12/01/2017

Press Release No 179, 2017

- The phenomenon occurrs by the concentration of the supply of services and social stigma.

Bogotá (DC), November 30, 2017. The concentration of patients with HIV in Colombia occurrs in Bogotá, Medellín and Cali, followed by Barranquilla and Bucaramanga. In turn, the highest number of care services is recorded in these cities since they have the institutions that provide the services required by this group of people.

According to the Atlas of Geographical Variations in Health of Colombia, prepared by the Ministry of Health and Social Protection and the World Bank, there is a record of travel in search of medical, nursing and psychology consultations as well as for laboratory tests, as a consequence not only of the concentration of services for these patients but apparently because of the stigma associated to having the infection.

These trips take place not only within the provinces, but many are also outside. So, the capitals are not the main places where the patients of the most dispersed municipalities travel seeking attention.

There are regions such as the Coffee Belt (Pereira, Armenia, Manizales) or the Caribbean (Barranquilla, Cartagena, Santa Marta) where there is a considerable number of travel between relatively close cities, but which do not coincide with the political and administrative division of the country.

The main capitals, that is, Bogotá, Medellín, Cali, Bucaramanga, and Barranquilla, are the most frequent destinations for HIV patients.

This situation, according to the Atlas, implies long-term interruptions in treatments and a deterioration in the health condition of these patients.

Another of the conclusions of the study is related to the low adherence to treatments for HIV that are in the health benefits plan, including access to consultation with a general practitioner or specialist, which peaked at 78.76% in the years 2013 and 2014. This information was included in the study from the reports of the different health promotion organizations (EPS). The consultation with nursing was received by 24.63% of the patients and the consultation with psychology by only 8.66%.

With respect to the viral load test, it was performed on 48.85% of the patients, while the lymphocyte test on 21.51% and blood count on 52.84%.

Another information collected by the Atlas is related to HIV mortality in Colombia, which increased since the appearance of the epidemic in the country in 1985 and stabilized in around 2,450 cases in 2004, a level that has been maintained each year since then.

In accordance with the conclusions of the Atlas, the Ministry of Health is focusing efforts towards combined prevention, which includes the use of condoms in all sexual relationships, improvement in diagnosis through rapid tests, and access to treatments. The latter, if used adequately by patients, following the medical recommendations, becomes a measure of disease prevention.

The coordinator of the Reproductive Health Group of the Ministry, Ricardo Luque, revealed that in Colombia, since the appearance of the disease in the country until December 31, there have been 120,622 cases, of which 11,328 were reported and confirmed in the National Public Health Surveillance System (Sivigila, in Spanish) of the National Institute of Health (INS) throughout 2016: 78.8% were men and 21.1% were women, with sexual transmission being the transmission mechanism in 98.5% of cases.

Mr Luque explained that the health system includes the distribution of male condoms as well as the voluntary test for HIV diagnosis, antiretroviral treatment as prevention, post-exposure prophylaxis or the initiation of treatment for occupational accidents or sexual exposure, Hepatitis B vaccine and the treatment of sexually transmitted infections.

In response to the situation, Colombia assumed the commitment to ensure that in 2020, 90% of cases are diagnosed in time, 90% of those infected are treated with antiretrovirals and that 90% of those receiving treatment reduce their viral load.

"To date the projection to reach the number of people needed to meet 90-90-90 by 2020 is as follows: 67% of people know their diagnosis, 54% of those diagnosed receive therapy and of these, 47% have suppressed viral load. The main challenge we face is to aim at reducing gaps in early diagnosis," he said.