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General Demographic Indicators Turkey

HIV in a low endemicity country; country response Turkey Serhat Ünal, M.D, FACP, FEFIM Professor in Medicine Chair Hacettepe University, Faculty of Medicine Department of Infectious Diseases President Hacettepe University HIV/ AIDS T reatment and Research Center.

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General Demographic Indicators Turkey

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  1. HIV in a low endemicity country;country responseTurkeySerhat Ünal, M.D, FACP, FEFIMProfessor in Medicine ChairHacettepe University, Faculty of Medicine Department of Infectious Diseases PresidentHacettepe University HIV/AIDS Treatment and Research Center

  2. General Demographic Indicators Turkey Source: Turkish Statistical Institute

  3. TURKEY - TÜRKİYE

  4. 7000/ 7000000 = 0.1 %

  5. 1985

  6. 1985

  7. CONDITION OF EPIDEMIC DISEASES AMONG THE GROUPS HAVING BEHAVIOURS OF RISK (TADOC – 2010)

  8. Main FactorsThatLeadToIncreaseTheNumber of HIV/AIDS CasesInTurkey • Turkey has a veryyoungpopulation (15-49 agesgroups) • General knowledge of populationregarding HIV/AIDS andsexualtransmittedinfectionsarelimited • Increase in useage of intravenousdrugs • Growth of theTurkishtourism • Largenumber of Turkish men workingabroad • Increase in number of commercialsexworkers

  9. Important Milestones in HIV/AIDS Turkey 1985Detection of the first AIDS case 1985HIV/AIDS; mandatory notifiable disease 1986HIV testing 1987Serological testing for: • Blood/tissue/organ donors • Registered sex workers • Before major surgical operations 1994 Medical treatment became free of charge 1994Coding system for notifications for HIV/AIDS cases 1996Establishment of National AIDS Commission 2004 Gonorrhea and Chlamydia;mandatory notifiable diseases 2005 “HIV/AIDS Prevention and Support Programme” funded by the Global Fund 2007Approval of 2007-2011 HIV/AIDS National Strategic Action Plan 2010 Establishment of Sexual Transmitted Diseases Scientific Committee

  10. State Planning Organisation PM Women’s Status and Issues GD Ministry of Labour and Social Security State Institute of Statistics AIDS Prevention Society Turkish Family Planning Association Ministry of Health Turkish Red Crescent Association PM Youth and Sport GD PLA PODER Ministry of Interior Health Professional Associations Association for Combat with AIDS Turkish Radio and Television NATIONAL AIDS COMMISSION PM – Family Research Institute Ministry of Culture and Tourism Human Resource Development Foundation Higher Education Council TGNA Population and Development Group Turkish Third Sector Foundation Ministry of National Education TGNA Legal Affairs Dep. Hacettepe AIDS Prev., Treat. and Research Center PM Social Services and Child Protection Turkish Journalists Association Artisans and Entrepreneurs Confederation Prime Ministry Ministry of Justice Ministry of Finance Ministry of Defence Religious Affairs

  11. HIV/AIDS National Strategic Action Plan Targets & Strategies • Prevention & Support • VCT • DiagnosisandTreatment • Supportive Environment • Monitoring & Evaluation • Socialsupport • Intersectoral Collaboration

  12. Vulnerable Populations • Commercial Sex Workers • Men Having Sex With Man • Intravenous Drug Users • Prisoners • HIV/AIDS (+) • Refugees and asylum seekers……….

  13. HIV/AIDS Prevention and Support Programme of Turkey DonorOrganisationThe Global Fund Grant NumberTUR-405-G01-H Principal RecipientMinistry of Health Program Duration36 Months Start- End Dates August 2005- 15 June 2008 BudgetUSD 3,891,762 85% out of the total budget has beendisbursed Programme citiesAnkara, Istanbul, Izmir, Gaziantep and Trabzon GoalTo prevent the further spread of HIV through active preventive interventions, especially among the most vulnerable populations, like IDUs, MSM, CSWs and detainees of penitentiary institutions and to support and empower vulnerable populations including PLWHA

  14. Objectives • Toincreasetheaccess of CSWs, MSMs, IDUstohealthcentersforpreventive HIV/AIDS services • Toincreasetheaccess of general populationto VCT servicesandcarryouttheirinstituationalisation • Toimprovetheaccess of psychosocialsupportservicesfor PLHA andimprovenationallegislativeframework • Toimprovepreventive HIV services in prisonsanddetentioncenters • ToimprovenationalSTIs/HIV/AIDS monitoringandevaluationsystem

  15. Activities • AwarenessraisingactivitiesforNGOs • Training of outreach workers • Training of policeofficers • 14 VCT centers, VCT Training forhealthstaff • Produceanddistribution of outreach servicesand VCT materials (brochures, posters, VCT guidelines, outreach guidelines) • Procurementanddistribution of rapid HIV tests, condoms, lubricants • Monitoringandevaluation • Behavioural Survey • 13 NGOs; including PLA and PODER, 16 projects, 1,8 million US Dollar • Workshop on IDU and HIV/AIDS • Workshop on HIV/AIDS and Human Rights • Workshop on the Evaluation of VCT Services • VCT Media Campaign

  16. Voluntary Councelling and Test CentersTurkey Begin to provide service in 2007 to high risk and critical groups in terms of HIV/AIDS • Information about transmission routes and protection from HIV/AIDS • Free and confidential HIV testing, • Pre and post test councelling • Guidance to a healthcare center for treatment

  17. HIV/AIDS Tests in Turkey HIV test groups HIV Test Number in Years (2002-2013*) • Blood donors (mandatory) • Sex workers (mandatory) • Volentary Councelling & Test Centers • Pre-marital councelling • After risky behavior, • Pre surgery *Until Oct 2013

  18. Diagnosis Time in Turkey

  19. Barriers to Testing in Turkey • Lack of awareness • Stigmatisation- social isolation • Cost • No quidelines • Low numbers of centers for testing • Social aspect – patient privacy • Hard ro reach groups • Homosexual men • Sex workers • Injecting drug users • Prisoners • Refugees , illegal immigrants

  20. HIV/AIDS TANI TEDAVİ REHBERİ – TÜRKİYEHIV/AIDS Diagnose and Treatment Guideline Turkey 2013 Turkish Ministry of Health 2013

  21. TURKEY - TÜRKİYE

  22. People newly infected with HIV UNAIDS global AIDS epidemic report 2012 Slide 33

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