Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1697646291402.pdf (Bahamas)
HIV/AIDS Overview: 2017 A Brief Review of the Scope of HIV/AIDS in The Bahamas General Surveillance Info HIV Prevalence Estimation models indicate that 5,287 persons were living with HIV in The Bahamas at the end of 2017, accounting for 1.3% of the general popula- tion.

This means that roughly 1 in 74 persons living in The Bahamas is HIV positive.

Fifty-five percent (55%) of PLHIV are estimated to be male and 74% of PLHIV are between the ages of 15-49.
Males Females 15-49 year olds Total PLHIV Estimated # PLHIV % PLHIV % General Population Translates to 1 in.. 2,894 2,392 3,901 55% 45% 74% 5,287 100% 1.5% 1.2% 1.9% 1.3% 66 Males 84 Females 53 Persons aged 15-49 74 Persons QUICK FACTS FOR 2017 5,287 persons estimated living with HIV in The Bahamas  1.3% of total population 5,294 AIDS deaths since 1985  92 AIDS deaths in 2017 151 new diagnoses 1 case of mother-to-child transmis- sion 15 HIV/TB co-infections New Diagnoses In 2017, 151 persons were diagnosed with HIV in The Baha- mas.
Twenty-two percent these cases had progressed to AIDS by the end of 2017.

Male new diagnoses exceeded female diagnoses (60% vs. 40%), while persons aged 30-39 accounted for the largest age group of new diagnoses (28%).

The majority of cases resided in New Providence (81%), and 70% were Bahamian nationals.

One case of mother-to-child transmission was reported in 2017 and 92 persons died of AIDS-related causes.

Fifteen cases of HIV/TB co-infection were also reported in 2017.
HIV cases de- creased among all demographic groups by 55% between 2008 (n=335) and 2017 and by 81% since 1994 (n=792).

AIDS Deaths HIV surveillance data indicate that 5,294 persons died of AIDS-related causes between 1985 and 2017, including 1,169 persons between 2008 and 2017.

In the past 10 years, the number of AIDS deaths in The Bahamas decreased by 30% from 131 to 92, resulting in a decrease in the age- adjusted AIDS death rate from 43 per 100,000 persons to 23 per 100,000.
AIDS deaths in 2017 occurred in PLHIV aged 7 through 82, with the median age of 44.5.
Number of AIDS Deaths by Gender, The Bahamas, 1985-2017 Number of Newly Diagnosed HIV Cases by Sex, The Bahamas, 1985 - 2017 New HIV Diagnoses by Demographic Category, The Baha- mas, 2017 Sex Age Group Island of Residence Nationality Total Male Female <1 1-14 15-24 25-29 30-39 40-49 50+ New Providence Grand Bahama Family Islands Bahamian Other Unknown n 90 61 1 1 28 25 42 25 29 122 23 6 105 44 2 151 % 60% 40% <1% <1% 18% 16% 28% 17% 19% 81% 15% 4% 70% 29% 1% 100% Did you know…?
The National AIDS Secretariat was established by the Ministry of Health in 1983 in response to the burgeoning AIDS epidemic.

The Secretariat be- came the National HIV/AIDS Programme in 1985 to improve access to care for persons living with HIV in The Bahamas.

HIV Overview: The Bahamas, 2017 Populations of Concern Young People (15-24 Years Old) There were 28 new HIV diagnoses among youth in 2017.

This represented a 24% decrease from 2008 (n=37) and a 48% decrease since 2013 (n=54).
The largest de- crease between 2008 and 2017 was observed among females (33%), while males experienced a 16% de- crease.

The number of new cases among males in this age group increased from 8 in 2005 to 30 in 2013, and then decreased to 16 cases in 2017.
New HIV Diagnoses among Youth (15-24 Years Old), The Baha- mas, 2000-2017 Men who have Sex with Men (MSM) Based on a Bio-Behavioural Surveillance Study (BBSS) car- ried out for MSM during 2014 and 2015, it is estimated that 19% of MSM in The Bahamas are living with HIV.

This is fourteen times the prevalence of the general population.

The study also indicated that 44% of MSM had with one or more sexually transmitted infections (STIs).
HIV/TB Co-Infection There were 15 documented cases of active tuberculosis (TB) among PLHIV in 2017.

Two of these cases occurred among persons newly diagnosed with HIV in 2017.

All cases of HIV/TB co-infection were over the age of 15.

Nine of the cases (60%) were female and 6 cases oc- curred among males (40%).

Twelve of the 15 cases (80%) received HIV treatment in 2017.

Six of the HIV/TB coinfec- tion cases in 2017 died of TB in that year (40%).
Number of Acute TB Cases by HIV Co-Infection Status and HIV Co- Infection Rate among Acute TB Cases by TB Diagnosis Year, The Bahamas, 2008-2017 Late Testers Twenty-two percent of persons who tested positive for HIV in 2017 received a diagnosis of AIDS by the end of 2017 (n=33).

The majority of these “late testers” were male (64%) and 25-49 years old (61%).

Eight late testing AIDS cases also died in 2017.


Late Testers by Age Group and Sex, Newly Diagnosed HIV Cases, The Bahamas, 2017 Migrant Populations Seventy percent (n=105) of the 151 persons newly diag- nosed with HIV in 2017 identified as Bahamian nationals.

Persons of other nationalities made up 29% of newly di- agnosed cases (n=44) and those of unknown nationality accounted for 1% of new cases (n=2).
The majority of diagnoses among Bahamian nationals were male (65%, n=68), while the majority of new diagnoses among non- Bahamians were among females (52%, n=23).

New HIV diagnoses by Nationality, The Bahamas, 2017 (n=151) Did you know…?

HIV medication is available free of cost to all PLHIV in The Baha- mas.
Bahamas Ministry of Health | National HIV/AIDS Programme 2 010203040506070CountFemaleMaleTotal HIV Overview: The Bahamas, 2017 National HIV/AIDS Response Milestones in HIV in The Bahamas National HIV/AIDS Programme (NAP) The NAP has been the action framework for the response to the AIDS epidemic and is guided by the National HIV/ AIDS Strategic Plan.

The NAP is charged with being the national oversight, planning, training, coordination and evaluation body for The Bahamas’ response to HIV and AIDS.
The NAP has also received support from the Clinton Foundation from 2002—2010 and the President’s Emer- gency Plan for AIDS Relief (PEPFAR) from 2010 to 2017.
The National HIV/AIDS Centre (NAC) is the arm of the NAP which provides the following services for persons at risk of, living with, or affected by HIV:  HIV Antibody Testing  CD4, Viral Load, DNA-PCR and HIV Resistance Testing  HIV Prevention Education/Community Outreach  Treatment, Care and Support (including home visits and adherence support)  Contact Tracing and Partner Notification  Prevention of Mother-to-Child Transmission (PMTCT)  Trainings for healthcare workers, school teachers, the armed forces The NAC provides services to the general public, key populations and PLHIV free of cost to the consumer.
The NAC’s team consists of doctors, nurses and professionals in pharmacy, prevention education, laboratory services and strategic information.

HIV/AIDS Resource Committee The Resource Committee was established in 1988 and serves as a multi-stakeholder advisory body to review strategic plans, programme activities and outcomes and to collaborate on joint initiatives.
Non-Governmental Organizations (NGOs) In addition to the NAC, there are several NGOs which contribute to addressing HIV and its effects in The Baha- mas.

The NAC has collaborated with NGOs in the areas of HIV prevention education, ending stigma and discrimi- nation and increasing access to care among PLHIV.
NGOs engaged in the fight against HIV include:  Bahamas AIDS Foundation  Bahamas Red Cross  Bahamas Urban Youth Development Centre (BUYDC)  Bahamian Transgender Empowerment for Healthy Living (BTEHL)  Care 242  D’Marco Foundation  Hatian Organization for the Prevention of HIV/AIDS and STDs (HOPHAS)  Samaritan Ministry  SASH Bahamas These NGOs currently engage PLHIV, the general public 1983  First AIDS case diagnosed in The Bahamas 1985  HIV testing (ELISA) first made available in The Bahamas  Bahamas AIDS Secretariat established 1988  Samaritan Ministry established for PLHIV 1992  Bahamas AIDS Foundation established 1995  Zidovudine therapy (AZT) offered to PLHIV through the Lyford Cay Foundation and Baha- mas AIDS Foundation 1998  Focus on Youth HIV/AIDS Education Compre- hensive Life Skills Programme established  ART made available for HIV/TB Co-infected cases 2002  Highly active antiretroviral therapy (HAART) introduced to The Bahamas  National HIV/AIDS Centre commissioned 2004  Focus On Youth Curriculum introduced in gov- ernment schools 2011  Rapid Testing introduced at NAC 2013  NAC HIV Reference Laboratory accredited 2015  Defaulter clinic established by NAC  Pre-exposure Prophylaxis (PrEP) made availa- ble through the NAC 2016  Treat All Policy* introduced by the NAC *Treatment administered to all irrespective of CD4 count Did you know…?
The National HIV/AIDS Centre was one of the first places in the region to initiate a PMTCT programme and was voted as a Centre for Excellence in 2007.

Please turn over for summary of key programme data.
Bahamas Ministry of Health | National HIV/AIDS Programme 3 HIV Overview: The Bahamas, 2017 Summary of Key Programme Data Continuum of Care (90-90-90 Targets) Prevention and Testing The NAC and multiple NGOs are currently engaged in prevention activities with the general population and Key Population groups (which include MSM, sex workers and transgender persons).

In 2017, 205,120 condoms were distributed through these organizations.
The NAC also tested 4,321 persons for HIV through out- reach events and testing at the HIV Reference Labora- tory.

The overall percentage of positive cases through rapid testing in 2017 was 0.8% (0.5% for females and 1.3% for males).

Mother-to-Child Transmission The rate of mother-to-child HIV transmission in The Bahamas decreased from 5.6% in 2008 to 2.0% in 2017.

Of the 4,363 women who received an HIV test during antenatal care in 2017, 1.1% tested positive.
Sixty- nine percent of the positive ANC cases had previously been diagnosed and 31% were newly diagnosed with HIV.

All of the 51 HIV positive women who delivered in 2017 received ART; 63% of these received ART for the first time during pregnancy (n=32) while 27% were already on treatment (n=19).

There were no HIV positive babies born to HIV positive mothers who received and ad- hered to appropriate PMTCT ARV treatment in 2017.
On- ly 1 of the 51 HIV exposed infants born in 2017 contract- ed HIV, yielding a mother-to-child transmission rate of 2%.

Seven cases of HIV mother-to-child transmission oc- curred between 2013 and 2017 — all cases involved mothers who refused antenatal care and received AZT upon delivery, or who did not adhere to treatment.
Births among HIV Positive Women and Mother-to-Child HIV Trans- mission Rates, The Bahamas, 1995-2017 26% The NAC has signed on to the UNAIDS Fast Track strategy for ending HIV transmission by 2030.

In order to accom- plish this, the NAC has adopted the UNAIDS 90-90-90 tar- gets which are to ensure that 90% of PLHIV are diag- nosed, that 90% of diagnosed PLHIV are linked to care, and that 90% of those linked to care are virally sup- pressed (viral load <1000 copies/mL).
These targets have been adopted by several countries in an effort to assess the progress of HIV nationally and globally.

HIV Continuum of Care, The Bahamas, 2017 100% 7 8 2 , 5 56% 8 6 9 , 2 39% * 3 5 0 , 2 *Corresponds to 69% of PLHIV who are on ART being virally suppressed There were 2,968 persons who were on ART in 2017, corre- sponding to 56% of PLHIV being on treatment (51% of male PLHIV and 63% of female PLHIV).

This is a 32% in- crease from the 2,255 persons on treatment reported in 2013.
Adherence on treatment remains a challenge among PLHIV in The Bahamas, as sixty-three percent of the 230 PLHIV newly initiated on treatment in 2017 were still on treatment at the end of 2017 (n=146).

The NAC also implemented an extended clinic in 2015, offering patient-friendly services which target newly diagnosed, key populations, patients who experience difficulty in adhering to treatment and defaulters, offering direct link- age or re-entry into care.
Number of PLHIV Newly Initiating Treatment by Retention Status, The Bahamas, 2012-2017 For more information on HIV and AIDS in The Bahamas, contact the Bahamas Ministry of Health at...  The National HIV/AIDS Programme: 323-5968  Health Information and Research Unit: 502-4700 Bahamas Ministry of Health | National HIV/AIDS Programme 4