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HIV and AIDS
Situation in Mauritius
Dr. A. Saumtally
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HIV/AIDS situation in Mauritius
HIV Prevalence rate
in the 15-49 yr old population in general: 0.97%
(C/Int. 0.6% 1.96%equivalent to around
6800people (New estimate 27th May 2010)
equivalent to around 7000 people
among Injecting Drug Users: 47.4%
among pregnant women: 0.42% in 2009
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From 1987 to end of December 2009
Detected cases of HIV/AIDS: with 4219
Mauritians (3429 males and 790 females).
Sex ratio male to female is 4:1
Deaths due to HIV/AIDS reported : 240 amongMauritians (236 adults and 4 children).
21 children (11 boys and 10 girls) of age 1 to
14 years: 4 died (1M & 3 F), 7 on ART *
Roughly an average of543 new infections
yearly
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Nombre Cumulatif de
Nouveaux Cas de VIH Dtects
0
500
1000
1500
2000
2500
3000
3500
4000
92 93 94 95 96 97 98 99 2000 2001 2002 2003 2004 2005 2006 2007 2008
HIV cases detected since 1987
FEMALE
MALE
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Detected cases
20 16 24 23 2850 55
98
225
525
921
542 546 538 548
0
100
200
300
400
500
600
700
800
900
1000
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
NUMBER
YEARLY HIV/AIDS CASES REGISTERED AMONG MAURITIANS1995 - 2009
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Modes of transmission among new cases in 2002
59%24%
6%
4%2% 5%
Hetero Hetero/IDU IDU Homo/Bisexual MTCT Unknow n
Modes of transmission among new cases in 2003
22%
29%
1% 4%
3%
41%
Hetero Hetero/IDU IDU Homo/Bisexual MTCT Unknown
Modes of transmission among new cases in
2004
0.5%
10%
87%
2%0%
0.5%
H etero H etero/ID U ID U H om o/Bisexual MTCT U nknown
>75% IDUs share needles andsyringes among friends or by
professionalinjectors
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200 4
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Evolution of HIV epidemic in Mauritius: 1987-2007
0
100
200
300
400
500
600
700
800
900
1000
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
years
cases
Total reported HIV/AIDS casesInjecting drug transmissionHeterosexual transmission
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Evolution de lpidmie selon les
modes de Transmission
0
10
20
30
40
50
60
70
80
90
100
2000 2001 2002 2003 2004 2005 2006 2007 2008
IDU HTS
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Ratio Homme:Femme parmi les cas dtects
Year Male Female Ratio M:F
2000 32 18 1.7
2001 34 21 1.6
2002 59 39 1.5
2003 167 58 2.8
2004 464 61 7.6
2005 815 106 7.6
2006 455 87 5.2
2007 452 94 4.8
2008 402 136 2.9
2009 436 112 3.9
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Reprsentation selon lage
Groupe dge (ans) Taux
15 - 24 18.6 %
25 - 39 56%
15 - 39 74.6%
12 - 19 1.7%
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Young aged 12-19 Years
MODE of
INFECTION
Female Male Total
Sexual 32 3 35Sexual + IDU 6 1 7
IDU 11 18 29
49 22 71
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Occupation among young aged 12-19 years
OCCUPATION Female Male Total
Manual Workers 0 13 13
Sex Workers 8 0 8
Housewives 24 0 24
Not identified 17 9 26
Total 49 22 71
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0
0.1
0.2
0.3
0.4
0.5
0.6
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Prevalence (%) of pregnant women
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Mapping of HIV
cases in Mauritius
Sources : AIDS Unit, MOH &QL, 2008
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Evolution de linfection VIH dans le tempsSropositif asymptomatique et SIDA
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Measures taken
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Measures
1987: Screening of Blood donation & Prevention
Campaigns
Dec 1999: Opening of a Day Care Centre dispensing:
VCT, PMTCT, Care & support.
April 2002: ART is being provided free of user costs :As at Dec 2009: 652 persons are on ART.
Annually, drugs to the tune of about Rs. 10 m Rs
15m are procured for the treatment of HIV patients.
2010: RS 23m TGF
Transport facilities (bus fare) are being given to all
patients attending the Day Care Centre
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Treatment, Care and support Issues
Only about 50% of those detected come from follow-up (2386/4219)
Poor adherence to ART treatment (study initiated for
more objective data)
Viral load recently introduced better follow up
Cases of resistance appearing: High cost of ART
Poor psychosocial support still: psychologist in
partnership Decentralisation of services Candos, Volcy Pougnet
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HIV Testing The VCT services have been decentralized and are
being provided in all regional hospitals since 2005 andin private clinics since 2006.
As from February 2009,
decentralization of HIV testing and Counselling extendedto all Area Health Centres and peripheral Hospitals.
Mobile screening services in the Mobile Clinic include acomponent of HIV and AIDS.
No. of VCTs carried out: 2008-1813; Jan-Dec 2009 2462 +71 (AHC)
No. of tests carried out in mobile clinics: 456
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Issues on VCT/PITC
In spite of decentralisation, VCT still low
5 regional hospitals
26 Area Health Centres
Of estimated 7000 PLWHA, only 4219detected
10% still diagnosed at AIDS stage
Confidentiality and Stigma& Discriminationissues
Paradox: VCT as a routine chronic disease test
and confidentiality
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2006
Harm reduction strategies:Needle -Syringe Exchange Programme
Methadone Substitution Therapy
HIV & AIDS Act
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Needle -Syringe Exchange Programme
November
2006:Introduction of the Needle Exchange Programme
(NEP) by NGOs with the support of the Ministry.December
2006Enactment of HIV and AIDS Act
May 2007 Financial support to NGOs(allowance to social worker
+ material) to carry out NEP
May 2008 Two mobile caravans have been made available and
staff of the Ministry carries out the NEP
As at April
2010
NGO : around 700 clients on 8 sites
MOH: covering 37 sites and around 5300 clients
reached
At present Almost all regions of the island are being covered.
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Methadone Substitution Therapy Programme
21
November, 2006
Introduction of Methadone Substitution Therapy Programme at
the National Detoxification Centre.
10 March 2008 Opening of National Methadone Substitution Therapy Centre
(Female).
2009/2010 Outpatient induction Unit: Mahebourg (2009) & Ste. Croix
(2010)
Mar 2010 2147 clients (2010 males and 132 females +5PDSO) have been
maintained on Methadone Substitution Treatment.
Dispensing Units:
16 in all
1 is operational at each Regional hospital + MBG hospital,
1 at Brown Sequard Mental Health Care Centre, and
1 at Bouloux AHC. 1 BBPrison
Caravan
dispensing
1 at Rose-Hill, 1 at Vacoas,
1 at Plaine Lauzun CHC, 1 at Plaine Verte, 1 at Ste Croix
1 at Pailles 1 at Valle Pitot.,
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HIV and AIDS Act
The only infection/disease which has a specific Law
Objectives:
1. To provide measures for control and preventionof propagation of HIV and AIDS: Testing Services
& NEP
2. To safeguard the human rights of persons
infected/affected with HIV
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Testing
1. Voluntary testing or PITC: 3 Cs No HIV test to be done without consent of the person
concerned
Consent, Counselling, Confidentiality
Testing for Minors
2. Testing without consent: Incapacity
3. Prohibited testing: Employment, promotion(Except for Immigration & Citizenship)
4. Mandatory testing: Blood and Organ donation
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Confidentiality
No person shall disclose any information
concerning results of an HIV test to any person
except:
with the consent of that person or legal administrator
M.O/N.O who is directly involved in Rx, Care,
counseling of the person where the status of HIV/AIDS
is clinically relevant
on court order for epidemiological study approved by the PS
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HUMAN RIGHTS
HIV +ve people should be guaranteed equal rights
Clause 6 Employment
Clause 3 - HIV +ve people should not to be considered as adisability
Clause 12 Care and Treatment:
Ensures no discrimination in delivery of health care. M.O,N.O, Dentist, HCW to provide care and treatmentirrespective of a person unwillingness to be tested
Clause 18[3]- Sanctions
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Penalties
Clause 18[3]-
Prescribes penalties to those who treat any
person or his relative unfairly, unjustly with
hatred or ridicule or contempt on account of
being infected or perceived to be infected will
be subject to penalties
fine--------------Rs25000-100000
Imprisonment - 6mnths-5years
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Your contact with HIV infected people
Students Infected with HIV????
Risky behaviours:
Through unsafe sex: Among students, with sex-
workers
Through Drug Use: (Alcohol, Tobacco, Hashish)
leading to unsafe behaviour
Transmission to Innocent child
During pregnancy
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Attitudes
To make students aware of the different riskybehaviours and precautions that need to be
taken Prioritize on Abstinence or delayed
debut.
To adopt non-stigmatising & non-discriminating
attitudes.
First Aid & Universal Precaution: wash, clean anywound & to obtain medical advice for any
conflicting situations
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Thank you