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HIV, a potential serious threat to the population

HIV and AIDS is increasingly becoming more of a social issue rather than a disease specific issue with people still harboring misconceptions and stigma against HIV patients, according to the Executive Director of Lhak-sam, Wangda Dorji during the media advocacy training on the two-day HIV ad SOGIE held from Monday.

Though Bhutan is a low HIV prevalence country with an estimated adult HIV prevalence of 0.02%, there is a risk that it may spread among the population with risk of experiencing concentrated epidemic among certain population groups.

It is estimated that at over 1,000-1,100 Bhutanese are living with HIV, however 570 were detected to be HIV positive and of which 528 were infected through sexual route, 35 were infected through transmission of HIV from the mother to child and three through intravenous drug use and three transmitted through blood transfusion.

An official with the National AIDS Control Program said that HIV and AIDS affect largely the younger and productive population.

Around 323 detected as HIV positive were aged between 25-39, 82 between 20- 24years and 26 were children were below five years while 24 were between age 6-19years.

“It has been discovered that increased availability of emergency contraceptive pills undermine the use of condoms,” said the health official.

Various occupational groups are infected. At 130, housewives were highest in numbers infected, second are farmers with 115 infected, followed by private/business with 92 and finally 53 drivers.

Of the total detected, 166 were detected through contact tracing, 124 each were detected through medical screening and voluntary testing, and 56 through antenatal care. Other cases were detected through blood donor screening, survey and construction site screening.

“With improvement of services, the number of cases is increasing in terms of detection,” said the health official.

Executive Director of Lhaksam, Wangda Dorji said that besides sex workers and those injecting for drug use, men having sex with men (MSM), and transgender are more vulnerable to HIV.

The program data maintained by Ministry of Health indicates that almost 90% of the infections are attributed to heterosexual transmission and currently 434 people are living with HIV in 19 of 20 districts.

Although the first HIV case was detected in 1993, it was only in 2006, the treatment guideline was introduced.  Last year the health ministry revised the treatment guideline and introduced treat – all policy and National Strategic Plan III for the Prevention and Control of STIs and HIV and AIDS. Its main goal is  to reduce new sexually transmitted infections (STIs) and HIV infections and provide continuum of care to people living with and affected by HIV.

The HIV prevention measure is done through counseling and testing services, raising awareness behavioral change communication, condom promotion, STI treatment, resource mobilization and unifying national and international efforts.

However due to high sexual promiscuity in the population, low condom usage despite continued media campaigns, increasing emergence of third gender population, MSM and Transgenders (TG), increasing emergence of other STIs including Hepatitis ‘B’ are some of the challenges in area of prevention.

To reduce new STIs and HIV infections and provide continuum of care to people living with and affected by HIV, ministry of health initiated new program, the public private partnership – installation of 59 condom winding machines in 13 districts as pilot project and introduction of HIV, Hepatitis B and Syphilis testing facilities in private diagnostic centers.

To achieve the broader health and developmental goal of the country, Lhak-Sam’s Strategic Plan is framed to achieve the overarching impact level target to reduce AIDS-related deaths, to reduce and eliminate vertical transmission of HIV from mother to child and to halt HIV incidence.

Pema Seldon from Thimphu

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