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Analytical summary - HIV/AIDS

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It is estimated that 28 000 people are living with either HIV-1 or HIV-2 in the Gambia and over 3000 people have developed the advanced stage of AIDS.[1] A national sentinel surveillance system was initiated by the Government of the Gambia with the assistance of the Medical Research Council in 2000. Recent estimates show a decline in HIV-1 prevalence from 2.8% in 2006 to 1.4% in 2008, whereas HIV-2 prevalence declined from 0.9% in 2006 to 0.4% in 2008.[2] This decline is a result of a concerted effort between the Government, the private sector and development partners.

In 2001, the Gambia acquired US$ 15 million funding from the World Bank, which scaled-up the national response to HIV/AIDS. A National AIDS Council and National AIDS Secretariat have been established under the Office of the President, with His Excellency the President of the Gambia serving as Chairman of the National AIDS Council, showing commitment at the highest level.

Community mobilization in support of HIV

HIV care is delivered by care teams that are located in certified hospitals, health centres and nongovernmental organization clinics. The challenge with identified teams is that other health workers tend to view HIV care as a vertical programme. There is the need therefore to train all health workers so that HIV care is part of general care. This will help to reduce stigma associated with this stand-alone care.

All blood for use in health facilities is screened for HIV and venereal disease. Testing for hepatitis has been discussed at several technical meetings but the lack of funding has been identified as the major barrier. However, it is necessary to engage partners to have this service introduced.

Antiretroviral therapy services started in the Gambia in 2004 and presently there are 10 sites offering the services in all regions of the country in both the public and private non-profit sector. By the end of September 2011, 2714 patients were on antiretroviral therapy. It is commendable that every effort is being made to give treatment when needed. However, there is still a need to increase access to antiretroviral therapy through an increase in health facilities offering this service.

The Gambia has recognized the urgent need to scale-up prevention of mother-to-child transmission of HIV and aims to reduce transmission from 9.1% in 2006 to 4% by 2015.[3] Presently, there are 35 prevention of mother-to-child transmission sites across the country. Use of triple antiretroviral prophylaxis for pregnant mothers has been implemented since July 2011.

Eight out of the ten antiretroviral therapy sites have tuberculosis clinics and the other two sites send their patients to nearby tuberculosis clinics for investigation. All HIV patients are offered HIV counselling and testing.

Health care workers are sensitized on prevention of HIV at the workplace through training and practical guidelines available in health facilities. In the event of accidental injuries, postexposure prophylactic antiretroviral therapy is supplied at all facilities.

Awareness of HIV remains high, although knowledge of the three ABC prevention methods has declined in the general population, particularly among unmarried youths, female sex workers and men who have sex with men. It was also noted that there is high-risk sexual behaviour within these groups. This has warranted the shift of emphasis from awareness raising to behavioural change communication.

References

  1. Banjul, Government of the Gambia, National AIDS Secretariat, 2008
  2. Report. Banjul, Government of the Gambia, National Statistical System, 2008
  3. Prevention of Mother-to-Child Transmission Policy, 2010. Banjul, Government of the Gambia