With 30 new HIV (Human Immunodeficiency Virus) positive cases detected (14 males and 16 females) between June and November this year, the total number of HIV cases since 1993 in the country stands at 627.

Of the new cases, 22 are aged between 25 and 49 years, one each between 15 and 19 years and 20 and 24 years, and a minor who is less than five-years-old.

A total of 57 HIV new cases have been diagnosed so far this year.

Health Minister Dechen Wangmo said that in the last 25 years of HIV epidemic in Bhutan, the country had made remarkable achievements in terms of case detection and treatment coverage among the people living with HIV (PLHIV).

“However, we cannot be complacent and must continue to sustain our current gains and strive hard to bridge the case detection gap of 50 percent and treatment gap of 6 percent,” Lyonpo said. “Encouraging all the PLHIV to know their HIV status is our priority to ensure timely care, support and treatment and prevent further transmission from the source.”

According to a press release from the health ministry, housewives, farmers and people doing business are among the infected groups with eight cases each. Four are drivers, one each a student and a minor.

In terms of mode of transmission, the heterosexual route remains the major mode of HIV transmission in Bhutan. Of the new detected cases, except for a case involving a minor who got HIV from the mother, the rest acquired the infection through unprotected sex.

While 12 cases in the last six months were detected through contact tracing, eight were detected through medical screening, seven through voluntary counselling and testing (VCT), and three from antenatal care (ANC).

“All the new cases are being put on care and treatment at the JDWNRH,” the press release states.

Director with the Department of Public Health, Dr Karma Lhazeen, said that with the introduction of treat all policy in 2016, PLHIV are now eligible for treatment irrespective of their CD4 count (body immunity level). “The quality care and treatment will help prolong the lifespan of PLHIV like any other uninfected individual”.

However, she cautioned that appropriate treatment and timely intake of drugs were important to achieve the good treatment outcome.

Although the HIV cases in Bhutan have been increasing over the period, with an average case detection of 55 for the last five years, there was still a case detection gap of 50 percent as of November 2018.

This shows that only 50 percent of the estimated 1,265 people living with HIV in Bhutan know their HIV status. The remaining 638 PLHIV are still unaware of their HIV status.

Of the total 627 detected cases, 323 are male.

According to the press release, like many other countries in the region, the majority (84 percent) of the reported HIV cases in Bhutan are between the age of 20 and 49 years.

“This shows that HIV in Bhutan has primarily affected the most economically productive age group,” it states.

About 93 percent of the reported cases have acquired the infection through unprotected sex, six percent through mother to child and 0.5 percent each through injecting drugs and blood transfusion done outside Bhutan.

The press release states that the transmission of HIV and AIDS in Bhutan is unique as compared to other countries in the region where HIV infection is mostly concentrated in one or two key population. In Bhutan, it has infected all sections of the Bhutanese population. As a result, HIV epidemic in Bhutan is generalised and diffused making it difficult to focus the interventions to a specific population.

The prevention effort needs to reach all the population in the country, which demands more time and resources while planning and implementing the prevention and control activities.

“The prevention of HIV is the shared responsibility of all individuals irrespective of their HIV status which ideally requires a concerted effort in minimising the stigma and discrimination at all levels,” it states.

Certain body fluids like blood, semen, vaginal or anal secretions and breast milk from a person who has HIV can transmit HIV.

Abstaining from unprotected sex, being faithful to one’s partner, the right use of condom and refraining from abusing drugs are some of the ways to prevent transmission of the virus.

Themed ‘Live life positively – know your HIV status,’ World AIDS Day this year will be observed in Samdrupjongkhar on December 1.

Health ministry will also organise a mobile national HIV testing week in Thimphu, Phuentsholing, Gelephu, Trongsa, Samdrupjongkhar and Lobesa in Punakha from December 1 to 8 with the national theme “Know your HIV status with Zero Stigma and Discrimination”.

Dechen Tshomo