In the Seychelles the first HIV infection was diagnosed in 1987 and the first AIDS case reported in 1992. Effective prevention strategies exist, but the number of people infected with HIV continues to rise.
Epidemic Trends
National estimates of HIV prevalence in the Seychelles are based on data from blood donors and pregnant women attending health centres for regular antenatal examination. Surveillance data show an increase of HIV in all sentinel groups. The highest rates were found among patients attending the CDCU and the lowest among blood donors. There is a concern that hidden epidemics might be occurring in sub-population groups such as men who have sex with men, drug users, alcoholics and commercial sex workers who often do not visit health care services and rarely test for HIV.
The epidemic in the Seychelles is dynamic and reflects rapidly changing patterns of risk behaviours. The most important mode of HIV transmission among the population in Seychelles remains heterosexual with 70%. However, in the early stages of the epidemic, men who have sex with men constituted less than 5% of all HIV-infected people.
National response
Prevention and care are the two most important and complementary components of the program of the Seychelles in the fight against HIV.
Information, education and communication
From the early stages information, education and communication was emphasised. Initiatives aim to educate the public about the disease in the media, in schools and in the work place. Nowadays, young people are targeted. HIV education is incorporated into school curricula and teachers receive special training.
Blood transfusion
No case of HIV transmission through blood transmission was recorded. The Seychelles remain vigilant by screening all donor blood prior to transfusion. However, there is a 1.4 fold increase in the HIV rate among blood donors in the last three years.
Prevention of mother to child transmission
HIV testing is now routinely offered to all women attending antenatal services. 15 HIV-positive pregnant women received PMTCT services such as antiretroviral therapy and breast milk substitutes.
Antiretroviral therapy
Since 2002 antiretroviral therapy is available to those who need it free of charge. At present more than 50 patients benefit from his treatment. The challenge is to ensure that the programme is sustained and to encourage people to come forward for testing.
Key Challenges
Perception of the AIDS crisis
In the Seychelles the perception prevails that the AIDS crisis constitutes a medical problem which is solely the responsibility of the Ministry of Health (MoH). Much is being done to stimulate a multi-sectoral approach.
Capacity
Within the MoH too few people are directly involved in the HIV prevention and control programme. Often the same few people have to do prevention treatment and international cooperation.
Research
There is a lack of research, especially behavioural surveys which we need to help us better target interventions and will also help with advocacy.
Young people and HIV
Increasingly young people are infected and this group will be targeted for more extensive prevention campaigns.
Illicit drug use
Heroin and cocaine use hitherto unheard of in the country have recently been introduced and already there is evidence that a lot of young people are using these illicit drugs.
At risk groups
It is difficult to target some at-risk-groups like men who have sex with men because of legislation, cultural beliefs and stigma.
Implementation of Three Ones: Achievements and Challenges
The Seychelles' response to the pandemic dates back to 1987 when the first HIV infection was detected. This has included a short term plan 1987-1988, a medium term plan 1989-1993, thereafter ongoing annual plans, and a strategic plan for HIV/AIDS/STIs in 2001.
The Seychelles Government has expressed its commitment by creating the national AIDS program, adopting a National Policy endorsed by the President, creating the National AIDS Council and National AIDS Trust Fund. Until recently, the country's president had chaired the NAC.
Current programmes aim at the primary prevention of HIV infection and provision of care and support. These encompass sensitization and education through IEC activities, PMTCT, VCT, surveillance, blood screening and safety, accessibility to post exposure prophylaxis, provision of ARVs, treatment of opportunistic infections and support for PLWHA. |
