A new set of national guidelines have been launched and a partnership announced between a local community group - Boutokaan, Inaomataia ao Mauriia Binabinaine Association (BIMBA) and the Ministry of Health, as part of efforts to strengthen the control, prevention and care for the human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs) on the island nation.
The announcements were part of several activities across Kiribati to mark World AIDS Day, which falls each year on 1 December. The theme for this year was ‘Live life positively—know your HIV status’.
The new guidelines bring together existing guidance from the World Health Organization (WHO), on the provision of HIV and STI-related interventions and are crucial to ensuring effective delivery of prevention, diagnosis, treatment and care services.
The four guidelines are: 1) guideline on the use of antiretroviral drugs for treating and preventing HIV infection; 2) guideline on HIV testing services; 3) comprehensive guideline on STI diagnosis, treatment and management; 4) and guideline on prevention of mother-to-child transmission of HIV, syphilis, and hepatitis B and C.
“Implementing these guidelines fully reflects our commitment towards achieving the UN 90-90-90 global targets[i],” said Minister of Health and Medical Services, Honorable Tauanei Marea. “The response to HIV and AIDS shall be one of the priorities in our efforts to develop our country. The future of the HIV response will rely on a constant willingness to build on past successes and rise to new challenges.”
The national guidelines were developed by the Kiribati Ministry of Health and Medical Services, Kiribati Family Health Association, United Nations Development Programme (UNDP), World Health Organization (WHO) and the Pacific Community. Similar national guidelines are being developed and rolled out in 11 Pacific island countries through the Multi-Country Western Pacific Integrated HIV/TB Programme in partnership with WHO.
“Today is an important day for the HIV response in Kiribati,” said Programme Manager for the Multi-Country Western Pacific Integrated HIV/TB Programme at the UNDP Pacific Office in Fiji, Anna Chernyshova. “By rolling out these national guidelines and enhancing community-based interventions, we are taking real steps towards strengthening the quality of care and improving access to essential health services for vulnerable populations.”
Also announced on World AIDS Day and vitally important to an effective HIV and STI response, was a new partnership between the Ministry of Health and BIMBA – a local lesbian, gay, bisexual, transgender and intersex organization and partner of the Multi-Country Western Pacific Integrated HIV/TB Programme. As part of the partnership, BIMBA opened a drop-in centre on the premises of the Ministry of Health in the capital, Tarawa.
“This partnership is a recognition of our movement and the need to strengthen control of HIV and STIs in Kiribati,” said Vice-President at BIMBA, Joeleen Ar. “It gives us an opportunity to reach new heights of involvement in the public health response. Of course, it’s not only about our own success, but achieving the goal of delivering services to key populations – men who have sex with men, transgender people, sex workers and other vulnerable youths – in the future."
In Kiribati, HIV prevalence is low but there are concerningly high rates of STIs, particularly among certain groups – namely men who have sex with men, transgender people, sex workers and seafarers. These key populations groups have limited access to preventative and diagnostic sexual and reproductive health services, and, according to a 2016 mapping and behavioural study, are engaging in high risk behaviours such as having multiple sexual partners and unprotected sex.
 The 90–90–90 targets were launched in 2014 by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and its partners with the goal of ending AIDS by 2020 and refer to targets of 90% of people living with HIV know their HIV status, 90% of people know their HIV status are receiving antiretroviral therapy and 90% of the people receiving ART have suppressed viral loads.