Prevention knowledge on HIV high nationally but myths & other issues affect knowledge indicators.

During a radio discussion this morning on HOT 102FM with representatives from the National Program through the Ministry of Health and PANCAP, the matter of HIV/AIDS was discussed overall, the MSM community was mentioned in as far as our high rates of infections were concerned and the moral issues attached. The experts suggested that the respective HIV/AIDS activists be they governmental or private find ways to solve the causes of the high rates and not just deal with the symptoms despite sexual orientation.

Despite all the HIV/AIDS, Sexual Transmitted Infections education programs prevention knowledge is high at 70% but myths still affect the work and outreach hence overall knowledge indicators have dropped to 40% when the ideal situation calls for a 90% rate.

There have been gains as mother to child transmission over the years the knowledge is present but it is not being transformed into the requisite behaviour change for reductions in infection rates.

Some areas briefly examined:
Prevalence rate in the general population is 1.6% and considered a generalized epidemic.

Among men who have sex with men the rate of infection is now 30% based on the last national study in that group done in 2007

Among commercial sex workers one in ten pen persons or ten percent (10%) are infected which is far higher than the MSM group combined but also includes male sex workers as well.

Amongst crack cocaine and other hard drug users the prevalence rate is 5%

Multiple risk factors are identified chief among them are multiple partners where some 60% of the males surveyed in the general count reported that they had more than two partners in the last twelve months.

Transactional sex was identified in and outside of commercial sex work where persons engage in sex for favours such as “top up sex” where sex is exchanged for phone credit or minutes purchased or high end transactions where bills, rent, tuition, an apartment or gifts are purchased in exchange for sexual favours especially with men in position of power in the white collar environment. This carried a high risk, 20% of the population have reported they have engaged in such activity.

Some actions taken through the national program include prevention messages, early childhood interventions that highlight recognition of self and sexuality, negotiation of safer sex and letting persons understand really what HIV is along with other sexually transmitted infections. Risk of transmission and empowerment of young persons are recently added areas that are and will be stressed through the Ministry of Health.

Gender inequality and other social ills were brought into the mix as possible factors for or to influence HIV infection rates. Cultural issues need to be addressed and those are not simple. In as far as the millennium development goals stress eradicating the epidemic and universal access to treatment to improve the life of PLWHAs.

Generalized epidemic refers to a prevalence rate of 1% and above the development goals seek to get that down to less than 1% however prevalence is interpreted as the total number of cases but with improved treatment the total number of cases will increase by virtue of persons living longer and better quality of life but at the same time the expectation is decrease the total number of cases by preventing new infections therefore it is hard to determine the rise and fall of the prevalence rate overall bearing in mind the new factors affecting it. One would have to measure new infections to see that side of the equation. Treatment not only has implications for better and longer quality of life but also prevention effects as well as persons on antiretroviral drugs are less infectious although they still have HIV/AIDS thus impacting on the rate of infection as transmission is less likely.

There is a need to push for reduction of infection rates in the age groups of 15 – 24 as this cohort is ore likely to be the bulk of new infections as a myriad of factors are at play here chief among them is age mixing sexual activity.

Younger persons are having sex with older men and women thus increasing their risk for acquisition. Condom use or proper condom use is of concern as many persons know the messages but lack the skill in negotiation and application of a condom during sex.

My added two cents to this in as far as the MSM community is concerned is a lack of sustained and properly structured intervention programs that will have some impact on empowerment and self reliance and development. Maybe we are going to have to work with the national program’s structure despite the political sensitivities as they don’t really want to be seen working openly with this group given the buggery law and such.

More on this as it unfolds.

Peace and tolerance

H