HIV remains a major global public health issue, having claimed 36.3 million lives so far. According to WHO, there were an estimated 37.7 million people living with HIV at the end of 2020, over two thirds of whom (25.4 million) are in the African Region. There is no cure for HIV infection. However, with increasing access to effective HIV prevention, diagnosis, treatment and care, including for opportunistic infections, HIV infection has become a manageable chronic health condition, enabling people living with HIV to lead long and healthy lives.
HIV and Tuberculosis (TB) are the world’s two most deadly infectious diseases. Additionally, these two epidemics are tragically interconnected, as TB is the leading cause of death for those living with HIV. In 38 million people living with HIV, 10 million develop active TB each year.
The Ethiopian HIV/AIDS epidemic is characterized as mixed, with wide regional variations and concentrations in urban areas, including some distinct hotspot areas driven by
#key_populations (Female Sex Workers (FSW) and their clients; Prisoners; People with injecting drug use (PWID)) and
#priority_populations (Widowed and divorced men and women Long distance drivers; Workers in hot spot areas; High risk adolescent girls and young women; PLHIV and their partners).
The National adult (15-49) HIV prevalence is 0.93% in 2019; prevalence in women constitutes 61% of infections (women 1.22%, men 0.64%). There are wide regional variations ranging from a high in Gambella at 4.5%, Addis Ababa at 3.42% with the lowest in Somali region at 0.01%. In 2019, the national HIV incidence rate in the adult population is estimated at 0.02% (0.03% in females and 0.02% in males) with an estimated 15,000 (9,000 females and 6,000 males) new infections, the majority (67%) of these occurring in the age group below 30 years. About 265 out of more than 1000 Woredas (districts) in the country constitute nearly two thirds of all new infections annually. The recent estimate of 14,842 new infections in Ethiopia in 2019 (Fig 10) indicates that there is on-going spread of HIV infection in the population; more than 60% of the new infections are occurring in Amhara, Oromia, SNNP, and Tigray. The burden of new infections in absolute number in these regions is due to their relatively large population size otherwise other regions such as Gambella and Addis Ababa have higher incidence rates.
Ethiopia has adopted the global goal to attain the 90-90-90 targets which is 90% PLHIV knowing their status, 90% percent of PLHIV who know their status being enrolled in antiretroviral treatment (ART) and 90% of PLHIV on treatment attaining viral suppression, which served for 2018_2020.
Six Strategic Objectives underpinned by critical social and programmatic enablers as HIV/AIDS NSP for Ethiopia 2021_2025:
1. Reach 90% of Key and Priority populations with targeted combination HIV prevention interventions by 2025
2. Enhance HIV case finding to attain 95% of PLHIV knowing their HIV status and linked to care by 2025
3. Attain virtual elimination of Mother to Child Transmission (MTCT) of HIV and Syphilis by 2025
4. Enroll 95% of PLHIV who know their status into HIV care and treatment and attain viral suppression to at least 95% for those on antiretroviral treatment.
5. Mobilize resources and maximize efficiencies in allocation and utilization.
6. Enhance generation and utilization of Strategic Information for an accelerated evidence-based response.
HIV/AIDS National Strategic Plan for Ethiopia 2021_2025
COVID-19 pandemic affected the planning process on this NSP, however, it remains essential that prevention activities and HIV testing by scaling up innovative approaches like self-testing and offering HIV testing at COVID19 quarantine and isolation sites need to continue and that there be no interruptions in the delivery of antiretroviral treatment, identification and treatment of co-morbidities as well as maintaining high levels of viral suppression.
World AIDS Day is designated on December 1 every year since 1988 dedicated to raising awareness of AIDS pandemic caused by the spread of HIV infection. Each year, organizations and individuals across the world bring attention to the HIV epidemic, endeavour to increase HIV awareness and knowledge, speak out against HIV stigma, and call for an increased response to move toward ending the HIV Epidemic.
The theme of World AIDS Day in 2021 is “End inequalities. End AIDS”. With a special focus on reaching people left behind, WHO and its partners are highlighting the growing inequalities in access to essential HIV services. Even though there is no cure for HIV infection, with increased access to effective HIV prevention, diagnosis, treatment and care, including for opportunistic infections, HIV infection is becoming a manageable chronic health condition, enabling people living with HIV to lead long and healthy lives.
Although this year, we are battling against COVID-19 pandemic, it remains incredibly important to celebrate world AIDS day by wearing a red ribbon which is the universal symbol of awareness and support for those living with HIV and AIDS. A new WHO report confirms that HIV infection is a significant independent risk factor for both severe/ critical COVID-19 presentation at hospital admission and in-hospital mortality. Overall, nearly a quarter (23.1%) of all people living with HIV who were hospitalized with COVID-19, died.
To reach the new proposed global 95–95–95 targets set by UNAIDS, we will need to redouble our efforts to avoid the worst-case scenario of 7.7 million HIV-related deaths over the next 10 years, increasing HIV infections due to HIV service disruptions during COVID-19, and the slowing public health response to HIV.
In addition by educating the community about the cause, transmission, prevention and treatment of HIV infection as well as encouraging them to get tested. Furthermore we should continue to work on stopping stigmatization against people living with the illness.
“End inequalities. End AIDS”
World AIDS DAY!
By: Dr. Sena Kebebew
Sources: WHO, CDC, HIV/AIDS NSP for Ethiopia 2021_2025
Oromia Physicians Association
Selfless commitment to give back!
December 01, 2021