With the detection of 36 new HIV (Human Immunodeficiency Virus) cases in the last six months, the case detection gap is closed by 2.4 percent resulting in an overall case detection gap of 47.6 percent.

As of December 2018, the case detection gap was 50 percent.

Of the total detected between January and June this year, 21 are males and a majority (83 percent) of the reported cases were between 20 and 49 years, according to a press release from the health ministry.

Occupation wise, 11 are housewives, seven reported working in private or business category, six are drivers, five are farmers and two are civil servants. Two are minors while one each reported being a corporate employee, uniformed personnel and unemployed.

Transmission of the infection through unprotected heterosexual remains the major mode of HIV transmission in the country with 34 of the new cases acquiring the infection through this route. Two acquired the infection from HIV infected mothers.

According to the press release, contact tracing remained the highest mode of case diagnosis with 36 percent.

Medical screening and voluntary and counselling (VCT) followed with 31 and 22 percent. Two percent each were detected from antenatal check-up (ANC) and blood donor screenings.

“Currently, all new cases are put on care and treatment at the national referral hospital in Thimphu,” it states.

“Encouraging all people living with HIV (PLHIV) to know their HIV status is our priority to ensure timely care, support, treatment and to prevent further transmission from the source,” health minister Dechen Wangmo stated in the press release.

Lyonpo said it is important for pregnant mothers to get tested for HIV during the entire pregnancy period and if found positive then must take an appropriate action to prevent mother to child transmission.

Lyonpo also cautioned HIV negative pregnant mothers to remain negative even after their delivery to ensure zero HIV transmission from mother to child through breastfeeding.

This, she said was important for Bhutan to gear towards the triple elimination of HIV, Syphilis and hepatitis B among the newborn by 2020 and beyond.

Department of public health’s director, Dr Karma Lhazeen stated that the ministry was looking forward to introducing more innovative means of HIV testing and counselling in future to ensure more holistic client-centred HIV-testing services.

With the change in time, she said that such innovative measures are required to encourage more people to get tested on time.

Since 1993, a total of 663 HIV cases (344 male and 319 female) have been diagnosed until June this year. With the detection of the new cases in the last six months, a total of 57 HIV cases were diagnosed in 2018 alone.

As per UNAIDS, Bhutan is estimated to have 1,265 HIV cases and the country now has a case detection gap of 47.6 percent. This means about 602 people are living with the HIV virus but unaware of their status.

Of the total detected cases in the country, the majority (71 percent) are aged between 25 and 49 years and 16 percent between 15 and 24 years. About six percent are below 15-years-old and eight percent above 50-years-old.

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

However, it states that the infection taking place among the older age group is also gradually picking up and if this group of population are into the intergenerational sex (sexual relationship between the young women and older men) and the transactional sex (non-marital sex involving exchange of monetary reward and gifts), the likelihood of increasing the risk of acquisition and transmission of HIV in Bhutanese population is high.

About 30 percent, a majority of HIV cases detected are through the contact tracing followed by medical screening (23 percent), VCT (22 percent) and the remaining through the ANC checkup and onsite mobile screening.

Programme manager with the national HIV, AIDS and STIs control programme, Lekey Khandu said contact tracing was a challenging task. “But, it is one key aspect of HIV case finding and need for adequate support both from the infected and affected individual is very important.”

“Contact tracing will enable our HIV counsellor to initiate a process of identification of persons who may have come into contact with an HIV infected person and subsequent collection of further information about these contacts,” he said.

However, he said that strict confidentiality of clients and persons traced are maintained during these processes.

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

The four main ways where these fluids can come in contact with each other are having unprotected sex, transfusion of HIV infected blood or blood products, sharing of HIV infected needles, syringes, blades, piercing instruments and HIV infected pregnant mother to her child.

The simple ways to prevent HIV and AIDS is to abstain from sex, be faithful to one’s partner, and use a condom correctly and consistently.

 Dechen Tshomo