In the Ivory Coast, preliminary findings from a demographic health survey describe changes in the HIV epidemic in terms of gender, age, and geographic distribution.
The new information is welcome as it provides crucial insight for planning HIV programmes and for evaluating and updating national strategic plans for HIV, health development, and maternal and child health.
The survey was conducted with financial and technical assistance from Inner City Fund Macro Inc (partner of United States Agency for International Development/President’s Emergency Plan For Aids Relief), the Ivorian government, United Nations Children Funds and the World Bank.
Decrease in prevalence among women
While overall HIV prevalence among adults decreased from 4.7% to 3.7%, HIV among women declined from 6.4% to 4.6%. This is still much higher than male HIV prevalence which remained almost unchanged at 2.7%. However, prevalence dropped dramatically among women aged 30-34, from 14.9% to 6.8%.
Semi Lou, coordinator of non-governmental organisation Femme Active, explained that: “Efforts have been doubled to provide HIV prevention services to women in order to close the gender gap. We educate young women and teenagers on safe sex and condom use. But we do not set women living with HIV apart from our efforts. We educate women living with HIV on positive prevention including preventing mother to child transmission, and also how to keep their partners free from HIV.”
The impact of such work can be seen when it comes to serodiscordant couples (when one person in the relationship is living with HIV), as currently 50% of women are HIV positive, which is down from about 67% in 2005.
General education also plays an important role and is evidenced in disparities in among women: HIV prevalence is higher among women with no education (5.0%) than among those who have reached secondary school (3.3%).
Increase in HIV among older men
While there was a marked difference in prevalence between the genders among the 15-29 age groups, there was little difference between women and men above the age of 35. One revelation is that HIV rates have increased significantly among older men, from 5.9% to 7.8% among men aged 40-49, and reaching 9% in the 50-59 age group.
Mr. Bogui, executive secretary of the International Center for Humanitarian Action, Networking and Grassroots Empowerment, said: “This shift is the result of behavioural change among older men who are putting themselves at risk of HIV infection. The other reason that may explain this is that according to the Ministry of Health and the fight against HIV, less than 1% of men know their HIV status.”
While the country is implementing its national strategic plan, further studies are needed to understand why prevalence is increasing among older men.
