| Estimated number of adults and children living with HIV/AIDS, end of 2003 |
| These estimates include all people with HIV infection, whether or not they have developed symptoms of AIDS, alive at the end of 2003: |
| Adults and children |
570,000 |
|
| Adults (15-49) |
530,000 |
Adult rate(%) 7 |
| Women (15-49) |
300,000 |
|
| Children (0-15) |
40,000 |
|
| Estimated number of deaths due to AIDS |
| Estimated number of adults and children who died of AIDS during 2003: |
| Deaths in 2003 |
47,000 |
|
| Estimated number of orphans |
| Estimated number of children who have lost their mother or father or both parents to AIDS and who were alive and under age 17 at the end of 2003: |
| Current living orphans |
310,000 |
|
Assessment of the epidemiological situation **
The adult HIV prevalence rate for Cote d'Ivoire is 7%, according to UNAIDS estimates in 2003. This indicates a decline in the prevalence of the disease. In 1988, when the first national survey was carried out, Cote d'Ivoire was recorded as having the highest prevalence of HIV in the West African region of 9.5%.
However, health workers fear that latest estimates have not taken into consideration the effects of political turbulence and further economic decline since a shock coup d'etat in December 1999. The same year, foreign assistance was cut, further damaging an already faltering economic record.
Following a further coup attempt in September 2002, rebels seized the northern half of the country. Though a peace deal, brokered by France, was signed in January 2003 Cote d'Ivoire remains divided ahead of elections in 2005.
Since the September 2002 rebellion, hospitals and clinics in the rebel controlled north have been cut off from central government funding. Many government workers, including health sector workers, have fled to the government controlled south. Most of those who remained in the north are not working.
At the same time, non-government activity has also been affected. NGO operations have largely halted in rebel-held areas, in particular HIV prevention efforts by local NGOs that included the social marketing of condoms, according to UNAIDS.
The climate of intense political instability and warfare has created a large IDP population of some 800,000 people according to the Global Fund to fight AIDS, TB and Malaria. The Global Fund, state that the war situation, with its accompanying violence, rape, population displacement and promiscuity and risky behaviour exacerbated by the explosion of the normal cultural context, have exacerbated the spread of HIV in Cote d'Ivoire.
Much of the difficulty in assessing the extent of the current HIV problem in Cote d'Ivoire lies in the lack of availability of up to date information. In September 2004, the government of Cote d'Ivoire announced plans to embark on the country's first nationwide HIV prevalence survey for 15 years.
Prior to the most recent outbreak of political unrest, several cross-sectional studies were conducted among female sex workers in Abidjan. Figures showed a decline in prevalence of HIV among those tested, down from 89% in 1992 to 32% in 1998, attributed to an increased use of condoms.
According to pre-crisis figures produced by UNICEF and UNPOP, the contraceptive prevalence rate in Cote d'Ivoire is estimated at 15% for the 1990 to 1999 period, though there are no figures to identify what proportion of these contraceptives are condoms.
Evidence of increased condom use is supported with a corresponding reduction in STDs such as Gonorrhoea and Chlamydia during the same period.
However, these studies predate the current political crisis and are limited to findings from the economic capital, Abidjan. Here, there is greater exposure to education campaigns on radio, television and on billboards and condoms are more readily available and the population more affluent.
Abidjan is of regional importance in the transmission of the HIV virus. Despite the political upheavals of recent years, Abidjan remains the hub of trade and commerce in francophone West Africa.
UNAIDS conducted a study in October 1999, which concluded that trade routes, such as the Abidjan - Lagos corridor, is a key migration route for goods, people and also, HIV.
In November 2003, the World Bank approved a US$ 16.6 million regional project to tackle the spread of AIDS along the Abidjan-Lagos transport corridor, due to run until 1 July 2007.
Background to monitoring of HIV
Sentinel surveys of women attending antenatal care clinics was established in 1986. By 2002, there was a total of 28 sentinel sites in eight districts including eight urban sites and 20 rural sites.
In 2002, the median HIV prevalence in Abidjan was estimated at 7.4% while median prevalence among attendees at the other seven urban sites was 10.3%. In the urban areas, prevalence rates ranged from a median of 7.4% in Abidjan, the lowest among the urban areas, to a high of 11.6% in Daloa.
The median prevalence among attendees at the rural sites was 5.8%, ranging from 1.9% in Yapelu to as high as 11% in Lopou.
** Information taken from UNAIDS/WHO epidemiological fact sheets on HIV/AIDS and Sexually Transmitted Infections, 2004 Update, The Global Fund for AIDS, TB and Malaria and various UN databases.
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