2016 Global AIDS Progress Report of Tuvalu Ministry of Health of Tuvalu Contents 1. Foreword by Ministry of Health ...................................................................................................... 2 1.2 Acknowledgements ........................................................................................................................... 3 2. Indicator Overview .......................................................................................................................... 4 3. Status at a glance ............................................................................................................................ 9 3.1 Geography ..................................................................................................................................... 9 3.2 Tuvalu Economy and Government................................................................................................ 9 3.3 Demographics ............................................................................................................................... 9 3.4 Tuvalu National AIDS Strategic Plan ............................................................................................ 10 3.5 Monitoring and Evaluation ................................................................................................... 11 3.6 Health Infrastructure in Tuvalu ............................................................................................. 13 3.6 STIs and HIV in Tuvalu ..................................................................................................................... 16 3.6.1 Chlamydia Statistics in Tuvalu .................................................................................................. 16 3.6.2 Gonorrhoea Statistics in Tuvalu ............................................................................................... 19 3.6.3 Syphilis Statistics in Tuvalu ...................................................................................................... 21 3.6.4 HIV statistics Tuvalu ................................................................................................................. 25 4. Key populations at risk .................................................................................................................. 27 4.1 Testing in pregnant women ........................................................................................................ 30 4.2 ART Treatment, Care and Support ............................................................................................ 30 5 Eliminating gender inequalities .................................................................................................... 30 5.1 Gender and Women .................................................................................................................... 30 5.2 Third gender ................................................................................................................................ 34 6 Stigma associated with HIV ........................................................................................................... 35 7. Best practices ................................................................................................................................... 36 1 1. Foreword by Minister of Health: It is time once again to review our pass years performance and achievement in Tuvalu. 2015 has been an eventful with strategic direction for the ministry of health moving forward as a member of UNAID bringing to fruition the implementation of the strategic goal of the Tuvalu National Strategic Plan for HIV and STI or priority program areas of the strategic plan. In June 2011, Tuvalu joined the international community to sign the 2011 Political Declaration on HIV and AIDS; reconfirming its previous commitments made in 2001 and 2006. The Political Declaration motivates and compels countries to work towards achieving the Millennium Development Goal. Goal Six to halt and reverse the spread of HIV epidemic. The 2011 Political Declaration demonstrates the spirit of planning for results through setting time bound targets that countries should achieved. I am pleased to announce achievements made in responding to the epidemic in Tuvalu, first of all by keeping Tuvalu a low level HIV country. People Living with HIV and AIDS are accessing treatment and we expect that this will translate into improvements in life expectancy. The Government has recognized the contribution of community organizations, in particular in prevention programmes. The National AIDS Spending Assessment (NASA) 2013 uncovered, that the Government contribution to HIV is on the rise and spending priority is given to the education of young population on how to prevent. The country is not only committed but has demonstrated political support for the response. Such support will be sustained to ensure that we achieve the Universal Access targets. I am pleased that this report demonstrates our collective successes and the achievements are attributed to the people of Tuvalu; the youth who begin their sexual lives having attuned to safer behaviours; the women who visit antenatal care clinics to protect their unborn children; the men who are getting circumcised; the key populations who are coming out to become active partners in HIV prevention efforts and the households who participate in national surveys. On behalf of the Government, I would like to conclude by taking this opportunity to express my gratitude and appreciation to all multisectoral stakeholders. The collective efforts of the friends of Tuvalu; the Civil Society, development partners, bilateral and multilateral donors, including business can never be overlooked. All this has been made possible by the commendable commitment of the Government of Tuvalu in providing the leadership and guidance that is necessary to spur the country to meet MDGs. Lastly, I still believe an HIV-free generation is possible; through continued engagement, participation and shared responsibility. For now let us carry this document with pride and the knowledge that significant milestones have been achieved by the country. Hon Satini Manuela Minister of Health 2 1.2 Acknowledgements This report was prepared by the Ministry of Health of Tuvalu on March 31, 2016 with technical support from UNAIDS Office in the Pacific. This report was coordinated by the Tuvalu Department of Public Health which is leading the HIV/AIDS program response in Tuvalu. The data and analyses presented in this report was drawn from a diverse range of sources including (but not limited to): Department of Public Health and the Tuvalu Princess Margaret Hospital, Laboratory and STI Clinic administrative and reporting data; Tuvalu’s Demographic Health Survey 2007 and key informant interviews. Contact person for the report: Taufala Nia, Ministry of Health of Tuvalu, HIV program Officer – e-mail: [email protected] 3 2. Indicator Overview Indicators Value Value Source 2014 2015 Comments Indicators for 1.1 Young People: Knowledge about HIV Prevention* Data No new DHS 2007 60,7% all the general reported in data males and population 2013 39.4% for females 1.2 Sex Before the Age of 15 Data No new DHS 2007 14.7% all reported in data males and 2013 1,7% all females 1.3 Multiple sexual partners Data No new DHS 2007 4% all reported data males and 2013 1.1% all females 1.4 Condom Use During Higher Risk-Sex* Data No new DHS 2007 Male 15-19 reported in data – 19,9%; 2013 Male 20-24 – 21,,9%; Female 15- 19 – 6,4%; Female 20- 24 - 1,1% 1.5 HIV Testing in the General Population n/a 50% MOH data 11 HIV/2 dead 1.6. HIV prevalence from antenatal clinics by age group 214 tested n/a 0,9% Routine 0 positive surveillance 1.20 HIV incidence rate Indicators for sex workers 2.2 Sex Workers: Condom Use n/a No new No activities data for FSWs 2.3 Sex Workers: HIV Testing n/a No new No activities data for FSWs 2.4 Sex Workers: HIV Prevalence n/a No new No activities data for FSWs Indicators for men who 2.5 Men who have sex with men: Condom Use n/a No new No activities have sex with data for MSM men 2.6 Men who have sex with men: HIV Testing n/a No new No activities data for MSM 2.7. Men who have sex with men: HIV Prevalence n/a No new No activities data for MSM Indicators for 2.8 People who inject drugs: Number of needles/IDU No IDUs IDUs 2.9. People who inject drugs: Condom Use No IDUs 2.10 People who inject drugs: Safe Injecting Practices No IDUs 2.11 People who inject drugs: HIV Testing No IDUs 2.12 People who inject drugs: HIV Prevalence No IDUs 2.13 People on opioid substitution therapy No IDUs Indicators for 2.14. HIV prevalence in inmates/detainees No data inmates Indicators for 2.15. HIV prevalence in transgender people No data transgender Prevention of 3.1 Prevention of Mother-to-Child Transmission 0% 0 pregnant mother-to- women, child total tested transmission (PMTCT) 126 3.2 Early Infant Diagnosis 0% 0 children born with HIV+ mothers 3.3 Mother-to-Child transmission rate (modelled) No data MOH 3.3 a Mother-to-child transmission of HIV (based on programme Not 0% MOH 0 children data) relevant born 3.4 Pregnant women who were tested for HIV and received their 100% 100% MOH 126 /126 results pregnant women all tested for HIV 5 3.5 Testing coverage of pregnant women's partners (UA) No data No data 3.7 Coverage of infant ARV prophylaxis (UA) Not No data 0 children relevant born with HIV+ 3.9 Cotrimoxazole (CTX) prophylaxis coverage (UA) Not No data 0 children relevant born from