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Since 1988, World AIDS Day has been commemorated annually on December 1. The Ministry of Health is also commemorating this day this year. In recent years, the most frequently asked question to Public Health around December 1 was: ‘And… how is the HIV data in Suriname?’ This thirty-third WAD 2021, Public Health asks you back the question: How is your HIV status? Do you know that one? HIV is not a far-from-our-bed show. In 2018 and 2019, there were 597 to 598 newly diagnosed people (male-female distribution almost 50-50) in Suriname.
In 2020 – probably as a side effect of the Covid-19 pandemic restrictions – there were 414 and, unlike before, slightly more women than men. In Suriname there are an estimated 5200 people living with HIV. They come from all layers of our society. 40 out of every 100 people living with HIV in Suriname do not yet know that they are infected. In the Caribbean this number is on average 20 per 100. Across the world, this gap of people who do not yet know their HIV status is on average 16 per 100. Therefore the encouragement: ‘ Sab i Libi, Tek a Test!’
HIV testing in Suriname
In Suriname you can get tested for HIV for free. This is possible at the Dermatological Service, the Malaria TropClinic on Geyersvlijt, the RGD test sites of Flora, Latour, Lelydorp, La Vigilantia and Wonoredjo. At St. Lobi this is possible for a fee. Anyone over the age of 16 can visit these test sites. At these counseling and HIV testing sites, the HIV result is known within an hour. Furthermore, one can request such a lab test through the general practitioner, with which one can go to each of the laboratories for an HIV test. This test is reimbursed by health insurance.
HIV treatment works
Although the group of people who know their status in Suriname is only 60%, we do see that of every 100 people with HIV who have registered for treatment, 83 are successfully started on antiretroviral medication (HIV inhibitors). We also see that in 87 of every 100 people who have been treated with HIV inhibitors, the viral load can be reached below the detection limit (ODG), or ODG is reached with faithful daily intake of HIV inhibitors. People with HIV who are ODG prevent them from dying prematurely from HIV complications and can therefore live and work for many years. There are several people in Suriname who have been treated successfully for more than 15 years now. Unfortunately, we also see that 1 in 4 people who start with inhibitors do not keep up well after the first year. The moment a person no longer takes his inhibitors every day according to schedule, the virus will become detectable again, thus being harmful to the carrier again and also more easily transferable to others during sex without a condom.
Covid-19 and HIV
In 2020, the HIV program was able to establish that significant numbers of people living with HIV were more likely to stay away from their doctor’s appointments and whether they had picked up their medication from the pharmacy late or not at all. The program has now been launched to find out where the ‘missing’ are now in order to get them back into care where possible. People living with HIV may be more vulnerable to the effects of COVID-19 infection. The best way to protect themselves against COVID-19 is to remain well-adjusted to their medication, to be vaccinated against COVID-19 and to observe the MoHanA measures. A booster vaccination shot is highly recommended to maintain immunity against COVID-19.
Elimination of AIDS as a health problem by 2030
Under the United Nations’ third Sustainable Development Goal (SDG 3) ‘Good health and well-being’ with regard to HIV, the aim is to end the AIDS epidemic no later than the year 2030.
HIV/AIDS is still a health care problem in the world in 2021
Worldwide, there are more than 37 million people living with HIV, of which 10 million are not yet on medication. In 2020, there were still 1.5 million new infections and 680,000 people who died from the effects of AIDS. Persons who are not aware of an HIV-positive status will not come for help and treatment until a late phase of the disease, the phase of AIDS. Taboo, stigma and discrimination surrounding HIV mean that people do not report for HIV treatment and/or interrupt their HIV treatment. Within societies there are groups that, because of their sexual orientation, gender or undocumented status, are at greater risk of being marginalized and therefore have less access to the available health care. On top of that, the COVID-19 pandemic that has now lasted for 20 months is putting pressure on access to HIV prevention, care and treatment.
Thema WAD 2021
The theme of the WAD 2021 is: End inequalities. End AIDS/End unequal access to care and treatment. End AIDS. The slogan ‘No one is safe until everyone is safe’ also applies to the HIV epidemic. This is a strategic principle for the fight against HIV/AIDS in the next 5 years and was confirmed by the world, including Suriname, during an HIV summit of the United Nations in June earlier this year. Over the past twenty years, Suriname has created certain provisions for HIV prevention, care and treatment to keep these services available to all groups in society. The current financial constraints within the government household pose a challenge to always finance government-funded facilities (condoms for key groups, HIV testing options, HIV inhibitors) in a timely manner. For the future, however, universal access to health care remains a guiding principle to be able to achieve the end of AIDS as a health care problem in Suriname before the year 2030.
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