3 December 2009

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
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13. Number of people receiving antiretroviral therapy in low- and middle-income countries,
by region, 2002–2008
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Towards Universal Access – Scaling up priority HIV/AIDS interventions in the health sector. WHO/UNAIDS/UNICEF, Sep 2009

14. Issues and Challenges
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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. 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
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HIV-negative spouse December 2009
November-3

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
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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%
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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)
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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;
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