HIV/AIDS in Rwanda
The last population-based survey on HIV prevalence was the Rwanda Demographic and Health Survey 2005 (DHS 2005). The survey found HIV prevalence of 3.0% (95% confidence interval: 2.6-3.5) in the general population aged 15-49. HIV prevalence in urban areas (7.3%) was much higher than in rural areas (2.2%), and HIV prevalence in women (3.6%) was significantly higher than in men (2.3%).
HIV prevalence data are also sourced from sentinel surveillance of pregnant women attending antenatal clinics (ANC). During the most recent survey in 2007, HIV prevalence in pregnant women was 4.3% [3.8-4.5]. Although older age groups are progressively more likely to be infected, the percentage of young pregnant women who are HIV+ remains very high, particularly for the 15-19 age group in Kigali. Both the DHS 2005 and the ANC 2007 data show wide regional variation in HIV prevalence.
According to national estimates [1], the total estimated number of people living with HIV in Rwanda was about 149,000 in 2008, including around 17,000 children. Among adults (15+ years old), approximately 75,000 were estimated in need of ART in 2008 [2], and more than 52,000 (70%) received treatment. In addition, 55% of HIV-positive pregnant women received a prophylaxis regimen through September 2007. It is estimated that 11% of infants born to HIV positive mothers are HIV infected.
According to the 2005 DHS, there are 1,350,820 orphans and vulnerable children in Rwanda between the ages of 0 and 17. It is estimated that AIDS accounts for nearly a fifth of these: the number of children (0-14 years old) having lost one or both parents because of HIV was estimated to be about 233,700 in 2008.
As already noted, women are disproportionately affected by HIV infection. In addition, a recent study [3] showed that HIV positive women are more likely to be in extreme poverty (50.2% live on less than 1US$ a day) than HIV positive men (38.6%), and the proportion of HIV positive people who have not had any formal education is also higher among women (18.5%) than men (12.2%). Around 20% of people living with HIV of either sex are unemployed and not working at all. 37.2% of respondents reported that they had been refused employment opportunities as a result of HIV status.
People living with HIV are particularly burdened by the costs of health care, with individual spending on out of pocket expenses related to healthcare averaging 20% higher among people living with HIV than among the general population [4]. The 2005 DHS highlighted the inability of households with orphans to meet the costs of schooling. Children living in child-headed households were experiencing the greatest difficulties. A 2006 study followed 692 young heads of household and noted, among other issues, their difficult living conditions, the problems in accessing education, and the psychological distress suffered by many orphans and vulnerable children.
[1] Rwanda 2008 HIV and AIDS Epidemic Update. www.cnls.gov.rw/publications
[2] This estimation is based on initiation of treatment at CD4 <200.
[3] HIV stigma index – preliminary findings.
[4] Cited in: National AIDS Commission (Republic of Rwanda). UNGASS Country Progress Report Period 2006-2007 (2008)
How does education fight AIDS in Rwanda?
EFA is now working with the Child Support Center to provide local orphans and vulnerable children with educational assistance, vocational training for out-of-school youth, income generation assistance, and psychosocial support.
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