Fight against HIV to target high-risk groups
Some HIV/Aids high-risk groups such as truck drivers and sex workers are the latest targets in the battle to minimize new infections. Dr Sabin Nsanzimana, Head of HIV/AIDS and other Blood Infectious Diseases Division in Rwanda Biomedical Center (RBC), says the latest findings on HIV among the most exposed groups indicate that there is a great need to give them more attention.
For instance, data shows that only 10% of the interviewed truck drivers reported to have consistently used a condom during the 12 months preceding the survey, even though they regularly have sex. “We found that truck drivers have sex at a high rate, but what’s worrying is that most of them do not use condom consistently,” Nsanzimana explains.
The findings indicate that among drivers, the infection rate is 2%; though Nsanzimana says this rate might be very low compared to reality. He says they had planned to interview 500 drivers, but only 200 accepted probably because the others apparently feared to know about their status.
Health officials therefore observe that there is a need to find other mechanisms to reach the drivers. “It requires changing the methodology to reach a large part of these target groups,” notes Catherine Kayitesi, another RBC’s official.
Two years ago, Nsanzimana mentions, a study by a university student in Butare had revealed an infection rate of 15% among truck drivers, an estimate which officials say would be more realistic. Therefore, he says they are still preparing another study to confirm the real status of HIV infection among the drivers.
According to the findings, truck drivers – especially those who are married – are likely to spread HIV infection if nothing is done. The study for instance shows that only 27% of those who were not married use condoms consistently versus 3% among those who were married.
Therefore, Nsanzimana says they are working on the issue by targeting the drivers wherever they are as their job inherently means they do not stay in the same place. “The first action for us is to identify them wherever they are, what they are doing and the infection rate among them; and then to take measures by providing them with services,” he explains, adding that they established mobile health facilities at borders crossings.
The services include providing condoms, antiretroviral treatment (ART), brochures and recorded messages talking about how to prevent HIV infection among others, Nsanzimana mentions, adding that they have been also talking with their counterparts from the region so that the drivers can get the same services wherever they are in the region.
“We are establishing an electronic network to be able to communicate easily with our counterparts and know our drivers who enter there so that we can inform them what they can do for us in order to control the HIV infection in our people,” he explains.
The endeavor also targets both legal and illegal partners of the drivers by providing them with the same services where they stay, Nsanzimana mentions.
However, the program does not only target drivers, but also other high-risk groups such as sex workers and homosexual people. According to a 2010 report, there was an estimate 3,200 female sex workers countrywide, and the HIV infection rate among them is alarmingly high: an estimated 51%.
As for the general HIV/AIDS prevalence in the country, Nsanzimana explains that the rate remains unchanged from 3% – an estimated 300,000 Rwandans living with HIV/AIDS. Though there has been an increase of the population over time, Nsanzimana is convinced that there has been a proper way of controlling new infections given that the prevalence rate has remained stable. According to him, this means that the rate of increase of the population might be equal to the rate of the new infection cases while the infected continue to survive.
The study indicates that the number of new infected persons decreased to 10,000 per year from 15,000 in the last five years, while HIV positive people are likely to live longer due to medical services available.
Nsanzimana discloses that Rwanda’s HIV mortality has been significantly reduced by 87% over the last few years. The HIV mortality in the country stands at less than 5% of the people infected, thanks to improved treatment.
For Nsanzimana, the next step is to reach out very corner of the country targeting all groups of the population in a bid to control the disease, considering that it is estimated that 50% of those living with HIV/AIDs still do not know their status.
“We used to work with those who were intentionally coming to us, but we are now going to change the approach,” Nsanzimana explains. “We will be reaching out at village level, working hand in hand with local health workers to ensure that our services reach everyone.”