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EPIDEMICS
Love hotels targeted to fight HIV among Cameroon's teens
By Liza Fabbian
Guider, Cameroon (AFP) July 25, 2017


Swaziland halves world's highest HIV infection rate: report
Paris (AFP) July 24, 2017 - Swaziland, which bears the world's heaviest HIV burden, has almost halved the rate of new infections in five years by boosting access to virus-suppressing drugs, researchers said Monday.

The country -- where one in three adults is infected with the AIDS-causing virus -- has vastly expanded public programmes to test people for HIV infection and put them on life-saving anti-retroviral treatment (ART).

"The rate of new HIV infections has been reduced by half," Velephi Okello of the Swazi health ministry told journalists at an HIV science conference in Paris.

"Remarkable progress has been made... in controlling the HIV epidemic."

In 2011, 31 percent of adults (aged 18-49) out of a total country population of just over 1.2 million were infected with HIV, according to government data.

This made Swaziland the country with the highest national rate of new infections, said the authors of the new study, as well as the highest proportion of people living with HIV.

The latest data, based on blood samples from almost 11,000 people aged 15 and over, showed that about 27 percent of the population was HIV-positive in 2016.

This translated to an infection rate of 1.39 percent among 18- to 49-year-olds, down from 2.58 percent in 2011 -- a 46-percent reduction.

Ninety-five percent of HIV-positive pregnant women last year received drugs to prevent transmission of the virus to their offspring.

"As a result, fewer than 1,000 children became infected with HIV in Swaziland in 2016," said the UN agency.

- 'Great news' -

The infection rate was higher among women than men, according to a survey report to the International AIDS Society conference. The decline was also steeper for men, with 52 percent, than for women (40 percent).

The survey showed that 73 percent of HIV-positive people had achieved suppression of the virus -- meaning it does not replicate to make them ill -- compared to 35 percent in 2011.

The gains were the fruit of a much improved HIV treatment programme, said the researchers. The share of infected people on ART rose from 37 percent in 2011 to 74 percent last year.

ART not only stops HIV from replicating and attacking a patient's immune system, but also curbs its spread to sexual partners.

"Our recipe for success is that we... have been able to scale up a lot of the prevention and treatment services in the country," said Okello.

"We have more than doubled the number of people who have started on anti-retroviral treatment, and we have also almost doubled the number of men who have been circumcised in the country."

According to the World Health Organization, there is "compelling evidence" that male circumcision reduces the risk of heterosexual sexual transmission of HIV by as much as 60 percent in men.

The number of HIV tests conducted in Swaziland more than doubled from 176,000 in 2011 to 367,000 in 2016.

"Basically, we think that that's one of the recipes (for success), and also the government commitment to buying and procuring the ARVs for people in the country so that there is a sustainable response going forward," said Okello.

Despite the "great news", she cautioned much more needs to be done to maintain the downward trend.

"While we do celebrate these findings, we still know that Swaziland is facing a severe HIV epidemic," she said.

"In the end, we would like to see a Swaziland which is free from AIDS."

The two big maps show the districts of the northern Cameroonian town of Guider along with its brothels, nightclubs and other seedy spots to identify places from where AIDS could spread among adolescents.

Cameroon, a country of 23 million that hugs Africa's Gulf of Guinea, has one of the highest HIV/AIDS prevalence rates in the world.

"The maps highlight the high-risk zones for transmission," said Boris Mbaho Tchaptchet, 21, speaking at a local youth club.

"We located the love hotels, the video clubs, the cabarets, the underground meeting places before putting into place an action and prevention plan in our community," he said.

The club in Guider was one of those selected for the "All In! End Aids among Adolescents" project launched in August 2015 with the backing of the UN children's agency UNICEF.

According to official figures, 79,771 children and adolescents are HIV-positive, but experts say it is much higher.

"This platform brings together all the interventions fighting HIV in the country targeting young people," said Jules Ngwa Edielle, who runs the HIV prevention in Cameroon's youth and civic education ministry.

It ropes in local administrative, political and religious authorities to fight the disease.

- 'You think I'm sick? -

With his colleagues, 21-year-old Bouba Saliou was trained as a peer-group educator in his neighbourhood.

"My role is to talk with other young people, ask them questions to understand their situation and to encourage them to get tested," he explained.

But broaching the delicate issue is not without its pitfalls.

"Some people react saying, 'You think I'm sick? Have you ever seen me having sexual relations?'

"Other simply refuse, saying that they are confident about their status. But I try to convince anyway," he added with smile.

Saliou cites the case of a 17-year-old who found out he was HIV-positive because of his intervention.

"He was very angry at me when he got the results," he recalled. "But today we talk regularly and he tells he is following his treatment regularly."

This community-based approach is essential if Cameroon is to attain the 90-90-90 target set by the UNAIDS, which Cameroon signed up to back in 2015.

The aim is to get to the point where 90 percent of those who are HIV-positive know about their condition; where 90 percent of those who know are on retroviral treatment; and where 90 percent of those receiving that treatment achieve viral suppression.

The hope is to be able to wipe out the virus by 2030.

Therese Nduwimana, who runs UNICEF Cameroon's HIV unit, said the programme had proved its worth in the north of the country with the No Limit for Women Project (Nolfowop).

"With a budget of just $40,000 a year the results have been spectacular," she said.

"In just months, the number of HIV-positive children identified has been multiplied by four," she said.

However, one of the problems is an acute shortage of medical staff. The hospital in Garoua, which serves an area with 2.7 million people, only has one paediatrist and one gynaecologist.

- Door-to-door campaigns -

A group of around 30 women were gathered at one of the town's health centres, waiting to be tested about their HIV status. The result is announced almost immediately.

"Our volunteers have gone door to door to encourage every pregnant woman to get tested," said Odette Etame, who heads the Nolfowop project.

Other mothers acting as mentors then made home visits to physically accompany HIV-positive women and their children for anti-retroviral treatment, she added.

This was one way to reach people who would other wise be lost from view, she said.

Cameroon had a 5.75-percent HIV prevalence rate for pregnant women in 2016, making it one of the 10 countries responsible for 75 percent of new paediatric infections worldwide.

EPIDEMICS
S.African girl, 9, is third child with HIV remission: study
Paris (AFP) July 24, 2017
A South African girl has become only the third child to beat the AIDS virus into long-term remission - almost nine years and counting - after receiving a drug cocktail in infancy, researchers announced Monday. The child was given a ten-month course of anti-AIDS medicine until she was one year old, then taken off the drugs as part of a medical trial. Eight years and nine months later, t ... read more

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