1. Notified AIDS and HIV Infection Cases in the Seychelles: Epidemiological Trends Ministry of Health, SeychellesMinistry of Health, Seychelles –N. E. Udonwa –J. Nwosu University of Brescia, ItalyUniversity of Brescia, Italy –G. Carosi –A. Matteelli Xth International Conference on AIDS and STD in Africa, December 1997

2. ABSTRACT Objectives: To determine the epidemiological pattern of reported AIDs and HIV test in the Seychelles. Methods: All requests for HIV tests in the Country’s Public Health facilities were sent to the central clinical laboratory. HIV ELISA tests were performed on all samples and reactive sera were confirmed by Western blot. All results were sent to the only categorical STD clinic for documentation and notification. Cases were notified as AIDS if there was infection with HIV and the patient was suffering from conditions related to deteriorating immune system. Data were entered and analysed in Excel computer files. Results: Between 1987 and 1996 there were 72 notified HIV infections out of which 21 (20%) were diagnosed with AIDS, Twelve (57%) of the AIDS cases had died. The pick of newly identified infections occurred in 1995 with 14 cases, while in 1996 12 cases were reported. Seventy six percent (n=55) were in the 20-39 years age group. The male female ratio was 39:33 (1.2%) with 77% (n=30) and 76% (n=25) respectively being in the 20-29 years age group. The was a female preponderance up to the age of 19 years while a reversed ratio was seen among those who were 20 years and above. The reported route of acquisition was heterosexual intercourse in the great majority of cases, with only 4 cases among the male homosexual, and two children born from HIV infected women, while none had a history of intravenous drug abuse or blood transfusion. The positivity rate of HIV testing was highest among STD patients (1.6%) compared to hospital inpatients (0.6%), and blood donors and pregnant women (less than 0.2%) in 1995. Comments:: HIV notifications present a rising trend in the Seychelles. The male female ratio is close to 1. Heterosexual transmission seems to be responsible for most notified infections and positivity rates are highest among STD patients. Preventive measures should include specific programmes of prevention of sexual transmission targeting the adolescent, the young and middle age group. Xth International Conference on AIDS and STD in Africa, December 1997

3. GEOGRAPHYCAL LOCATION OF SEYCHELLES AND ITS THREE MAIN ISLANDS Xth International Conference on AIDS and STD in Africa, December 1997

4. HEALTH FACILITIES: ACCESS and DISTRIBUTION Xth International Conference on AIDS and STD in Africa, December 1997

5. METHOD All requests for HIV tests in the country’s public health facilities were sent to the central clinical laboratory. HIV ELISA tests were performed on all samples and reactive sera were confirmed by Western Blot. All results were sent to the only categorical STD Clinic for documentation and notification. Cases were notified as AIDS if there was infection with HIV and the patient was suffering from conditions related to deteriorating immune system. Data were entered and analyzed in Excel computer files. Xth International Conference on AIDS and STD in Africa, December 1997

6. Seychelles Population Distribution by Age Group (n=76,440) Xth International Conference on AIDS and STD in Africa, December 1997

7. Seychelles Population Distribution by Age Group and Gender (n=76,440) MalesFemales Xth International Conference on AIDS and STD in Africa, December 1997

8. Reported HIV positive Cases 1987 - 1996 (n=72) Xth International Conference on AIDS and STD in Africa, December 1997

9. Reported HIV positive Cases 1987 - 1996 (n=72) Xth International Conference on AIDS and STD in Africa, December 1997

10. Yearly Incidence of HIV Infection Point Prevalence (61/76440=0.8 x 1,000) Xth International Conference on AIDS and STD in Africa, December 1997

11. Number of HIV positive Cases by Age Group and Gender ( M/F=1.18) Xth International Conference on AIDS and STD in Africa, December 1997

12. Reported HIV positive and AIDS Cases (n=72) Xth International Conference on AIDS and STD in Africa, December 1997

13. Nationality of HIV positive Subjects (n=72) Xth International Conference on AIDS and STD in Africa, December 1997

14. Population Source of HIV positive test (n=72) Xth International Conference on AIDS and STD in Africa, December 1997

15. Proportion of HIV positive Test among Sentinel Populations Xth International Conference on AIDS and STD in Africa, December 1997

16. Proportion of Total HIV Tests and Positive Tests among Sentinel Populations HIV positive tests Total HIV tests Xth International Conference on AIDS and STD in Africa, December 1997

17. HIV INFECTION AMONG TOTAL TESTED ACCORDING TO SENTINEL SITES *Most detection among STD patients *Almost 50% among 10% of total tested

18. Acceptance of HIV Testing among STD Patients (STD Clinic) Xth International Conference on AIDS and STD in Africa, December 1997

19. Partner tracing and HIV test Results among 72 HIV positive Subjects Xth International Conference on AIDS and STD in Africa, December 1997

20. Distribution of HIV positive Cases by Risk Transmission Categories (n=72) Xth International Conference on AIDS and STD in Africa, December 1997

21. Point prevalence low but notifications still in the rising phase.Point prevalence low but notifications still in the rising phase. Male :female ratio approximately 1Male :female ratio approximately 1 Peak age 20-29 for females and 30-39 for males.Peak age 20-29 for females and 30-39 for males. Trasmission mainly through the heterosexual route.Trasmission mainly through the heterosexual route. Test positivity rate highest among STD Clinic attendants.Test positivity rate highest among STD Clinic attendants. HIV Epidemic in the Seychelles Conclusions Xth International Conference on AIDS and STD in Africa, December 1997

22. At the end of 1997 the HIV epidemic is in the nascent phase in the Seychelles, providing great potential for effective control.At the end of 1997 the HIV epidemic is in the nascent phase in the Seychelles, providing great potential for effective control. Prevention efforts should mainly focus on specific programmes for sexual education among the adolescents and the young.Prevention efforts should mainly focus on specific programmes for sexual education among the adolescents and the young. Xth International Conference on AIDS and STD in Africa, December 1997