By: Necus M. Andrews
Liberia: In commemoration of the 2021 World AIDS Day, the National AIDS Commission of Liberia (NAC) has warned that the country and its citizens are at risk to HIV infection and other co-infection diseases once stigma and discrimination still exist.
The Commission said if Liberia must be on par in ending AIDS by 2030, the country must first end HIV-related Stigma and discrimination against people living with HIV and key populations that are directly exposed to HIV infection.
In 2010, the National AIDS Commission of Liberia (NAC) was by an act of legislation established to play an oversight coordinating role by mobilizing partners to address HIV related issues affecting the population void of stigma and discrimination, and ensuring an improved access to care, treatment and respect for human rights in case of violence against people based on real or perceived sexual orientation of HIV status.
Speaking at programs marking the official commemoration of World AIDS Day on December 1, 20201, Madam Theodosia S. Kolee, Chairperson of the National AIDS Commission of Liberia (NAC) wants the outcome of the 2018 Integrated Bio-Behavioral Surveillance Survey (IBBSS) which revealed increased HIV prevalence among key populations to be a compelling call for stakeholders and policymakers to double their efforts and say no to stigma and discrimination.
Madam Kolee told the gathering that the IBBSS report indicates that Liberia must join achieving countries in 2030, a positive mindset must be developed by Liberians by discouraging stigma and discrimination, and embracing diversity and tolerance in the provision of healthcare services to all, regardless of their health status and sexual orientation.
“We need the support of our policymakers (legislators) and state actors in a positive way by ensuring that no new HIV-related discriminatory laws, regulations and policies should be passed, existing HIV-related discriminatory laws, regulations and policies are repealed, and 90% of Persons living with HIV and members of the key population have access to justice and can challenge their rights violations and they can get equal protection under the law, Madam Kolee said”
According to her “eliminating stigma and discrimination which is mostly directed at Persons living with HIV, Key Populations and marginalized groups will need deliberate and practical actions if the risk we are faced with must be reduced. We need to reduce incidences of violence including sexual and Gender Based Violence, madam Kolee said”.
Addressing various stakeholders in the national HIV response who have gathered for the World AIDS Day, said there was no time better than now for this year’s global Theme: “End Inequalities. End AIDS. End Pandemics” and national Theme: “Equal Opportunity for all…let’s end AIDS in Liberia”, because collective efforts are required to defeat HIV-related stigma and discrimination in all sectors of the country.
Madam Kolee: “The situations that persist such as the IBBSS and stigma index reports should be seen as wake-up call for us to do things differently and better in many aspects. This is so because we cannot make progress in ending AIDS by 2030, if the populations that have high HIV prevalence are left out due to societal stigma and discrimination”.
Liberia has a generalized HIV epidemic with reproductive aged population showing HIV prevalence of 2.1%, according to the 2013 LDHS, even though UNAIDS 2021 Spectrum Estimates show 1.1%, with an estimated HIV population of 35,000 . Significant variations in HIV prevalence exist between and within regions and counties. HIV prevalence is higher in urban (2.6%) than in rural (0.8%) areas.
The South-Central Region has the highest prevalence of 2.8% among the five regions and Montserrado, Margibi, and Grand Bassa counties have the highest HIV prevalence among the 15 counties and together account for about 70% of the burden of disease in the country.
In 2018, an Integrated Bio-Behavioural Surveillance Survey (IBBSS) found high HIV prevalence among predominately male key population sub-groups: 37.9% in Men who have sex with Men (MSM); 9.6% in People Who Inject Drugs (PWIDs), a predominantly male behaviour; and 14.4% in transport workers (long distance bus and truck drivers), a heavily male dominated workforce.
The prevalence among female sex worker was 16.7%. The recent 2018 IBBSS has provides critical information to inform programmes for key populations and when compared to the data in the IBBSS 2013 there seems to be an unprecedented rise in levels of HIV infection in MSM, Uniformed Services Personnel, People Who Inject Drugs, Female Sex Workers and Transport Workers.
The only group in which the HIV infection rate seems to have dropped is that of the mine workers. Except for miners, the HIV prevalence in all key populations has risen by a minimum of 70% for FSW and a maximum increase of 252% for Uniformed Service Personnel and 270% for PWID. The HIV prevalence for MSM and transport workers has doubled from their values in 2013.
The 2017 Size Estimates study showed that key population groups have grown in size with MSM now at 74,634, FSW now at 163,031, PWID now at 4,088, Miners now at 9,016, LDTD (long distance bus and truck drivers) now at 3,450 and Prisoners at 2,390. HIV prevalence is also higher in urban than in rural areas, in females as compared to males, and in key populations (MSM, FSW, PWID, long distance drivers, females).