HIV in West Africa
The HIV-AIDS epidemic in West Africa has always had a rather low prevalence rate in the general population, unlike the Eastern and Southern Africa’s one. As a result, the first massive response efforts focused mainly on the south of the continent.
Today, while the overall situation in the fight against AIDS is showing encouraging results in terms of screening, access to treatment and viral load monitoring, West Africa is lagging behind in achieving the targets.
A “silent” epidemic has continued, particularly among vulnerable populations, and access to testing remains the most important objective to be achieved in order to also improve therapeutic management and viral load suppression.
In West and Central Africa, 5 million people are living with HIV, representing a prevalence of 1 %. In 2019, 240,000 new infections and 140,000 deaths were recorded.
of the world population
of new infections
child deaths from HIV/AIDS-related cause
Source : Unaids Data 2021.
Populations at higher risk of infection remain vulnerable populations, due to persistent stigma and discrimination and the criminalization of certain behaviours in some countries in the subregion (in 2017, at least 11 countries in the region had laws criminalizing same-sex relationships or expression).
The 90-90-90 Strategy at global and regional level
While many strategies are needed to close the chapter on the AIDS epidemic, one thing is certain : it will be impossible to end the epidemic without providing HIV treatment to all those who need it. To achieve this, UNAIDS launched the 90-90-90 strategy in 2015. By 2020 :
- 90% of people living with HIV know their HIV status.
- 90% of all HIV-infected people tested receive sustainable antiretroviral treatment.
- 90% of people receiving antiretroviral treatment have a permanently suppressed viral load.
In 2019, in the world
38 million people are living with HIV
- People living with HIV know their status 81% 81%
- People who know their positive status have access to treatment 82% 82%
- People on treatment have an undetectable viral load 88% 88%
Source : Unaids Data 2021
In West and Central Africa
5 million people are living with HIV
- People living with HIV know their status 68% 68%
- People who know their positive status have access to treatment 85% 85%
- People on treatment have an undetectable viral load 78% 78%
Source : Unaids Data 2021
PrEP (Pre-exposure Prophylaxis)
What is PrEP ?
PrEP, or Pre-exposure Prophylaxis, is for people who do not have HIV and consists of taking a drug to avoid becoming infected. Several studies have proven the effectiveness of Prep in continuous and on-demand use : Iprex Ole (United States), Partners Prep (Kenya, Uganda), Proud (United Kingdom), ANRS-Ipergay (France, Canada). These studies were conducted mainly with men who have sex with men (MSM), but some also involved transgender people and heterosexual couples. All these tests show that when the drug is taken correctly according to the indicated regimen, the risk of contamination is minimal. On the basis of these good results, the Prep is now recommended by many national and international bodies.
Benefits of screening
Protecting yourself from HIV
Protecting your loved ones
Ending transmission to babies
Saving lives : people screened can start treatment
Knowing earlier to treat yourself earlier
Stay alive and healthy
Support : the modalities
After a positive screening, the health worker must refer the patient to a structure to enter care. However, the initiation of treatment must remain the patient’s choice.
Since the identification of HIV and the beginning of therapeutic research, many advances have been made in terms of efficacy and intake. HIV drugs belong to different classes and therefore act in different ways. Treatment with at least three molecules (triple therapy) has now become the norm for anyone newly diagnosed. Their combined actions prevent the spread of the virus, overcome possible infections and prevent the development of AIDS. Treatment taken according to strict medical prescriptions can reduce the viral load (amount of virus) sufficiently so that the HIV-positive person is no longer contaminant.
To ensure the success of the therapy, regular testing must be carried out, including viral load measurement. This is very important because it makes it possible to assess whether or not it is necessary to modify the treatment. If therapy is no longer appropriate, the patient may see the replication of the virus resume. Follow-up is therefore as important as treatment !