HIV/AIDS in East Timor

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The southeast-Asian nation of East Timor has dealt with HIV/AIDS since its first documented case in 2001. It has one of the lowest HIV/AIDS-prevalence rates in the world. [1]

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Prevalence

Timor-Leste is a low HIV-prevalence country with less than 0.2 percent of the adult population estimated to be HIV-positive. However, social factors such as massive social dislocation, cross-border migration, high unemployment, and a weak and limited health system could dramatically increase the spread of HIV infection. Many young people are not well-equipped with the knowledge and life skills to manage HIV risk in an increasingly challenging environment. [2]

The first HIV/AIDS case in Timor-Leste was detected in 2001. Forty-three cases of the disease were confirmed in 2007 and are now under treatment, according to the Ministry of Health. However, limited surveillance capabilities and inadequate testing could mean that more people are infected. [2]

Although HIV prevalence among the general population appears to be quite low, there are signs of a low-level epidemic among Timor-Leste’s sex workers and men who have sex with men (MSM). According to data collected in mid-2003 by Family Health International (FHI), HIV-prevalence rates among sex workers and MSM were 3 percent and 1 percent, respectively. According to the same study, among female sex workers (FSWs), 14 percent tested positive for gonorrhea, 15 percent for chlamydia, 16 percent for trichomonas and 60 percent for herpes simplex virus-2. No comparable data have been collected since, and consequently, the current situation is unknown. Timor-Leste is also vulnerable due to its close proximity to nearby countries that are experiencing localized epidemics such as Indonesia and Papua New Guinea. [2]

General public health knowledge on primary health care, including reproductive health, sexually transmitted infections (STIs), and HIV/AIDS, is very limited especially in remote areas. Only 50.7 percent of the population 15 years old and over ever heard about HIV/AIDS; and among those in that same population group who think it can be avoided, only 41.8 percent know that it can be avoided by use of condoms, according to the 2007 Timor-Leste Living Standards Measurement Study. There are others factors that contribute to the risk and impact of HIV/AIDS among women; they include domestic violence, lower literacy and education levels, and cultural constraints in discussing issues of sex. Providing the general population with information to combat HIV/AIDS is complicated due to low prevalence and limited access to the communities. According to the National Statistic Directorate Census 2004, most people live in the rural areas, mainly around the northern coastal regions in small, dispersed villages. According to the Demographic and Health Surveys conducted in 2003, more than 60 percent of women and 70 percent of men do not recognize any method of family planning, and only 10 percent of women are using any contraceptive method. [2]

Timor-Leste can still be classified as a conflict country. The civil unrest that erupted in April/May 2006 continues to be unsettled and constitutes a risk for high rates of domestic violence and sexual assault, thereby leaving women more vulnerable to infection since they are unable to negotiate condom use. The country has a high tuberculosis (TB) burden, with 250 new cases per 100,000 people in 2005, according to the World Health Organization. [2]

From the 43 cases under treatment, data from the Ministry of Health due to be released in early 2008, shows that at least three people have HIV-TB co-infections; two children under five received the infection from their mothers; and two pregnant women are under prevention of mother-to-child transmission (PMTCT) HIV treatment. [2]

National response

HIV/AIDS has had a devastating impact on other countries in comparable circumstances to Timor-Leste. Among Timor-Leste’s nearest neighbors, Papua New Guinea appears to be in the early stages of a generalized HIV epidemic that threatens to not only halt, but also reverse the development achievements the nation has made in its relatively short history. Many of the circumstances that have led to the current HIV situation in Papua New Guinea are also present in Timor-Leste, including large-scale social dislocation and high levels of HIV-related risk. [2]

In 2002 a National HIV/AIDS/STI Strategic Plan (2002–2005) was adopted. In the period since, Timor-Leste has adopted and implemented strategies, policies, programs, and projects to address HIV/AIDS. However, among key stakeholders, it is generally accepted that while many effective activities have been implemented, overall coordination is weak, and important gaps exist. Knowledge about HIV/AIDS across the general population remains low, the level of unsafe sex practices is high, and STI rates are also high. [2]

In mid-2005, the Ministry of Health, with support from UN Agencies and key civil society organizations, initiated a process to review the National HIV/AIDS/STI Strategic Plan (2002–2005) and develop a new national strategic plan to cover the period 2006–2010. The new National Strategic Plan for HIV/AIDS/STIs 2006–2010 was approved by the Council of Ministers in August 2006. The goal is "to maintain Timor-Leste as a low prevalence HIV nation and minimize the adverse consequences for those infected with HIV". Four program components were identified:

A key part of the national strategy is the establishment of the National AIDS Commission, to provide independent advice to the Government of Timor-Leste on all matters related to HIV/AIDS and to monitor and advise on the progress in implementation of the National Strategic Program. [2]

In 2006, the Global Fund to Fight AIDS, Tuberculosis and Malaria approved a fifth-round grant for Timor-Leste to scale up the national response to HIV/AIDS through the delivery of services and information to at-risk populations and people living with HIV/AIDS. The grant was signed in December 2006 and now is on quarter three implementation. Assessment reports show good performance in relation to targets settled for quarter 1 and quarter 2. [2]

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Kenya has a severe, generalized HIV epidemic, but in recent years, the country has experienced a notable decline in HIV prevalence, attributed in part to significant behavioral change and increased access to ARV. Adult HIV prevalence is estimated to have fallen from 10 percent in the late 1990s to about 4.8 percent in 2017. Women face considerably higher risk of HIV infection than men but have longer life expectancies than men when on ART. The 7th edition of AIDS in Kenya reports an HIV prevalence rate of eight percent in adult women and four percent in adult men. Populations in Kenya that are especially at risk include injecting drug users and people in prostitution, whose prevalence rates are estimated at 53 percent and 27 percent, respectively. Men who have sex with men (MSM) are also at risk at a prevalence of 18.2%. Other groups also include discordant couples however successful ARV-treatment will prevent transmission. Other groups at risk are prison communities, uniformed forces, and truck drivers.

Although Senegal is a relatively underdeveloped country, HIV prevalence in the general population is low at around 0.08 per 1000 people, under 1% of the population. This relatively low prevalence rate is aided by the fact that few people are infected every year – in 2016, 1100 new cases were reported vs 48,000 new cases in Brazil. Senegal's death due to HIV rate, particularly when compared it to its HIV prevalence rate, is relatively high with 1600 deaths in 2016. Almost two times as many women were infected with HIV as men in 2016, and while almost three times as many women were receiving antiretroviral therapy (ARV) as men, only 52% of HIV positive people in Senegal received ARV treatment in 2016.

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With less than 0.1 percent of the population estimated to be HIV-positive, Bangladesh is a low HIV-prevalence country.

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<span class="mw-page-title-main">HIV/AIDS in Nepal</span>

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HIV/AIDS in Bolivia has a less than 1 percent prevalence of Bolivia's adult population estimated to be HIV-positive. Bolivia has one of the lowest HIV prevalence rates in the Latin America and Caribbean region.

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HIV/AIDS in El Salvador has a less than 1 percent prevalence of the adult population reported to be HIV-positive. El Salvador therefore is a low-HIV-prevalence country. The virus remains a significant threat in high-risk communities, such as commercial sex workers (CSWs) and men who have sex with men (MSM).

Honduras is the Central American country most adversely affected by the HIV/AIDS epidemic. It is estimated that the prevalence of HIV among Honduran adults is 1.5%.

HIV/AIDS in Jamaica has a 1.5 percent prevalence of the adult population estimated to be HIV-positive. There has been no significant change over the last five years and therefore Jamaica appears to have stabilized its HIV/AIDS epidemic.

Nicaragua has 0.2 percent of the adult population estimated to be HIV-positive. Nicaragua has one of the lowest HIV prevalence rates in Central America.

With less than 1 percent of the population estimated to be HIV-positive, Egypt is a low-HIV-prevalence country. However, between the years 2006 and 2011, HIV prevalence rates in Egypt increased tenfold. Until 2011, the average number of new cases of HIV in Egypt was 400 per year. But, in 2012 and 2013 it increased to about 600 new cases and in 2014 it reached 880 new cases per year. According to UNAIDS 2016 statistics, there are about 11,000 people currently living with HIV in Egypt. The Ministry of Health and Population reported in 2020 over 13,000 Egyptians are living with HIV/AIDS. However, unsafe behaviors among most-at-risk populations and limited condom usage among the general population place Egypt at risk of a broader epidemic.

With an estimated 120,000 people living with HIV/AIDS, the HIV/AIDS epidemic in Colombia is consistent with the epidemic in much of Latin America as a whole, both in terms of prevalence of infection and characteristics of transmission and affected populations. Colombia has a relatively low rate of HIV infection at 0.4%. Certain groups, particularly men who have sex with men, bear the burden of significantly higher rates of infection than the general population. Colombia's health care system and conception of a "right to health", created by the T-760 decision of 2008, have revolutionized access to HIV treatment. Despite this, the quality of health insurance and treatment for HIV has often been disputed.

References

  1. ↑ "AIDSinfo | UNAIDS". aidsinfo.unaids.org. Retrieved 2023-09-13.
  2. 1 2 3 4 5 6 7 8 9 10 11 "Health Profile: Timor-Leste" Archived 2008-08-17 at the Wayback Machine . United States Agency for International Development (February 2008). Accessed August 25, 2008. PD-icon.svg This article incorporates text from this source, which is in the public domain .

[HIV-AIDS and Homophobia in Timor-Leste]http://easttimorlegal.blogspot.com/2009/09/hiv-aids-and-homophobia-in-timor-leste.html

[Timor Leste Red Cross excludes homosexuals from HIV-AIDS Reduction Program] http://easttimorlegal.blogspot.com/2009/09/timor-leste-red-cross-exludes.html

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