The prevalence of HIV in 11 Pacific Island nations including Samoa continues to be low with an overall prevalence estimated at just 0.1 per cent.

The prevalence rate was highlighted in a report by the United Nations Development Programme (UNDP) on a three-year (2018-2020) US$11,368,713 programme that is supported by the Global Fund. 

The Multi-Country Western Pacific Integrated HIV/ tuberculosis (TB) Programme aims to strengthen control of HIV and TB in 11 Pacific island countries: Cook Islands, Federated States of Micronesia, Kiribati, Nauru, Niue, Palau, Republic of Marshall Islands, Samoa, Tonga, Tuvalu and Vanuatu. The UNDP is the programme’s principal funding recipient.

However, the report cautioned that despite the low rates and numbers, vulnerability to contracting HIV remains high due to “as widespread migration and mobility, dense sexual networks, a large caseload of untreated sexually transmitted infections (STIs), low knowledge about HIV and STIs, high levels of transactional sex and significant levels of intimate partner violence”.

For TB in 2017 the incidence rate per 100,000 for each of the 11 programme countries as per the WHO 2018 Global TB Report are as follows: Cook Islands (0), Federated States of Micronesia (165), Kiribati (413), Niue (71), Nauru (91), Palau (106), Republic of the Marshall Islands (480), Samoa (18), Tonga (12), Tuvalu (236), Vanuatu (51). Regionally, since 2013 there has been a gradual increase in the TB incidence rate per 100,000: 2013=131, 2015=132, 2016=143.

The report, when discussing the increase in TB incidences, said: “This increase may be attributed to the increased active case finding interventions at the community level and the adoption of GeneXpert as a first line diagnostic test in the majority of the programme countries. Treatment success rates for all forms of TB are stable, averaging 86 per cent for those cases registered in 2017 whose treatment outcomes were reported in 2018.”

For Samoa, the report made reference to what it described as “major achievements” after the Global Fund programme was rolled out last year.

These achievements included: enhanced TB diagnostic and case detection through procurement of diagnostic tools – including three GeneXpert machines – where training was also provided on the tools for health workers; through point-of-care testing using the SD Duo test kit where 1,111 members of key populations (men who have sex with men, transgender people, female sex workers and seafarers) were tested for HIV and syphilis, and provided with counselling and referred for care. Training was also provided for health care workers on how to administer the SD Duo test kits for STI/HIV screening and testing; a review and update of national guidelines in line with the latest WHO guidelines for HIV testing services, and STI diagnosis, treatment and management with the guidelines getting launched at the 2018 World AIDS Day celebration; and building the capacity of health workers, which were strengthened through participation in regional trainings, including a regional strategic information and reporting workshop, and a regional HIV forum. Amongst other achievements was the setting up of a formal office for the Samoa Faafafine Association, with support from the programme, to enable better coordination of activities and availability to transgender groups in Samoa to gather for meetings and utilise a private room for HIV and STIs walk-in testing.