Health Experts "Fear" Impending HIV Epidemic in Southern Sudan After Two-Decade Civil War

Health experts "fear" that southern Sudan, emerging from more than two decades of civil war, could experience a major HIV epidemic because of low levels of HIV/AIDS awareness among the population, an influx of returning refugees from neighboring countries with higher HIV prevalence and an increase in cross-border trade, IRIN News reports (IRIN News [1], 4/10). HIV prevalence in southern Sudan is estimated to be 2.3%, according to a report by U.N. Population Fund (IRIN News [2], 4/10). The civil war devastated the region and left people without basic services and access to HIV prevention information and support. "It is so hard to disseminate information when literacy levels are so low, and there is a complete lack of television and radio," Sheila Mangan, a UNICEF officer based in Juba, the capital of southern Sudan, said. A series of studies by the World Health Organization, conducted after a peace agreement was reached in January 2005, suggest that authorities in southern Sudan face many obstacles in HIV prevention and education. Health experts also are worried that, as the country rebuilds, increased mobility among people threatens to intensify the spread of HIV (IRIN News [1], 4/10). There is concern that returning refugees will fuel the spread of the virus. More than 4.5 million people fled during the civil war, with four million displaced internally and another half a million living as refugees in neighboring Uganda, Ethiopia and Kenya, all countries with a high HIV prevalence (IRIN News [2], 4/10). Commercial sex work among tea-sellers and low-income women also is increasing as traders and truck drivers from Uganda travel through southern Sudan.

Solutions
Despite having limited resources, the government of southern Sudan is gradually implementing HIV prevention strategies. The region's first voluntary HIV counseling and testing center has been operating in Juba since 2004. To date, about 1,000 people have been tested for the virus, and 216 have been found to be HIV-positive. The center also has begun providing antiretroviral therapy to a small number of patients. Felix Wani, a national HIV/AIDS officer, said the center since January has been monitoring 80 HIV-positive patients with high CD4+ T cell counts, 35 of whom have been provided antiretroviral treatment. WHO also is operating three antiretroviral drug treatment sites in the towns of Juba, Wau and Malakal. The agency plans to open eight more by the end of 2006 and aims to have 200 patients receiving antiretroviral drugs by December, according to Patrick Abok, WHO's HIV/AIDS program officer in southern Sudan. WHO also plans to increase antiretroviral treatment in areas that could possibly have high a HIV prevalence, including towns located close to the borders of Uganda and the Democratic Republic of Congo, Abok said. In addition, the U.N. Development Program is supporting an HIV awareness campaign in the Sudan Mirror, one of the region's largest weekly newspapers. Southern Sudan also is looking to Uganda for ideas on how to tackle HIV/AIDS, although there is disagreement among authorities about whether to focus primarily on promoting abstinence or condom usage (IRIN News [1], 4/10).

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