Tuesday, 2 December 2014 00:11
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Sri Lanka’s traditional low rate of HIV/AIDS is a success story in the region but consistent vigilance is necessary to protect the population.
UNAIDS estimated that about 3,000 Sri Lankans were living with HIV as at the end of 2009. HIV prevalence is less than 0.1%. As of December 2011, there were 1463 reported HIV cases in the country out of which 253 have died. Sixty percent of reported HIV cases are males and more than half are from Colombo.
The proportion of women infected with HIV has been rising, from 21% (1987-1991) to 42% (2011), in part because of increased testing of women over the last few years. Underreporting of cases is mainly due to low knowledge about how HIV is spread and barriers to seeking services due to stigma and discrimination.
Despite the low HIV prevalence, the presence of important risk factors in Sri Lanka suggests it may not be maintained if action is not taken. Key among the risk factors are low condom usage, large numbers of commercial sex workers who receive little information on protection, stigma and isolation of infected people.
High mobility rates, particularly among migrant workers, are also another cause for concern. Marginal assistance provided to victims, both socially and from authorities, can leave patients isolated. Addressing these issues in a comprehensive and open national plan is still necessary.
Yet around the world there is positive news.
An estimated 1.1 million HIV infections among children under 15 have been averted, as new cases declined by over 50% between 2005 and 2013, according to data released by UNICEF ahead of World AIDS Day.
This extraordinary progress is the result of expanding the access of millions of pregnant women living with HIV to services for the prevention of mother to child transmission (PMTCT). These include lifelong HIV treatment that markedly reduces the transmission of the virus to babies and keeps their mothers alive and well.
The sharpest declines took place between 2009 and 2013 in eight African countries: Malawi (67%); Ethiopia (57%); Zimbabwe (57%); Botswana (57%); Namibia (57%); Mozambique (57%); South Africa (52%) and Ghana (50%).
But the global goal of reducing new HIV infections in children by 90% between 2009 and 2015 is still out of reach. Only 67% of pregnant women living with HIV in all low- and middle-income countries received the most effective antiretroviral medicines for PMTCT in 2013.
Disparity in access to treatment is hampering progress. Among people living with HIV in low- and middle-income countries, adults are much more likely than children to get antiretroviral therapy (ART).
In 2013, 37% of adults aged 15 and older received treatment, compared with only 23% of children (aged 0-14) – or less than 1 in 4.
AIDS mortality trends for adolescents are also of significant concern. While all other age groups have experienced a decline of nearly 40% in AIDS-related deaths between 2005 and 2013, adolescents (aged 10-19) are the only age group in which AIDS-related deaths are not decreasing.
UNICEF’s Statistical Update on Children, Adolescents and AIDS provides the most recent analysis of global data on children and adolescents from birth to 19 years of age. It gives reason for comfort but not complacency.
