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The prevalence of the Human Immunodeficiency Virus (HIV) in Guyana is just over one percent, statistics which correlate with the prevalence of the local health sector’s Prevention of Mother to Child Transmission (PMTCT) which is used as a proxy for general prevalence in the population, according to Programme Co-ordinator of the National AIDS Programme Secretariat (NAPS), Dr Shanti Singh.Dr Singh, during a recent interview, revealed that the Secretariat has revised local estimates with UNAIDS, a process which is done using historic as well as current data that are a reflection of the ongoing programme.“We have confirmed with UNAIDS and this will be out in the End of Year Report that our prevalence is just over one percent…” Dr Singh asserted.At the moment, Region Four reportedly has the highest concentration of persons living with HIV, a state of affairs Dr Singh attributed to the fact that the Region has some 42 percent of the entire population.According to her, the percentage of cases in Region Four is disproportionately affected as it accounted for about 52 percent of the reported cases as at the end of last year.  However, that proportion has decreased, Dr Singh noted “because early on in the epidemic it accounted for about 60 percent…So if you looked at the percentage of cases across the country, Region Four is disproportionate.”Dr Singh said that at the local level the national programme focuses on the public health effort to reduce transmission even as measures are engaged to help improve the lives of those persons already living with the virus.She however highlighted concerns about several groups of vulnerable people including the young people that are both in and out of school.“We have seen from the behavioural survey that we have done that among the young people and that there has been an increase in behaviours that put them at a high risk of contracting Sexually Transmitted Infections (STIs)…whether it is directly due to the low level of condom use, sexual practices that are risky or indirectly where there has been an increase in alcohol consumption.”Meanwhile, NAPS has been looking at the drop rate of clients accessing the local treatment programme, according to Dr Singh. The local programme,Harrison Barnes USA Jersey, she said, has a definition for what a drop might mean or what a death of a client might mean.She said that for a relatively good programme, the World Health Organisation (WHO) recommends that there should be a drop rate of no more than 15 percent, an amount which is accepted as reasonable.In the meantime though, Dr Singh said, that WHO is revising its guidelines and “I think they are considering a drop rate of about 10 percent to be reasonable. Because a drop rate in our definition is that we haven’t seen you back in three months which is also WHO’s definition.”The local programme, she disclosed, currently has a drop rate of about 12 percent even as efforts are being made to review the available statistics.“WHO recommends 15 percent but we are striving to make sure that we are somewhere about five to six percent,” Dr Singh added. For this reason, she said that NAPS has brought on board a consultant who will sit and work with the local programme over a three-month period to make sure that all of the necessary steps are in place to make sure that persons are counselled throughout the programme and are given all the necessary information to be able to decrease the existing drop rate.

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“Yes, now more than ever. You remember what you once said about the graveyard, and the old story writing itself over? Only it is we who write it, with the best we have.”
They paused on the last ridge of the pasture, overlooking the house and the windmill and the stables that marked the site of J
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