𝐇𝐈𝐕 𝐏𝐫𝐞𝐯𝐞𝐧𝐭𝐢𝐨𝐧 𝐢𝐧 𝐁𝐡𝐮𝐭𝐚𝐧 𝐁𝐲 𝐏𝐫𝐢𝐨𝐫𝐢𝐭𝐢𝐳𝐢𝐧𝐠 𝐭𝐡𝐞 𝐕𝐮𝐥𝐧𝐞𝐫𝐚𝐛𝐥𝐞

…𝑮𝒐𝒗𝒆𝒓𝒏𝒎𝒆𝒏𝒕 𝒊𝒏𝒊𝒕𝒊𝒂𝒕𝒊𝒗𝒆𝒔 𝒇𝒐𝒄𝒖𝒔 𝒐𝒏 𝒎𝒆𝒏 𝒘𝒉𝒐 𝒉𝒂𝒗𝒆 𝒔𝒆𝒙 𝒘𝒊𝒕𝒉 𝒎𝒆𝒏, 𝒑𝒆𝒐𝒑𝒍𝒆 𝒘𝒉𝒐 𝒊𝒏𝒋𝒆𝒄𝒕 𝒅𝒓𝒖𝒈𝒔, 𝒂𝒏𝒅 𝒐𝒕𝒉𝒆𝒓 𝒗𝒖𝒍𝒏𝒆𝒓𝒂𝒃𝒍𝒆 𝒈𝒓𝒐𝒖𝒑𝒔 𝒕𝒐 𝒄𝒖𝒓𝒃 𝒓𝒊𝒔𝒊𝒏𝒈 𝒓𝒊𝒔𝒌𝒔

By Lhendup Wangmo

While Bhutan has successfully kept its overall Human Immunodeficioency Virus (HIV) epidemic relatively low, certain high-risk populations continue to face an elevated vulnerability to HIV infection, mentioning the need for targeted interventions.

In a new effort to curb the spread of HIV, the government is increasing its focus on key populations who play a central role in the transmission of the virus. These populations are at greater risk of HIV and include groups such as men who have sex with men, people who inject drugs, sex workers, and those in closed settings like prisons.

In Bhutan, while the overall HIV prevalence remains low, certain groups experience a much higher risk of infection. Research shows that people who inject drugs in Bhutan have a 35 times greater risk of contracting HIV than the general population, and in some cases, this risk can be up to 50 times higher.

Additionally, the nation’s HIV epidemic disproportionately affects younger people, with the majority of infections occurring among those between the ages of 20 and 39. This group, often considered economically productive, is particularly vulnerable due to a combination of behavioral and social factors.

Notably, more females are affected by HIV at a younger age than males, punctuating the need for targeted interventions that address the specific needs of women.

To address these challenges, the Bhutanese government has taken significant steps to provide free HIV diagnosis and treatment. This includes comprehensive access to Voluntary Counseling and Testing (VCT) services, available at health facilities, Health Information and Service Centers (HISCs), and other strategic locations. The government also offers hospital admissions, medications, and other essential HIV services to those affected.

Despite these efforts, experts agree that sustained focus on key populations and targeted prevention strategies are essential to reducing new HIV infections in Bhutan. By addressing the unique risks and challenges faced by these groups, Bhutan is working toward minimizing the impact of HIV, ensuring that resources are directed where they are most needed, and strengthening its ability to manage and reduce the spread of the virus in the long term.

This focused response stress Bhutan’s commitment to not only providing comprehensive healthcare but also ensuring that its most vulnerable populations have access to the services they need to stay healthy and HIV-free.

According to health experts, people who inject drugs and men who have sex with men (MSM) are among the most vulnerable groups in Bhutan, facing a much higher likelihood of HIV infection compared to the general public. These populations are being prioritized in national HIV prevention programs aimed at reducing new infections and providing targeted care.

While Bhutan’s overall HIV prevalence remains relatively low, health officials have mentioned the importance of addressing the needs of these key populations. People who inject drugs, are at an elevated risk due to practices like needle sharing, which significantly increases the likelihood of HIV transmission. Similarly, MSM often face social stigma and discrimination, creating barriers to access to prevention, testing, and treatment services.

To address these risks, Sustainability of HIV services for key populations has been actively working to provide tailored HIV services for these at risk populations. The government offers free HIV testing and treatment, including access to antiretroviral medication and counseling services. Voluntary Counseling and Testing (VCT) services are also available at health centers, aimed at encouraging individuals in these high-risk groups to get tested and seek medical support.

Experts spotlight that a focused approach to these populations is essential for controlling the spread of HIV in Bhutan. By providing targeted prevention and care services, the government hopes to reduce the incidence of new infections and ensure better health outcomes for those most vulnerable to the virus. Key populations (KPs) which include men who have sex with men, sex workers, people who inject drugs, transgender people, and prisoners represent a group at heightened risk for HIV due to a combination of biological, socioeconomic, and structural factors. These populations face significant vulnerabilities stemming from discrimination, criminalization, and limited access to healthcare services.

In 2020, key populations and their partners accounted for 62 percent of new HIV infections globally. This stark statistic highlights the ongoing challenges in addressing the HIV epidemic, particularly in regions with high levels of stigma and barriers to care.

Efforts to curb the HIV transmission among key populations require targeted interventions, improved access to health services, and the decriminalization of behaviors that increase risk. Public health strategies must also focus on overcoming social and legal barriers to ensure these vulnerable groups receive the care and support they need.

Recent data has highlighted the alarming disparity in HIV risk among key populations, showing that certain groups are far more likely to contract HIV compared to the general public. Female sex workers, for example, face a risk of HIV acquisition 26 times higher than that of the general population. People who inject drugs are even more vulnerable, with a risk 35 times greater. Similarly, gay men and other men who have sex with men are 25 times more likely to acquire HIV, while transgender individuals face a 34 times higher risk.

These statistics emphasize the urgent need for focused interventions targeting these populations, who often face multiple layers of vulnerability, including societal stigma, legal barriers, and limited access to healthcare services. Experts stress that addressing these disparities is crucial in the global fight against HIV. Tailored prevention and treatment programs, as well as efforts to reduce discrimination and improve healthcare access, are critical to reducing the transmission of HIV among these high-risk groups.

The National AIDS Control Program (NACP), with support from the SKPA-2 project, is rolling out Pre-Exposure Prophylaxis (PrEP) as part of a comprehensive HIV prevention strategy starting in June 2024. This phased rollout will be complemented by a series of demand generation activities aimed at raising awareness about HIV prevention, particularly among key populations.

As part of these efforts, Save the Children Bhutan is seeking local consultancy services to produce a variety of media content. The goal of these materials is to raise awareness about HIV and PrEP, ensuring that information reaches communities at higher risk of HIV exposure. The selected consultant or firm will be responsible for producing media content as outlined in the Terms of Reference (ToR) provided by Save the Children Bhutan.

This initiative is a critical component of the country’s ongoing efforts to curb the HIV epidemic and promote safer practices within vulnerable communities.