Make HIV part of mainstream health system – study

Published: April 20, 2011

Guyana must integrate its HIV services into the general healthcare system in order to better utilise the limited resources available to the sector, according to a study released on Wednesday.

The report, done with USAID support, notes that Guyana provides high coverage and quality HIV services, but for this to continue there is a need to secure financial and human resources.

“Decrease in HIV funding requires continuing implementing sustainable solutions, mainly the integration of HIV services into other health and social services,” it stated.

The study is aimed at providing Guyana with a preliminary analysis of the unit costs and financial and human resources available and needed to sustain its HIV/AIDS programme through 2015.

Integration, it stated, is essential for sustaining HIV services over the long term.

“The HIV response has seen a decline in the funding they receive from their largest donor, PEPFAR (President’s Emergency Plan for AIDS Relief), and competition on the remaining donors’ AIDS funding, also increasingly limited, is becoming fiercer  due to improved absorptive capacity of many AIDS programmes globally,” it read.  

The summary provided to the media added that the need for capital investments is diminishing and Guyana’s AIDS programme can now focus its resources on the remaining programme gaps, such as services for vulnerable populations and youth.

It noted that men who have sex with men (MSM) and commercial sex workers (CSWs) have the highest HIV prevalence in Guyana and while it is estimated that HIV prevention reaches a large portion of CSWs, the coverage of MSM seems to be low.

“According to UNAIDS, it is very probable that the transmission of HIV from MSM to the wider sexually active population is an important route of HIV transmission in Guyana. There is a need to scale up outreach to MSM,” the report stated.

It also calls for an increase in targeted use of mass media and an increase in the use of effective stigma reduction interventions. According to the study, HIV-related stigma and discrimination remains a major concern despite the high knowledge levels of the disease.

“Based on the recommendations of a 2009 report on stigma and discrimination in Guyana, stigma reduction training is needed for all health professionals across Guyana’s health facilities. In addition, community leaders should be trained on this topic,” it continued.

According to the report, stigma reduction is likely to increase adherence to anti-retroviral treatment since adherence is linked to “self-HIV stigma.”

Health minister Dr. Leslie Ramsammy, who was present at the opening of a workshop where the report was handed over, laid out similar sentiments.

“I am not certain that in the face of climate change, in the face of a real calamity facing us in terms of diabetes and hypertension and heart diseases and so on, that we can continue diverting as much resources to HIV.  And yet we need to spend even more in the fight against HIV; so how we do that will be a major challenge,” the minister said.

The challenge, he added, would be in ensuring that the cost of HIV treatment does not escalate and the only way to do that was by mainstreaming it in a strengthened health system.

“The initial approach of separating the human resource cannot be a wise one. We maintain primary healthcare physicians that are suppose to be dealing with diabetes and heart diseases and malaria and other infection; they will also have to be able to deal with HIV and that is the truth,” Dr. Ramsammy stated.

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