1. Bi-national Commission for Collaboration on Health Guyana and Suriname. Presenter Mr. Nicholas Persaud –National HIV Care and Treatment Coordinator. Guyana Ministry of Health National AIDS Programme Secretariat

2. National Response to the HIV/AIDS Epidemic Since the first reported case of AIDS in 1987, the GoG has been cognizant of the effects of HIV/AIDS. The GoG has demonstrated strong political will in combating the HIV/AIDS epidemic. In 1998, the GOG established: National AIDS Programme (NAP) under the Ministry of Health. Gentio Urinary Medicine (GUM) Clinic which is now known as the National Care and Treatment Centre ( Premier Treatment site) The National Laboratory for Infectious Disease (NLID) The National Blood Transfusion Service (NBTS) In 1992, the National AIDS Programme Secretariat (NAPS) was established and charged with the role of coordinating the national response to the HIV/AIDS epidemic.

4. Guyana Response Female Commercial Sex Workers, Men Sexing Men (MSM)Miners and Loggers are prioritized in the HIVision 2020 as key populations at Higher risk for HIV Biological Behavioural Surveillance Survey (BBSS) being conducted among miners & loggers in 2013 and includes testing for HIV/STI, Malaria, Dengue, anemia, HepB. Prevention: PMTCT,VCT, IEC,HIV Hotline, CSW and MSM Special Project, Condoms, Blood Screening and Safe Injection. Treatment: ARV, OI and STI Management and Laboratory Monitoring Care and Support: HBC Services, Orphans and Vulnerable Children, Food Bank Services NB :Guyana is participating in a study “Control of Histoplasmosis on HIV-infected patients in the Guiana Shield” -Increasing awareness of the problem of American Histoplasmosis in HIV-positive patients in the Guiana Shield, · Diagnostic capacity building for histoplasmosis improved in the Guiana Shield, · Clinical practice in HIV patients in the Guiana Shield improved, · Strategy for Histoplasmosis control developed, · Network of trained health professionals reinforced in the Guiana Shield.

5. Overview of the National HIV Care and Treatment Programme.

6. Year of prevalence: Pregnant women, TB patients- 2012, Adult Prevalence, 2011; FSW and MSM- 2009; Security Guards and Prisoners- 2004; Miners- 2003 Epidemiological Over View

7. 1.NCTC 2.SJHM 3.Davis Memorial Hospital 4.Dorothy Bailey Health Centre 5.Campbelville Health Centre 6.West Demerara Hospital 7.Suddie Hospital 8.Wismar Upper Demerara Hopsital 9.Rosignol Health Centre 10.New Amsterdam Family Health Clinic 11.Skeldon Hospital 12.Bartica Hospital 13.Mobile Clinic Region #1,7,8,9 14.Enmore Poly Clinic 15.Beterverwagting Health Centre. 16.Georgetown Chest Clinic 17.East La Penitance Health Centre 1.NCTC 2.SJHM 3.Davis Memorial Hospital 4.Dorothy Bailey Health Centre 5.Campbelville Health Centre 6.West Demerara Hospital 7.Suddie Hospital 8.Wismar Upper Demerara Hopsital 9.Rosignol Health Centre 10.New Amsterdam Family Health Clinic 11.Skeldon Hospital 12.Bartica Hospital 13.Mobile Clinic Region #1,7,8,9 14.Enmore Poly Clinic 15.Beterverwagting Health Centre. 16.Georgetown Chest Clinic 17.East La Penitance Health Centre

8. Overview of the National HIV Care and Treatment Programme.

12. 2006200720082009201020112012 Average on Second Line (2 nd ) Number of Persons on Second Line (2 nd ) 5869169262296287366 Total Number on Treatment 1611195624732662305934323717 Percentage of Population on Second Line (2 nd ) 3.6%3.5%6.8%9.8%9.7%8.3%9.8% 7.4% Adult proportion on Second Line (2 nd ) 9.1%9.6%12.1%10.3% Pediatric proportion on Second Line (2 nd ) 18.1%10%6.9%11.7%

13. National Cohort 2011-2012 Start-Original Cohort 12 Month End Point MaleFemale MaleFemale 0-14 15+ 0-14 15+Total 0-14 15+ 0-14 15+ Total A. Number of person initiated on ART 13221152765251322115276525 B. Number of transfers IN −−−−−11921739 C. Number of transfers OUT −−−−−−6−1319 D. Net Cohort (A+B-C) 13221152765251423417280545 E. Number died -−−−−−23−1538 F. Number stopped −−−−−−711321 G. Number dropped (LTF) −−−−−115−2642 H. Number on original first-line regimen 13221152765251317616207412 I. Number on alternate first-line regimen −0−00−12−1527 J. Number on second line regimen (switched) −0−00−1−45 K. Percent of cohort alive and on ART at 12 months (H+I+J)/D*100 100% − 92.9%80.8%94.1%80.7%81.5%

15. Challenges Retention in Care ; adherence to clinical appointment and medications TB/HIV Co-infection Third Line Regimen need; the future cost Sustainability of the response

16. THANK YOU