Unaids
Retention in care Seventeen countries of the region reported data on retention in care or survival for people receiving antiretroviral therapy after 12 months, an important indicator of programme effectiveness. Not surprisingly, the data clearly show the extraordinary impact that antiretroviral therapy can have on the lives of people who are eligible for antiretroviral therapy. Their life expectancy can increase dramatically and it can have transformational impact on the overall quality of their life. In addition, for the marginalized populations heavily affected by HIV in the MENA region, the health benefits of antiretroviral therapy help reduce the stigma for people living with HIV. The global average for retention at 12 months in low and middle-income countries is 82%. Based on the 2011 Universal Access reporting, only six MENA countries reported a percentage above this average and a number of them have very low rate, such as Djibouti, Yemen and Sudan. It is important to note that many countries have problems linking people who are living with HIV to treatment and care because of poor referral systems. Also, as is the case in other regions of the world, there are also problems with retention and loss for follow-up. As a result, the connection between HIV testing, treatment and care is tenuous and problematic. The extensive use of mandatory HIV testing in the region is not an effective gateway to treatment. For many people at increased risk (e.g. people who inject drugs, men who have sex with men and sex workers), this testing occurs when they are arrested, admitted to hospital or incarcerated. In these situations, the results are rarely followed by counselling or access to treatment. The fact that the three Cs of HIV testing are not widely used in the region has a negative impact on country efforts to provide universal access to treatment.
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The fact that the three Cs Confidentiality, informed Consent and Counselling of HIV testing are not widely used in the region has a negative impact on country efforts to provide universal access to treatment.