32 new HIV cases detected

In terms of mode of transmission, the Ministry of Health states that all 32 cases have acquired the infection through unprotected sex and there is no Mother to Child Transmission reported

A total of 54 HIV cases have been diagnosed in 2020 alone

Sonam Penjor

In a startling development, the Ministry of Health (MoH) has detected 32 new human immunodeficiency virus (HIV) cases, comprising of 17 male and 15 female, in the last six months from January-June 2021.

The majority, 53 percent of them, are between the age range of 25-49 years old and 25 percent above 50-years. Among the new cases by occupational group, 11 belongs to housewives, five each belong to private/business, driver and farmers while three from the religious body, one from prisoner and two from unemployed youths.

In terms of mode of transmission, the press release from the MoH states that all 32 cases have acquired the infection through unprotected sex and there is no Mother to Child Transmission (MTCT) reported.

Among the new cases, 15 of them were diagnosed through Voluntary Counseling and Testing (VCT), five each from antenatal screening and contact tracing while six of them through the medial screening and then one from blood donor screening. Currently, all the new cases are being put on care and treatment.

Health Minister, Dechen Wangmo, said, “We are committed to strive harder in making resilient HIV prevention and treatment response, commit to rapid recovery post-Covid-19 and will apply the lesson learned from the colliding epidemic of HIV and Covid-19 to create more resilient societies and health system that are ready to meet the future health challenges.”

Lyonpo added that knowing one’s own HIV status is the single most important responsibility that we all can take to help the country fight against this epidemic because HIV testing is an essential entry point to HIV treatment, prevention, care and support services to enable us to live a quality life and prevent onward transmission from the source.

Lyonpo said that in addition to the existing facility-based and mobile HIV testing services we are also gearing up for the community-based testing using the HIV Self-Testing (HIVST) kit where trained laymen from the identified communities will conduct the testing within their network.

The health minister also said that this will help many of those unreached keys and vulnerable populations will have greater access to HIV testing services with convenience.

However, Lyonpo cautioned about the likely risk associated with it such as false-negative results and false reassurance during the acute infection, insufficient counselling and possible delayed entry into care and treatment if one doesn’t adhere to the HIVST protocol of the MoH.

The Offtg. Director, Department of Public Health, Rixin Jamtsho, said that the MoH has expanded its HIV testing program like never before and it’s available in all the health care facilities across the country, standalone community testing centres called health information and service centre (HISC) in six major urban areas.

The major urban areas includes Thimphu, Phuentsholing, Gelephu, S/Jongkhar, Lobesa and Trongsa/Bumthang) including the Private Diagnostic Clinics.

Further, he also mentioned such testing facilities were also provided through mobile outreach clinics, routine outreach activities to the high-risk groups and then from the private diagnostic clinics.

He also further reiterated the importance of coming forward for testing and most importantly the pregnant mothers to ensure AIDS-free generation through timely care and treatment from the health centres.

Meanwhile, the press release from the MoH states that the MoH through the Global Fund (National and Regional Grant) and WHO support is now ready with the required guidelines and protocols to roll out the HIV Self-Testing demonstration project from July 2021 onwards in six priority districts of Thimphu, Paro, Phuentsholing, Gelephu, S/Jongkhar and Samtse.

The Regional Multi-Country Global Fund Grant is being managed by the Save-the Children Bhutan where the MoH is one of the key implementing partners.

It further states that the HIV Self-Testing will be piloted among the key and general populations to assess the uptake and delivery models of HIV Self-Testing by the unreached key population like Men having Sex with Men (MSM), Transgender (TG), Female Sex Workers (FSW), and other general populations.

The pilot testing also includes assessing the choices made between assisted (supervised) and unassisted (unsupervised) HIV Self-Testing.

Since 1993-until June 2021, of the estimated 1300 HIV cases, the MoH has diagnosed 773 out of which, 401 are male and 372 are female cases. However, still need to find 527 missing cases to bridge the current detection gap of 40.5 percent.

Like many other countries in the region, the majority which accounts to70 percent of the reported HIV cases in Bhutan is between the age range of 25-49 years old while 14 percent are between 15-24 years old and the remaining five percent are below 15 years of age and then 11 percent above 50 years, added the press release.

“This shows that HIV in Bhutan has primarily affected the most economically productive age group. About 93.9 percent of them have acquired HIV infection through the heterosexual route, five percent from MTCT, 0.8 percent from injecting drug use.”

In adding, the press release also added that HIV–related stigma and discrimination are major barriers to the successful control of HIV. Stigma is associated with the disease as well as the behaviours that lead to infection. Stigmatizing behaviours were primarily associated with fear of HIV and its route of infection linked to sex and sexuality.

“The stigma and discrimination can largely discourage key and vulnerable populations like men having sex with men, sex workers and injecting drug use to show up for testing.”

In today’s world, these marginalized populations who are at higher risk of getting infected with HIV continue to face stigma and discrimination based on their actual or perceived health status, race, socioeconomic status, age, sex, sexual orientation or gender identity or other grounds. Such stigma and discrimination is the number one cause for HIV transmission to the larger population and other psychosocial issues among those living with the virus and marginalized key populations.

The press release further added “The likelihood of occurring stigma and discrimination in health care settings is also high, barring people from accessing health services on a timely basis.

Therefore, such stigmatization and violation of human rights in any setting should be avoided to enable those marginalized communities to access the required health care services without any fear and prejudice. We should have multi-stakeholder and rights-based collaborative action to end acquired immune deficiency syndrome (AIDS) and deliver health for all.”

Meanwhile, unlike in the past, the release states, “Now we have scientifically well-proven effective HIV medicine that can reduce HIV in the body and improve their immune system to stay healthy and live a long life like any other uninfected individual. However, we must know that timely testing is the only means to know your HIV status to initiate early treatment and then good adhere to the treatment.”