One UN family supports Fast Track HIV prevention and access to Sexual and Reproductive Health services in Rwanda cities

Rwanda has maintained since the last decade, the national HIV prevalence at 3% in the general population but much higher rates among key populations and in urban areas.

As part of the delivering results together, catalytic support was provided by WHO, UNICEF, UNAIDS and UNFPA to the city of Kigali. A 5-year citywide evidence – informed HIV strategic plan (2018 – 2023) and districts’ specific operational plans for adolescent HIV and Sexual Reproductive Health (SRH) were developed and are being implemented. In addition, support was provided WHO to Rwanda Biomedical Centre to revise and update HIV and STDs national guidelines and capacity building was provided to health care workers on the provision of integrated quality HIV, STDs and SRH services to the general and key populations.

Mr. Fodé Ndiaye, UN Resident Coordinator in Rwanda, said:

"These strategic plans will help advance the Fast track agenda with targeted programs for specific groups and locations.” 

With stakeholders’ support including the One UN, Her Excellency The First Lady of Rwanda launched the Free-To-Shine Campaign to strengthen the national eMTCT programme. The event helped to increase local leaders’ motivation to advance the Fast-Track agenda in the city and national wide.

Among female sex workers the HIV prevalence is 45.8% overall, and 55.5% in Kigali. The national response to the HIV epidemic has been encouraging. HIV Testing Services are available in 99% of health facilities, Prevention of Mother to Child Transmission (PMTCT) coverage is very high (99% of pregnant women attending ANC services are tested for HIV and receive their results and 85.9%of HIV+ pregnant women receive ARVs while 96% of HIV exposed infants received the Nevirapine at birth), Anti Retrovirus Treatment (ART) is offered to 82.6% of eligible HIV+ adults and children. There is however an alarming increase in the HIV prevalence in the age group 20-24 years old.

According to DHS-2010 and DHS 2015, HIV prevalence decreased from 2.4% to 1.8% among girls and women 20-24 years and HIV prevalence increased from 0.5% to 1% among boys 20-24 years. The increase of HIV prevalence may not reflect the increase of HIV new infections rather the effect of survival due to the success of HIV treatment program. 

Although HIV testing and treatment services are available and accessible in all public health facilities, adolescents and young people are least likely to be receiving HIV testing and treatment due to health seeking behavior. Evidence from 2015 DHS shows that less than 30% of adolescents (15-19 years) had tested and received treatment in the past 12 months. Mark Bryan Schreiner, UNFPA Representative here in Rwanda, said:

“Preventing HIV is integral to UNFPA’s support to achieving universal access to sexual and reproductive health as a human right. We work with partners to increase access for young people, key populations, and women and girls, including those living with HIV”

Support to HIV positive adolescents in the City of Kigali through One UN partner – Imbuto Foundation - collaborated with local non-governmental organizations working on prevention of and response to HIV/AIDS for the planning of peer educators training.

70 peer educators trained on how to fight against stigma and discrimination for their peers who are HIV positive and how to help them in the treatment journey.  Moreover, these peer educators and young people living with HIV engaged in a debate on prevention of new infection and promotion of HIV treatment among youth.

“Progress towards the global Fast track targets demonstrates that Rwanda is on course towards ending AIDS epidemic as public health threat. As the One UN we are committed to supporting Rwanda’s path to zero new HIV infections, zero discrimination and zero AIDS-related deaths.”

These are the words of Dr Betru Woldesemayat, UNAIDS Country Director.

Although much progress is recorded, remaining challenges include the highest HIV prevalence in the City of Kigali 6.3%, roughly double that of the country. HIV prevalence is higher among older people and female sex workers.

With Stakeholders’ support the Rwanda Biomedical Centre continues to scale-up response to reaching key populations especially female sex workers by placing condom kiosks in sex work hot-spots.