Several experts on HIV/AIDS from several partner institutions in country and beyond have recommended that self-testing and test-and-treat strategies be implemented in combating the spread of the virus.

This, they say, will ensure that people start treatment as soon as they test positive, a move that would – with some counselling – help prevent new infections and foster clinical benefits for individuals.

The recommendations were arrived at after a two-day workshop in Kigali that disseminated results of key studies on HIV and discussed the way forward in mainstreaming the test-and-treat strategy into the existing national HIV guidelines for people living with HIV.

According to Dr Sabin Nsanzimana, the head HIV prevention at Rwanda Biomedical Centre, the recommendations are based on research, and will be further considered in the 2015 Rwanda HIV Guidelines for the use of antiretroviral drugs for the treatment and prevention benefits for individuals and the community.

"Evidence-based research is needed in HIV management to inform national HIV policy and guidelines,” he said, adding that among the new guidelines is to ensure that whoever is positive starts anti-retroviral therapy.

Nsanzimana said that the current guidelines do not recommend treatment until an HIV positive person has only below 500 CD4 but this could change.

He said immediate treatment could reduce deaths by 53 per cent and avoid transmission to others by over 90 per cent.

Steve Kanters, from Global Evaluative Sciences in Canada, said the new tools are already in use in the US, France, Australia and Brazil, adding that all that is needed is a sound policy backed by science to guide the implementation.

Other measures are promoting male circumcision, which, it was revealed, has increased from 13 per cent in 2010 to 20 per cent in Rwanda due to mobilisation and availing materials at different health centres and hospitals.

Male circumcision, studies have shown, reduces the chances to contract HIV by 60 per cent.

Dr Agnes Binagwaho, the minister for health, said government will continue prioritising evidence-based policy formulation, adding that researchers should continue playing a critical role in the fight against HIV/AIDS.

The minister said that now that the self-test and test-and-treat tools had been given a go-ahead by scientists, the next step by the government is to mobilise funds and capacity building to put the two tools into use.

Study findings

The Rwanda AIDS Indicators and Incidence Survey (RAIHIS) indicate that the country maintained the prevalence rate of HIV at 3 per cent due to successful treatment and prevention programmes while the incidence rate is at 0.27 per cent .

The prevalence among women is 3.5 per cent and men 2.5 per cent and higher in urban areas with 5.6 per cent, while in rural areas it was found at 2.6 per cent.

It also shows that condom use was only at 25 per cent.

The study indicates that there had been 50 per cent decline in new infections over the last 10 years, while HIV-related deaths have reduced by 78 per cent.

The study shows that between 10,000 and 12,000 people face new infections every year and 5,000 die of HIV per year while government injects $40 million for treatment every year.

editoria@newtimes.co.rw

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Overwhelming evidence indicates that rapidly scaling up quality-assured HIV treatment will prevent millions of people from dying, prevent millions of people from acquiring HIV infection, save money and lay the foundation for the end of the AIDS epidemic. The time to act is now, since speed is essential to success.

Expediting the comprehensive scale-up of HIV treatment will have a transformative effect on humankind, making our world healthier, more just and more prosperous.

Accelerating the scale up of antiretroviral therapy will drive progress across the broader AIDS response. It will reduce HIV-related illness and death, prevent people from acquiring HIV infection, address the needs of women and girls, reduce stigma and social exclusion and promote service integration.

UNAIDS 2015