Rwanda

In 2009, the total estimated number of people living with HIV in Rwanda was 169,200 [146,100–193,400], including about 22,000 [11,100–34,200] children[1].

The Rwandan Demographic and Health Survey 2005 (DHS 2005) provides the most recent figure for HIV prevalence, estimating it at three per cent (95 per cent confidence interval: 2.6–3.5) in the general population aged 15–49.

HIV prevalence is significantly higher in urban areas (7.3 per cent) than rural areas (2.2 per cent) and in women (3.6 per cent) than in men (2.3 per cent) [2]. Rwanda’s DHS 2010 had not yet been published at the time of writing.

Young people aged 15–24 have relatively low HIV prevalence compared to the general population, but young women have higher rates of infection than young men. In urban areas, 3.9 per cent of young women (15–24 years) are living with HIV compared to 1.1 per cent for young men. In rural areas, one per cent of 15–24 year-old women are HIV-positive compared to 0.3 per cent of young men in the same age bracket. The gender difference is particularly striking for women and men aged 20–24, where women have a five times higher prevalence than men (2.5 per cent versus 0.5 per cent)[3]. A staggeringly high prevalence can be found in commercial sex workers where a 2010 study showed that, in Kigali, 59 per cent tested positive[4].

In 2012, 91 per cent of women and 92 per cent of men aged 15–49 reported that using condoms every time they had sex can reduce the risk of HIV infection. Even though an overwhelming majority of women and men are aware of this, only 29  per cent of women and 28 per cent of men reported using a condom during their last sexual intercourse[5].

Thanks to successes in antenatal care coverage and training of health staff in prevention of mother-to-child transmission of HIV (PMTCT), the Government of Rwanda is looking at ways to completely eliminate mother-to-child transmission. According to the 2008 national PMTCT report, 98 per cent of pregnant women enrolling in antenatal care services accepted HIV testing. The current prevalence of HIV in pregnant women tested at these sites is 4.3 per cent according to sentinel studies. In 2009, the coverage rate for HIV-positive pregnant women in need of antiretroviral prophylaxis to reduce the risk of mother-to-child transmission reached 68 per cent, up from only 56 per cent in 2008. This shows Rwanda is on track to reach the June 2013 target of 90 per cent coverage.

Antiretroviral treatment (ART) has been free in Rwanda since 2005. In 2009, 77 per cent of adults and 49 per cent of children with advanced HIV infection received ART (eligibility criteria of CD4<200) [6]. The government is aiming to achieve 90 per cent coverage of ART for adults and children in need by June 2013.