Demographic and Health Survey 2009-10 - Timor-Leste Ministry of ...
Demographic and Health Survey 2009-10 - Timor-Leste Ministry of ...
Demographic and Health Survey 2009-10 - Timor-Leste Ministry of ...
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HIV/AIDS-RELATED KNOWLEDGE, ATTITUDES,<br />
AND BEHAVIOR 14<br />
Acquired Immune Deficiency Syndrome (AIDS) was first recognized internationally in 1981.<br />
According to the Joint United Nations Program on AIDS (UNAIDS), the number <strong>of</strong> people living<br />
with the human immunodeficiency virus (HIV) continued to grow, <strong>and</strong> it is estimated that in 2008<br />
33.4 million people worldwide were living with HIV, with a threefold increase in prevalence since<br />
1990 (UNAIDS <strong>and</strong> WHO, <strong>2009</strong>). <strong>Timor</strong>-<strong>Leste</strong> was free <strong>of</strong> HIV during most <strong>of</strong> the time when the<br />
developed countries were compiling measures to fight the epidemic. However, as contact with the<br />
outside world increases, cases <strong>of</strong> HIV have been on the rise, although no information to date is<br />
available on the prevalence for the country as a whole. According to the <strong>Ministry</strong> <strong>of</strong> <strong>Health</strong> the first<br />
reported case <strong>of</strong> HIV in <strong>Timor</strong>-<strong>Leste</strong> was in 2003. Between then <strong>and</strong> December <strong>2009</strong>, there have been<br />
151 cases <strong>of</strong> HIV reported in the country (DRTL, 20<strong>10</strong>). Forty-eight percent <strong>of</strong> HIV-positive cases in<br />
the past 12 months were reported among men <strong>and</strong> 52 percent among women (DRTL, 20<strong>10</strong>). In<br />
addition, 8 percent <strong>of</strong> HIV-positive cases were among children under age 5.<br />
Epidemiological studies have identified sexual intercourse, intravenous injections, blood<br />
transfusions, <strong>and</strong> fetal transmission from infected mothers as the main routes <strong>of</strong> transmission <strong>of</strong> HIV.<br />
Integrated bio-behavioral surveys (IBBS) conducted on a regular basis since <strong>2009</strong> among the most atrisk<br />
populations, such as female sex workers (FSWs), injecting drug users (IDUs), men having sex<br />
with men (MSM), the Policia Nacional de <strong>Timor</strong>-<strong>Leste</strong> (PNTL), Falintil-Forças de Defesa de <strong>Timor</strong>-<br />
<strong>Leste</strong> (F-FDTL) <strong>and</strong> clients <strong>of</strong> FSWs, in selected geographical areas <strong>of</strong> <strong>Timor</strong>-<strong>Leste</strong>, indicate a lowlevel<br />
epidemic concentrated in high-risk groups (DRTL, 20<strong>10</strong>).<br />
To address the challenges posed by HIV, the government <strong>of</strong> <strong>Timor</strong>-<strong>Leste</strong> has identified clear<br />
strategic directions under its National HIV/AIDS/STI Strategic Plan for 2006-20<strong>10</strong> (MOH, 2006).<br />
The National HIV/AIDS/STI Strategic Plan outlines the following principles:<br />
• A strategy based on respect for human rights<br />
• A strategy that is participatory <strong>and</strong> multi-sectoral<br />
• A strategy that is built on partnership <strong>and</strong> that draws upon the strengths <strong>of</strong> government,<br />
nongovernment, private-sector, <strong>and</strong> faith-based organizations <strong>and</strong> that includes the<br />
involvement <strong>of</strong> HIV-positive people<br />
• A strategy that is evidence-driven but encourages creativity<br />
• A strategy that is consistent with the principles underlying the development <strong>of</strong> <strong>Timor</strong>-<br />
<strong>Leste</strong><br />
• A strategy that is multifaceted, drawing on the underlying tenets <strong>of</strong> health promotion<br />
The health service delivery is outlined in the Basic Package <strong>of</strong> Services Policy, which is<br />
particularly relevant to HIV/AIDS <strong>and</strong> STI strategies as it provides a context for planning capacity<br />
development actions to address service delivery needs <strong>and</strong> to identify linkages in service delivery<br />
across different policy areas (MOH, 2004d).<br />
Currently, the National HIV/AIDS Program is in the process <strong>of</strong> revising the strategic plan for<br />
the 2011-2016 five-year period. The activities <strong>of</strong> the National HIV/AIDS Program include screening<br />
blood samples; producing strategic information; implementing a comprehensive monitoring <strong>and</strong><br />
evaluation system, which includes a surveillance plan; generating information, education, <strong>and</strong><br />
communication (IEC) materials; promoting condoms; <strong>of</strong>fering voluntary counseling <strong>and</strong> testing<br />
(VCT) for screening <strong>and</strong> treatment <strong>of</strong> sexually transmitted infections (STIs); providing antiretroviral<br />
HIV/AIDS-Related Knowledge, Attitudes, <strong>and</strong> Behavior | 181