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World AIDS Day: Reaching more people with HIV services and reducing inequalities

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World AIDS Day: Reaching more people with HIV services and reducing inequalities

The low prevalence of HIV in Somalia can be attributed to Somali culture and society, and few risk factors as a result of behavioral

CAIRO, Egypt, December 1, 2021 / APO Group / –

World AIDS Day is commemorated on December 1 of each year to shed light on the plight of people living with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS), and the challenges that face. This year’s World AIDS Day is celebrated under the slogan “End inequalities. End AIDS ”. In the Eastern Mediterranean Region of the World Health Organization (WHO), the campaign has a regional theme “Getting back on track – Focus on testing” in response to the disruption of HIV testing services during the HIV pandemic. COVID-19, with a special focus on reaching the people left behind.

As HIV remains a major public health problem and remains a global pandemic, WHO calls on global leaders and communities to come together to address the inequalities that drive AIDS and to try to reach those who do not have access to essential HIV services. . Rising inequality, if left unaddressed, can only fuel and widen the gap between those who have access to HIV testing and services and those who do not have access to testing, treatment and care.

HIV prevalence in Somalia

Regular surveys of HIV prevalence in Somalia have shown that the infection rate has been declining over the past 14 years. Results of a 2014 survey showed that HIV prevalence in Somalia had dropped to a level that could be classified as a low-level epidemic in all states. The most recent survey, conducted during 2018, showed that the average prenatal HIV prevalence nationwide was 0.1% for all states. By geographic area, it was 0.15% in Somaliland, 0.17% in Puntland, and 0.04% in other federal member states. Despite the overall decline, the most dramatic drop in Somaliland, from just over 1.0% between 2004 and 2010, to 0.15% in 2018, meant that for the first time in 14 years of surveys, HIV prevalence in Puntland it was higher than in Somaliland.

“The low prevalence of HIV in Somalia can be attributed to Somali culture and society, and few risk factors as a result of behavior,” said Dr. Sadia Abdisamad Abdullahi, Manager of the National HIV / AIDS Program.

Despite the overall decline in HIV prevalence in Somalia, there are places like Garowe and Bosasso in Puntland where infection rates have simply stabilized, with the risk of increasing once again. The next survey of pregnant women is scheduled for 2023.

Salim Musa *, diagnosed with HIV in March 2014 and an advocate for supporting HIV and AIDS patients in Somalia, believes that HIV rates may be higher in some groups and places that were not covered in recent surveys. It is fairly easy for Somalis living in urban areas to access free HIV testing and antiretroviral therapy (ART) at 17 health centers in various states. For those in rural areas, it can be difficult for people to get tested, explains Salim. Most people do not even know the symptoms of HIV or where to access services. It is usually at a late stage when many people living with HIV contact doctors for support.

Despite the challenges, in September 2021, 3,784 patients were receiving ART in the 17 health centers spread over different states, 72.5% of whom were already on the newest and most effective regimens based on dolutegravir. .

Families, workplaces, health workers and policies are critical to achieving change.

Salim feels he was lucky: He credits his father, a doctor, and his well-educated siblings with encouraging him to seek treatment early after his diagnosis and giving him the confidence to deal with his struggles in life.

However, there is still a lot of stigma and shame associated with HIV in Somalia, adds Salim. Years ago, at his workplace, people treated him very badly and asked him to work from home so that no one could be in contact with him. This experience isolated him and forced him to leave to find a more empathetic team. Now, Salim has many functions: he works with non-governmental organizations, vulnerable populations, the government, AIDS commissions and technical advisers to defend the rights of people living with HIV. The people you speak to have been fired from their jobs or denied employment because of their HIV positive status.

When Salim first visited a health center to confirm his HIV status, he was surprised to see that the director of the center, who tested him, was critical and authoritarian, and did not respect him or other patients.

Salim shares some of the stories of patients he has worked with. One day, he spoke with a woman who was living with HIV and had broken her leg. She was in excruciating pain. Although she had enough money, Salim describes, no doctor in the nine hospitals she visited was willing to help her because of her HIV status.

In another case, a woman living with HIV contracted COVID-19. She rushed to the hospital when she needed oxygen but sadly no one helped her and she died. Another woman was forced to deliver her baby outside a hospital when medical staff refused to let her in, as it was known that she was HIV-positive.

“I feel very sad when I hear these stories,” said Salim. “I believe that policy makers should help enforce oversight systems and mechanisms to ensure that health workers do not discriminate at all against any patient, including those living with HIV. No one should stop receiving medical care and no health personnel should deny services to anyone. They are in a profession in which they must help others. “

“We must all work together to end the inequalities that keep Somalis out of the health care system. Decision-makers, health facilities, families and individuals must support people living with HIV and prevent the spread of this disease, ”said Dr Mamunur Rahman Malik, WHO Representative in Somalia. “Early testing and treatment can help people with HIV fight this disease in good time.”

* Name changed to protect identity.

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