Translating Science to End HIV in Latin America and the Caribbean

Transcription

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2 Translating Science to End HIV in Latin America and the Caribbean Mexico City, Mexico, 17 th - 18 th and 21 st April

3 IAS 2017 post-conference workshop, 17 April 2018 Challenges for PrEP and PEP Implementation HIV In The Caribbean Dr. Kevin Harvey MBBS, MPH, MSc. DrPH. Caribbean Regional Director- AIDS Healthcare Foundation

4 Adult HIV Prevalence by region 2017 Source: UNAIDS Estimates, 2017

5 Comparing Latin America and the Caribbean 2016 Latin Amer Caribbean Prevalence (% ) PLHIV (#) 1,800, ,000 Know Status (%) ARV (%) New Infections (#) 97,000 18,000 Incidence/ 1000 pop UNAIDS 2017

6 People living with HIV in the Caribbean, 2016

7 No. of Persons in Caribbean: Living with HIV, Newly Infected, % on Treatment & Deaths Year % No. of PLHIV New HIV infections % of PLHIV on ART No. of deaths Haiti , % 4600 Dom Rep , % 2200 Jamaica , % 1300 Cuba , % 200 T & T , % 500 Bahamas 3.3 8, % 390 Caribbean ,000 18,000 52% 9,400 UNAIDS 2017

8 The annual number of new infections in the Caribbean has remained static for the last six years New HIV infections among adults >15, global, New HIV infections among children, global, Source: UNAIDS 2016 estimates.

9 New infections increased in some countries, decreased in others Percent change in new HIV infections, by country, Caribbean, Source: UNAIDS 2017 Estimates

10 New infections increased among men, decreased among women Distribution of estimated new HIV infections among adults, Caribbean, by sex and year, Source: UNAIDS Estimates, 2017

11 There were fewer than 1000 new infections among children in 2016 Number of new HIV infections, children (0 14), Caribbean, Source: UNAIDS 2017 Estimates

12 HIV prevalence among MSM in the Caribbean Trinidad and Tobago/2015 Saint Vincent and the Saint Kitts and Nevis/2011 Jamaica/2013 Haiti/2015 Guyana/2014 Dominican Republic/2012 Dominica/2011 Cuba/2015 Barbados/2014 Bahamas (the)/2011 Antigua and Barbuda/ Source: WHO/UNAIDS. GARPR

13 HIV prevalence among Caribbean FCSWs, % 9.00% 8.00% 7.00% 8.70% FCSW HIV prevalence 6.00% 5.50% 5.00% 4.00% 4.60% 3.90% 3.70% 3.00% 2.60% 2.00% 1.00% 0.00% Haiti, 2014 Guyana, 2014 Jamaica, 2011 Suriname, 2012 Dominican Republic, 2012 Antigua & Barbuda, % Cuba, 2015 Source, GARPR,

14 Nearly two-thirds of people living with HIV in the Caribbean knew their status in 2016

15 Testing among Caribbean MSM, % MSM testing coverage 100% 99% 97% 95% 80% 70% 69% 60% 55% 51% 46% 40% 38% 36% 32% 20% 24% 19% 0% Antigua & Barbuda, 2012 Suriname, 2011 St. Kitts & Nevis, 2011 Haiti, 2015 Jamaica, 2011 Bahamas, 2011 Trinidad & Tobago, 2015 Barbados, 2014 Guyana, 2014 Dominica, 2011 St. Vincent & Grenadines, 2011 Cuba, 2015 Dominican Republic, 2012 Source, GARPR,

16 Testing among Caribbean FCSWs, FCSW testing coverage 120% 100% 99% 95% 85% 80% 67% 65% 63% 60% 40% 39% 20% 0% Antigua and Barbuda, 2011 Suriname, 2014 Dominican Republic, 2011 Jamaica, 2015 Haiti, 2012 Guyana, 2014 Cuba, 2011 Source, GARPR,

17 More than half of all Caribbean PLHIV on treatment in % % of all PLHIV on ART in % 60% 50% 70% 62% 58% 55% 50% 48% 46% Regional estimate (52%) 40% 30% 38% 35% 32% 28% 20% 21% 10% 0% Cuba Trinidad & Tobago Guyana Haiti St. Vincent & Grenadines Suriname Dominican Republic Antigua and Bermuda Jamaica Belize Bahamas Dominica

18 Four of five diagnosed Caribbean PLHIV were on treatment in 2016?

19 Two-thirds of Caribbean PLHIV on treatment virally suppressed in 2016

20 One-third of all Caribbean PLHIV virally suppressed in 2016 % of all PLHIV virally suppressed in % 45% 40% 35% 47% 46% 41% 38% 36% 34% Regional estimate (34%) 30% 28% 25% 20% 23% 22% 21% 18% 17% 15% 10% 5% 0% Guyana Trinidad & Tobago Cuba Haiti Suriname Barbados Dominican Republic Antigua and Barbuda Belize Jamaica Bahamas Dominica Source: UNAIDS 2017 Global AIDS Update

21 AIDS-related deaths declined by 55% since 2000 Antiretroviral therapy coverage and number of AIDS-related deaths in the Caribbean, 2000 to 2016 Source: UNAIDS Estimates, 2017

22 Are we meeting the 2020 targets? Caribbean HIV Testing and Treatment Cascade, 2016 Source: UNAIDS 2017 Global AIDS Update

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24 Test & Treat AHF Census Audits /CHARES-UHWI-Kingston- 30% of clients inactive Partnership to end gender based violence

25 AHF- Haiti working in 13 prisons Actual - Contact tracing in all 13 prison 3 mobile units

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28 Summary 1. Continuing decline of AIDS related deaths. 2. We are on track in preventing MTCT 3. Improving testing coverage for KPs- MSM and FCSW 4. New infections are not declining. 5. Increase in new infections among men and young people. 6. Many countries are not practicing test and treat. 7. Treatment coverage is low 8. Many who have started treatment (maybe 30%) are not adhering/loss to follow up 9. Viral suppression rates are inadequate to break the chain of transmission 10.More needs to be done to reach and test young people

29 Acknowledgements AIDS Healthcare Foundation Dr. Patricia Campos Mr. Michael Kahane PANCAP Dr. Shanti Singh Mr. Dereck Springer UNAIDS Thank You.