Judge Paula da Conceição Machatine Honwana sworn in as RSCSL Justice
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An academic journal has estimated that only 57 per cent of people living with HIV in Mozambique enrol for life-saving treatment, with only 44 per cent continuing to receive antiretroviral treatment three years later.
The study published in the Journal of Acquired Immune Deficiency Syndrome was conducted in the semi-rural area of Manhica District in the southern Mozambican province of Gaza.
Researchers enrolled 1,122 adults with a recent diagnosis of their HIV positive status onto the study. The average age was 33 and 56 per cent were female.
They found huge differences between those whose HIV status was tested in clinics compared with those who undertook home-based tests. Over ninety per cent of those diagnosed HIV positive in clinic enrolled for care within three months, compared with just 35 per cent of those who were home tested.
Treatment with antiretroviral drugs has been dependent on the Cd4 white blood cell count (although this will no longer be a criterion for drug initiation). Thus, not everyone who tested HIV positive is immediately put on antiretroviral drugs.
The study found that a year after patients were prescribed treatment, 84 per cent remained on the drugs. This falls within the estimates of antiretroviral treatment retention in other parts of southern Africa.
The treatment pathway follows four stages: enrolment in care, first consultation, linkage to care, and the initiation of antiretroviral treatment.
The authors found that only 23.8 per cent of HIV positive people who home tested were linked to care within three months. Linked to care refers to patients being accepted into the health system where they are monitored to ensure that they receive antiretroviral drugs when appropriate.
The paper concluded that those tested at home need to be better connected with ongoing health services and it suggested using SMS reminders or patient navigators (people who guide patients through and around barriers in healthcare systems) to increase the numbers accessing services.
The latest estimate of HIV prevalence among Mozambicans aged between 15 and 49 is 13.2 per cent. However, it is thought that only 64 per cent HIV positive people know their HIV status.
According to figures revealed in July by the executive secretary of the National AIDS Council, Francisco Mbofana, 2.1 million people in Mozambique are living with the HIV virus that causes AIDS. Of those, 168,763 are children from 0 to 14 years old, and 1.9 million people aged 15 and over. He added that last year 70,000 Mozambicans died from AIDS.
The number of health units providing antiretroviral treatment that prolongs the lives of HIV positive people has increased by 75 per cent from 753 in December 2014 to 1,320 by the end of 2017. Over the same period, the number of people receiving antiretroviral treatment increased from 646,312 to just over 1.1 million – a growth of 70 per cent.
In 2014, the Joint United Nations Programme on HIV/AIDS (UNAIDS) launched its 90 90 90 targets. These are: 90 per cent of people living with HIV know their HIV status; 90 per cent of people who know their status are receiving antiretroviral treatment, and 90 per cent of people on treatment have suppressed viral loads. The deadline for this target is 2020.
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