Papua New Guinea, with one of the world's highest rates of new HIV infections, has made gains in reducing the spread of AIDS. However, AIDS advocates and counselors, meeting at a UNAIDS conference in Bangkok, say changing male behaviors and ensuring more HIV positive pregnant women have access to antiretroviral drugs remain challenges.
Papua New Guinea, facing a general AIDS epidemic, has slowed the virus? spread as education programs and a marked increase in health facilities conducting HIV tests among pregnant women have had an impact.
The stepped up surveillance has allowed for a downward revision in new AIDS cases to around one per cent of the population, or about 35,000, with most cases in urban areas of this country which occupies the eastern half of the Pacific island of New Guinea.
In 2009 the AIDS death toll stood at 1,300. A combination of drug and alcohol abuse as well as multiple sex partners and gender-based violence has contributed to the diseases? spread.
UNAIDS, a joint United Nations program on HIV/AIDS, says the evidence points to a leveling off in new cases in Papua New Guinea, marking substantial progress over recent years.
But Murray Proctor, HIV/AIDS ambassador from the Australian Agency for International Development, says the challenge for Papua New Guinea is ensuring prevention programs are sustained.
"The challenge is still though to get the prevention message across to high risk groups and differently in different places. In Papua New Guinea you have 1.0 per cent prevalence and it?s mainly heterosexual," said Proctor. "In other parts of East Asia it?s injecting drug users and increasingly men who have sex with men."
But concerns remain. Rising numbers of babies are being born HIV positive. Linda John, an AIDS advocate diagnosed with HIV in 2004, says too many pregnant women refuse to take prenatal HIV tests. A woman found to be HIV positive can access antiretroviral medications and prevent mother to child transmission.
"Mothers are given choices to do the HIV test or not,' she said. "Some mothers refuse to do the test. But it?s important to consider the child that is in the mother?s womb because the child also has the right. What if the mother is infected and if she doesn?t want to hear her status? This is a high risk in transmitting the virus to the child and that?s one of the challenges seen in Papua New Guinea. After the delivery mothers are rushing the baby to the clinic and they are diagnosed as HIV positive, and it?s too late."
But fewer than three per cent of HIV-positive pregnant women in Papua New Guinea receive anti-retroviral medications.
John says more women need to have greater access to legal rights and there have to be steps to end domestic violence.
Papua New Guinea?s churches and faith-based organizations are also involved in HIV/AIDS programs aimed at reducing stigmatization and discrimination.
Eddie Kekea, an AIDS counselor at the Anglican Church division of Education, based in the Papua New Guinea capital of Port Moresby, says a challenge is changing male behavior to curb domestic violence and promote safe sex.
"We have one strategic plan through a framework by UNAIDS. But as far as I am concerned the behavior change in men is progressing at a slower rate; and it?s a challenge not only to the churches but to other civil societies as well," said Kekea.
Kekea says the churches themselves have succeeded in dealing with stigma and discrimination within their own organizations and have integrated HIV programs that have led to a better understanding of the impact of AIDS on both individuals and communities.