. BACKGROUND
B a c k g r o u n d :
Egypt is a low HIV epidemic country, Egypt has an estimated 26,000 people living with HIV (PLHIV). However, available data showed that the HIV epidemic in the country had evolved but remains mostly concentrated and mostly affecting the key populations. The overall HIV prevalence among the general population estimated at 0.02%.
Egypt has demonstrated a continued commitment to combat HIV epidemic. Contextualized Global guidance has given direction to Egypt’s national response in addressing HIV and AIDS including the most recent alignment to the Global Health Sector Strategy on HIV. The global strategy incorporated the Sustainable Development Goals and new international targets for ending AIDS as a public health threat by 2030. The National AIDS Program of Egypt (NAP) continued to play a central role in the response, with support from partners. Following a restructuring that took place in 2014, the program encompassed a more inclusive collaboration
with national stakeholders which has contributed to the broader spirit of ownership and partnership in the national response. There have been positive developments in the national response over the last several years.
Despite the progress, some challenges and gaps continued to undermine the national response and its outcomes. The most recent Global AIDS Update of 2018 highlighted some of these gaps; The apparent rise in the number of new confirmed HIV infections from 2010 to 2018, The significant absence of knowledge and misconceptions about HIV among the general population and the high level of stigma towards people living with HIV that continues to challenge programs and initiatives in addition to unavailability of updated strategic information.
HIV testing and counselling services (HTC) are an entry to HIV prevention, care and treatment. Different evidences illuminated that access to quality testing and counseling can significantly contribute to the global target to End HIV/AIDS as public health threat by 2030 and will support the government of Egypt to accelerate its response and meet the national target of 90-90-90. Supporting indivdiauls, particularly those among the most vulnerable populations to know their HIV sero-status can substantially enhance their abilities to reduce the risk of acquiring or transmitting the virus. Access to quality HTC is important entry point for wider-range of HIV related services including care, support and treatemnnt and would subsequently contributes to elimination HIV associated stigma and discrimination.
There are many HIV testing approaches available in Egypt:
- 1. Testing and counseling in clinical treatment settin
- 2. “opting out” of testing as in tuberculosis diagnosis and ANC.
- 3. Voluntary testing and counseling
- 4. Routine testing as renal dialysis, blood donors, etc.
Those services may be offered through:
– Free-standing VCT sites.
– Hospital services.
– NGOs.
– Integrated into general medical services.
– As part of specialist medical care.
– Private sector (clinics and hospitals).
– Workplace clinics.
– Referral sites for legal requirements, pre-employment, pre-travel, pre-marital.
– Health services for vulnerable groups.
Similar to many essential healthcare services, access to HIV testing and counseling has been partially interrupted by the outbreak of Covid19 pandemic. With the fluctuation of Covid19 daily new infections, the priorities for healthcare services have rapidly changed to effectively respond to the newly emerging pandemic. Additionally, by early March 2020, the Government of Egypt has applied several restrictive measures and policies to contain
the spread of the virus and manage its adverse impact on the healthcare system. Such measures include, inter alia, imposing nationwide curfew, closing of public spaces and educational facilities such as schools and universities as well as restrictive economic policies to impose social distancing. Consequently, such measures and rapid shit within the healthcare sector had have disrupted the available health services including HIV testing and counseling for key populations. Such distribution can be manifested by temporal change in the governmental VCT units in some governorates and the complete closure for few weeks of several NGOs services including outreach activities to link vulnerable groups to HCT as well as the VCT services provided by these NGOs.