Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1697744414978.pdf (Guyana)
, .,r, / Contents Background 2 1.Information, Education and other preventative Health Measures3 2.Medical �nd Ethical ·, Considerations 2.1 Confidentiality 2.2 Testing/Counselling 2.3 Rights and Responsibilities 2.4 Health Workers 2.5 Norms and Standards 3.Social Benefits Services 4.Laboratory 5.Data Collection 6.Research AIDS Committee AIDS Committees 7.The National 8.The Regional 9.The National 1 O. Appendices AIDS Programme Secretariat 6 6 6 .7 9 10 10 11 11 12 13 13 14 15 BACKGROUND: HIV/AIDS reported cases of HIV/AIDS.
has been recognized in the early 1980's, as a global problem.

Ever since the first case was almost all countries around the world have reported total of seven hundred In Guyana the first a cumulative There were four (274) females.

successive five (105) in 1993 and one hundred five hundred case of AIDS was reported and ninety (519) males and two hundred and seventy There has been an increase in the number of cases during in 1987 and up to the end of 1995 six (796) cases were reported.
and nineteen in 1990; one hundred and 1995. years -ten (10) cases in 1987, sixty two(62) two (192) during and ninety More than three-quarter (76.8%) -one (2.64%) of the cases were among persons were less than thirty-nin e years old and twenty less than five years old.

There has also been a progressive 5.8:1 in 1988; 2.8:1 in 1990; 2:1 in 1992 and 1.3:1 in 1995, reflecting increasing role is greater reported cases in 1989 and 42.2% in 1995.

It was the of AIDS transmission.


among females than males; females accounted for 25 % of the in the male:female The rate of increase of heterosexual decline ratio.

to the effect which In addition it can have a negative families, problems country.
Social and orphaned disintegration affect young persons, predominantly force can be diminished leading children HIV/AIDS has on infected impact on the socio-economic increasing include and their of a development rates of family individuals caused by HIV/AIDS through the quality death and divorce.

and quantity of a country's labour Since HIV/AIDS to economic crises.
must be seen and treated and economic HIV/AIDS psychological the national governmental persons living level must per force include and community based organizations, with HIV/AIDS and/or their advocates.

and given the social, Problem efforts at of the HIV/AIDS the private sector, governmental, non­ where possible epidemic, the including implications as a National Women and other persons e.g.
Sex Workers and their clients, Transmitted Diseases needs to be targeted adolescents for special with Sexually education/intervention.

and persons who are usually considered to be at high risk of HIV 2 It has a Project Manager as operational of HIV/AIDS, a National the organizational structure AIDS Programme of the Ministry of head and has overall the threat Having recognized within , Secretariat was established Health.

responsibility monitoring/evaluation, to combat the epidemic.
done in collaboration for the management, reporting Planning with the National and educational planning, co-ordinating, function$ implementation, of the national efforts will be of the programme and implementation AIDS Committee.

The Ministry of Health recognizes fidelity, structure HIV/AIDS.
marriage and family values as effective and strengthening and positive and endorses lifestyles patterns the promotion reinforcement against of abstinence, of the family the spread of 1.INFORMATION, EDUCATION HEALTH & OTHER PREVENTATIVE MEASURES 1.1 Information and Education its National responsibility for the dissemination to the Human Immunodeficiency AIDS Programme of Virus that of Health of Guyana, through (NAPS} shall have overall in the country with respect The Ministry Secretariat information (HIV) and AIDS.
Through the information national establish organizations, governmental agencies of information evaluation disseminated and international partnerships non-governmental In so doing, levels.

in the planning, dissemination.


and community with other Ministries, its technical staff, the Ministry of Health is based on the available the Ministry religious the private and inter­ based organizations and implementation co-ordinating, sector, will ensure scientific data at the to of Health will seek recognises of Health to measures The Ministry with respect spread of HIV in Guyana.

any agency/organization risk" However, which through population in Guyana.
and accepts the fact that there are diverse views the which must be taken in order to prevent/control the Ministry of Health has the right its policies endangers to sanction the "at the life of with respect to as wide a cross-section at greater those sub-populations policy of Health's The Ministry information particularly the public and private methods as constructive about: to information of the population is to disseminate as possible, and it shall seek to use risk.
In so doing, media and other traditional agents in the drive to inform and educate and non-traditional the public 3 1.1.1 The Hwnan Immunodeficiency Virus (HIV), HIV infection, the definition of AIDS and HIV related illnesses.

the causative agent of AIDS, as well as 1.1.2 a.

The mode of transmission of HIV and risk factors for HIV.

1.1.2 b.

The means of preventing the transmis of HIV.

sion/spread 1.1.3 The diagnos!ic for confirming criteria HIV infection.
criteria for HIV infection and AIDS as well as laboratory 1.1.4 The clinical symptoms and signs of HIV infection and its related illnesses.

1.1.5 The counselling with HIV/AIDS, individuals and their relatives.

resources, laboratory facilities and treatment to available 1.1.6 The legal, HIV/AIDS and their families.

medical and ethical considerations regarding individuals infected with situation The epidemiological with respect to HIV infections, and AIDS AIDS cases 1,1.7 deaths in the country.
1.1.8 Educational materials to HIV and AIDS within awareness the formal and informal and responsible educational to promote sectors.

behaviour with respect 1.1.9 The availability of further information and assistance if required, and, 1.1.10 All other issues related to HIV/AIDS.

1.2 Preventative Measures.

1.2.1 HIV positive methods superinfected.


individuals in order to avoid infecting must be encouraged to practice being and from themselves others preventative 1.2.2 HIV positive semen or body tissues and organs for transplant.

individuals must be advised to abstain from donating blood, 4 the use of disposable syringes, 1.2.3 As far as possible, instruments piercing guidelines Every institution for sterilization for the proper where invasive and the disposal procedures of sharps.

will be encouraged.
will be encouraged.

The Ministry instruments, are undertaken disposal of these needles, of H:ealth lancets and other skin will provide proper based on international guidelines.

must provide adequate facilities dental and other equipment used for invasive procedures norms and standards must be properly sterilized for sterilization after each use.

The Ministry of these instruments, based on international and which are of Health will 1.2.4 Surgical, normally provide guidelines.
re-used 1.2.5 The Government will support lity by not imposing affordabi importation taxes on condoms.

widespread condom use and facilitate 1.2.6 Condoms m\!st be made accessible population and to all persons who may choose to use them.

of the to all sexually active members 1.2.7 All hotels, approved guest houses brands of condoms.
and so on should be encouraged to make available to guests regarding to all pregnant 1.2.8 Information available is found to be HIV positive, as the options any intervention available HIV Testing and Counselling Services women and women planning a pregnancy.

she shall be informed of the possible be made should woman Ifa pregnant risk to the foetus as well must be made by the woman and not by health care workers.

for the reduction of such risks.


The final decision with respect to 1.2.9 Blood & Blood Products HIV testing 1.2.9.1 which will be used for the preparation used for transfusion.

must be carried out on all blood used for transfusion of blood products.

as well as that blood shall be Only seronegative Potential 1.2.9.2 must be advised donors there shall be confidentiality that blood donated of the test.
regarding the result will be tested for HIV and that 1.2.9.3 as on the significance Prior to blood donation, of the result donors will of the test.

receive information on HN and AIDS as well 5 All HIV positive 1.2.9.4 of counsel availability ing services and follow up care.

donors must be informed of the result and advised on the 1.2.9.5 Sero-positive blood shall be disposed of following international guidelines.

2.

MEDICAL and ETHICAL CONSIDERATIONS .


2.1 Confidentiality 2.1.1 Individuals who will be tested for HIV must be assured of confidentiality.

2.1.2 Personal be held in strictest confidence the individual's information concerning individuals personnel by all health condition.

with HIV infection and/or AIDS must who may be privy to information on 2.1.3 a.

The confidence which the patient places in health workers must be respected.

2.1.3 b.
2.1.3 b.

All discussions relating health provided, confidential examinations nature.

and of a strictly must be discreet to information status and carried out, 2.1.4 Access to records number of persons of a person's HIV/ AIDS status will be restricted to a very limited and will be accorded only by level of privileges.

2.1.5 The Ministry complaints on breaches of confidentiality.
of Health will establish a committee to receive and investigate 2.2 Testing/Counselling 2.2.1 Extensive testing surve.illance, transplantation.

chance to opt out.

the screening Patients for the HIV will only be carried out during epidemiological of blood for transfusion will be informed and don:�1s of such programmes and given the and organs and tissues for 2.2.2 No individual solicit an HIV test must be offered shall be compelied to undergo to the test.
counselling, prior to and subsequent an HIV test and all individuals who 6 2.2.3 For persons must be done before the test result who have an initial is conveyed positive result, to the individual.

a confirmato ry/supplemental test 2.2.4 Results only be given to a third party with the consent of an HIV test must first be given to the client.

of the client.

The results of such test must be carried to children the foregoing 2.2.5 · With respect children should guardian.
pre and post-test guardian is available, adult, responsible In general, out with the knowledge and consent of a parent should or legal guardian that the parent receive parent where neither circumstances In extenuating make arrangements personnel or state by the child, and appropriate, counseling.

medical if possible should approved It is recomtp.ended sections will apply.

to act in their nor legal for some other on or legal HIV tests stead.

appropriate 2.3 Rights and Responsibilities ,.


·, The concern for human rights emanates with HIV/ are taken to ensure known by the public on the rights from the appreciation AIDS may be discriminated against that they are protected at large.
In keeping by government with international shall be emphasized: of the individual and that these are understood and standards, the following areas of the possibility that persons unless measures against such discrimination 2.3.1 All HIV positive sexual orientation care available without being individuals, and socio-economic subjected regardless of nationality, status, have the right to the best quality of health;,; to any form of discrimination.
;::-,, ""' , • race, age, religion, gender, ilLr should 2.3.2 No individual be compelled to undergo an HIV test.

2.3.3 No HIV positive should individual be subjected 2.3.4 All HIV positive to clear, individuals, and unrestricted be they symptomatic information scientific on their exact, state of health.

to undue isolation .

.ti --: · � ,; �-JI!

or asymptomatic, and segreg&ijon.

have the right 2.3.5 An adult, or therapeutic principles document same.
mentally procedures of medical competent recommended practice, HIV/ AIDS may refuse the diagnostic Based on the common by health personnel.

will be asked to who refuse any intervention individual with persons 7 2.3.6 The patient's rights teaching institutions.

to privacy must be respected, especially if they are in medical with HIV/ AIDS has the responsibility, and should exposure to of health in the notification ged, this personnel.

of partners be encoura HIV.


Ideally, the involvement personnel possible of information promptly and should of their directly, be done without assistance from health .

such assistance 2.3.

7 Any individual to notify partners exchange Individuals who request should be provided with .

2.3.8 Forfeiture of the privacy to no avail, been informed, community.

2.3.9 Any HIV positive who knowingly manner so as to infect other unsuspecting members prosecution.
of an HIV positive individual of his/her responsibilities to protect individual may occur after he/she has of the other members conducts himself/herself in such a of the public shall be liable for 2.3.10 of the individual's be removed seropositivity.

No individual with HIV should from or refused work solely on the basis 2.3.11. any individual who is HIV positive.
There must be no reduction or restriction of the social and working environment of 2.3.12 transfer There must be no discrimination and attendance and/or at educational other training facilities.

of HIV positive persons in terms of admission, 2.3.13 in the working HIV positive individuals will only be granted sick leave, and/or recommendation.

treatment a change environment or school on medical Persons 2.3.14 form of discrimination can afford it.
provided they with HIV/AIDS with respect have the right to shelter to the quality and should not be subjected to any of accommodation they may choose, 2.3.15 Persons they request, with HIV will not be denied private medical and other insurance coverage provided they can afford to pay the premiums.

8 2.4 Health Workers personnel attending opportunistic 2.4.1 Health aware of the possible receive spread institution.
infections the best available therapy of these infections with HIV related and should in order to alleviate i,lnesses etj.sure that these patients and to prevent the same medical their suffering who may be':sharing to staff and other patients persons should be made the 2.4.2 Training module on HIV/AIDS.
programmes for all categories of Health Care Workers should a include 2.4.3 Health of professional personnel competence attending patients with HIV/ AIDS must demonstrate a high level and conduct in their relationship with the patient.

2.4.4 HIV infected personnel.

persons must be treated in a cordial and res�ectful manner by health 2.4.5 HIV infected in order that they give voluntary therapeutic proc persons edures.

consent must receive, from health before being subjec�ed workers,.
to any diagnostic information or appropriate 2.4.6 Persons closely themselves with HIV related illnesses medical must be advised, by!

health personnel follow the prescrip tions of the attending by non-medical professionals.

to be influenced and not allow care workers, to 2.4.

7 All health from transmission care workers must of the HIV.
take precautions to protect �hemselves and patients 2.4.8 Health from all direct performing care workers patient invasive lesions patient until the condition care and from handling who have exudative procedures or weeping care equipment dermatitis must refrain used in and devices resolves.

2.4.9 Health nursing barrier body fluids.


care workers in protecting whose duties themselves entail and their patients a high risk of injury must make full use of of blood and from ahy transfer 2.4.10 Health Care Workers/Providers HIV/AIDS.

cannot refuse to atteI!ld to any person with 9 2.5 Norms and Standards The Ministry Guidelines for: of Health will establish norms and standards, based on International 2.5.1 The protection with HIV .
are infected of health personnel who care and attend who may be or individuals 2.5.2 Precautions instruments.

to be taken by personnel who handle blood, body fluids, syringes and 2.5.3 Precautions to be taken to prevent HIV transmission .

in medical centres 2.5.4 Precautions to be taken by personnel who handle corpses.

2.5.5 Personnel who do laboratory testing for HIV.

2.5.6 The sterilization instruments and disposal and dental as surgical as well equipment.
of syringes, needles, lancets, other skin piercing 2.5.

7 Management of infected persons.

2.5.8 Counselling (pre-and post-test) 2.5.9 Condom storage and quality control.

3.

SOCIAL BENEFITS 3.1.1 HIV positive to the same social individuals must not be discriminated against in the society.

as any other individual benefits and must have access 3.1.2 Individuals Insurance financial Scheme and develop support from the National AIDS will not be discriminated Scheme.
Insurance against, who have made the required number of contributions to the National and will receive 3.1.3 Individuals develop practitioner from the State.

who have not participated in the National Insurance against AIDS will not be discriminated should is deemed incapable and if on the advice to receive be entitled of working Scheme and of a medical support financial 10 of persons 3.1.4 Children enjoy the same social HIV/ AIDS patients against.
be discriminated benefits will be afforded with HIV/AIDS must not be discrimipated as any other child in the society.

against of In µtis context, as oilier orphans and must orphans and will not the same opportunities 4.

LABORATORY SERVICES of Health The Ministry wilr: 4.1 Specify norms, procedures laboratories supplemental where testing tests.

for HIV is carried and standards which must: be adhered to by all the: appropriate and initial out, including 4.2 Provide for HIV.
· testing acces�ible laboratory services to carry out initial as well as supplemental 4.3 Require periodic and standards.

all laboratories where testing for HIV is carried!

inspections to ensure that they adhere to the specified out, to be subjected to norms, procedures labofatory 4.4 Require quality control recommended all laboratories systems by the Ministry where HIV testing and to participate of Health.
in any external is carried out to have in place internal programmes qual�ty control 4.5 Draw up a list of approved based on international allowed of Health with prior written approval guidelines.

The importation I from the Ministry brands of HIV test kits to be imt><>rted for use in Guyana, and sale of �ther brands will only be 5.

DATA COLLECTION 5.1 HN infections Ordinance No.


15 of 1934 as amended in 1990) and AIDS are notifiable diseases (Mihistry of Health Public 5.2 The Ministry AIDS cases and AIDS-related infections, data base to be used will ensure confidentiality.

requires of Health within deaths all medical practitioners to provide reports seven CJ) days of diagnosis.
of HIV The 5.3 The Ministry of Health be used by all medical will determine practitioners, the format for the fFporting form which will in the private and pub�ic sectors.

11 5.4 The Ministry information on HIV and AIDS.

of Health will determine the periodicity of reporting epidemiological 5.5 All laboratories will be required to provide reports of all positive HIV tests.

6.

RESEARCH The main objective studied.


of research is to obtain a better understanding of the problem being any research related to HIV/AIDS is undertaken a written 6.1 Before submitted collaboration to and approved �ith the relevant by the Ministry departments of Health.

of the Ministry of Health.

All research work proposal be shall must be done in 6.2 Priority duplication to all individuals, shall be given to areas of concern and all efforts will provide work.
The Ministry of Health of research departments or institutions involved in research shall be made to avoid the necessary related to HIV/AIDS.

guidance 6.3 In cases where research must be obtained subjects to withdraw from all human subjects in such research.

from the study at any time shall be maintained.


involved involves the participation of human subjects, prior consent The right of the where research that the participant 6.4 In instances to ensure arrangements shall be made for all HIV positive follow-up surveys involves his/her care.

Exceptions are undertaken to the foregoing HIV testing, for the purpose receives result all measures shall be put in place In addition, in complete confidence.
appropriate receive subjects to will only be made in situations where special of epidemiological surveillance.

6.5 Copies the appropriate addition, from any such research.

of all reports departments of Health the Ministry emanating of the Ministry from research of Health activities to shall be made available agencies.

In on(s) resulting and all other relevant publicati of all scientific shall be informed 12 7.
NATIONAL AIDS COMMITTEE (NAC) AIDS Committee formed by representativel of many sectors and including persons insurance, and counseling services, organizations, education, religious, non-governmental health, with HIV/ AIDS and/or their legal and pol�tical bodies, advocates, the media, international and research organizations, will meet on a regular basis to advise the Ministry of Hklth on matters relating 7.1 A National organizat ions, social communications, institutions to the National AIDS Programme.
7.2 The membership the Chief Medical Officer will be the chairman of the committee.

of the Committee will be determined by the Minister of Health and Manager 7.3 The Project member of the National Ministry precise of Health, and efficient, the National AIDS Committee as well as ensuring co-ordination AIDS Programm� will be an ex-officio the that comniunication between AIDS Secretariat is and activities.

of strateg�es and the Natiohal AIDS Committee, ensuring of the National 8.
REGIONAL AIDS COMMITTEES level, cross-section Regional of organizations 8.1 At the regional a wide services, and counseling religious, non-governmental communications, institutions.

AIDS Committees and individuals, insurance, shall be,formed including tjealth, legal and politi�al international organizations social the media, and research by members education, organizations, bodies, of 8.2 The Regional Health membership to function.
of the committee Officer will be responsible as well as to put in place for organizing the mechani$m(s) and determining the for the committee 8.3 The committee Committee will be required as well as the National to provide AIDS Secretariat.

feedback to the Regional Health 13 9.

NATIONAL AIDS PROGRAMME SECRETARIAT (NAPS) AIDS Programme 9.1 The National which will, in collaboration with other Governmental perform the management,planning, and reporting including HIV/ AIDS i.n Guyana.
with respect functions Secretariat is a unit within the Ministry of Health and Non-governmental agencies, monitoring/evaluation co-ordination,implementation, to the prevention/control of STDs and management 14 APPENDICES Appendix 1: Role of The National AIDS Committee The National AIDS Coilllllittee will: I 1.Have sub-committees progranune.

which will concentrate on specific aspects of the national ' 2.Recommend the National to the Minister HIV/ AIDS strategies the basic principles and activities.
and plans of actioq which will detennine 3.Recommend for all aspects ethical, managerial, policies financial of the HIV/ AIDS progrrupme as well as technical and international issues.

legal, including 4.Advise National on educational, HNI AIDS Programme.

training and public information activitjies in support of the 5.
Advise including governmental on the organization programme organizations and use of existing of the HIV/ AIDS prevention and control programme i involvement of non­ responsibilities, intersectoral co-operation, health and other infrastructure resources.

6.Advise on measures which should be taken to improve the HIV/ AIDS programme.

7.Share ideas on sources may be mobilized to support international, of the national and non-governmental finance which HIV/ AIDjS programme.
the activities of national, basis and recommen� 8.Review HN/AIDS in Guyana, and subsequent on a regular legislative reforms as is n�cessary.

changes to the present Policy Document on 15 Appendix II: Regional AIDS Committees 1.The Regional will be selected AIDS Committees from among them.

will be comprised of volunteers and the Chairperson 2.The regional Committee evaluation and education AIDS Committees will have to that of the National AIDS and will.
also be responsible co-ordinating, monitoring, a role similar for planning, within the AIDS Programme at the Regional level.

3.The Regional Committee the National previously AIDS Programme set out in this document Secretariat.

AIDS Committees will follow the guidelines and will receive of the National AIDS support from technical AIDS Committees will 4.The Regional in order to carry through fund-raising out its educational activities.
Clear measures be funded by the Regional Funding bility should and other functions.

of accounta Councils can also be acquired be put in place.

Administrative 5.Given the voluntary nature on the number of Regional on the sizeof of the Regional Sub-Committees, AIDS Committees, its members to be formed within the Region, shall decide dependent the Region and the availability of volunteers.
6.The Regional these exist,the AIDS Committee Health Regional will report to the Regional health where Committee, Officer and the National AIDS Programme Secretariat.

7.The RHO or his/her Administration and NAPS.

representative will be responsible for liaising with the Regional 8.Representatives of each RAC will be invited, to participate in NAC meetings.

9.Regional these should AIDS Committees fall within the National Programme.
will plan their activities in collaborat ion with NAPS and 16 Appendix III: The National AIDS Programme Secretariat The National governmental AIDS Programme and non-governmental agencies: Secretariat will , in collaboration with other relevant 1.Develop plans of acti�n which will determine strategies and acti-l,ities to be carried out.

2.Carry out epidemiological in support surveillance of the HIV/AIDS program.me.
3.Plan, co-ordinate and public information activities in support implement, monitor and evaluate ofthe National HIV/AIDS programmes1on education, training Programme.

4.Co-ordinate and implement all policy decisions.

5.Analyze development Committee.

the broad scope of the HlV / AIDS epidemic to the Ministry and make reconunendations on social and its potential impact AIDS and the National of Health 6.Develop plans with respect to financing the National HIV/AIDS Programme.
the formation 7.Encourage governmental managing and sustainabi undertaking in Guyana.

lity of Regional activities the HIV/ AIDS epidemic organizations, AIDS Committees and Non­ and aimed at preventing/controlling 17 PROPOSED AMENDMENTS TO FINAL DRAFT POLICY DOCUMENT ON HIV/AIDS Committee of the National The Legal & Ethical of consultation, a wide cross-section progranunes.
various organisations, with a view to producing of views through and indivi Organisations medical professions, private concerned and public organisations institutions, Aids Committee policy a national interviews, individual in these exercises practitioners, with rights care-givers and the media.

discussions were drawn from the duals who participated since 1995 has conducted workshops, religious a process and training and counseling on HIV-AIDS.
This process canvassed The draft policy is scheduled section following amendments.

of organisations In a final to be laid in Parliament.

review 15, 1998 during on October and agencies of the draft document, a cross­ the a Day of Review proposed Page 2: BACKGROUND •· .

old para.

4: Note:Participants agreed that statistics need to be updated, if possible, from 1995.

(Inclusion made on 'Day of Review'.)

new para.


5: "However, Several factors practitioners to submit these statistics contribute may disguis to this situation, degree one of them being the failure e a signific.int of private of under-reporting.

reports to the Ministry of Health."

(Amendment old para.

6: line 4: delete "where made on 'Day of Review') possible" to read"including persons living with HIV/AIDS" .... (Amendment old para.
7: delete made on 'Day of Review ') "Women and other" begin sentence with "Persons who are ..... .

Ethical Legal & made through (Inclusion new para.

8: Women play a critical Societal sexual HIV/AIDS attitudes must activity, accepted role in the success promote Committee, the right of women to choose so ?..3 to allow them to work effectively by consensus by 'Day of Review' of HIV/ AIDS policies and programmes.

to engage whether in of to prevent the: spread (Inclusion new para.
9: The creation of peer groups by consensus for HIV/AIDS persons and amended on 'Day of Review') to share experiences Committee, made through Legal & Ethical accepted has proven in building capacities to be beneficial.

to provide support Such groups should to HIV positives.
be encouraged and assisted 18 Page 3: INFORMATION,EDUCATION & OTHER PREVENTATIVE 1 HEALTH MEASURES (Inclusion made through New para 2: "Given Legal & Ethical that the percentage Committee, accepted by consensus and amended on 'Day of Review') of HIV infected as early as possible, of adequate rising programmes young peoplelis at a rapid rate, the awareness of HIV/AIDS is importrui,t.

learning to implement these programmes shall on risky sexual Efforts in schools and be emphasized.
and the impact of higher development, behaviour institutions The Ministry of Health, ensure implemented that appropriate for STD/AIDS school curriculum health in collaboration with the MinistJir of Education, will seek to and teaching materials are developed and education."

I Old para.

2: (Note this paragraph was not submitted in 'Day of Review made the following Line 3: "The Ministry insert)investigate and advise amendment.)
of Health has the right to ... (delete 'sanc..'tion ' and any agency/organization w�ch ..... " the Final Draft by the Legal and Ethical Committee.

The Page 5: Preventative Measures ·, (Inclusion Old para:l.2.3: made through Delete the Legal & Ethical "As far as possible needles, lancets Committee, the use of disposable .. " Beg;,n sentence with "Syringes, and other skin-piercing proper must not be re-used.''
guidelines instruments will provide for the proper accepted by Consensus o� 'Day of Review') "The Ministry of Health (Delete disposal of these instruments, ..... ) accepted (Inclusions New para.

l .2.

6a.

"Condoms for sale and use in the country the Legal & Ethical Committee, by Consensus must conform on 'Day of Review') to the norms and standards made through determined by the Ministry of Health and informed Newpara.l.2.6b.
"Condoms must be stored under conditions which will prevent by international deterior research."

ation or decay."

(Inclusion 1.2.9.

(Include made through the Legal & Ethical after line 2) "Likewise, women regarding Committee, accepted by consensus information anonymous, on 'Day of Review') be made available and advice �hould to Ante-Natal HIV testing unlinked within all pregnant Departments."

Page 6: MEDICAL & ETHICAL CONSIDERATION Confidentiality made and accepted (Amendments 2.1.1.
"Individuals by consensus who will be tested on 'Day of Review 1 for HIV must be {deleye 'assured of' and insert) guaranteed confidentiality."

2.1.2.

"Personal information ...... (emphasize) confidence " "must be held ip �trictest .... 2.1.3a.

"The confidence which the patient(emphasize)"must be tespected."

19 2.1.3b.

(Emphasize) "discreet" and of a "strictly confidential nature".
2.1.4. to read: "Access to records of a person's IDV / AIDS status to a very selected number of persons and must be accorded only must be by level of Change sentence restricted privileges."

2 .1.

5.

Change sentence to read: disciplin "An effective to receive,.investigate ary mechanism and act on complaints must be put in place by the Ministry of Health on breaches of confidentiality."

(Inclusions 2.1.7.
(Inclusions 2.1.7.

"Employers/employee Legal & Ethical made through Committee and accepted by consensus on 'Day of Review'.

policies regarding the IDV/AIDS status organizations must develop s/members."

of employee on confidentiality 2.1.8.

"All agencies/or deve4>p explicit ganizations confidentiality particularly statements those in the area of HIV/AIDS should and policies."

2.2.5.

Line 2 ... (delete 'children should', guardian "children guardian and insert)"legal .
must" ..... insert) should" must" ... Line 3 ... (delete "legal (Continue sentence "Results guardian, The results of HIV tests carried or in special be given with.)

should circumstances, out on children or legal the test.

adult, the responsible after the adult has received post-test must be given to the parent who permitted counselling."

Rights and Responsibilities (Amendments made and accepted on 'Day of Review') Para.

1.

(Last line: delete "shall" insert) "must".

2.3.1.


Include 'disabilities" of nationality, .... " status, economic ...

Sentence race, age, religion now to read:" disabilit All HIV positive individuals, sexual orientation regardl�ss and socio­ ies, gender, 2.3.7b.

Include,.,,,"Information having and post-test to partners on confidential must be made available to the infection, counselling.

been exposed HIV testing on the implications of and pre­ facilities 2.3.8./9.
Note: These paragraphs were not submitted 1he following accepted by paragraph was submitted consensus on the 'Day of Review '.)

through the Legal & Ethical and Committee through the Legal & Ethical Committee.

"Where the behaviour community, responsibilities of his/her members immediate of an individual is deemed to· be a threat of his/her care will be taken to inform the individual the privacy the of the individua vulnerability."
and, while safeguarding to his/her community l, to educate special of their 20 2.3.15 "Persons with IDV (delete 'will".

insert) "must" .... through (Inclusion 2.

3.

16.

"No person the Legal & Ethical Committee, accepted by consensus on 'Day of Review').

access shall be denied sporting eating and drinking places, However, right their where bleeding public or an AIDS patient.
be curtailed especially to public facilities such as place of entertainment, facilities, on account to participate bf being HN positive sports may in bo4y contact or transfer of other bo�y fluids may occur."

2.3.17. right have a "All people causes and transmission in their human and ",exual relationship or .dlformation, in this matter nation."

All persons to good health.

and safely ofHIV/AIDS in order to be able to act .-esponsibly has a clear obligation know and understand with others.
should the Governmen� and communicatio tj to the people of the education _ Page 9 Health Wo.rkers (Amendments made and accepted by consensus on 'Day of Review') 2.4.2.

"Training programmes .. .

.

(delete 'should include ',insert) 'must include' ... 2.4.4.
Emphasize : "IDV infected persons must be treated .... " (Inclusion made by Medical 2.4.7 (Continue & Ethical sentence accepted Committee, with) handling by consensus ... "These precautions of specimens, washing, proper the proper disposal of needles s. ,,J and other sharp instrument on 'Day of Review') the use of appropriatd hand­ must include satisfactory and protective apparel 2.4.9a.
(Continue status, they shall sentence with) ...... "While they are encouraged to determine their HIV not be subjected to mandatory testing."

2.4.9b.

Staff involved must complete institution that may be necessary.

in accidental an accident and the Ministry of Health exposure to blood or body fluidf from any patient/client form and inform the relevant authorit who will provide and any couns�lling the ies within follow-up 2.4.10.
(Place emphasis on "cannot refuse" 2.4.11. new sentence:) "Health (Include procedures in which they may be injured care workers and inadvertently with H.[V must not perform jnfect another person."

21 2.5.

Norms and Standards (Amendments by consensus made and accepted 2.

5.

I.

Add' and care givers'.

of health New sentence personne on 'Day of Review') naw reads: "The protection individuals who may be or are infected with IIlV."

l and care-givers who care and attend to 2.5.3.

Add'"care facilities".


New sentence now reads: to be taken to prevent mv transmission in medical centre/ "Precautions care facilities."

LABORATORY SERVICES 4.

(Amendment made and accepted The Ministry Bureau of Standards of Health by consensus on 'Day of Review') statement must:" agencies and other specialized (include additional to read)" in collaboration with the National 4.3.

45.
45.

(De/et(_ 'to be subjected' and insert) "must be subjected" (Delete 'Draw up a list of' and insert) "Have an approved list of brands ..... " 5.

(Amendment made and accepted DATA COLLECTION by consensus on 'Day of Review') 5.2.

Rephrase sentence to read: "All medical practitioners must provide to the Ministry of Health reports ofIDV.

.. " (Inclusion made through the Legal & Ethical Committee and accepted by consensus on 'Day of Review') 5.3.a.
(New paragraph to read:) The Ministry of Health, Association Medical IIlV/AIDS, will determine medical (GMA) and appropriate the format for the reporting sectors.

and public the NAPS, and in collaboration organisations with the Guyana with concerned form which wilJ be used by all practitioners, in the private through 5.3.b.
(Additional paragraph to read:) through The Ministry determine of Health, the NAPS and in collaboration with the periodicity ofreporting epidemiological information the GMA, will o IBV/AIDS.

5.5.

6.

6.2.

All laboratories must provide reports of all positive HIV tests.

RESEARCH (Amendments made and accepted by consensus on 'Day of Review'.)

to read:) (New paragraph "Priority duplicati National must be given to areas of concern and all efforts on of research Aids Progamme work.
The Ministry Secretariat of Health in collaboration with the (NAPS) and the Guyana Medical Association must be made to avoid 22 6.3.

6.4.

6.5.

(GMA) should departments seek to provide involved or institutions and i4£ormation guidance in research related to IDV/AIDS.

to all individuals, (Delete 'shall be maintained' and insert) "must be maintained."

(Line 1:delete 'shall 'will {Line 4:delete be put in pla�e' only be made' and insert) and insert) "must �nly be made" ... "mus{ be put in place' ...
The Ministry of Health emanating such research from research relating should activities to mv / AIDS in Guyana.

make every effort tol receive and all scientific copies publications of any reports from any resulting 7.

NATIONAL AIDS COMMITTEE (NAC) page 13 (Amendments made and accepted by consensus on 'Day of Review ') 7 .1.

(Line 1: Include interested (Include (RAC) must also be a member of the NAC."
representatives ... " after Line 6: "A representative the word 'interested' "AN ational of each active A.ids Committee formed by Regional Aids Committee 7.2.

7.3.

(Amendment) "The membership The Committee will choose its Chairp erson and Secretary will be determi�d of the Committee by the Minister of Health.

from the membership.

(Amendment) "The Project Communicable Diseases Committee .....

Manager " of the National Aids Programime and the Director AIDS members of the National of will be ex-officio 8.
8 .1.

(Include REGIONAL AIDS COMMITTEES (RACs) t he phrase at end of paragraph.')

" ... and persons living with IDV/AIDS."

8.2.

(Amendment) "The Regional interest Health within groups Officer along with committed the community representatives of for organising will be responsible .... " 9.

NATIONAL AIDS PROGRAMME SECRETARIAT (NAPS) 9.2.


(To be included -role of Project Manager, relatio•ship with NAC/RACs) Note: Appendices on Roles of the NAC, RACs and NAPS to be doJbJe-checkedin Mandate as spelt out on pages 13 and 14 of Final Draft and Recommendations keeping with from Day of Review.
23 ORGANIZATIONS/AGENCIES WHO HAVE PARTICIPATED CONSULTATION PROCESS ON THE DRAFT NATIONAL POLICY ON HIV/AIDS ALLEYNE'S HIGH SCHOOL -GEORGETOWN AMERINDIAN PEOPLES ASSOCIATION ANGLICAN CHURCH -BERBICE, ARTISTES IN DIRECT.
ATTORNEY GENERAL'S CHAMBERS SUPPORT LINDEN BAHAI NATIONALASSEMBLY BELVEDERE BIO MED LABS BISHOP'S BRICKDAM SECONDARY SCHOOL HIGH SCHOOL PRlMAR Y SCHOOL -BERBICE C AMAL INTERNATIONAL OF GUY ANA CANA NEWS SERVICES CENTRAL ISLAMIC ORGANISATION CHRISTIAN BRETHREN CHURCH -LINDEN CLERICAL & COMMERCIAL WORKERS UNION COLONIAL LIFE INSURANCE COMPANY -LINDEN COMMONWEAL TH YOUTH PROGRAMME COMMUNITY BASED REHABILITATION PROGRAMME COPE TV -LINDEN CORENTYNE COMPREHENSIVE HIGH SCHOOL-BERBICE DAVE'S TV.-BERBICE F RYISH VILLAGE COUNCIL -BERBICE G+ GAHEF GENITO URINARY l\.1EDICINE CLINIC GUY ANA AGR.ICUL TURAL WORKERS UNION GUY ANA AHMADIYY A ANRJMAN GUYANA ASSOCIATION GUY ANA BAR AS SOCIA TlON ON AIDS TRAINING, EDUCATION & COUNSELLING 24 SERVICE INSURANCE SCHEME CORPORATION GUY ANA BROADCASTING GUY ANA CHRONICLE NEWSPAPERS GUY ANA CONFERENCE OF 7rn _ DAY ADVENTIST GUY ANA COOPERATIVE GUY ANA COUNCIL OF CHURCHES GUY ANA IDNDU bHARMIC SABHA GUY ANA HUMAN RIGHTS ASSOCIATION GUYANA INFORMATION GUY ANA ISLAMIC TRUST GUYANA LABOUR UNION GUY ANA MANUFACTURERS ASSOCIATION GUY ANA MEDICAL ASSOCIATION GUY ANA MINE WORKERS UNION GUYANA NATIONAL SERVICE GUY ANA NURSES ASSOCIATION GUY ANA POLICE FORCE GUY ANA PRESBYTERIAN GUY ANA PRISON SERVICE GUYANA PUBLIC SERVICE UNION GUY ANA RESPONSIBLE GUYANA STATE PLANNING GUY ANA TEACHERS' UNION GUY ANA TRADES UNION CONGRESS GUYSUCO TRAINING CENTRE GENERAL WORKERS UNION CHURCH -BERBICE SECRETARIAT PARENTHOOD ASSOCIATION IsMA v SUPERMARKET -LINDEN J ACS SUPERMARKET -LINDEN JESUIT IN GUY ANA JESUS DISCIPLES MISSION -LINDEN �TEUR NEWS RESOURCE CENTRE SUPPORT GROUP LINDEN HANDICAPPED CENTRE LINDEN LEARNING LIGHTHOUSE LIFELINE COUNSELLING SERVICES LINMINE LIBRARY LITTLE ROCK TV ST A TION -BERBICE LOWER CORENTYNE SECONDARY SCHOOL -BERBICE 25 LUTHERAN CHURCH IN GUY ANA MACKENZIE HOSPITAL MATRIX YOUTH GROUP MAYOR & CITY COUNCIL -GEORGETOWN/LINDEN/NEW MAYOR & TOWN COUNCIL CLINICS METHODIST CHURCH IN GUY ANA -NEW AMSTERDAM & EAST CANJE MINISTRY OF EDUCATION MINISTRY OF HEAL TH -QUALITY ASSURANCE DIVISION MINISTRY OF HEAL TH -GEORGETOWN, WEST DEMERARA, LEONORA, NEW AMSTERDAM/PORT MOURANT MOURANT,LINDEN & WISMAR HOSPITALS MINISTRY OF HEALTH-REGIONAL HEALTH SERVICES MINISTRY OF LABOUR MINISTRY OF TRADE MISSION CHAPEL MISSION CHAPEL FAMILY LIFE CENTRE CONGREGATIONAL UNION AMSTERDAM.
PORT & INDUSTRIAL EMPLOYEES OF CLERICAL ASSOCIATION NATIONAL AIDS PROGRAMME SECRETARIAT NATIONAL NATIONAL BLOOD TRANSFUSION SERVICE NATIONAL CENTRE FOR EDUCATION ASSOCIATION NATIONAL ISLAMIC SISTERS NATIONAL INSURANCE NATIONAL -LINDEN NEW SIL VER CITY SECONDARY SCHOOL NUTEC CO. -LINDEN SCHEME LABO RA TORY FOR INFECTIOUS DISEASES DEVELOPMENT p ANAMERICAN HEAL TH ORGANISATION/WORLD & WELFARE SER VICES -GEORGETOWN, PROBATION HEAL TH ORGANZATION NEW AMSTERDAM, LINDEN DEMOCRATIC �IO ANTILLES REGIONAL REGION 6 AIDS COMMITTEE REGION 1 O AIDS COMMITTEE ROMAN CATHOLIC COUNCIL -LINDEN CHURCH -GEORGETOWN,LINDEN, LOWER EAST COAST, PORT MOURANT STABROEK NEWS ST. AIDAN'S PRIMARY SCHOOL-LINDEN ST. FRANCIS XAVIER R. C. YOUTH GROUP 26 ST. STANISLAUS COLLEGE UNICEF UNITED MISSION CHURCH -LINDEN UNIVERSITY OF GUY ANA -FACULTY OF HEAL TH SCIENCES VIEIRA COMMUNICATIONS VOLUNTEER YOUTH CORPS W1sMAR HILL PRIMARY SCHOOL -LINDEN WOMEN'S AGLOW WOMEN'S PROGRESSIVE ORGANISATION y OUNG MEN'S CHRISTIAN ASSOCIATION YOUNG WOMEN'S CHRISTIAN ASSOCIATION YOUTH CHALLENGE £NTERNAT10NAL 27