Yesterday was the World AIDS Day. Rwanda in the recent years has made significant progress in its battle against HIV/AIDS.

The rate of new infections has declined by 50 per cent, roughly 80 per cent of adults in need of anti-retroviral drugs are receiving the medication, while mother-to-child transmissions at 18 months have reduced to less than 2 per cent, according to statistics from Rwanda Biomedical Centre.

There is also a significant progress toward achieving the UNAIDS ‘90-90-90 targets’, which aims at diagnosing 90 per cent of all HIV positive people, providing antiretroviral therapy (ART) for 90 per cent of those diagnosed and achieving viral suppression for 90 per cent of those treated, by 2020, according to Dludlu Sibongile, the UNAIDS country director.

"Rwanda has made exceptional progress towards achieving the 90-90-90 targets. It is also one of the few countries on the continent that are likely to reach achieve goals well ahead of the deadline. It has to be acknowledged that maintaining a low and steady prevalence is an achievement in itself,” she told The New Times on Wednesday.

Official figures show that Rwanda’s HIV prevalence among the general population aged 15-49 years remained stable, at 3.0 per cent, for the last decade.

This year’s theme for the World AIDS Day, "Get up all against HIV/AIDS-Still there”, focused on community mobilisation and involvement in HIV prevention and treatment to end AIDS.

The theme is a call to action from everyone.

This year, the Ministry of Health launched the Treat-All campaign, putting more emphasis on HIV and AIDS prevention, treatment, care and support, as well as general sexual and reproductive health, among adolescents and young people.

Inclusion in HIV fight

With the private sector partaking in the journey towards ending AIDS in Rwanda, the HIV standard minimum package, that was developed in 2011, involved consultations with Private Sector Federation (PSF), private companies, UN agencies, RBC and the Civil Society Organisations.

It addressed elements of HIV/AIDS response within the private sector companies: prevention, treatment, care and support, impact mitigation, human resources and management.

Leon Pierre Rusanganwa, the PSF Global Fund Project Officer, explains that the aim was to establish the HIV context in the private sector using available data sources.

They have since involved a number of chambers in scaling up HIV prevention and treatment services.

"Initially, PSF entered a partnership with Rwanda Hospitality association under which the latter committed to avail services for their clients and staff. 

"We have now involved the Chamber of Art and Crafts which signed performance contract to avail the services to their staff through provision of kits and also provide space for HIV testing as a strategy for treatment for all,” Rusanganwa told The New Times on Wednesday.

"We have now agreed with Society for Family Health to avail condoms in all retail shops for accessibility, affordability and availability. We also intend to provide HIV-related information to 6,000 fishermen around Lake Kivu through peer educators,” he added.

Persons with disabilities

A local umbrella organisation of persons with disabilities in the fight against HIV/AIDS and for health promotion (UPHLS) recently called for concerted efforts to meet the needs of each type of Persons with Disabilities (PWDs) in formulating guidelines, policies and legislation on HIV and general health promotion.

Faustin Xavier Karangwa, the executive director of UPHLS, noted that even though there has been improvement in the scaling up of health services for people with disabilities, there are gaps that need to be filled.

"There has been a lot of improvement in terms of health services provided to the people with disabilities, including HIV/AIDS services, such as maintaining doctor-patient confidentiality despite some of them having speech impairment,” he said.   

Karangwa added: "The public and civil society organisations, however, have a role to play in ensuring that certain challenges such as stigmatisation against persons with disabilities are addressed and adequate health care extended to them.” 

Targeting sex workers

The HIV prevalence is higher in the population aged 15-49 and concentrated in such high risk groups such as female sex workers, according to the Rwanda Demographic Health Survey 2015.

In the City of Kigali alone, the prevalence rate remained higher than anywhere else in the country, at 6.3 per cent, while it averaged 2 per cent in the rural areas.

The city has in the recent past come up with different initiatives to curb the spread of the virus, including introducing a 24-hour condoms distribution system in areas with high numbers of high-risk people, particularly prostitutes. 

But, even with the Condom Distribution Kiosks Initiative – active mostly in HIV high-risk areas across the city – the city continues to lag behind other parts of the country as far as checking the virus is concerned.

This, according to Leonard Bantura, the Clinical Team Lead of AIDS Healthcare Foundation (AHF), is attributed to several factors, including the fact that high-risk sections of the population, such as female sex workers and truck drivers, are mostly in urban centres than in the countryside.

"Groups at a higher risk of catching the virus are usually left behind, these include female sex workers, homosexuals, and truck drivers,” he says.

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