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22 new HIV cases

Twenty-two new Human Immunodeficiency Virus (HIV) positives cases (10 male and 12 female) were detected in the last six months. This means at least three people tested positive every month.

Until November this year, a total of 55 HIV cases were detected, taking the total number of cases detected since 1993 to 570, according to a press release from the health ministry.

Among the new cases, housewives and farmers are among the infected groups with eight cases each.

Twelve cases are aged between 30 and 39 years, six between 20 and 29 years, and three between 40 and 49. One case is aged above 50.

Health Minister Tandin Wangchuk said as per the UNAIDS estimates, Bhutan is expected to detect 1,100 cases. “As of now, we have detected a cumulative of 570 cases. So we have a case detection gap of about 48 percent to achieve.”

Lyonpo urged people to come forward and avail of HIV testing and counselling services to determine one’s HIV status. “Early diagnosis of HIV is important for initiation of care, treatment, support, and to prevent further transmission of the infection.”

Heterosexual route remains the major mode of HIV transmission in Bhutan. All the new cases acquired the infection through unprotected heterosexual route.

While six new detected cases in the last six months were detected through medical screening, five cases each were detected through voluntary counselling and testing (VCT), antenatal care (ANC) and contact tracing. One person was detected through mobile screening at a construction site.

Director of Department of Public Health, Dr Karma Lhazeen, said HIV testing and counselling services were expanded to the Basic Health Units (BHUs) Grade II in 2013. “HIV infection from mother to child has reduced drastically with zero reporting among the recent cases.”

She said health ministry is targeting to triple elimination of HIV, Syphilis, and hepatitis B among the newborn. “We will strive to achieve it by 2020.”

Of the total 570 detected cases, 294 are male. It has been established that women are exposed to HIV at younger age compared with men.

Of the total detected cases, 93 percent contacted infection through the heterosexual, six percent through mother to child transmission, and one percent through injecting drugs and blood transfusion outside the country.

In terms of diagnosis, 29 percent was through contact tracing, 22 percent each by medical screening and VCT, 11 percent through mobile screening and 10 percent through ANC, and six percent through blood donation screenings.

Currently, there are 430 people living with HIV in the country. Among them, 390 are on antiretroviral treatment (ART) and 40 (10 percent) are defaulters and non-complaint cases.

The government spends a total of Nu 4.7 million on ART every year.

Programme officer with the National AIDS Control Programme, Lekey Khandu, said when a person is tested positive for HIV, he or she is linked to care and ART. But because of stigma and discrimination associated with the infection, some people prefer to lead a private life. As a result, health workers and counsellors are not able to trace them. They do not want to adhere to the care and treatment. They are so counted as non-complaint cases.

Defaulters are people living with HIV who start the care and treatment but discontinue the ART and do not come for the counselling on time.

“Health workers and the counsellors can only counsel them to adhere to the continuum of care. We cannot force them,” he said.

Studies conducted by the health ministry show that young age sexuality, multiple sexual practices, low-risk perception, sex under the influence of alcohol, increased mobility, and low condom use are some of the key factors contributing to acquisition and transmission of HIV in the country.

Mobile HIV testing and counselling services, condom vending machines, rolling out of treat all policy, and the introduction of viral load testing are some of the new initiatives to prevent transmission of HIV in the country.

Dechen Tshomo

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