HIV and AIDS situation in Mongolia
Mongolia is in the early stage of HIV epidemic with 28 reported cases of HIV infection (Health Statistics, February 2007). While this number may look small compared to number of HIV infected people globally, the number of infections appears to be increasing rapidly in the country. The fact that only five HIV and AIDS cases were registered during 1992-2005 and 20 people were diagnosed as HIV positive during 2005-2006 suggests that an environment which is favorable for the rapid spread of HIV infection has already been created in the country and many indications point that Mongolia is on the brink of HIV epidemic with an imminent risk to the widespread dissemination of HIV to the general population mainly through sexual transmission. The main indicators of vulnerability include:
1. Increasing STI rate: The National Health Indicators for 2006 showed that increased number of reported cases of STIs (gonorrhea, syphilis and trichomoniasis) in Mongolia compared to the previous years and now it accounts for 47.3% of all communicable diseases.
2. Low knowledge: 2005 Multi-Indicators Cluster Survey (MICS) reveals that only around 40% had comprehensive knowledge of HIV and AIDS defined as women who could identify both the two main means of prevention as well as the three most common misconceptions.
3. Increasing high risk behavior: According to the 2005 Second Generation Sentinel surveillance data, more than half (51.3%) of mobile men (mobile traders, long distance drivers) had sex with casual partners.
Number of sex workers is increasing and a recent rapid assessment reveals that the number of sex workers might be as high as 18,900.
4. Low condom use: Condom use rates among the general population and vulnerable groups are very low. The data from the Second Generation Sentinel surveillance (2005) indicate that less than half (49.5%) of male STI clients had used condoms at last sex with SWs, and only 28.6% of them reported consistently using condoms with SWs in the last 12 months.
Country Response to HIV/AIDS
Control of STIs and preventing HIV epidemic has been a priority for the Government for many years and commitment has been shown in many ways. The Law on Prevention of HIV and AIDS amended in 2004 refined a formal structure for combating an HIV and AIDS epidemic and identified the rights and duties of people affected by HIV or AIDS so as to be consistent with international conventions and standards. In 2006, the Government of Mongolia has undertaken several measures to adopt the “Three Ones” Principle. First of all, the National Committee on AIDS Prevention was re-established under supervision of the Deputy Prime Minister. The decision to develop a new HIV and AIDS strategy in Mongolia was the result of a growing understanding of the significant vulnerabilities and risks which could potentially expose Mongolian children and adolescents to HIV and AIDS. Therefore, the National Strategy on HIV and AIDS Prevention (2006-2010) was developed in consultation and collaboration with various sectors. In addition to that, national monitoring and evaluation indicators were developed and agreed to by all stakeholders. In October 2006, Mongolia hosted the first “Low to Zero: First Asia-Pacific Conference on Universal Access to HIV Prevention, Treatment, Care and Support in Low Prevalence Countries” putting HIV high on the political agenda, with a set of agreed recommendations as stated in the `Ulaanbaatar 2006 Call for Action`.
In the new Country Programme cycle (2007-2011), UNICEF in collaboration with the Government of Mongolia is implementing HIV and AIDS programme which supports the National Strategy and the National sub-programme on HIV and AIDS. The programme consists of 2 projects; the first, Voluntary Confidential Counseling and Testing (VCCT) and prevention of mother to child transmission (PMTCT) project will address high risk populations through the use of existing health structures at national and sub-national levels. The project supports national policy on PMTCT and pediatric care and will develop capacity of pediatricians, health care providers and equip health care centers at national and sub-national levels to effectively respond to pediatric HIV and AIDS. It will provide quality counseling and testing along with outreach interventions among high risk groups. The second project, Life Skills Based Education project will provide training of in-service teachers, development of training modules and student textbooks on HIV and AIDS prevention. It will also provide technical assistance in the revision of the curriculum and advocate for increased number of classrooms hours devoted to HIV and AIDS prevention. The programme will also provide technical support to mainstream HIV and AIDS within the country programme and support participation of children and young people in improving their knowledge, awareness and safe behaviour practices for prevention of HIV and AIDS and in the design of activities and project monitoring and evaluation.