HIV prevalence increases

Saturday, March 20, 2010 (The Mirror Pg 13)

By Rebecca Kwei
GHANA’s 2009 adult national HIV prevalence is estimated at 1.9 per cent as compared to 1.7 per cent in 2008.
Also, the HIV prevalence among pregnant women attending antenatal clinics was 2.9 per cent, representing a 31 per cent increase of last year’s 2.2 per cent.
Giving the facts and figures of the 2009 HIV Sentinel Survey and National HIV and AIDS Prevalence Estimates, Dr Nii Akwei Addo, Programme Manager of the National AIDS/STI Control Programme said,despite the increase in prevalence of HIV in 2009, Ghana’s epidemic is still on the decline.
He was however, quick to add that more effort was required by all stakeholders to keep the HIV prevalence on further decline since complacency would erode the progress made so far.
The HIV prevalence had increased after a decline for the second time in 2008 after 2007 as observed in 2003 and 2006. Prior to this, it had risen from 2.3 per cent in 1999 to 3.6 per cent in 2003.
The sentinel survey is a cross sectional survey targeting pregnant women attending antenatal clinics (ANC) in selected ANC sites in Ghana. The surveillance system was initiated based on the premise that prevalence of HIV among pregnant women was a good proxy indicator of the spread of the infection among the populace.
A total of 18,833 samples were collected from 69 ANC located in 40 sentinel sites (23 urban and 17 rural) across the country and records on 18,809 were analysed.
Dr Addo said there was an estimated 267,069 persons comprising 112,457 males and 154,612 females living with HIV AIDS in Ghana and 25,666 of that were children; 12,579 being females.
Additionally, there were 22,177 new infections and 20,313 AIDS deaths with 2,566 being children.
The HIV site prevalence ranged from 0.7 per cent in North Tongu (rural) to 5.8 per cent in Koforidua and Agomanya (urban).
Interestingly, Agomanya saw a drop in prevalence from the 2008’s figure of eight per cent but still maintained its position as the site with the highest prevalence with Koforidua.
Although Fanteakwa’s prevalence dropped to four per cent, it still remained the rural site with the highest prevalence.
All the regions, with the exception of the Eastern Region, recorded an increase in prevalence over 2008. Upper West Region recorded the highest increase of 3.1 per cent from 1.6 per cent. However, Eastern Region continued to be the region with the highest prevalence level.
For the age group, 40 to 44 years recorded the highest prevalence of four per cent, while the 15-19 year group had the least prevalence of 1.9 per cent. Prevalence among the youth of age group 15-24 years, which is used as a marker for new infections, was 2.1 per cent.
According to the report, 91.8 per cent of the HIV positive samples were HIV type I; HIV type II was 5.2 per cent, while HIV types I and II was three per cent.
Dr Addo said the country was gradually getting more HIV type II and HIV types I and II and considerations for a review of national antiretrovirals (ART) guidelines must take this trend into account, given the limited regimens available for managing HIV type II.
For syphilis, Central Region remained the region with the highest syphilis prevalence and Asikuma Odoben Brakwa (rural), the site with highest prevalence.
The report indicated that rural areas continued to have higher syphilis prevalence than urban areas.
HIV prevalence among Sexually Transmitted Infections (STI) clients was almost halved from 10.5 per cent in 2008 to 5.5 per cent in 2009, due to decreases at both the Adabraka and Kumasi sites.
???Dr Addo while the number of AIDS deaths is expected to decline???, the number of people living with HIV is expected to increase gradually with improved access to ART
coupled with resulting new infections.
He said more persons living with HIV would need ART and co-trimoxazole prophylaxis but the demand for these medications in children was expected to decline as the risk of Mother-to-Child transmission of HIV is reduced through PMTCT intervention.
The Deputy Minister of Health, Mr Rojo Mettle-Nunoo, expressed the government’s commitment to work together with all sectors of the society to fight against HIV AIDS.
“Equally important for us is the need to work with academics and researchers as we continue to find new ways to respond to this challenge,” he added.
Mr Mettle-Nunoo said the results of the survey remained an important indicator for monitoring the trend of the disease in the country and provide useful information for policy intervention.
He cautioned against complacency in order not to erode the gains made so far saying “the more we reduce the prevalence, the more we must work hard to keep it low”.
The Director-General of the Ghana AIDS Commission, Dr Angela El-Adas, said the survey report would help the commission in the development of the third national strategic framework response for HIV AIDS.
She said there was the need to move away from organising floats to preparing specific HIV AIDS messages for various target groups and also intensify efforts to prevent new infections
The World Health Organisation (WHO) representative in Ghana, Dr Daniel Kertesz, expressed the hope that the data derived from the survey would be used to impact on public health.