UN Integrated Regional Information System - November 6, 2008

"The epidemic is still increasing more rapidly than the response," said the report by the Independent Review Group (IRG) on HIV/AIDS, a panel of experts established in 2007. The IRG conducts two assessment missions yearly on the planning and implementation of the National Strategic Plan on HIV and AIDS, and the report covers an assessment undertaken from 27 August to 9 September.

Stressing its concern over the infection level in rural areas, where there are too few clinics to cope with even routine diseases, the IRG commented:

"Provincial responses hinge on an ability to understand the local epidemic, design and implement programmes, and monitor effectiveness. Little has been done to help stakeholders in provinces and districts develop the skills to do so."

In 2007, UNAIDS estimated that 59,537 people, including 1,057 children, in PNG's population of 5.1 million were HIV-positive, with an urban rate of 1.38 percent and a rural rate of 1.65 percent.

According to World Health Organisation (WHO) officials, the Pacific Ocean country has 49 antiretroviral (ARV) therapy sites and almost 400 healthcare workers trained in HIV management, with 4,500 patients on treatment.

Awareness issues

The Heduru HIV/AIDS clinic at the General Hospital in Port Moresby, the capital, is treating 1,665 patients, of whom about 1,000 are receiving ARVs. Opina Ragagalo, who runs the clinic, said each week between seven and 10 new cases arrived at the clinic for treatment, of which counselling and awareness-raising formed an important part.

An IRIN/PlusNews reporter met April Natara by chance as she arrived at the clinic for the first time to pick up ARVs for her 14-year-old daughter. "She couldn't come [to the clinic] today because she is so thin and feeling so weak," Natara said.

"I am sad and distraught ... She is my only child and I don't know how she got this disease. I know my daughter is going to die, and I'm told I cannot give birth again ... Please can you find me a doctor who can make it possible for me to have another child?" Natara was not aware of ARVs or the benefits of counselling offered by the clinic, NGOs and faith-based groups.

However, another patient, Carla (not her real name), who has been on the medication since January 2007, praised clinics such as Herudu both for their treatment plan and awareness-raising. Carla became HIV-positive from her husband, who died in July 2007. "I was so angry with him, but we eventually made up," she said.

"I feel the drugs are successful. I've gained weight and I've even joined a basketball team, I feel so good. It is because of this clinic that I am now alive."

Socio-economic factors

"Most patients are unemployed," Tau Naunaan, an HIV/AIDS medical officer at Herudu clinic, told IRIN/PlusNews. "This directly affects their nutritional status. Many are unable to pay the transport to get to the clinic and don't have family support. This leads to poor compliance, with patients not showing up on time for their tests and their drugs."

While Carla has not come out publicly with her status, mainly because her husband was a prominent figure in Port Moresby, she is close to doing so. "I've been doing some work with several NGOs that provide awareness training and support for people who are HIV-positive," she said.

"There is still not enough awareness, people are not educated enough about HIV and condom use, and I believe those of us who are HIV-positive have a role to play ... I want to come out and tell everyone to be faithful to one partner."

One of the key suggestions in the IRG report was the need to more fully involve HIV-positive people in counselling, assisting with home care and increasing awareness in all aspects of prevention, as they are best placed to talk about effective treatments.

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