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Analytical summary - HIV/AIDS

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A 2005 national population-based seroprevalence survey for HIV reported a national prevalence of 1.53%.[1] The Sierra Leone health and demographic survey, 2008 found that 1.7% of women and 1.2% of men were HIV positive, with an overall prevalence of 1.5%.[2]

However, in spite of the low HIV prevalence rate there are predisposing factors for increased HIV infection, such as the high prevalence of sexually transmitted infections and ignorance; only 17.2% of young females and 27.6% of young males have comprehensive knowledge about HIV prevention. During the Sierra Leone Health and Demographic Survey 2008, it was found that only 13% of women and 8% of men aged 15–49 years, respectively, had had an HIV test in the past 12 months.[1]

Sierra Leone is committed to accelerating HIV prevention. This is evident by the implementation of special programme areas.[3]

Blood safety
With respect to blood safety, the service availability and readiness assessment conducted in 2011 showed that only one third of hospitals had adequate blood-typing capacity and only 50% had access to safe blood. Half of the hospitals experienced blood shortages.[4]

Antiretroviral therapy
By 2007, with support from the Global Fund to Fight AIDS, Tuberculosis and Malaria, antiretroviral therapy and treatment of opportunistic infection were made available free of charge in a number of treatment centres nationwide. Antiretroviral therapy sites increased from 111 in 2009 to 131 in 2010. Similarly, the number of HIV-positive cases on antiretroviral therapy increased from 14.1% in 2009 to 21% in 2010.[5]

Prevention of mother-to-child transmission
Prevention of mother-to-child transmission (PMTCT) services were introduced in Sierra Leone on a pilot basis in 2004. By the end of June 2010, 497 voluntary confidential counselling and testing sites and 454 PMTCT sites were operational. The uptake of PMTCT services among pregnant women with HIV has increased from 40.4% (equivalent to 650 women) in 2009 to 47.7% (equivalent to 717 women) in 2010.

In the 2011 service availability and readiness assessment, approximately 37% of facilities (77 of 207) offered PMTCT services.[4] It is planned that by 2014 all 1040 health facilities throughout the country will offer PMTCT services.[6]

HIV testing and counselling
The 2011 service availability and readiness assessment showed that approximately 42% (87 of 207) of facilities offer HIV testing and counselling services; however, less than half of these had the capacity to conduct an HIV diagnostic test on the day of the assessment. This may indicate a shortage of testing kits, equipment and reagents needed to conduct diagnostic testing. Most facilities (91%) had staff trained in testing and counselling and most also had privacy rooms (88%) and male condoms (83%) available.[4]

Prevention of HIV in health care settings
Prevention of HIV in health care settings is carried out mainly through adherence to universal precautions such as the use of gloves and protective clothing during medical and surgical procedures. Prevention is also carried out through the diagnosis and treatment of sexually transmitted infection, voluntary confidential counselling and testing, PMTCT, including breastfeeding substitutes, and postexposure prophylaxis.

Sierra Leone has a policy that promotes information, education and communication on HIV to the general population.[7] Intervention strategies used for behaviour change communication are well founded on research.

The National AIDS Secretariat conducts regular national annual reviews to monitor and evaluate progress in implementing the national strategic plan along the well-accepted principles of one national strategy, one coordinating authority and one national monitoring and evaluation system.[8]

References

  1. 1.0 1.1 Sierra Leone HIV modes of transmission study. Know your epidemic, know your response (pdf 2.90Mb). Freetown, Sierra Leone, National AIDS Secretariat, 2010
  2. Sierra Leone health and demographic survey, 2008: key findings (pdf 3.15Mb). Calverton, Maryland, Statistics Sierra Leone and ICF Macro, 2009
  3. National HIV/AIDS Policy, final 2002. Government of Sierra Leone, Ministry of Health and Sanitation, 2002
  4. 4.0 4.1 4.2 Sierra Leone service availability and readiness assessment (4.9Mb). Government of Sierra Leone, Ministry of Health and Sanitation, 2011
  5. Performance report. Government of Sierra Leone, Ministry of Health and Sanitation, 2010
  6. Leigh B. Child survival and development mid-term review report for the programme 2008–2010. Sierra Leone, United Nations Children’s Fund, 2009
  7. National HIV/AIDS Policy, 2002. Government of Sierra Leone, Ministry of Health and Sanitation, 2002
  8. National AIDS Secretariat institutional report, 2009. Government of Sierra Leone, National AIDS Secretariat, 2009