HIV/AIDS in Angola
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Prevalence
Angola is at a critical point in its fight against the HIV/AIDS epidemic. While the Joint United Nations Programme on HIV/AIDS (UNAIDS) estimated adult prevalence at the end of 2003 at 3.9%, recent statistics from the Angolan Ministry of Health and the National AIDS Control Program demonstrate a prevalence of 2.8% among pregnant women seeking prenatal care. While the low rate is heartening news, a number of factors in place argue that the prevalence could soon mimic the rapid upward trajectory experienced in other African countries.[1]
Angola’s 27-year civil war (1975-2002), deterred the spread of HIV by making large portions of the country inaccessible. Angola was thus cut off from most contact with neighboring countries that had higher HIV infection rates. With the end of the war, however, transportation routes and communication are reopening, therefore enabling a greater potential for the spread of HIV/AIDS. Indeed, current statistics indicate that the border provinces, especially certain areas bordering Namibia and the Democratic Republic of the Congo, currently have higher prevalence than the rest of the country.[1]
Nearly 70% of the population in Angola is under the age of 24. A 2003 knowledge, attitudes, and practices (KAP) survey conducted among people aged 14 to 24 showed 43% of young people had had sex by the age of 15, one of the highest rates in the world. The respondents identified as barriers to HIV prevention limited availability and use of condoms, and limited access to health care. They also reported a high incidence of sexually transmitted infections, all conditions that leave the country ripe for a spike in HIV.[1]
HIV is transmitted primarily through multi-partner heterosexual sex, with a male-to-female ratio of 0.8:1, indicating that women are more likely to be infected than men. Contaminated needles, medical devices, and blood transfusions are the second largest spreader of HIV/AIDS, although more specific research in this area is needed. Mother-to-child transmission currently accounts for approximately 15% of HIV cases.[citation needed]
National response
Angola faces extreme economic, social, and political problems. An estimated 68% of the population lives in poverty and 26% in extreme poverty. Nevertheless, the government is committed to confronting the HIV/AIDS epidemic and is working vigilantly with international donors, churches, foundations, and nongovernmental organizations to deliver HIV/AIDS-prevention and mitigation services to the public.[1]
Angola’s National AIDS Control Program [Programa Nacional de Luta contra o Sida (PNLS)] was established as part of the Ministry of Health in 1987 to serve as the national coordinating body in the fight against HIV/AIDS. With the exception of employee salaries, the PNLS’ work has been financed almost entirely through external donations.[1]
The National AIDS Commission was established in 2002 to bring stronger, high-level government attention to the epidemic, and an HIV/AIDS strategy for the 2003–2008 period is being carried out. The strategy calls for special attention to a wide variety of vulnerable populations: sex workers, truck drivers, mine workers, military personnel, youth, street children, pregnant women, dislocated people, refugees and resettled populations, prisoners, injecting drug users, blood transfusion recipients, traditional healers, traditional birth attendants, health workers, and children living with or affected by HIV/AIDS.[1]
In June 2004, the Angolan National Assembly passed a comprehensive HIV/AIDS law with the purpose of “protecting and promoting full health through the adoption of measures needed to prevent, control, treat and investigate HIV/AIDS.”3 Specifically, the law is designed to protect the rights of those living with HIV/AIDS, including the right to employment, free public health care, and confidentiality in the health care system.[1]
Angola has developed national guidelines for providing integrated care to people living with HIV/AIDS; however, the mechanisms for distributing antiretroviral drugs need to be implemented outside of Luanda. Approximately 2,750 people are currently on antiretroviral therapy, but approximately 30,000 people are in need of the drugs.[1]
Thus far, the low HIV prevalence in Angola has not had a severe impact on Angola’s economic productivity; however, if the spread of HIV continues, it is likely that the epidemic will be particularly devastating to the agricultural, transportation, mining, and education sectors. Fear of HIV/AIDS is strong, and people with HIV/AIDS face stigma on a daily basis. In fact, the 2003 KAP study reports that, “If a local shopkeeper were known to be HIV-positive, nearly half of all young people (and more than two-thirds of those with no education) said they would refuse to buy food from him. Similarly, more than one-third (and nearly two-thirds of those with no education) would refuse to share a meal with an HIV-positive person.” Finally, Angola has approximately 1 million orphans, about 11% whom have lost one or both parents to AIDS.[1]
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