HIV/AIDS on decline for first time

...in 5 years, survey shows

ACCRA, 15 April (IRIN) - Ghana's HIV-AIDS infection rate has dropped for the first time in five years, and is now down countrywide to 3.1 percent from 3.6 percent in 2003, according to a new sentinel survey released this week.

But officials in Ghana, whose population of 20 million has one of the lowest HIV rates in West Africa, remain concerned by big regional differences and increasing signs of unprotected sex among youths.

The survey shows a fall in HIV infection rates in 14 of the 35 areas registered. In the south, Ghana's most populous area and the one hardest hit by the pandemic, six sentinel sites had a prevalence rate of five percent, against eight sites in 2003.

"I think our behavioural change strategies might be beginning to pay off," Sakyi Awuku Amoa, director-general of the Ghana AIDS Commission (GAC), told IRIN. "But for the moment, I do not want to over-emphasise our achievements."

"I hope these recent figures will allow us to channel our strategies into the right interventions to enable us to achieve a three-year significant drop in our prevalence rates," Amoa added.

Between September and December 2004, 15,711 blood tests were analysed in 35 sentinel sites country-wide from pregnant women attending ante-natal clinics as well as patients seeking treatment for Sexually Transmitted Diseases (STD).

In southern Ghana, prevalence rates vary from three to 6.5 percent while in the northern areas, which have been less affected by the epidemic, there was an average prevalence rate of 1.8 percent.

Areas with a concentration of travellers, transporters and businessmen recorded prevalence rates as high as six percent. In Ho, the capital of the eastern Volta region bordering Togo in the east, 5.8 percent of people tested are HIV positive, and Tema, Ghana's main harbour city, 20 km from the capital Accra, recorded 6.4 percent.

In the western region on the border with Cote d'Ivoire, prevalence rates reached 6.8 percent in the towns of Wenchi and Fanteakwa, the highest HIV rates recorded in rural areas.

In the eastern region, the sentinel site in the regional capital Koforidua registered 5.4 percent while Agomanya had 7.4 percent, the country's highest prevalence rate, but less than 9.2 percent in 2003.

Located near the Akosombo hydroelectric dam, the administrative centre of Agomanya has always suffered the country's highest HIV infection rate. Farmers who lost their lands on the creation in the 1960s of Lake Volta, the world's second largest artificial lake, often migrated while wives worked in hotels and bars across the region, sometimes becoming sex workers.

Despite the dip in HIV prevalence, authorities responded with caution.

"This drop does not mean HIV infections are coming down in Ghana," Nii Akwei Addo, programme manager of the National AIDS Control Programme (NACP), told IRIN. "We need a consistent fall over three years."

"We can only start rejoicing if all the sentinel sites record drops, which unfortunately was not the case with the 2004 survey," Akwei Addo added.

Concerns emerged from the survey results over HIV prevalence rates as well as high levels of syphilis infections among youth, suggesting that increasing numbers of young people are engaging in unprotected sex.

The survey showed that the age groups 15-19 and 25-29 recorded a slight increase of 0.1 percent over rates recorded in 2003 to hit a 4.5 percent HIV prevalence rate in 2004.

AIDS Control Programme officials say these results should be an issue of concern as they may indicate either high sexual activity or very little impact in prevention on the two groups.

"We better start thinking of having sentinel sites in schools or places where concentrations of youths are high," said Warren Naamara, UNAIDS country coordinator.

"If we want the figures to go down, we need to go beyond ante-natal clinics and Sexually Transmitted Infection (STI) sites and go into these large but unknown populations," Naamara suggested.

Meanwhile, health officials have given assurances that government will stick to its HIV treatment targets. Antiretroviral (ARV) drugs are available only in four hospitals, all located in southern Ghana, but the government plans to extend them to all 10 regional hospitals in the country by the end of the year.

"It is going to be [difficult] but we have to take up the challenge and stick to the targets of scaling up this year," Akwei Addo said. "April will see the opening of another treatment centre at the Koforidua government hospital".

According to Ghanaian authorities, about 2,028 people are currently receiving state subsidised ARVs, out of the 70,000 people who should be on treatment.

In 2004, the Global Fund to Fight AIDS, Tuberculosis and Malaria gave Ghana a grant of US $15 million over two years for the distribution of ARVs. The government has planned for a six million dollar budget in 2005 to subsidise ARV therapy. [ENDS]