Archive for category: HIV/AIDS

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HIV/AIDS In Panama: Political Actions and Awareness

HIV/AIDS In Panama: Political Actions and AwarenessIn Panama, approximately 30,000 people are living with HIV/AIDS, with numbers increasing each year. The rise reflects improved testing and awareness, allowing more people to seek and receive the care they had long been without. However, poverty remains a major barrier, particularly among Indigenous communities, where extreme living conditions increase vulnerability to the disease.

Poverty in Panama

Poverty significantly influences both the spread of HIV and access to treatment. While Panama’s overall poverty rate stands at 22%, the impact is disproportionately severe in nonurban areas, where 76% of Indigenous people live in poverty. This stark contrast highlights the need for targeted support, as many Panamanians, particularly in remote regions, still lack essential resources.

The Intersection of Poverty and HIV/AIDS

Economic hardship often results in limited access to hygiene products, including affordable condoms, increasing the risk of HIV transmission. Those infected face further challenges in accessing life-saving medical treatment.  The adult HIV prevalence rate in Panama stands at 1.0% and the country reports nearly 1,000 AIDS-related deaths annually. In the Ngäbe-Buglé territory, AIDS is the leading cause of death, accounting for more than 7% of fatalities, according to Panama’s National Statistics Institute. This intersection of poverty and health disparities highlights the urgent need for comprehensive strategies, including targeted education, expanded health care access and culturally sensitive prevention efforts to curb the spread of HIV/AIDS in Panama.

Political Action Driving Change

Panama began addressing the HIV epidemic in 1985 by offering testing and treatment services. In the early 2000s, the government passed legislation requiring agencies to provide both material and financial support to combat HIV/AIDS. Initially, the national budget focused solely on treatment medication. However, in response to the evolving epidemic, Panama expanded its funding to include public education initiatives. The passing of General Law 3 on STIs in 2000 marked a significant step forward, aiming to prevent discrimination and ensure equitable access to HIV-related services. By 2005, Panama had allocated approximately $10 million from the federal budget toward HIV/AIDS prevention, treatment and awareness campaigns.

Raising Awareness and Reducing Stigma

While increased funding has improved access to treatment, stigma remains a significant obstacle, particularly within Indigenous communities. Misconceptions about HIV/AIDS continue to fuel discrimination, preventing many from seeking testing and care. Public education campaigns have played a crucial role in dispelling myths and fostering a more informed society. These initiatives not only teach people how HIV spreads but also promote understanding and compassion for those affected by the virus. Expanding educational resources to Indigenous regions remains a priority, as these communities face the highest rates of both poverty and HIV/AIDS.

Looking Ahead

The combination of political action, increased awareness and targeted support has allowed Panama to make meaningful progress in addressing HIV/AIDS. However, continued efforts are needed to ensure that vulnerable populations—particularly Indigenous communities—have equitable access to education, prevention tools and medical care. By prioritizing both policy-driven solutions and grassroots awareness initiatives, Panama can continue to bridge the gap between poverty and health, creating a safer, healthier future for all its citizens.

– Kaleb Monteith

Kaleb s based in Greeley, CO, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

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HIV/AIDS in Paraguay: UNAIDS at the Forefront of the Response

HIV/AIDS in ParaguayHIV/AIDS left 7,000 children as orphans in Paraguay in 2023 alone. Natanael, an HIV-positive boy living in Paraguay, became an orphan after his mother died of HIV.

What Is HIV?

The human immunodeficiency virus (HIV) is an illness that affects a person’s white blood cells, specifically ones called CD4 cells, that are responsible for immune function. HIV is transmitted through the exchange of bodily fluids. 

Methods of preventing the virus includes using a condom, avoiding used or unclean needles, getting tested regularly, and in some cases, preexposure prophylaxis (PrEP). Treatment for HIV/AIDS involves antiretroviral therapy (ART). 

HIV/AIDS in Paraguay

Despite there being both preventative measures and treatments, HIV/AIDS is an epidemic that continues to burden many parts of the globe. In Paraguay, at least 22,000 people are currently living with HIV/AIDS. Of that number, about half are receiving ART for HIV/AIDS, meaning at least 10,000 are going without life-saving treatment.

HIV/AIDS is concentrated both geographically and among populations in Paraguay. Greater than 75% of those infected with HIV live in the country’s capital, Asunción, with the total number of nationwide cases rising each year. HIV/AIDS is also more prevalent among men who have sex with men (MSM) and sex workers.

Natanael, a young boy living with HIV in Paraguay, became an orphan when his mother died of the virus. Natanael’s mother contracted the illness at her work at a children’s home for kids with HIV, where she and her son also lived.

After her passing, Natanael became an orphan and had to continue living in the home without his mother, because his own family rejected him and his mother after discovering that they were diagnosed with HIV.

UNAIDS Response

To bring aid to people like Natanael, The United Nations has a Joint Programme called UNAIDS. UNAIDS is a global health effort that aims to address HIV/AIDS as a public health crisis. 

As a result, HIV/AIDS in Paraguay and other countries may begin to see a decline as the Joint Team successfully implements different health services throughout the country.

With a program expenditure of $425,483 USD in 2022-2023, UNAIDS was able to: 

  • Provide nearly 550,000 students in Paraguay with comprehensive sex education. 
  • Provide more than 15,000 people in uniform with information regarding HIV/AIDS.
  • Provide more than 5,000 people in Paraguay’s armed forces with rapid HIV and syphilis testing services.
  • Distribute nearly 11,000 condoms throughout the country to prevent the transmission of HIV/AIDS, and other STIs.

The Future

Looking to the future, UNAIDS hopes not only to continue to meet their 90-90-90 goal – 90% of those with HIV are diagnosed, 90% of those diagnosed are treated with ART and 90% of those on ART become virally suppressed — but have targets of 95-95-95.

UNAIDS in Paraguay has worked not only to achieve its 95-95-95 goal but to prevent HIV/AIDS altogether through comprehensive sex education for students and the distribution of condoms throughout the country.

Without education or awareness of HIV, the couple who fell in love with Natanael may have never felt prepared to adopt him. At 12 years old, Natanael finally met his new parents. He was able to go to a loving home and maintain his HIV treatment. 

Other initiatives, such as SOS Children’s Villages, work to provide stable and nurturing homes to children around the globe living in poverty and other extreme situations. Anyone can donate or sponsor a child living in Paraguay, and help them gain access to medical care, food, clothes and love. 

Looking Ahead

HIV/AIDS is a global epidemic. The efforts of UNAIDS in Paraguay since 2022 have expanded public awareness of HIV and its transmission, provided HIV self-testing programs in key areas, and provided health services and information to those in uniform. Efforts such as these are at the forefront of the HIV/AIDS response and should help to decrease the number of cases in the future. 

– Hannah Pacheco

Hannah is based in Boston, MA, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

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Methods of Treatment and Testing for HIV/AIDS in Italy 

HIV/AIDS in ItalyHIV/AIDS infection and treatment are consistent concerns that health organizations in Italy are levying. Since high infection numbers in the early 21st century, rates of diagnoses have decreased from 3,858 in 2013 to 1,888 in 2022 according to WHO. Still, the health risk of the disease remains prevalent. Poverty can be an obstacle for seeking diagnosis and treatment for HIV/AIDS in Italy. Universal health services provide a great resource for those experiencing poverty. Currently, hospitals and health organizations in Italy are developing programs to make this impact more wide-spread.

The Ministry of Health and other national organizations are working towards spreading awareness, providing testing and developing medication. They hope to eliminate the possibility of HIV infection altogether. Many institutions have created goals which aim to reduce the number of new diagnoses and provide equitable treatment and counseling to all residents of Italy, regardless of their financial situation.

Injective PrEP Could Prevent HIV/AIDS in Italy

In December 2024, The National Institute for Infectious Diseases (IRCCS) and the Regional Hospital of Lombardy (ASST) collaborated on a solution-oriented program. Authorities in health spoke about emerging technologies at the national health conference, “Long-Acting Retrovirals–looking to the future.” The goal is to investigate and approve PrEP (pre-exposure prophylaxis) as a preventative measure against HIV/AIDS in Italy. Currently, the only available form of PrEP is the once-daily pill.

PrEP is a medication that reduces the risk of contracting HIV when individuals who are at-risk for infection take it. In the United States, the FDA has approved both the oral and long-acting injective forms of PrEP. 

The Italian initiative will provide controlled access to the injective method for 800 individuals and monitor their response. These health servicers wish to provide an alternative to at-risk people who have difficulty accessing or using the oral method. Injective PrEP allows for longer periods between intake compared to the daily oral method. 

“Three Times Zero” 

To commemorate International Day Against AIDS in Italy (December 1, 2024), IRCCS held a health conference. Many Italian changemakers attended including the Minister of Health, Orazio Schillaci, and the Director General of Health of the Lazio Region, Andrea Urbani. 

IRCCS aims to promote the goal of “three times zero against HIV: zero risk of transmission, zero diagnoses and deaths, zero stigma and discrimination.” Powerful entities such as the Italian Red Cross signed the protocol. It sets the precedent for advances in prevention and treatment. It also addresses the marginalization that those with HIV in Italy experience. 

Likewise, this protocol acknowledges the groups of Italian residents facing a disproportionate risk of contracting HIV. This includes men who have sex with men, foreign-born migrants and injective drug users. 

The DiMePReJ (Clinic of Infectious Diseases, Department of Precision and Regenerative Medicine and Ionian Area) found that individuals living in marginalized conditions have higher rates of infection. Risk factors include “financial difficulties and lack of secure housing.”

UNAIDS argues that the fight against HIV/AIDS cannot succeed without upholding the human rights of those suffering from the disease.  

Free Testing for HIV/AIDS in Italy

Accessible testing and education are vital to the reduction of HIV infections, especially among marginalized communities. Many free and readily accessible testing methods are available in major cities of Italy. “Let’s do it quick” (facciamolo rapido) launched in 2017 to provide an alternative to the typical blood test for HIV and HCV. This innovative test offers results by testing the saliva, removing the risk of blood contamination among health workers. 

This program supplements “room 13” (stanza 13) at IRCCS in Rome. The institute offers blood tests for HIV and Syphilis at no cost with same-day results. It also provides free counseling for those seeking preventive measures or treatment information. Search engines are readily available online for residents to locate their closest testing and counseling facility.

Vaccine Development

New developments are on the horizon. The Higher Institute of Health (ISS) in Italy partnered with the European HIV Alliance in 2016 to support its development of an HIV vaccine. The EU’s Horizon 2020 Research and Innovation program provided funding for their work. The alliance hoped to develop two new prophylactic vaccine candidates for clinical development using a multidisciplinary vaccine platform (MVP) and further identify scientific basis for continued research. 

Although the alliance has concluded, clinical trials for their vaccine, “EHVA P01” continued. Trials concluded at the end of 2024 with pending results. Scientists aimed to test the efficacy of a vaccine for HIV-uninfected adults. A preventative vaccine for HIV in Italy could reduce infection rates by large margins.

Global Collaboration Against HIV/AIDS

Still, many trials for preventative and therapeutic HIV vaccines are ongoing. Italy is one actor in an international mission to reduce–and eventually eliminate–the risk of infection for HIV. Health authorities are employing both preventative and therapeutic measures to address at-risk and infected individuals. Programs like “Three Times Zero” are reducing the stigma surrounding the disease and those who carry it. National hospitals, like IRCCS, have the potential to close the infection gap between income and population groups by continuing to provide free and accessible health services. Scientific collaboration in Italy has led to emerging treatments that indicate an HIV-free future.

– Sarah Lang

Sarah is based in Pittsburgh, PA, USA and focuses on Technology and Politics for The Borgen Project.

Photo: Pexels

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Diseases Impacting Lesotho

Diseases Impacting Lesotho
Lesotho is a tiny country totally encircled by South Africa. It has a land mass more than 11,000 square miles. With the country sitting within the mountain range of Maloti, Lesotho is frequently called the “Kingdom in the Sky.” While nature-made peaks and valleys provide the country with a beautiful landscape, the population struggles under an ineffective health care system that is challenged with managing several diseases impacting Lesotho.

3 Diseases Impacting Lesotho

  • Tuberculosis (TB): Tuberculosis in the country ranks as the second-highest in the world. The World Health Organization (WHO) indicates that TB is the leading cause of death in Lesotho, and among men. It is the second-leading cause of death among women and almost three quarters of TB incidences occur in individuals who are also HIV positive.
  • HIV/AIDS: HIV infections in Lesotho are high. In fact, the country ranked as the second-highest country with HIV in 2023. HIV/AIDS is the number one cause of death among women and the second leading cause of death among men. In 2023, there were approximately 260,000 adults living with HIV and more than half of these individuals were women.
  • Cervical Cancer: Cervical cancer rates are also high in this country. While globally this type of cancer falls within the top five most common cancers affecting women, it is the number one type of cancer impacting Lesotho’s female population. On average, more than 500 women in Lesotho are diagnosed yearly with this type of cancer. Unfortunately, more than two-thirds of them die from the disease. The main virus contributing to developing cervical cancer is the Human Papillomavirus (HPV). A common virus easily spread during sexual activity. However, women infected with HIV have a six-time greater risk for developing cervical cancer compared to women who are not HIV infected.

Optimism in Lesotho

The good news is that the country is making progress in addressing the diseases impacting Lesotho. Lesotho’s Ministry of Health (MOH) is working jointly with the Center for Disease Control (CDC) on several projects focused on improving the country’s health care system. Some of these changes include:

  •         Updating processes for disease surveillance and detection in general.
  •         Improving policies addressing public health concerns.
  •         Providing additional training for medical personnel regarding testing and samplings.
  •         Modernizing laboratory facilities to work with the newest diagnostic tools.

With support from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), the CDC and Lesotho’s MOH also made improvements with testing, diagnosing and treating, specifically for HIV and TB.

Addressing TB in Lesotho

Regarding TB, the partnership between the World Health Organization (WHO) and MOH is focusing on identifying individuals with TB in a much quicker fashion. With many of the population living in difficult-to-reach areas, local health facilities are making an effort to screen and test individuals who seek care. This cost-effective practice is helping to identify TB positive individuals sooner and get them started on medication treatment quicker. In doing so, a higher survival rate is being achieved along with decreasing the risk for spreading the disease.  

Although the burden of TB is still high in Lesotho, the country is seeing success. As of spring of 2024, approximately 77% of positive TB individuals were on medication treatment. Many of the partnered organizations are confident that Lesotho will achieve WHO’s established goals for ending TB by 2030.

Lesotho and the 90-90-90 Goals

 As for HIV/AIDS, the country met the United Nations Programme on HIV/AIDs (UNAIDS) 90-90-90 goals. These goals roughly defined are:

  • 90% of people with HIV will know their diagnosis
  • 90% of people with HIV will receive antiretroviral medication
  • 90% of people with HIV on antiretroviral medication will have their viral load suppressed

Lesotho achieved these goals impart through partnerships between the MOH, CDC and PEPFAR. The joint efforts created a survey tool called the Lesotho Population-based HIV Impact Assessments (LePHIA). The purpose of this tool was to identify how the country was managing HIV disease. Data collection involved trained surveyors making home visits to evaluate people’s risks for contracting HIV. The surveyors also provided preventive education and performed HIV testing and counseling. These same surveyors also helped to ensure HIV positive individuals were receiving medication treatment.

Although rates continue to be high, additional data finds Lesotho improving with addressing HIV disease. Data collected from a second survey (LePHIA 2020) found the rate of new HIV infections dropped more than 50%. Furthermore, the data indicates that more HIV positive individuals are being appropriately treated for maintaining viral suppression. Similar to TB, improvements with the management of HIV are leading to higher survival rates and lower disease transmission rates. 

The HPV Vaccine

To address cervical cancer, Lesotho’s MOH and the CDC jointly implemented a nation-wide vaccination program. This program focused on immunizing young girls with the HPV vaccine. The program effectively immunized 93% of young girls with the HPV vaccine. With an efficacy rate more than 98%, the program is a strong effort towards decreasing the occurrence of cervical cancer.

Looking Ahead

In a country where more than 40% of the population lives in the remote areas of the mountain and foothills, controlling diseases country-wide is crucial. Especially when access to care is challenging. With meaningful changes to the health system, the health of the population will improve and with new processes in place for TB, HIV and cervical cancer, individuals will have much healthier lives. The life expectancy rates which averaged around 48 and 54 years of age for men and women respectively in 2021, will rise. With longer life expectancies, family life will improve. Besides providing loving and nurturing environments for children, having parents living longer will also help to ensure the education and personal growth of children. These are crucial elements for a population to retain its identity and to feel of value. These changes in the health system will go far for addressing the diseases impacting Lesotho and its population.

– Kelly Chalupnik

Kelly is based in Kirkland, WA, USA and focuses on Global Health for The Borgen Project.

Photo: Flickr

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Fighting HIV in Lesotho

hiv in lesothoLesotho, a small country in southern Africa, is making notable progress in tackling HIV and addressing the poverty it creates. With an HIV prevalence rate of approximately 24.6% among adults aged 15-49, Lesotho faces one of the highest infection rates globally. This epidemic continues to impact the country’s economic and social development. Through innovative programs and global partnerships, Lesotho shows that progress is achievable and impactful.

Universal HIV Treatment: Lesotho’s Test and Start Policy

In April 2016, Lesotho became the first country in sub-Saharan Africa to implement the “Test and Start” policy, which offers antiretroviral therapy (ART) to all HIV-positive individuals regardless of their CD4 count. This approach ensures early intervention, preventing the virus from progressing and reducing transmission rates. As of 2020, approximately 273,000 adults living with HIV in Lesotho were receiving antiretroviral therapy (ART), representing about 84% of the total HIV-positive adult population. Community-based testing initiatives have also played a key role. These programs bring services to rural areas through mobile clinics and health workers, enabling more individuals to know their HIV status and connect with treatment. Such efforts are vital in addressing HIV in Lesotho.

Advancing HIV Care Through Global Partnerships

International partnerships and government initiatives have significantly contributed to Lesotho’s HIV response. For the fiscal year 2024/2025, the Government of Lesotho allocated 233 million Maloti (approximately $15 million) for antiretroviral therapy (ART) procurement, demonstrating its commitment to a sustainable HIV response.

In 2022, PEPFAR contributed $75 million to support Lesotho’s HIV/AIDS response. This funding has been crucial in providing resources for HIV testing, prevention, and treatment, helping the country make significant progress toward achieving its UNAIDS 95-95-95 targets

These combined efforts, along with support from organizations like the Global Fund, have helped Lesotho progress toward the UNAIDS 95-95-95 targets. By 2020, 94% of people living with HIV in Lesotho knew their status. Additionally, 91% were receiving treatment, and 98% of those on treatment achieved viral suppression.

Using Technology to Improve HIV Care

Lesotho’s use of technology is revolutionizing HIV care and improving treatment outcomes. Electronic medical records (EMRs), implemented across healthcare facilities, improve patient tracking and continuity of care. For instance, HIV-positive pregnant women benefit from care recorded in EMRs linked to national health systems, ensuring more efficient service delivery.

Mobile health (mHealth) interventions, such as text message reminders, have also improved treatment adherence. A study in Lesotho found that patients receiving SMS reminders for medications and appointments demonstrated a 20% increase in adherence rates.

Digital tools have further enhanced public education campaigns, raising awareness about HIV prevention and reducing stigma. Mobile platforms ensure critical information reaches even the most remote communities.

Empowering Lives Through Comprehensive Care

Lesotho’s HIV programs are not limited to medical care—they also address the economic and social impacts of the epidemic. Many ART clinics now provide additional services, including food assistance and vocational training. These initiatives ensure patients remain healthy and economically active, reducing the cycle of poverty linked to HIV in Lesotho.

By addressing broader community needs, these programs empower individuals to lead productive lives and strengthen local economies. In rural areas, access to healthcare and economic support has helped families remain stable despite the challenges of living with HIV.

A Model for Global Progress

Lesotho’s progress provides a powerful example of how innovation and partnerships can transform a nation. By prioritizing health and integrating it with poverty reduction efforts, Lesotho demonstrates what can be achieved through collective action and sustained investment.

With continued collaboration and funding, Lesotho’s success story can serve as a model for other developing nations facing similar challenges. Indeed, as the global fight against HIV continues, HIV in Lesotho stands as a testament to the power of progress in overcoming an epidemic and its broader impacts on poverty.

– Fiza Meeraj

Fiza is based in London, UK and focuses on Good News for The Borgen Project.

Photo: Unsplash

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HIV/AIDS in Syria

HIV/AIDS in SyriaHealth care in Syria has experienced significant disruption due to the ongoing civil war, which first began in March 2011. The conflict has resulted in a cumulative diminishment of the health care system to a partly-functioning institution. Medical facilities and hospitals have been targeted, with nearly 15 million people in desperate need of medical attention. 

Despite HIV prevalence remaining low in Syria and just 762 people diagnosed with HIV/AIDS in Syria between 1987 and 2011, the Middle East is one of the only regions in the world where HIV/AIDS infection is spiking. This spike can be attributed to factors such as increasing rates of poverty, labor migration and human trafficking, which can potentially manifest in an HIV/AIDS epidemic. 

Vulnerable, marginalized groups such as female sex workers and intravenous drug users are at a significantly higher risk of contracting HIV than the general population. Therefore, the response to HIV/AIDS in Syria has to focus on these groups, as their behaviors have the potential to kickstart an epidemic.

Health Care in Syria

The Syrian health care system impairs many citizens’ ability to access medical professionals and treatment. As a result of the war, approximately 70% of health care professionals have left the country. Similarly, 50% of health care facilities have been obliterated. Consequently, Syria lacks the necessary staff, facilities, treatment options, funding and capacity to manage health problems effectively. This shortfall significantly affects the handling and control of communicable diseases such as HIV.

The country’s response to HIV/AIDS remains significantly lower than global targets in terms of preventative measures, diagnosis, testing and treatment. Those living with HIV/AIDS in Syria are significantly impacted by the lack of health care, as sexual and reproductive issues are often overlooked.

The civil war has induced unrest in the form of human rights violations, financial decline and environmental crises. health care costs have skyrocketed, with medical treatments and private care becoming increasingly inaccessible to the general public. In northwest Syria, approximately 2.3 million women and girls do not have access to medical care, including reproductive and sexual health, such as treatment for HIV/AIDS.

Stigma Surrounding HIV/AIDS in Syria

The availability of treatment for sexually transmitted infections (STIs) such as HIV is the least attainable because of the stigma attached to sexual diseases. This stigma affects the likelihood of certain groups being informed about HIV and understanding how to prevent infection. HIV/AIDS in Syria is most prevalent among intravenous drug users and female sex workers. These marginalized groups often face negative identity prejudice, which can hinder their access to HIV/AIDS education and health care due to discrimination.

A study by the United Nations Development Programme (UNDP) found that adequate knowledge among female sex workers, intravenous drug users and prisoners of HIV/AIDS was below 30%. Additionally, the study showed that despite the subgroups being predominantly aware of HIV/AIDS, the participants’ overall knowledge and understanding of risk factors was insufficient. They experienced very little exposure to HIV/AIDS health campaigns. 

Tackling HIV/AIDS in Syria

To address HIV/AIDS in Syria, the Ministry of Information launched a nationwide media campaign across television, the press and radio stations. The campaign intended to raise awareness and improve knowledge about HIV/AIDS, empowering people to make better-informed decisions.

The Syrian Family Planning Association also implemented a program to improve HIV awareness among Syrians. This initiative included a peer education component designed explicitly for vulnerable groups such as young people, female sex workers and prisoners, aiming to educate them about HIV/AIDS and encourage safer choices.

These programs offer a foundational approach to HIV/AIDS education by providing valuable and potentially life-saving information that equips citizens with the knowledge to make well-informed decisions. Ultimately, this will contribute to the curbing of a war-induced HIV/AIDS epidemic.

– Ella Dorman

Ella is based in Worcestershire, UK and focuses on Global Health for The Borgen Project. 

Photo: Wikimedia Commons

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Efforts to Stop Mother-to-Child HIV Transmission in Indonesia

Mother-to-Child HIV Transmission in indonesiaIn 2023, about 570,000 people in Indonesia were living with HIV. Recognizing the urgency, the Indonesian government intensified its efforts to support individuals and prevent mother-to-child HIV transmission. Community organizations play a crucial role in this endeavor, providing care and treatment access to those in need.

The Situation in Indonesia

Since 2008, UNICEF has supported the governments of Papua and West Papua in Indonesia in establishing a Prevention of Mother-to-Child Transmission of HIV (PMTCT) program. This program emphasizes HIV prevention, diagnosis and treatment within communities. Providing antiretroviral treatment during pregnancy can significantly reduce the risk of mother-to-child transmission. Ideally, since 2009, HIV testing should be part of antenatal care for pregnant women in Indonesia. However, more than a decade later, 37% of pregnant women still do not receive HIV screening. In 2022, only 18% of mothers with HIV accessed antiretroviral therapy.

Current Action to Prevent HIV Transmission

The National Alliance to End AIDS in Children, established in 2023, unites government, international organizations and civil society to improve access to health services and mental support for women and children living with HIV. The alliance focuses on three primary priorities:

  1. Advocating for the specific needs of adolescent girls and children living with HIV.
  2. Raising awareness by disseminating information about PMTCT (Prevention of Mother-to-Child Transmission), Early Infant Diagnosis and sexual education.
  3. Empowering communities to support children living with HIV effectively.

Importance of the Community

With renewed political commitment, supporting community-based services becomes crucial to providing necessary care and support for women and children living with HIV. Mobilizing community health workers is essential not only to prevent transmission but also to assist those affected by the disease. Organizations like Lentera Anak Pelangi (LAP), operating since 2009, play a vital role in this effort. As Indonesia’s first multidisciplinary service provider focusing on children with HIV, LAP collaborates with volunteers, sponsors and partners to enhance the quality of life for those living with the disease.

Key Focuses of LAP

  • Improving the Quality of Health and Nutrition. LAP offers health and nutrition assessments, family counseling and support during child hospitalizations. The organization also educates on sanitation and hygiene. Additionally, LAP provides monthly free medical checkups, non-BPJS laboratory testing and financial support for medications.
  • Advocating for ARV treatment. Its program raises public awareness about treatment options and conditions through training, social media campaigns and mass media efforts. It also extends its outreach to schools by educating both staff and students.
  • Ensuring the psychosocial well-being of children and their families. The program teaches children life skills and includes a school that monitors their development. It offers vocational training tailored to each child’s talents and interests. Additionally, the organization facilitates peer support groups for parents.

Providing a Community

A mother describes how her daughter’s confidence has grown since joining LAP, highlighting the friendships they have both formed with others in similar situations. Another parent comments on the bonds her son has created and the benefits he has received from LAP’s educational and nutritional support. Despite the stigma in Indonesia, where 33.5% of adults believe children with HIV should not attend school with uninfected children, programs like LAP play a crucial role. They counter isolation and stigma while ensuring families receive necessary support and help prevent the disease’s spread.

– Amelia Short

Amelia is based in Bradford, UK and focuses on Global Health for The Borgen Project.

Photo: Flickr

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Mental Health in Namibia 

Mental Health In Namibia
Extreme poverty looms over Namibia, negatively affecting its population of 2.6 million and keeping living standards low. These high levels of socioeconomic hardship often cause people to overlook the country’s mental health issues, although illnesses such as anxiety, depression, Post-Traumatic Stress Disorder (PTSD), trauma, bipolar disorders and psychosis affect 25.6% of its population and the number could double by 2025. Here is information about the correlation between poverty and mental health in Namibia.

Poverty and Mental Health in Namibia

Namibia has a poverty rate of 47% and 46% of its youth workforce is unemployed, according to ISS African Futures. These factors contribute to a lack of financial resources and constant pressure to earn more, leading to high stress and anxiety levels. The Namibian reported that “approximately 70% of Namibians suffer from stress and chronic health conditions.” Additionally, people with low incomes often have limited access to mental health services, further worsening their situations.

The country suffers from a traumatic history. From 1915 to 1990, apartheid South Africa occupied Namibia, during which many of the latter’s citizens were killed and displaced. The country only gained independence in 1990, after a long, drawn-out war, which caused 20,000 to 25,000 deaths.

HIV and Psychological Issues

Furthermore, Human Immunodeficiency Virus (HIV) is quite prevalent in Namibia. According to the World Bank, the virus infects 11% of adults aged 15 to 49 years in the country.

Studies have shown that HIV has a direct link to mental health; it causes damage to brain cells and leads to a variety of neurocognitive disorders. Living with HIV also causes acute psychological distress and depression, both for the patient and their loved ones. A 2024 study found that depression affects 24.6% of HIV patients and 17% suffer from anxiety.

Approximately 9.3% of Namibians die from HIV. The burden of carrying the disease and the discrimination against it also increases the risk of suicide. From April 2020 to March 2023, 1,542 Namibians committed suicide, 82% being men. 

Cultural Influences

Another factor that further complicates mental health in Namibia is the stigma and cultural beliefs toward mental health issues. Many Namibians consider mental illness to be a sign of weakness or low willpower. Because of this, people go undiagnosed and there is less availability of treatments. A 2020 study showed that the level of public prejudice against mental health was 41% on the Community Attitudes towards Mental Illness (CAMI) scale.

The country has only two major mental institutions: Windhoek Central Hospital, which dedicates only 220 beds to mental health care, and Intermediate Hospital Oshakati, which offers 60 beds but often deals with 200 patients at once.

Solace in Drugs and Alcohol

Citizens affected by poor mental health in Namibia often cope through substance abuse. However, this can further exacerbate their condition and can result in psychosis, bipolar disorders, and depression, along with a decline in physiological health as well.

 The United Nations Office on Drugs and Crime reported that: “in 2020, the Government of Namibia confiscated 843,892 kg of cannabis, 4,930 tablets of mandrax, 2,922 grams of crystal meth, and 1,072 grams of cocaine.” Also, in 2023, WHO stated that Namibia drinks “2.38 of pure alcohol per capita amongst people aged 15 or above.”

Alleviating These Issues

Despite all these challenges, there is still a ray of hope for Namibians. Countless organizations have stepped up to advocate for mental health awareness and solutions. Established in 1980, Lifeline/Childline focuses on supporting emotional wellness and child protection in Namibia. It now has wide-reaching services all across the country and has gained international recognition from organizations such as USAID and UNICEF.

Lifeline/Childline operates a free counselling helpline that is available 24/7, providing mental health support to individuals suffering from a wide range of issues such as anxiety, depression and trauma. The organization provides counselling via telephone, text message or in person, making them accessible to a large sum of the population. From April 2024 to June 2024, its toll-free helpline answered 10,101 calls.

The non-profit also runs awareness programs that aim to reduce the stigma regarding mental health in Namibia and the importance of seeking help through social media campaigns, educational workshops, community outreach programs and its radio show.

Even though Namibia seems to be struggling in the face of these challenges, it’s important to acknowledge the fact that non-profits such as Lifeline/Childline are making a palpable difference and are changing people’s lives for the better. With more progress from the country’s numerous non-profits and government, mental illness rates in Namibia will likely decline and its citizens will be able to have bright, optimistic futures.

– Mustafa Tareen

Mustafa is based in Lahore, Punjab, Pakistan and focuses on Global Heath and Celebs for The Borgen Project.

Photo: Flickr

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HIV/AIDs in Indonesia

HIV/AIDs in Indonesia Nearly 39.9 million people are currently living with HIV/AIDs today. Human Immunodeficiency Virus (HIV) attacks cells that protect the body from infections, leading to increased vulnerability to infections and diseases within the human body. HIV can lead to Acquired Immunodeficiency Syndrome (AIDs), which often signifies a highly impaired immune system and can heavily reduce the predicted lifespan. While there is no standalone procedure for HIV, patients can receive antiretroviral therapy (ART), which is an ongoing treatment that uses viral suppression to decrease the amount of HIV in the blood. Some medicines can help prevent people from contracting HIV before a certain activity or experience (sex, drugs, etc.). However, without testing opportunities, it is nearly impossible to detect the presence of HIV, which is why having structured programs and opportunities for testing and treatment is crucial to our livelihoods

HIV/AIDs in Indonesia: Barriers

In 2023, 570,000 people were living with HIV/AIDs in Indonesia. Indonesia is the fifth most vulnerable (to HIV/AIDs) country in Asia. The main causes of HIV/AIDs transmission in Indonesia are unprotected sexual activities, unsanitary drug injection and communal needle use. The leading cause is sexual transmission, which accounts for nearly 89% of all cases. Not enough information is available among the Indonesian population, leading to an absolute lack of awareness.

Currently, the largest barrier regarding HIV/AIDs treatment in Indonesia is financial access to health care. Most Indonesians are unaware of their status (regarding the virus) and do not have access to testing or cannot afford treatment. Additionally, there is the social fear of rejection that many living with HIV/AIDs face. Having HIV/AIDs, though out of people’s control, often leads to social rejection and distancing. People may fear having ties cut between them and their family or friends, disallowing them from sharing their status and getting help.

Treatment of HIV/AIDs in Indonesia

As of February 2024, nearly 130,000 people are receiving ARP therapy in Indonesia, which is a great start, according to the 2024 Frontiers Article. With the help of UNAIDS, Indonesia is now much more intensive on HIV testing (so people living with HIV/AIDs are aware of their status and can get help) and treating those with HIV as well. Additionally, the government is attempting to put HIV or STI services into health benefits packages, so more people can access them, according to the 2024 Frontiers Article. The Indonesian Government is also taking the World Health Organization (WHO) guidelines much more seriously and attempting to implement them in more facets of the country.

According to the 2024 Frontiers Article, Indonesia is also actively trying to involve private health care providers and diversify treatment to increase its outreach.

IAC and AHF

Based in Jakarta, the Indonesian AIDs Coalition (IAC) primarily helps communities and locals. It has specifically worked on the financial aspects of treatment (increasing accessibility) and allowing for a more inclusive and accepting space for those living with HIV/AIDs in Indonesia, according to the 2024 Frontiers Article. The IAC holds the Global Fund Principal Recipient status and used the Global Fund to Fight AIDs, Tuberculosis and Malaria’s grant for HIV in Indonesia.

AIDS Healthcare Foundation (AHF) has been conducting HIV testing to help people figure out their status. It helps with treatment, specifically by offering free ARV drugs, according to the 2024 Frontiers Article. AHF has also begun focusing on “housing, food security, and pandemic response and preparedness” as well.

LAP, SWING and UNAIDS

One Child One Life program by Lentera Anak Pelangi (LAP) primarily focuses on psychological support for adolescents and children. This program specifically offers mental support along with educating younger people who have HIV/AIDs, according to the 2024 Frontiers Article. By providing an environment of people with similar circumstances, LAP can provide solidarity to children with HIV and build their confidence. The program is especially good at helping those with HIV/AIDs return to school and continue their normal lives.

Service Workers in Group Foundation (SWING) focuses on working with female sex workers. In the process, the group tries to highlight the dangers of HIV/AIDs and how to protect themselves and others from the disease,  according to the 2024 Frontiers Article. Often, sex workers are not able to access health clinics (due to working hours and schedule), though they need to check their health and stay in good condition. Considering that their job provides many opportunities for contraction of diseases (such as HIV/AIDs), getting tested is incredibly important.

Along with the US Government, UNAIDS has partnered with the Indonesian Government to partake in PEFPAR, to help Indonesia reach its HIV targets and improve treatment. One of UNAIDS’s many focuses is eradicating stigma or discrimination towards those living with HIV, and fostering a more accepting community, according to its website.

Overall, there is so much being done to increase HIV testing, improve treatment, and address and eliminate stigma around HIV in Indonesia. With these groups working together and in tandem with the Indonesian government, Indonesia is getting closer and closer to reaching its goal of HIV eradication!

– Lakshya Anand

Lakshya is based in Bellevue, Washington, USA and focuses on Global Health for The Borgen Project.

Photo: Unsplash

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EpiC in Laos: HIV/AIDS Prevention for Marginalized Communities

EpiC in LaosThe Meeting Targets and Maintaining Epidemic Control (EpiC) is an eight-year project (2019-2027) funded by the United States President’s Emergency Plan for AIDS Relief (PEPFAR) and the United States Agency for International Development (USAID). EpiC’s goal is to achieve control over the HIV/AIDS epidemic by enhancing technology and service access to key populations.

EpiC is led by FHI 360, a global organization that rallies technology, research and relations to improve global health. FHI 360 is present in more than 60 countries. Its EpiC project has been implemented in 35 countries, from Laos to Central Asia and Africa. With a budget of $4.2 million for 35 countries, including Laos, EpiC has seen success in controlling HIV/AIDS and improving the living conditions of those affected.

HIV/AIDS in Laos

Laos, located in the heart of Southeast Asia, borders Myanmar, Thailand, Vietnam and China. The country has a population of 7.5 million. The first case of HIV in Laos was recorded in 1992, involving a female sex worker who frequently traveled to Bokeo at the northern border of Laos and Thailand. Since then, Laos has maintained a low HIV prevalence, with an infection rate of 0.3%, affecting approximately 20,000 people by 2022.

The epidemic has a death toll due to the disease of less than 500. However, among the cases, 39.2% are female sex workers (FSM) and 11.5% are men who have sex with men (MSM). Approximately 11.682 cases of HIV/AIDS are on antiretroviral therapy (ART). Furthermore, 9,910 instances received a viral load test within the past 12 months.

EpiC’s Initiatives

EpiC is different from past HIV/AIDS control projects because it identifies that support for high-risk individuals is its target. High-risk populations include sex workers, pregnant women who have HIV and children whose one parent has HIV. Building on existing HIV/AIDS relief programs, EpiC improves management, accurate health information and funding.

Rolling out HIV testing and pre-exposure prophylaxis (PrEP), setting up a total market for open access to condoms and ART and decentralizing access to HIV/AIDS-related services to local and private sectors with appropriate funding health care providers to smaller regions are current EpiC’s actions. EpiC also prioritizes providing services to lessen the stigma and violence surrounding HIV/AIDS in health care and law enforcement.

EpiC’s Success

In 2022, EpiC achieved its goal of 95-95-95 in Laos. This means that 95% of people living with HIV/AIDS are aware of their health status. Additionally, 95% of those receive treatment and among individuals who receive treatment, 95% have suppressed viral infection and have no risk of passing the virus to others.

Moving Forward

With EpiC strategically set in place, the future is looking bright for HIV/AIDS patients and the health condition of developing countries, especially Laos. EpiC has made positive changes toward open access to HIV/AIDS control services to vulnerable communities through joint efforts and critical strategies.

– Jimmy Nguyen

Jimmy is based in Savannah, GA, USA and focuses on Global Health for The Borgen Project.

Photo: Flickr