HIV Prevention in Papua New Guinea: Is It Working or Not?

Abstract

Introduction: There is a global call for structural approaches to HIV that go beyond awareness and HIV testing to approach prevention work via the social and economic drivers of the epidemic. Papua New Guinea is the epicentre of the HIV epidemic in the Pacific, with an adult prevalence rate of 0.9%. Since 2004, there has been a concerted response to HIV, with vastly increased rates of HIV testing and roll-out of antiretroviral therapy, and considerable funding for HIV prevention. Objectives: While incidence is slowing there are still a considerable number of new infections each year and many commentators are worried that HIV prevention is not working in that country. This article aims to critically examine HIV prevention programs in Papua New Guinea to show whether HIV prevention is effectiveness in reaching those most vulnerable to infection. Methods: Using data from HIV prevention programs and behavioural surveys this article will assess how HIV prevention has been carried out and the effectiveness of those programs. Results: There is little evidence to indicate that HIV prevention in Papua New Guinea, particularly among those most at risk of HIV has been successful. Conclusion: there is a dearth of HIV prevention interventions in Papua New Guinea that go beyond awareness-raising to deal with the structural drivers of the epidemic

Prevalence and predictors of HIV testing among young men in Papua New Guinea: a cross-sectional analysis of a nationally representative sample

“…Efforts to strengthen the availability and accessibility of HIV testing services as part of the National Strategic Plan for HIV and AIDS (Acquired Immunodeficiency Syndrome) have expanded over the years [22]. HIV testing, which includes risk reduction counselling that greatly influences one's perception of HIV acquisition and increases access to ART, has been shown to change HIV-related risk behaviours in PNG [23][24][25].…”

“…It confers multiple benefits for individuals who test positive and those who test negative and encourages preventive behaviors [5,6]. Despite the significant benefits, young people remain the least likely to get an HIV test and know their HIV status [15,27]. Studies have shown that not all, particularly men willingly seek HIV testing services as a way to prevent HIV transmission and/or acquisition due to various barriers, such as individual (poor HIV/AIDS knowledge, testing availability, and unwillingness to test), social (stigma, discrimination, and lack of social support), and health service utilization (loss of trust or confidence in health workers and lack of medication, including ART) [7–9].…”

“…Among young people, the prevalence of HIV is estimated at 0.2% for males and 0.5% for females [24], demonstrating the high vulnerability of this priority group in the country. Although HIV testing services are widely available throughout PNG [25], the current testing rate among young people is suboptimal, especially among those most at risk of HIV [26,27]. Furthermore, a major obstacle in the country continues to be young men’s participation in HIV programs and their access to sexual and reproductive health care [28,29].…”

“…It confers multiple benefits for individuals who test positive and those who test negative and encourages preventive behaviors [5,6]. Despite the significant benefits, young people remain the least likely to get an HIV test and know their HIV status [15,27].…”

What's happening with HIV in Papua New Guinea?

“…The list goes on. Along with Worth [14], the Reviews concluded that there was little direct evidence that prevention, treatment and policies have had an impact.…”