1. National AIDS Program in Palestine Dr. Asad Ramlawi Director General of PHC

2. National HIV / AIDS program established in 1990. Incorporated STDs & STIs in 1996 & 1998,respictivelly.

3. AIDS / HIV Surveillance Report Number of casesAID S Asymptomatic HIV Total During this period112 Cumalulative Total 441761 Number of cases of AIDS/ HIV

4. Number of AIDS Cases by year Up to 1986 878889909192939495 0041016133 96 97 98 99 00 01 02 03 04 05 Total 1 9 3 1 3 1 2 1 1 3 44

5. Cumulative of HIV AIDS by year In Palestine 2005 Year 88899091929394 95 96 97 No of Cases 4101827 5 1 8 Cumulative No. 4556141623 28 29 37 98 99 00 01 02 03 04 05 3 4 4 5 0 2 2 4 40 44 48 53 53 55 57 61

7. AIDS Cases by Age & Sex Age/yrs During this period M F Unknown Total Cumulative Total M F Unknown Total 0-40 0 1 0 0 1 5-90 0 1 0 0 1 10-140 0 0 1 0 1 15-190 0 0 0 0 0 20-240 0 5 1 0 6 25-290 0 5 1 0 6 30-340 0 9 0 0 9

8. AIDS Cases by Age & Sex Age /yr M F U K T M F U K Total 40-441 0 0 0 1 0 0 1 45-490 0 1 0 0 1 50-540 0 0 1 0 1 55-590 0 0 0 0 0 60+0 0 5 1 0 6 Unknown 0 0 5 1 0 6 Total1 0 0 1 39 4 1 44

9. AIDS Cases by mode of Transmission Mode of TransmissionDuring this periodCumulative Total Heterosexual024 Homosexual01 Blood/bld products110 Injection Drug Use01 Mother to child01 Other known00 Multiple02 Un known05 Total144

10. Results of all HIV tests Group tested High Risk Groups During this period Tested Positive Total for this year Tested Positive STD Patient N.A N.AN.A ProstituteN.A Bar GirlsN.A HomosexualN.A Injecting drug user0 Blood recipient0 Sexual contact of AIDS0 1 0 Prisoners0

11. Group tested High Risk Groups During this period Tested Positive Total for this year Tested Positive Suspected AIDS 0 0 TB patients1 03 0 Long distance truck drivers N.A N.A N.A Voluntary council ling & testing N.A Others0 4 0 Sub Total1 08 0

12. Group tested Low Risk Groups During this period Tested Positive Total for this year Tested Positive Blood donors 12556 0 36401 0 Pregnant mothers4 0 13 0 In-migrant0 0 0 Pre marital 1 0 Out- migrant 119 0 465 0 Others 3467 1 11472 2 Sub Total 16147 1 48352 2 Total 16148 1 48360 2

13. Cumulative Number of HIV/ AIDS by mode of transmission in Palestine 2005 Heterosexual34 Bisex2 Homosexual1 Hemophilia4 Addicts3 Transmission1 Others7 Unknown9 Total61

14. Challenges 1.Political situation 2.Emergency / Prioritization 3.Budget 4.Behavioral surveillance 5.Identification of risky of behavioral group 6.Harmonization of H E material & strategies

15. 7. Privacy / Stigma 8. Patient follow up & treatment 9. Medical awareness 10. Lack of experts / Clinics / & centers

16. Lessons learned 1.Community awareness STDs/ HIV/ AIDS 2.STDs prevalence is similar to other countries in the region 3.Counseling program still weak in Palestine by health provider 4.No harmonized surveillance system for STDs / HIV in Palestine by different health providers

17. 5. STDs surveillance & counseling should be integrated within R H services 6. NGOs & private sectors should be involved in training / Implementation of National products & guideline of STDs / HIV

18. Achievements 1.AIDS / STDs guidelines 2000 copies 2.Counseling guidelines ( health education Booklets ) 1000 copies 3.Training of 250 health personal on guidelines of STDs / AIDS 4.Training of 100 health personal of counseling

19. 5. Training on 100 personal surveillance 6. STDs survey for TV & CA, prevalence

20. Recommendation 1. Sexually transmitted diseases are a public health problem in Palestine, as the case in other countries in the region. 2. Dealing with STDs and STIs should receive more attention by MOH and other health providers. 3.The National committee for Prevention and Control of AIDS and STDs should be reactivated and supported.

21. 4.Condom promotion for preventive purposes should be adopted and implemented by all health providers. 5.This survey should be disseminated to all health providers, including those in the private sector, in order to ensure their involvement with MOH in prevention and control.

22. 6.Health education program should be developed, carried out, and implemented by the National Health Education Committee. 7.Medical and community awareness should be increased by all means. 8.Adaptation and implementation of WHO guideline on STDs (Etiological and Syndromic approach to diagnosis and treatment should be reinforced

23. 9.Medical staff should receive training on diagnosis, treatment and counseling. Laboratory technicians and health workers should be included in the training programs. 10. Clinics and laboratories should be provided with dugs needed for the treatment and prophylactic treatment, in addition to condoms for preventive purposes, as well as reagents needed for diagnosis.

24. 11.STDs surveillance system should be improved by promoting notification and reporting by all health providers. 12.Plans for surveys on other STDs are required in order to have a complete picture about STDs in Palestine, which can assist in as improved planning of prevention activities.