HIV and AIDS Situations in Mauritius (1)

8/8/2019 HIV and AIDS Situations in Mauritius (1)

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HIV and AIDS

Situation in Mauritius

Dr. A. Saumtally


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HIV/AIDS situation in Mauritius

HIV Prevalence rate

in the 15-49 yr old population in general: 0.97%

(C/Int. 0.6% 1.96%equivalent to around

6800people (New estimate 27th May 2010)

equivalent to around 7000 people

among Injecting Drug Users: 47.4%

among pregnant women: 0.42% in 2009


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From 1987 to end of December 2009

Detected cases of HIV/AIDS: with 4219

Mauritians (3429 males and 790 females).

Sex ratio male to female is 4:1

Deaths due to HIV/AIDS reported : 240 amongMauritians (236 adults and 4 children).

21 children (11 boys and 10 girls) of age 1 to

14 years: 4 died (1M & 3 F), 7 on ART *

Roughly an average of543 new infections

yearly


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Nombre Cumulatif de

Nouveaux Cas de VIH Dtects

0

500

1000

1500

2000

2500

3000

3500

4000

92 93 94 95 96 97 98 99 2000 2001 2002 2003 2004 2005 2006 2007 2008

HIV cases detected since 1987

FEMALE

MALE


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Detected cases

20 16 24 23 2850 55

98

225

525

921

542 546 538 548

0

100

200

300

400

500

600

700

800

900

1000

1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

NUMBER

YEARLY HIV/AIDS CASES REGISTERED AMONG MAURITIANS1995 - 2009


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Modes of transmission among new cases in 2002

59%24%

6%

4%2% 5%

Hetero Hetero/IDU IDU Homo/Bisexual MTCT Unknow n

Modes of transmission among new cases in 2003

22%

29%

1% 4%

3%

41%

Hetero Hetero/IDU IDU Homo/Bisexual MTCT Unknown

Modes of transmission among new cases in

2004

0.5%

10%

87%

2%0%

0.5%

H etero H etero/ID U ID U H om o/Bisexual MTCT U nknown

>75% IDUs share needles andsyringes among friends or by

professionalinjectors


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200 4


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Evolution of HIV epidemic in Mauritius: 1987-2007

0

100

200

300

400

500

600

700

800

900

1000

1987

1988

1989

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

years

cases

Total reported HIV/AIDS casesInjecting drug transmissionHeterosexual transmission


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Evolution de lpidmie selon les

modes de Transmission

0

10

20

30

40

50

60

70

80

90

100

2000 2001 2002 2003 2004 2005 2006 2007 2008

IDU HTS


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Ratio Homme:Femme parmi les cas dtects

Year Male Female Ratio M:F

2000 32 18 1.7

2001 34 21 1.6

2002 59 39 1.5

2003 167 58 2.8

2004 464 61 7.6

2005 815 106 7.6

2006 455 87 5.2

2007 452 94 4.8

2008 402 136 2.9

2009 436 112 3.9


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Reprsentation selon lage

Groupe dge (ans) Taux

15 - 24 18.6 %

25 - 39 56%

15 - 39 74.6%

12 - 19 1.7%


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Young aged 12-19 Years

MODE of

INFECTION

Female Male Total

Sexual 32 3 35Sexual + IDU 6 1 7

IDU 11 18 29

49 22 71


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Occupation among young aged 12-19 years

OCCUPATION Female Male Total

Manual Workers 0 13 13

Sex Workers 8 0 8

Housewives 24 0 24

Not identified 17 9 26

Total 49 22 71


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0

0.1

0.2

0.3

0.4

0.5

0.6

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

Prevalence (%) of pregnant women


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Mapping of HIV

cases in Mauritius

Sources : AIDS Unit, MOH &QL, 2008


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Evolution de linfection VIH dans le tempsSropositif asymptomatique et SIDA


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Measures taken


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Measures

1987: Screening of Blood donation & Prevention

Campaigns

Dec 1999: Opening of a Day Care Centre dispensing:

VCT, PMTCT, Care & support.

April 2002: ART is being provided free of user costs :As at Dec 2009: 652 persons are on ART.

Annually, drugs to the tune of about Rs. 10 m Rs

15m are procured for the treatment of HIV patients.

2010: RS 23m TGF

Transport facilities (bus fare) are being given to all

patients attending the Day Care Centre


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Treatment, Care and support Issues

Only about 50% of those detected come from follow-up (2386/4219)

Poor adherence to ART treatment (study initiated for

more objective data)

Viral load recently introduced better follow up

Cases of resistance appearing: High cost of ART

Poor psychosocial support still: psychologist in

partnership Decentralisation of services Candos, Volcy Pougnet


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HIV Testing The VCT services have been decentralized and are

being provided in all regional hospitals since 2005 andin private clinics since 2006.

As from February 2009,

decentralization of HIV testing and Counselling extendedto all Area Health Centres and peripheral Hospitals.

Mobile screening services in the Mobile Clinic include acomponent of HIV and AIDS.

No. of VCTs carried out: 2008-1813; Jan-Dec 2009 2462 +71 (AHC)

No. of tests carried out in mobile clinics: 456


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Issues on VCT/PITC

In spite of decentralisation, VCT still low

5 regional hospitals

26 Area Health Centres

Of estimated 7000 PLWHA, only 4219detected

10% still diagnosed at AIDS stage

Confidentiality and Stigma& Discriminationissues

Paradox: VCT as a routine chronic disease test

and confidentiality


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2006

Harm reduction strategies:Needle -Syringe Exchange Programme

Methadone Substitution Therapy

HIV & AIDS Act


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Needle -Syringe Exchange Programme

November

2006:Introduction of the Needle Exchange Programme

(NEP) by NGOs with the support of the Ministry.December

2006Enactment of HIV and AIDS Act

May 2007 Financial support to NGOs(allowance to social worker

+ material) to carry out NEP

May 2008 Two mobile caravans have been made available and

staff of the Ministry carries out the NEP

As at April

2010

NGO : around 700 clients on 8 sites

MOH: covering 37 sites and around 5300 clients

reached

At present Almost all regions of the island are being covered.


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Methadone Substitution Therapy Programme

21

November, 2006

Introduction of Methadone Substitution Therapy Programme at

the National Detoxification Centre.

10 March 2008 Opening of National Methadone Substitution Therapy Centre

(Female).

2009/2010 Outpatient induction Unit: Mahebourg (2009) & Ste. Croix

(2010)

Mar 2010 2147 clients (2010 males and 132 females +5PDSO) have been

maintained on Methadone Substitution Treatment.

Dispensing Units:

16 in all

1 is operational at each Regional hospital + MBG hospital,

1 at Brown Sequard Mental Health Care Centre, and

1 at Bouloux AHC. 1 BBPrison

Caravan

dispensing

1 at Rose-Hill, 1 at Vacoas,

1 at Plaine Lauzun CHC, 1 at Plaine Verte, 1 at Ste Croix

1 at Pailles 1 at Valle Pitot.,


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HIV and AIDS Act

The only infection/disease which has a specific Law

Objectives:

1. To provide measures for control and preventionof propagation of HIV and AIDS: Testing Services

& NEP

2. To safeguard the human rights of persons

infected/affected with HIV


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Testing

1. Voluntary testing or PITC: 3 Cs No HIV test to be done without consent of the person

concerned

Consent, Counselling, Confidentiality

Testing for Minors

2. Testing without consent: Incapacity

3. Prohibited testing: Employment, promotion(Except for Immigration & Citizenship)

4. Mandatory testing: Blood and Organ donation


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Confidentiality

No person shall disclose any information

concerning results of an HIV test to any person

except:

with the consent of that person or legal administrator

M.O/N.O who is directly involved in Rx, Care,

counseling of the person where the status of HIV/AIDS

is clinically relevant

on court order for epidemiological study approved by the PS


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HUMAN RIGHTS

HIV +ve people should be guaranteed equal rights

Clause 6 Employment

Clause 3 - HIV +ve people should not to be considered as adisability

Clause 12 Care and Treatment:

Ensures no discrimination in delivery of health care. M.O,N.O, Dentist, HCW to provide care and treatmentirrespective of a person unwillingness to be tested

Clause 18[3]- Sanctions


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Penalties

Clause 18[3]-

Prescribes penalties to those who treat any

person or his relative unfairly, unjustly with

hatred or ridicule or contempt on account of

being infected or perceived to be infected will

be subject to penalties

fine--------------Rs25000-100000

Imprisonment - 6mnths-5years


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Your contact with HIV infected people

Students Infected with HIV????

Risky behaviours:

Through unsafe sex: Among students, with sex-

workers

Through Drug Use: (Alcohol, Tobacco, Hashish)

leading to unsafe behaviour

Transmission to Innocent child

During pregnancy


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Attitudes

To make students aware of the different riskybehaviours and precautions that need to be

taken Prioritize on Abstinence or delayed

debut.

To adopt non-stigmatising & non-discriminating

attitudes.

First Aid & Universal Precaution: wash, clean anywound & to obtain medical advice for any

conflicting situations


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Thank you

Documents

HIV and AIDS Situations in Mauritius (1)