The number of HIV cases remains low in Egypt, around 11,000. However, since 1990, there has been a sharp increase of 268% of detected HIV cases. Egypt belongs to one of only two regions in the world with rising HIV epidemics. Although, part of the increase in Egypt can be attributed to enhanced HIV testing, current figures indicate that the MDG target of reversing the spread of HIV will not be met.
The HIV epidemic in Egypt is concentrated among most-at-risk populations, with HIV infection above 5% among injecting drug users and men who have sex with men. Current data and the many linkages between risk groups and the general population highlight the urgency to inform and sensitize Egyptians about HIV to prevent further transmission. The first cases of HIV among children living in street situations were detected in 2010, prioritizing the need to prevent an epidemic among this vulnerable population.
In Egypt, 71% of HIV transmission occurs sexually, with heterosexual transmission representing almost half of all detected cases. Transmission through injecting drug use, blood and mother-to-child transmission are all below 5%. However, transmission through renal dialysis and cases where the mode of transmission is unknown each represent 9% of detected cases.
The continuum of care has been significantly enhanced, with the provision of anonymous counselling and testing for HIV, free adult and paediatric antiretroviral therapy and support groups for people living with HIV (PLHIV). However, the specific needs of women and children require enhanced attention, particularly in the areas of medical treatment, psycho-social support and the prevention of mother-to-child transmission.
Key efforts to reach young people also require enhanced attention given that:
• Young women aged 15-24 who are knowledgeable about AIDS and received recent information on the disease decreased from 62% in 2005 to 30% in 2008.
UNICEF works in close partnership with the government, civil society and UN agencies working on HIV and AIDS in Egypt. The main priorities of the HIV Programme are to prevent HIV among young people and most-at-risk populations and to provide people infected and affected by HIV/AIDS with comprehensive medical, social and psychological care and support.
Key strategic interventions have included:
• Prevention of HIV/AIDS among 3900 young people, 1500 at-risk children residing in juvenile detention centres, 200 children living in street situations, 3200 female sex workers, and 325 peer mentors;
• Capacity building of 380 staff members working with at-risk children in governmental and civil society organizations;
• Supporting establishment of Egypt’s first PLHIV-led NGO and Egypt’s first home-based care intervention, delivering care and support for people infected and affected by HIV/AIDS, resulting in the enhanced capacity of 20 community health workers, about 100 PLHIV and 100 caretakers/family members, and 500 home visits to 60 PLHIV and their families;
• Establishing a cadre of 50 medical student peer educators, supporting capacity building of about 650 medical students, as future PLHIV caregivers;
• Supporting the national HIV response, particularly through procurement of paediatric and adult antiretroviral therapy and other supplies to support testing and counselling facilities;
• Communication and social mobilization to combat stigma and discrimination, through airing of radio spots, internet and campaigns targeting young people, celebrities and the media.
Programme Expected Results
UNICEF will emphasize supporting HIV prevention among young people and most at-risk populations, particularly children living in street situations and young girls vulnerable to sexual exploitation. Interventions will be mainstreamed into approaches supporting child protection and adolescent development. An initiative providing interactive support group sessions and psycho-social interventions will be specifically tailored to children and women infected and affected by HIV/AIDS. This initiative will also work to enhance the prevention of mother-to-child transmission of HIV. New data will be generated for evidence-based programming and advocacy, including implementation of the “People Living with HIV Stigma Index” and an assessment of women’s vulnerability to HIV.
Specific expected results are as follows:
• Enhanced approaches and mechanisms to equip children living in street situations with knowledge and skills to protect themselves from HIV.
• Capacity building of social workers and psychologists to provide comprehensive HIV prevention, care and support to most at-risk young people.
• Outreach interventions to inform and sensitize most-at-risk and vulnerable young girls on HIV/AIDS.
• Tools developed to support HIV awareness and capacity building of relevant stakeholders.
• New data generated to support evidence-based programming and advocacy for the rights of people infected and affected by HIV/AIDS.
• Care and support systems in place to assist children infected and affected with HIV/AIDS and their families to live healthy lives.
• Targeted approaches to support women living with HIV and enhance prevention of mother-to-child transmission of HIV.
• Antiretroviral medications procured to support all adults and children currently receiving treatment for HIV.
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