| Overview : In 2015 Belize successfully secured a grant from the Global Fund for the period January 2016 to December 2018 for programmes and activities aimed at the reduction of incidence and deaths related to HIV/AIDS and tuberculosis nationally. This grant follows the submission of a concept note which described the goals and objectives of the national HIV and TB programmes respectively, as well as the challenges facing each. One of the most crucial components of the national HIV/AIDS programme, to which this consultancy is tied, is that of adherence to anti-retroviral (ARV) medications for persons living with HIV (PLHIV). According to the latest figures from the Epidemiology Unit of the Belize Ministry of Health only 24.3% of PLHIV were retained on ARV treatment in 2014. Adherence retention is also significant as it underpins the Ministry’s treatment-as-prevention strategy which seeks to reduce HIV incidence through improved adherence to ARVs in conjunction with other strategies. Given the known risks associated with improper and inconsistent use of ARVs such as increased susceptibility to opportunistic infections (including tuberculosis), greater risk of spreading HIV to uninfected persons, and overall reduced life expectancy, the current low level of adherence essentially represents one of the most critical make-or-break factors in achieving goals set out in the concept note. The full scope of this challenge however, becomes more apparent when one considers that due to factors related to stigma and discrimination towards the HIV+ community, and particular subgroups, such as the men who have sex with men (MSM), commencement and continuity of treatment among the community remains below acceptable rates and if continued, threatens to potentially reverse gains made over the past decade. |
