World AIDS Day is celebrated around the world on December 1st each year. It has become one of the most recognized international health days and a key opportunity to raise awareness, commemorate those who have passed on, and celebrate victories, such as increased access to treatment and prevention services.
The global HIV epidemic claimed fewer lives in 2015 than at any point in almost twenty years. Prevention programs reduced the number of new HIV infections per year to 2.1 million in 2015, a 35% decline in incidence since 2000. The massive expansion of antiretroviral therapy has reduced the number of people dying of HIV related causes to approximately 1.1 million 2015 – 45% fewer than in 2005.
The situation in Mongolia is not any better than in many other countries, including specifically developing countries, around the world.
249 cases of HIV positive cases have been registered as of 20 November 2017. Of them 56 percent are aged from 20 to 44 and 80 percent of them are male. Medical experts estimate that there are probably more than 530 HIV positive unregistered cases.
It has also been estimated by UNAIDS focal point in Mongolia that HIV prevalence, through modelled estimates, is expected to double by the year 2020, without an expanded national AIDS response.
The country is characterized by a number of high risks, including consistent high levels of STIs (Sexually Transmitted Illnesses), growing HIV prevalence in men who have sex with men (MSM) in urban settings, and evidence of high risk sexual behaviors such as multiple, casual sex partners and low condom use among general population.
More than 30 percent of infectious diseases registered annually are Sexually Transmitted Infections (STI). The prevalence rate of STIs in 2013 was 40 percent, 45 percent in 2014, 28 percent in 2105, and 21 percent in 2016. As of October 2017, it was 33 percent, according to HIV/AIDS Surveillance and Research Office of the National Center for Communicable Disease of Mongolia.
In 2016, cases of syphilis decreased to 1485 cases per 10,000 population and gonorrhea was also done to 600 per 10,000 of the population, however trichominiasis has increased by 333 cases for every 10,000 population.
STI is more common among young people between the ages of 20 and 29. The main reason for increased STI is related to poor self-prevention and preventative effort.
The HIV surveillance office also reports that 19 healthy babies were born from 13 HIV positive women since 1992. Currently, there are 2 HIV positive pregnant women under medical observation and 14 HIV (+) adolescents between the ages of 15 and 19.
The country also has a high prevalence of TB (tuberculosis). This urges the country to pay extra attention to the prevention of HIV, TB co-infection. However, no isoniazid preventive therapy has been currently provided to people living with HIV/AIDS (PLWHA), who are newly enrolled in HIV care. Furthermore, the percentage of PLHWA, newly enrolled in this care that have active TB diseases has increased.
The current state of national AIDS response also calls for more attention to the sexual health education of adolescents and young people.
A revised Law on HIV/AID Prevention was adopted in December 2012 by the Parliament. The revised law has provisions on having a National Committee in charge of coordinating national AIDS response, and a full-time secretariat. However, these provisions remain neglected to date.
The are many challenges to sustaining the HIV/AIDS prevention program, and from among them, of quite a serious nature, is the fact that the sustainability of the national AIDS response remains dependent largely on donor support. As Mongolia has transitioned to lower middle-income country, international and donor funding for national AIDS response is expected to decline further.
In addition to this, with a relatively young population, open societal sexual norms, and increased domestic and international cross-border mobility, Mongolia will need to refocus and reprioritize its national response based on strategic evidence in order to stay one step ahead of a looming HIV epidemic.