In the Terms of Reference (TOR), which further justify the holding of National Woman AIDS Week, from January 25 to 31, 2023, we read from the outset that the political commitment in favor of the response to HIV / AIDS remains high and continues to grow, especially since our country has made the fight against AIDS a priority. Thus, multisectorality was adopted. It integrates all sectors of active life against the AIDS pandemic. This strategy has now made it possible to stabilize AIDS at a prevalence rate of 0.3% in the general population, according to the 2021 CNLS Annual Report.
0.4% of women and 0.3% of men aged 15-49 are HIV positive in 2021
However, after more than thirty-five (35) years of response to HIV and AIDS, new infections have appeared: 69.2% according to the UNAIDS Spectrum, 2021. Indeed, 0.4% of women and 0.3 % of men aged 15-49 are HIV positive. Added to this is the increase in the number of cases of STIs estimated at 801,176 cases recorded during the period of implementation of the National Strategic Plan to Fight AIDS (2018-2022) and correlatively to the losses in the cascade PMTCT (Prevention of Mother/Child Transmission), the problem of lifting anonymity among relatives of certain patients who are not observant of treatment or prevention rules.
STI cases: 801,176 cases identified during the PSN implementation period between 2018 and 2022
The vulnerability of children – If the figures are scary, it should also be noted that the care of children remains weak. Indeed, in 2021, out of an estimate of 3,957 children infected with HIV in Senegal, only 1,661 were diagnosed, i.e. 42.0%, and around 1,446 had access to antiretroviral treatment, i.e. 36.50%, so that the Barriers to accessing treatment for children are considerable.
3,957 children infected with HIV in Senegal, only 1,661 have been diagnosed, i.e. 42.0% and about 1,446 are treated
In the achievement of 95-95-95, figures showing poor performance indicate that 72% of PLHIV (People living with HIV) know their serological status against 35% for children; 87% of people living with HIV who know their serological status are on ARV treatment, compared to 31% for children, 79% of patients on ARV treatment have an undetectable viral load, compared to 17% for children.
In view of these results, the Ministry of Women, Family and Child Protection, as well as the National Council for the Fight against AIDS (CNLS) believe that it is necessary to remobilize all the actors in order to reduce the gaps , to make up for the delay in caring for children with HIV and to eliminate mother-to-child transmission.
Among adolescents, girls are more affected than boys: In question, they use condoms less, etc.
Apart from the gaps in the care of children, other challenges must be met. Among them, the care of adolescents. Indeed, although new infections are down, they represent 14.3% among young adolescents and young girls are twice as infected as boys. This state of affairs would be partly linked to the low knowledge of means of HIV prevention, the low use of condoms among girls (27%), the low knowledge of screening locations, early pregnancies… However, the target adolescent has a higher prevalence rate than the national average and 7 out of 10 new infections occur before the age of 35.
Girls and young women under the age of 24 have much higher rates of HIV infection than boys and young men of the same age
Furthermore, the ptransition period between adolescence and adulthood is accompanied by complex physical, emotional and cognitive changes, with greater influence of peers in decision-making. A supportive social environment that enables adolescents to access health information, stay in school and learn social skills to prepare for economic independence helps empower young people to remain HIV-negative.
Why access to information related to their sexual health is a challenge
According to the RDTs, girls and young women under the age of 24 have much higher rates of HIV infection than boys and young men of the same age. Adolescents and especially young girls are often deprived of information and cannot protect themselves if they are unaware of the modes of transmission and prevention of HIV infection.
The urgency to redouble our efforts
Considering the various problems stated, the stakeholders recognize that it is important to reflect on an innovative strategy that integrates differentiated care for children and adolescents with HIV. Prevention of HIV infection is more effective when adolescents and young people are able to take control of their health and build a better future, armed with the skills to make good choices and change behavior .
A few challenges…
It is also important to fight against the inequalities that hinder progress in ending the AIDS epidemic and to accentuate the vulnerability of children and adolescents by strengthening the availability, quality and compliance of treatment, testing and prevention programs so that they are accessible to all.
Amadou Dia (Actusen.sn)