The AIDS epidemic is responsible for over 20 million deaths worldwide, tens of millions of children left orphaned, and some 33 million people living with HIV. Although global HIV prevalence has leveled off, AIDS is among the leading causes of death globally and remains the primary cause of death in Africa. As one of ten co-sponsors of UNAIDS, UNFPA works to intensify and scale up HIV prevention efforts using rights-based and evidence-informed strategies, including attention to the gender inequalities that add fuel to the epidemic.
Within UNAIDS, UNFPA takes a leadership role in prevention among young people and women, two groups who are increasingly at risk of infection. It also reaches out to other vulnerable populations. Egypt is considered a low prevalence country with regard to HIV and AIDS in the general populations, with less than 0.1 percent of the 15–49 population being infected in 2008. WHO/UNAIDS estimate the total number of people living with HIV to be 9,200 individuals (Global report on Epidemic Update 2008).
Among cases officially reported to the National AIDS Programme (NAP), heterosexual intercourse was the primary mode of transmission (60 percent), followed by homosexual intercourse (27 percent), renal dialysis (3 percent), blood transfusion (3 percent), and drug use (2 percent). Injecting drug use accounted for 2.9 percent of HIV infections and mother-to-child transmission for 1.6 percent; 5.2 percent are from 'unknown' causes.
Out of reported cases, the male to female ratio is 4:1, but this may be due to more men testing for HIV than women. Other people most likely to be exposed to HIV in Egypt include sex workers, street children, prisoners, and refugees. There is, however, no adequate surveillance system in place. Hence, the true extent of infection in the general population is not known. It is generally agreed upon that HIV-prevalence has been rising in Egypt since it was first recognized officially in 1986.
One of the biggest challenges is the low level of knowledge among Egyptians on HIV and AIDS, which also contributes towards stigmatizing views with respect to people living with HIV and groups most at risk to infection. The NAP was established in 1987 and has been working with UN agencies and civil society on prevention, treatment and care. However, there is a need to strengthen a multi-sectoral approach to address gaps in the response. Egypt recently received a Global Fund grant. UNFPA Egypt is an active member of the UN Joint team on AIDS and participates in the UN Joint Programme of Support for HIV and AIDS in Egypt. UNFPA is currently chairing the UN Theme Group on AIDS.
UNFPA supports the Ministry of Health on:
- Strengthening the available Voluntary Counseling and Testing (VCT) and Sexually Transmitted Infections (STIs) services targeting young people and specifically Most-at-Risk Populations (MARPs). The expansion/strengthening of VCT services are a key entry point for HIV prevention and care activities. The increased focus on availability and quality of VCT services coincides with the NAP’s growing awareness of the need for anonymous testing for HIV, coupled with counseling.
- Establishment of clinics for the detection and treatment of sexually transmitted infections. Given that the presence of an STI significantly increases the risk of HIV transmission, it is of great importance to also reduce the spread of these infections. UNFPA supports nine mobile VCTs, in addition to strengthening the capacity of services provided in seven STDs centers and 14 fixed VCTs. Activities include training and on job supervision visits jointly with NAP.
- Supporting the development of a demand creation plan for VCTs to increase demand for VCT/STI services among most-at-risk groups. The purpose of the demand creation plan is to provide guidelines for promoting attendance among specific populations at risk of HIV and STI infection at the 27 UNFPA supported VCT/STI sites. UNFPA is the lead agency of a Joint Programme on prevention of HIV and AIDS amongst vulnerable women.
The UNFPA HIV/AIDS programme focuses on expanding the knowledge and access to services for women and men with high risk of exposure to HIV, changing risk behaviors, providing social, medical and legal support services and strengthening life skills. UNFPA Egypt is committed to working with young people and other vulnerable groups on the prevention of HIV and to widen their access to reproductive health care that meets their specific needs.