1. Acceleration of HIV Prevention:
Where are we?
I.Ntaganira, Regional adviser HIV Prevention,
WHO Regional Office for Africa
5th SAHARA Conference, 30
November-3 December 2009

2. Outline
• Background information;
• Actions taken;
• Progress made
• Issues and challenges
• Way forward
5th SAHARA Conference, 30
November-3 December 2009

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
5th SAHARA Conference, 30
November-3 December 2009

4. Brazzaville, November 2005
5th SAHARA Conference, 30
November-3 December 2009

5. Addis Ababa, 11 April 2006
5th SAHARA Conference, 30
November-3 December 2009

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)
5th SAHARA Conference, 30
November-3 December 2009

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
5th SAHARA Conference, 30
November-3 December 2009

8. Progress made
5th SAHARA Conference, 30
November-3 December 2009

9. Prevention of Mother-to-Child Transmission of
HIV
2008: 600,000
HIV positive
pregnant
women
received ARV
for PMTCT
5th SAHARA Conference, 30
November-3 December 2009

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
5th SAHARA Conference, 30 services
November-3 December 2009

11. Male Circumcision for HIV prevention:
Botswana, Burundi,
Kenya, Lesotho,
Malawi,
Mozambique,
Namibia, Rwanda,
South Africa,
Swaziland, Zambia,
Zimbabwe, Uganda,
United Republic of
Tanzania,
5th SAHARA Conference, 30
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
5th SAHARA Conference, 30
November-3 December 2009

13. Number of people receiving antiretroviral therapy in low- and middle-income countries,
by region, 2002–2008
5th SAHARA Conference, 30
November-3 December 2009
Towards Universal Access – Scaling up priority HIV/AIDS interventions in the health sector. WHO/UNAIDS/UNICEF, Sep 2009

14. Issues and Challenges
5th SAHARA Conference, 30
November-3 December 2009

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
5 SAHARA Conference, 30
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
5th SAHARA Conference, 30
November-3 December 2009

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%
5th SAHARA Conference, 30
November-3 December 2009

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)
5th SAHARA Conference, 30
November-3 December 2009

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;
5th SAHARA Conference, 30
November-3 December 2009