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Although Senegal is a relatively underdeveloped country, HIV prevalence in the general population is low at around 0.08 per 1000 people, under 1% of the population.[1] This relatively low prevalence rate is aided by the fact that few people are infected every year– in 2016, 1100 new cases were reported vs 48,000 new cases in Brazil. Senegal's death due to HIV rate, particularly when compared it to its HIV prevalence rate, is relatively high with 1600 deaths in 2016.[2] Almost two times as many women were infected with HIV as men in 2016, and while almost three times as many women were receiving antiretroviral therapy (ARV) as men, only 52% of HIV positive people in Senegal received ARV treatment in 2016.[2]

One way that Senegal maintains a low HIV prevalence is through conservative cultural norms that discourage sex outside of marriage, limiting the number of sexual partners an average Senegalese person will have and thus limiting their chance of coming into contact with the virus. The government also passed legislation to make working closely with sex workers to ensure they get regular STI and HIV tests and treatment possible.[3] Senegal also has had huge public health campaigns to promote condom usage. Senegalese hospitals have also had their blood supplies screened for syphilis and hepatitis since 1970, leading to the removal of some blood contaminated with HIV before an HIV antibody test was created. Currently, hospitals are well equipped with sterile equipment in order to prevent transmission of HIV by hospital procedure.[3]

New infection statistics[edit]

In the general population, 80% of new infections occur in people in monogamous relationships. According to Senegal's AIDS authority, among the newly infected, three-quarters of people engage in some high risk behavior. About one quarter of the newly infected engage in high risk behaviors themselves and about half of the newly infected have a partner who engages in high risk activities.[4] Because homosexuality is illegal in Senegal, many MSMs have long term female partners as well as male partners, so many women unknowingly have a partner who is in a high risk group.[4]

At risk populations[edit]

While the overall HIV prevalence rate in Senegal is low, the prevalence rate is significantly higher in certain populations. Among men who have sex with men (MSM), the prevalence rate is around 19% and among sex workers, the prevalence rate is close to 22%. As a result, the Senegalese government has put emphasis on preventing transmission of the virus from these groups.[5] The HIV transmission rate in MSM communities has not decreased, partially because Senegal maintains laws against homosexuality.[6] As a result, MSMs fear seeking testing and treatment for HIV for fear of being arrested.[7] Despite promising to work to reduce the HIV prevalence rate in communities of people having non-heterosexual sex, the Senegalese government arrested 9 men working in HIV prevention for violating anti-homosexuality laws. Despite the later overturning of their convictions, the arrests created fear and suspicion in the MSM community.[7]

The Senegalese government provides medical services to registered sex workers, but in recent years, the number of covert sex workers has been increasing. These unregistered sex workers cannot access sex worker-specific government health services.[8] These women often live in poverty but do not become sex workers until a tragedy occurs, such as the death of parents or a husband.[8] As many as 80% of all Senegalese sex workers may be unregistered. As a result, most sex workers do not have access to government sponsored STI and HIV testing and education about HIV prevention.[9]

National response[edit]

Unlike many African countries which denied the existence of the HIV epidemic, Senegal responded quickly when its first AIDS case was diagnosed in 1986. The Programme National de Lutte contre le SIDA (PNLS) was established to coordinate the government's anti-AIDS activity in 1986 and was later renamed the Conseil National de Lutte contre le SIDA (CNLS).[3] The Senegalese government worked in cooperation with religious leaders and health professionals in order to maximize the reach of HIV/AIDS prevention education.[9] Muslim leaders emphasized that condoms were permissible for married couples if one spouse were HIV positive and the other were not and agreed to collaborate with Christian leaders in order to prevent the spread of HIV in Senegal's large devout population.[8]

In addition to working with religious figures to enhance public cooperation, the Senegalese government ran a condom marketing campaign and distributed more than 10 million free condoms in partnership with USAID in order to try to limit HIV transmission.[3] Much of the rural Senegalese population cites their local health center as the source of their information on HIV/AIDS with a smaller but still sizable contingent citing television and radio.[10] Many HIV positive people make efforts to hide their status because there is much discrimination against them, which complicates the government's attempts to provide services to the HIV positive population.[9]

The Senegalese government is still working to stop the spread of AIDS. CNLS's goals for 2030 include zero new infections, zero deaths tied to AIDS, and zero discrimination against HIV-positive Senegalese citizens.[4]

Government treatment efforts[edit]

In 2003, Senegal became the first African country to offer free HIV tests, antiretroviral medications (ARVs), and treatments for some opportunistic infections.[11] This free access to ARVs has been key to the relative socio-economic stability of people living with HIV in Senegal who have been able to stay health, keep jobs, get married, and have children because of the government's commitment to funding treatment programs.[12]

Before 2010, Senegal's government provided free infant formula to mothers with HIV. In 2010, the policy was changed to provide antiretroviral therapy to prevent mother to child transmission of HIV without the provision of formula.[13] While this was considered a step forward in treatment and prevention by the government and NGOs, many families continued to want to feed their infants formula leading to a cost burden that destabilized their socioeconomic status.[13]

Migration[edit]

In many African countries, migration in pursuit of seasonal jobs contributes greatly to the spread of diseases. However, in Senegal, the return of migrants to rural areas did not contribute to the spread of HIV.[14] The movement of businessmen and prostitutes, however, between Senegal and other West African countries did contribute to the spread of HIV.[15]

See also[edit]

References[edit]

  1. ^ "Senegal". www.unaids.org. Retrieved 2017-10-31.
  2. ^ a b "AIDSinfo | UNAIDS". aidsinfo.unaids.org. Retrieved 2017-10-31.
  3. ^ a b c d "HIV/AIDS in Senegal: A USAID Brief" (PDF). US AID. July 2002.
  4. ^ a b c yacine. "Conseil National de Lutte contre le Sida - Plan Stratégique 2014-2017". www.cnls-senegal.org (in French). Retrieved 2017-11-09.
  5. ^ Drame, Fatou Maria; Foley, Ellen E. (2015-05-01). "HIV/AIDS in mid-sized cities in Senegal: From individual to place-based vulnerability". Social Science & Medicine. 133 (Supplement C): 296–303. doi:10.1016/j.socscimed.2014.11.038. PMID 25433973.
  6. ^ Wade, Abdoulaye S.; Larmarange, Joseph; Diop, Abdou K.; Diop, Oulimata; Gueye, Khady; Marra, Adama; Sene, Amsata; Enel, Catherine; Diallo, Pape Niang (2010-04-01). "Reduction in risk-taking behaviors among MSM in Senegal between 2004 and 2007 and prevalence of HIV and other STIs. ELIHoS Project, ANRS 12139". AIDS Care. 22 (4): 409–414. doi:10.1080/09540120903253973. ISSN 0954-0121. PMID 20131126. S2CID 19557773.
  7. ^ a b Poteat, Tonia; Diouf, Daouda; Drame, Fatou Maria; Ndaw, Marieme; Traore, Cheikh; Dhaliwal, Mandeep; Beyrer, Chris; Baral, Stefan (2011-12-14). "HIV Risk among MSM in Senegal: A Qualitative Rapid Assessment of the Impact of Enforcing Laws That Criminalize Same Sex Practices". PLOS ONE. 6 (12): e28760. doi:10.1371/journal.pone.0028760. ISSN 1932-6203. PMC 3237497. PMID 22194906.
  8. ^ a b c Foley, Ellen E.; Nguer, Rokhaya (2010-12-01). "Courting success in HIV/AIDS prevention: the challenges of addressing aconcentrated epidemic in Senegal". African Journal of AIDS Research. 9 (4): 325–336. doi:10.2989/16085906.2010.545628. ISSN 1608-5906. PMID 25875881. S2CID 902811.
  9. ^ a b c Diouf, D. (2007) HIV/AIDS Policy in Senegal: A Civil Society Perspective. New York, Open Society Institute.
  10. ^ Lagarde, E (1998-10-01). "Risk behaviours and AIDS knowledge in a rural community of Senegal: relationship with sources of AIDS information". International Journal of Epidemiology. 27 (5): 890–896. doi:10.1093/ije/27.5.890. ISSN 0300-5771. PMID 9839749.
  11. ^ The political economy of HIV/AIDS in developing countries : TRIPS, public health systems and free access. Coriat, Benjamin. Cheltenham, U.K.: Edward Elgar. 2008. ISBN 978-1848440777. OCLC 301734431.{{cite book}}: CS1 maint: others (link)
  12. ^ Coutherut, J.; 1215, groupe d’étude de la cohorte ANRS (2014-10-01). "Impact socio-économique d'une décennie de prise en charge thérapeutique pour les personnes vivant avec le VIH traitées par ARV au Sénégal". Bulletin de la Société de pathologie exotique (in French). 107 (4): 261–265. doi:10.1007/s13149-014-0380-7. ISSN 0037-9085. PMID 25103748. S2CID 116079746. {{cite journal}}: |last2= has numeric name (help)
  13. ^ a b Desclaux, Alice (2013-04-02). "When a prevention policy leads to economic vulnerability: the case of PMTCT in Senegal". Global Health Promotion. 20 (1_suppl): 39–44. doi:10.1177/1757975912462421. PMID 23549701. S2CID 43152915.
  14. ^ Lalou, Richard; Piché, Victor; Ltd., Accenta (2004). "Migrants and AIDS: Risk Management versus Social Control. An Example from the Senegal River Valley". Population (English Edition, 2002-). 59 (2): 195–228. doi:10.2307/3654903. JSTOR 3654903.
  15. ^ Renaud, Michelle (2010-05-21). ""We're All in it Together": AIDS Prevention in Urban Senegal". Practicing Anthropology. 15 (4): 25–29. doi:10.17730/praa.15.4.m3553v51r13g5060.
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