2008 HIV/AIDS Strategic Plan to address Risk Factors
By Pauline Waruguru
Nevis Reporter-SKNVibes.com
~~Adz:Right~~ CHARLESTOOWN, Nevis - The 2008-2012 St. Kitts and Nevis National Strategic Plan (NSP) will respond aggressively to risk factors and vulnerability that may fuel HIV/AIDS.
According to information contained in the Draft NSP disseminated last week to stakeholders in St. Kitts and Nevis, the National AIDS Secretariat (NAS) and implementing partners would reach more most-at-risk group, including Men Having Sex With Men (MSM) and sex workers, in order to prevent HIV transmission in most-at-risk groups and the general population.
Experts have assessed that a cross-section of vulnerable groups including persons living with the HIV disease remain underground, afraid of accessing health services and information due to stigma and discrimination.
Public sector and civil society are more involved but more partners and broader involvement is needed. Prevention education takes place, but needs to become evidence based and better targeted.
As of July 2007, 55 people with advanced HIV disease are under medical supervision of which 31 receive ART (Anti-Retroviral Treatment).
Challenges that have been faced by AIDS workers include underreporting of AIDS diagnoses because of stigma and discrimination. Also complicating response is Kittitians and Nevisian seeking treatment abroad due to stigma.
Sexually Transmitted Diseases (STDs) are common in the Federation, but there is limited STD prevalent data because most STDs are treated outside the government health services
HIV is spread in the Federation predominantly through unprotected sex. Women are supposed to be faithful to one partner, but men are allowed and encouraged by their peers to have multiple partners; thus women who are faithful to one partner may be at risk for HIV infection. Participants in recent HIV/AIDS workshops were quick to point that women too had multiple sexual partners.
Behavioural surveillance indicated that girls and boys are subjected to forced sex, which obviously makes them vulnerable. Teenage pregnancies are very common and there are many reports of (illegal) abortions, which indicate wider sexual and reproductive health needs of young people.
Cultural taboos around HIV, sex and sexuality are barriers to access sexual health services. Many people are reluctant to admit (and seek support to change) risky behaviours. Young people are reluctant to buy condoms, few people access VCT or STD treatment, for fear of confidentiality, and many AIDS patients do not want to get their ARV from the pharmacy.
~~Adz:Left~~ Line ministries, the private sector, CBOs, and Faith-Based Organisations have not factored HIV/AIDS into their budgets and work plans. Only a few companies have included HIV/AIDS in their work plans and budgets.
Prevention interventions need to target the most at-risk populations. Life skills-based HIV and sexual health education in the school system is necessary and promising.
VCT services coverage is broad but demand remains low due to stigma and discrimination. The MOH set up VCT services in 17 sites (11 St. Kitts, 6 Nevis), including all health centres.
There is a general consensus that line ministries, civil society organisations (NGOs, FBOs and private sector) are very important for service delivery for prevention, care and support, complementing and expanding government services.
According to the envisaged NSP, NGOs are expected to work with most-at-risk populations who do not or cannot access government services, and to advocate for safeguarding human rights in policy development and service delivery.
FBOs are expected to reach out to their congregation members, address stigma and discrimination in the church setting to expand prevention messages beyond abstinence and to provide pastoral and community care.
Private companies are expected to develop non-discriminatory workplace policies and workplace programmes.
Ministry of Health (MOH) officials attached to HIV/AIDS coordinating offices have called on members of the public to point out gaps that may have been overlooked by the architects of NSP.
