Fighting HIV and AIDS: Situation and Trends

• In 2009, it was observed that the prevalence of HIV/AIDS was higher in women (18.4%) than in men (12.8%).
• Prevalence of HIV/AIDS is higher in the urban areas (15.9%) than in the rural areas (9.2%).
• Provincially viewing, Gaza has the highest prevalence (25.1%) and Niassa Province has the lowest prevalence of HIV/AIDS (3.7%).
• The rate of prevalence was higher in women than in men in all wealth quintiles.
• More than 860,000 people have attended various health counselling and testing units by 2009. A total of 760,490 were tested, of whom 146,337 were positive.  
• The number of health units offering Vertical Transmission Prevention (PTV) service increased to 832 units in 2009, against 744 units in 2008.
• In 2009, a total of 888,861 pregnant women had attended health clinic with prevention programmes (712,768 in 2008).
• Until December 2009, 66,615 pregnant women had received anti-retroviral treatment for the prevention of vertical transmission.
• In 2008 a total of 46,848 pregnant women received anti-retroviral treatment (32.1% of the total).

Anti-Retroviral Treatment (ART)

• Until 30 December 2009 there were 156,688 adults and 13,510 children under 15 years of age receiving ART, giving a total of 170,198 ART patients.
• In December of 2009 there were 222 health units providing antiretroviral treatment, of which 221 (99.5%) provided antiretroviral treatment to HIV positive children, compared to 188 of 213 (88%) in 2008 and 148 of 211 (70%) in 2007.
• Of the 242,854 registered patients who entered for ART as new (230,181) or resuming (12,673) patients since the beginning of the treatment provision at the end of 2003, to the end of 2009 3% had been suspended (6,269), 17% had abandoned (39,098), and 8% had died (18,794).
• At the end of 2009, the target of 148,500 adult patients receiving ART was exceeded by approximately 8188 patients, with 156,688 adult patients in fact receiving ART.
• About 37% of adults in need of treatment were receiving ART.

Children and Anti-Retroviral Treatment (ART)

• The number of children under 15 years of age in treatment in the country increased from less than 677 in 2004 to 13,505 at the end of 2009. This represents coverage of 28% of eligible children.
• In 2006, 68% of all children receiving treatment were living in the four southern provinces and 55% were living in Maputo City. In 2008, the southern provinces had 56% of all children in anti-retroviral treatment and Maputo City had 33%. Also, in 2009 the southern provinces represented 57% of all children in ART, with Maputo representing 30%. In spite of the expansion to other provinces, the geographical distribution of the children with access to treatment is still not fair.
• Until December 2009 there were 226 health units with anti-retroviral treatment services and 221 of these units (98%) offered anti-retroviral treatment to seropositive children, against 188 of 213 units (88%) in 2008 and 148 of 211 units (70%) in 2007.

Availability of contraceptives

The availability of contraceptives increased considerably in 2009 in comparison to the previous year. Of the 93,600,034 male contraceptives planned for 2009, 88,257,368 male and 922,950 female contraceptives were distributed. There was an increase of 54.4% in a year.

Challenges for the achievement of the targets for 2015

For the achievement of the targets for 2015, the country should:

• Focus actions on the high risk groups and on people in stable relations (a single partner);
• Promote and consolidate the consistent use of female and male contraceptives;
• Prepare specific communication strategies for social and behavioural change;
• Continue the expansion of quality paediatric and adult ART;
• Decrease of the regional inequalities of access to HIV care and treatment;
• Promote Institutional capacity-building and training of health professionals in nutritional assessment and referral systems, as well as setting up community distribution systems and the “basic food basket” monitoring system;
• Strengthen counselling and advising, nutritional/food support and monitoring of the impact of the activities carried out by the grassroots community organizations;
• Reduce the time between HIV diagnostics and the beginning of ART;
• Continue to ensure the implementation of a comprehensive paediatric package, which includes strong psychosocial support to the child, support to the parents and support staff and above all mobilize them to enter ART and care;
• Strengthen the capacity of the health unit and community health staff regarding nutrition and HIV, particularly the selection of patients on the basis of anthropometrical measurements, monitoring, follow-up and evaluation.

Positive factors of progress in the indicators

• Commitment of the Government. Mozambique approved the Prevention Acceleration Strategy (at the end of 2008) and the National Strategic Plan III for the fight against the pandemic (in 2010).
• The implementation of the Nutritional Support Strategy for People Living with HIV/ AIDS and other chronic diseases started in 2009.
• Sector plans for several governmental institutions to fight the epidemic with emphasis on the approval of the Strategy to Combat HIV/AIDS in Public Administration 2009-2013.
• Significant improvements in the collection, analysis and splitting up of data at sector level and particularly in the ART area.
• The health information system (SIS) was decentralized in 2008 from the central level to the provincial and district levels through the training of relevant teams of technicians of all provinces in data inputs and in standard operational monitoring and evaluation procedures.

Source: Report on the Millennium Development Goals - Mozambique 2010