Afghanistan

2 Basic socio-demographic indicators HIV prevalence and epidemiological status (2003-2009) Risk behaviors (2007-2009) Vulnerability and HIV knowledge (2005-2009) HIV Expenditure (2008-2009) National Response (1997-2009) Archives CONTENT

3 BASIC SOCIO-DEMOGRAPHIC INDICATORS Sources: 1.UNFPA. (2010). State of World Population 2010, 2. UN Statistics Division. (2010). Social Indicators 3.Word Bank. World Data Bank: World Development Indicators & Global Development Finance. Retrieved January, 2011, from http://databank.worldbank.org/ddp/home.do?Step=12&id=4&CNO=2, 4. WHO. (2010). World Health Statistics 2010, 5. UNDP. (2010). Human Development Report 2010, and 6. UN Population Division. (2009). World Population Prospects The 2008 Revision.

HIV prevalence and epidemiological status

Number tested (+) for HIV and HIV prevalence among key affected populations by age group, 2009 5 Source: Prepared by www.aidsdatahub.org based on 1. National AIDS Control Program Afghanistan. (2010). UNGASS Country Progress Report: Afghanistan and 2. UNAIDS. (2010). Global Report: UNAIDS Report on the Global AIDS Epidemic citing Afghanistan, IBBS, 2009

HIV prevalence among male IDUs, selected cities, 2009 6 Source: Prepared by www.aidsdatahub.org based on Integrated Bio-Behavioral Surveillance 2009 cited in National AIDS Control Program Afghanistan. (2010). UNGASS Country Progress Report: Afghanistan

HIV prevalence among IDUs and Sex workers, selected cities, 2007-2008 7 Source: Prepared by www.aidsdatahub.org based on Todd CS et al_HIV, Hepatitis C and Hepatitis B infections and associated risk behavior in IDUs, Kabul.Emerg.Infect.Dis.2007 Sep, 13(9):1327-1331:Todd CS_Seroprevalence and behavioral correlates of HIV, Syphilis, and Hepatitis B & C among High Risk Groups in Three Afghanistan Cities, 2008 cited in National AIDS Control Program Afghanistan, JHU, & Indian Institute of Health Management Research. (2008). Understanding HIV in Afghanistan: The Emerging Epidemic and Opportunity for Prevention. Kabul N= 464 Herat N=340 Kabul, Jalalabad & Mazari-Sharit N= 543

HIV prevalence among prisoners and IDU prisoners, selected prisons, 2008 - 2009 8 Sources: Prepared by www.aidsdatahub.org based on Afghanistan, Integrated Bio-Behavioral Surveillance 2009 cited in 1. National AIDS Control Program Afghanistan. (2010). UNGASS Country Progress Report: Afghanistan, and 2. The World Bank (2008). Afghanistan HIV/AIDS Prevention Project Implementation Support Mission (June 1-9, 2008) Aide Memoire cited in National AIDS Control Program Afghanistan, J. H. University, et al. (2008). Understanding HIV in Afghanistan: The Emerging Epidemic and Opportunity for Prevention : A Desk Review of HIV in Afghanistan.

HIV prevalence among general population (15-49), 2003-2009 9 Sources: Prepared by www.aidsdatahub.org based on 1. UNAIDS. (2006). 2006 Report on the Global AIDS Epidemic, and 2. National AIDS Control Program Afghanistan. (2010). UNGASS Country Progress Report: Afghanistan, used information from MIS Data of Afghan National AIDS Control Programme

HIV testing at eleven VCT centers, 2008-2009 10 % of HIV tests by gender % of HIV positive by gender Persons tested for HIV = 19875 Source: Prepared by www.aidsdatahub.org based on National AIDS Control Program Afghanistan. (2010). UNGASS Country Progress Report: Afghanistan, used information from MIS Data of Afghan National AIDS Control Programme

Population interaction of most at risk populations in 4 cities, 2007-2008 11 Source: Todd CS et al_HIV, Hepatitis C and Hepatitis B infections and associated risk behavior in IDUs, Kabul.Emerg.Infect.Dis.2007 Sep, 13(9):1327-1331:Todd CS_Seroprevalence and behavioral correlates of HIV, Syphilis, and Hepatitis B & C among High Risk Groups in Three Afghanistan Cities, 2008 :cited in National AIDS Control Program Afghanistan, Johns Hopkins University, & Indian Institute of Health Management Research. (2008). Understanding HIV in Afghanistan: The Emerging Epidemic and Opportunity for Prevention.

Estimated population size of FSWs per 1,000 adult women in 3 cities, 2006-07 12 Source: Prepared by www.aidsdatahub.org based on The World Bank. (2008). South Asia Human Development Sector: Mapping and Situation Assessment of Key Populations at High Risk of HIV in Three Cities of Afghanistan.

Estimated population size of IDUs per 1,000 adult men in 3 cities, 2006-07 13 Source: . Prepared by www.aidsdatahub.org based on The World Bank. (2008). South Asia Human Development Sector: Mapping and Situation Assessment of Key Populations at High Risk of HIV in Three Cities of Afghanistan.

Estimated number of drug users, 2005 14 Source: Prepared by www.aidsdatahub.org based on The World Bank. (2008). HIV/AIDS in Afghanistan.

Estimated people living with HIV and estimated deaths due to AIDS, 2005 15 Source: Prepared by www.aidsdatahub.org based on UNAIDS. (2006). 2006 Report on the Global AIDS Epidemic.

Risk behaviours

% of IDUs reporting the use of sterile injecting equipment the last time they injected, 2007 and 2009 17 Source: Prepared by www.aidsdatahub.org based on UNAIDS. (2010). Global Report: UNAIDS Report on the Global AIDS Epidemic.

% of IDUs reporting the use of sterile injecting equipment the last time they injected by age group, 2009 18 Source: Prepared by www.aidsdatahub.org based on 1. National AIDS Control Program Afghanistan. (2010). UNGASS Country Progress Report: Afghanistan and 2. UNAIDS. (2010). Global Report: UNAIDS Report on the Global AIDS Epidemic citing Afghanistan, IBBS, 2009

% of IDUs having ever shared needles or syringes in 4 cities, 2007-2008 19 Source: Prepared by www.aidsdatahub.org based on Todd, CS, UCSD/WRAIR/NAMRU Project, 2007 cited in National AIDS Control Program Afghanistan, Johns Hopkins University, & Indian Institute of Health Management Research. (2008). Understanding HIV in Afghanistan: The Emerging Epidemic and Opportunity for Prevention. Kabul (N=464) Herat (N=340) Mazar-i-Sharif (N=187) Jalalabad (N=96)

% of IDUs with frequency of lending a used syringe to other IDUs, 2007-2008 20 Source: Prepared by www.aidsdatahub.org based on The World Bank. (2008). South Asia Human Development Sector: Mapping and Situation Assessment of Key Populations at High Risk of HIV in Three Cities of Afghanistan.

% of IDUs with frequency of sharing (borrowing) a used syringe from other IDUs, 2007-2008 21 Source: Prepared by www.aidsdatahub.org based on The World Bank. (2008). South Asia Human Development Sector: Mapping and Situation Assessment of Key Populations at High Risk of HIV in Three Cities of Afghanistan.

% of IDUs with frequency of using a new, sterile syringe/needle for injection, 2007-2008 22 Source: Prepared by www.aidsdatahub.org based on The World Bank. (2008). South Asia Human Development Sector: Mapping and Situation Assessment of Key Populations at High Risk of HIV in Three Cities of Afghanistan.

% of IDUs with injecting behavior and frequency of injection per day, during the past 6 months, 2007-2008 23 Source: Prepared by www.aidsdatahub.org based on The World Bank. (2008). South Asia Human Development Sector: Mapping and Situation Assessment of Key Populations at High Risk of HIV in Three Cities of Afghanistan.

FSWs and IDUs who reported the use of a condom at their last sexual encounter, 2007-2009 24 Sources: Prepared by www.aidsdatahub.org based on Afghanistan. MOH, HIV/AIDS Prevention Project (AHAPP), Annual Project Report, July 2007 to June 2008; Afghanistan IBBS-2009 cited in National AIDS Control Program Afghanistan. (2010). UNGASS Country Progress Report: Afghanistan

% of key affected populations who reported condom use at last sex by age group, 2009 25 Source: Prepared by www.aidsdatahub.org based on 1. National AIDS Control Program Afghanistan. (2010). UNGASS Country Progress Report: Afghanistan and 2. UNAIDS. (2010). Global Report: UNAIDS Report on the Global AIDS Epidemic citing Afghanistan, IBBS, 2009

% of IDUs with selected sexual behaviors in 4 cities, 2007-2008 26 Source: Prepared by www.aidsdatahub.org based on Todd, CS, UCSD/WRAIR/NAMRU Project, 2007 cited in National AIDS Control Program Afghanistan, Johns Hopkins University, & Indian Institute of Health Management Research. (2008). Understanding HIV in Afghanistan: The Emerging Epidemic and Opportunity for Prevention.

% of IDUs with selected sexual behavior, 2007-2008 27 Source: Prepared by www.aidsdatahub.org based on The World Bank. (2008). South Asia Human Development Sector: Mapping and Situation Assessment of Key Populations at High Risk of HIV in Three Cities of Afghanistan.

% of MSMs with selected sexual behaviors in Kabul & Mazar-i-Sharif, 2009 28 MSM (N=100) 50 from Kabul 50 from Mazar-i-Sharif Source: Prepared by www.aidsdatahub.org based on Khan, S., Bargami, Rasheed, et al. (2009). Rapid Assessment of Male Vulnerabilities to HIV and Sexual Exploitation in Afghanistan.

FSWs with condom use behavior, 2007-2008 29 Source: Prepared by www.aidsdatahub.org based on The World Bank. (2008). South Asia Human Development Sector: Mapping and Situation Assessment of Key Populations at High Risk of HIV in Three Cities of Afghanistan.

Reported average number of clients of FSWs per month, 2007-2008 30 Source: Prepared by www.aidsdatahub.org based on The World Bank. (2008). South Asia Human Development Sector: Mapping and Situation Assessment of Key Populations at High Risk of HIV in Three Cities of Afghanistan.

Vulnerability and HIV knowledge

% FSWs and IDUs with comprehensive knowledge of HIV, 2009 32 Source: Prepared by www.aidsdatahub.org based on IBBS, 2009 cited in National AIDS Control Program Afghanistan. (2010). UNGASS Country Progress Report: Afghanistan

% of key affected populations with comprehensive knowledge of HIV by age group, 2009 33 Source: Prepared by www.aidsdatahub.org based on 1. National AIDS Control Program Afghanistan. (2010). UNGASS Country Progress Report: Afghanistan and 2. UNAIDS. (2010). Global Report: UNAIDS Report on the Global AIDS Epidemic citing Afghanistan, IBBS, 2009

% of IDUs who have ever heard of HIV and AIDS, Kabul, 2005-2006 34 Source: Todd, C. S., Abed, A. M., Strathdee, S. A., et al. (2007). Association between Expatriation and HIV Awareness and Knowledge among Injecting Drug Users in Kabul, Afghanistan: A Cross-Sectional Comparison of Former Refugees to Those Remaining During Conflict. N= 464

% of IDUs with knowledge of HIV prevention through use of condom in Kabul, 2005-2006 35 Source: Todd, C. S., Abed, A. M., Strathdee, S. A., et al. (2007). Association between Expatriation and HIV Awareness and Knowledge among Injecting Drug Users in Kabul, Afghanistan: A Cross-Sectional Comparison of Former Refugees to Those Remaining During Conflict. A total sample of 464 IDUs was taken in Kabul. 86% had lived or worked outside country in the past 10 years.

% of IDUs with knowledge of specific HIV transmission ways, Kabul, 2005-2006 36 Source: Todd, C. S., Abed, A. M., Strathdee, S. A., et al. (2007). Association between Expatriation and HIV Awareness and Knowledge among Injecting Drug Users in Kabul, Afghanistan: A Cross-Sectional Comparison of Former Refugees to Those Remaining During Conflict. Note: A total sample of 464 IDUs was taken in Kabul.

% of IDUs with knowledge of HIV transmission in Kabul, 2005-2006 37 Source: Prepared by www.aidsdatahub.org based on Todd, C. S., Abed, A. M., Strathdee, S. A., et al. (2007). Association between Expatriation and HIV Awareness and Knowledge among Injecting Drug Users in Kabul, Afghanistan: A Cross-Sectional Comparison of Former Refugees to Those Remaining During Conflict. Note: A total sample of 464 IDUs was taken in Kabul. 47.4 41.2 77.8 71.9 0 50 100 Through sharing needles Through donated blood Through sexual intercourse Through used needles %

% of FSWs with HIV and AIDS related knowledge, 2007-2008 38 Source: Prepared by www.aidsdatahub.org based on The World Bank. (2008). South Asia Human Development Sector: Mapping and Situation Assessment of Key Populations at High Risk of HIV in Three Cities of Afghanistan.

% of MSMs with correct knowledge of HIV, Kabul & Mazar-i-Sharif, 2009 39 Source: Prepared by www.aidsdatahub.org based on Khan, S., Bargami, Rasheed, et al. (2009). Rapid Assessment of Male Vulnerabilities to HIV and Sexual Exploitation in Afghanistan. MSM (N=100) 50 from Kabul 50 from Mazar-i-Sharif

HIV expenditure

Amount of domestic and international HIV expenditures and % shared by government, 2008 - 2009 41 Source: Prepared by www.aidsdatahub.org based on UNAIDS. (2010). Global Report: UNAIDS Report on the Global AIDS Epidemic.

% distribution of total HIV expenditures by financing source, 2008 - 2009 42 Source: Prepared by www.aidsdatahub.org based on UNAIDS. (2010). Global Report: UNAIDS Report on the Global AIDS Epidemic.

Amount of HIV expenditures by service category, 2008-2009 43 Source: Prepared by www.aidsdatahub.org based on UNAIDS. (2010). Global Report: UNAIDS Report on the Global AIDS Epidemic.

Amount of total HIV expenditures by major spending category, 2008-2009 44 Source: Prepared by www.aidsdatahub.org based on UNAIDS. (2010). Global Report: UNAIDS Report on the Global AIDS Epidemic.

% distribution of total HIV expenditures by major spending category, 2008-2009 45 Source: Prepared by www.aidsdatahub.org based on UNAIDS. (2010). Global Report: UNAIDS Report on the Global AIDS Epidemic.

Amount of total HIV expenditures on prevention by service category, 2008 – 2009 46 Source: Prepared by www.aidsdatahub.org based on UNAIDS. (2010). Global Report: UNAIDS Report on the Global AIDS Epidemic.

% distribution of total HIV expenditures on prevention by service category, 2008 - 2009 47 Source: Prepared by www.aidsdatahub.org based on UNAIDS. (2010). Global Report: UNAIDS Report on the Global AIDS Epidemic.

National response

Status of health facilities providing VCCT services and uptakes by gender, 2008-2009 49 Sources: Prepared by www.aidsdatahub.org based on 1. WHO, UNAIDS, & UNICEF. (2009). Towards Universal Access: Scaling up Priority HIV/AIDS Interventions in the Health Sector- Progress Report 2009, and 2. WHO, UNAIDS, & UNICEF. (2010). Towards Universal Access Scaling up Priority HIV/AIDS Interventions in the Health Sector - Progress Report 2010

% of key affected populations who received an HIV test in the past 12 months and knew the results by age group, 2009 50 Source: Prepared by www.aidsdatahub.org based on 1. National AIDS Control Program Afghanistan. (2010). UNGASS Country Progress Report: Afghanistan and 2. UNAIDS. (2010). Global Report: UNAIDS Report on the Global AIDS Epidemic citing Afghanistan, IBBS, 2009

HIV prevention coverage and HIV testing among key affected populations, 2009 51 HIV prevention coverage % tested for HIV in last 12 months Sources: Prepared by www.aidsdatahub.org based on 1. The World Bank, Project Midterm Review 2010 cited in National AIDS Control Program Afghanistan. (2010). UNGASS Country Progress Report: Afghanistan, and 2. IBBS, 2009 cited in National AIDS Control Program Afghanistan. (2010). UNGASS Country Progress Report: Afghanistan

% of key affected populations reached with HIV prevention programme by age group, 2009 52 Source: Prepared by www.aidsdatahub.org based on 1. National AIDS Control Program Afghanistan. (2010). UNGASS Country Progress Report: Afghanistan and 2. UNAIDS. (2010). Global Report: UNAIDS Report on the Global AIDS Epidemic citing Afghanistan, IBBS, 2009

Status of health facilities providing ART and number of adults (15+) received ART, 2008 and 2009 53 Sources: Prepared by www.aidsdatahub.org based on 1. WHO, UNAIDS, & UNICEF. (2009). Towards Universal Access: Scaling up Priority HIV/AIDS Interventions in the Health Sector- Progress Report 2009, and 2. WHO, UNAIDS, & UNICEF. (2010). Towards Universal Access Scaling up Priority HIV/AIDS Interventions in the Health Sector - Progress Report 2010

PLHIV who registered for anti-retroviral treatment in two clinics, Herat and Kabul, 2009 54 Sources: Prepared by www.aidsdatahub.org based on National AIDS Control Program Afghanistan. (2010). UNGASS Country Progress Report: Afghanistan used information from MIS Data of Afghan National AIDS Control Programme

PLHIV who registered for anti-retroviral treatment and who are on ART, 2009 55 Sources: Prepared by www.aidsdatahub.org based on 1. WHO, UNAIDS, & UNICEF. (2010). Towards Universal Access Scaling up Priority HIV/AIDS Interventions in the Health Sector - Progress Report 2010 and 2. National AIDS Control Program Afghanistan. (2010). UNGASS Country Progress Report: Afghanistan used information from MIS Data of Afghan National AIDS Control Programme

% of pregnant women 15-49 yrs with access to antenatal care, 1997-2005 56 Source: Prepared by www.aidsdatahub.org based on UNICEF, UNAIDS, & WHO. (2007). Children and AIDS: A Stocktaking Report- Actions and Progress during the First Year of Unite for Children, Unite against AIDS. Dying to Give Life: Maternal Mortality in Afghanistan In Badakhshan, for every 100,000 babies born, 6,500 women will lose their lives. In Afghanistan as whole, a woman dies of pregnancy-related causes every 27 minutes of every day. In Badakhshan, a woman faces almost 600 times the risk of dying in childbirth than do her counterparts living in North America. Of the thousands of infants left motherless, 75 per cent will perish either during, or soon after, delivery. Source: UNFPA, July, 2006

NGOs providing services to populations at higher risk 57 AFGA stands for Afghan Family Guidance Association JACK stands for Just for Afghan Capacity and Knowledge MDM stands for Medicine Du Monde ORA stands for Orphans, Refugees and Aid OTCD stands for Organization for Training and Cooperative Development SAF stands for Solidarity for Afghan Family SDO stands for Sanayee Development Organization SHRO stands for Society for Health Research Organizations Source. National AIDS Control Program Afghanistan, Johns Hopkins University, & Indian Institute of Health Management Research. (2008). Understanding HIV in Afghanistan: The Emerging Epidemic and Opportunity for Prevention.

Archives

HIV prevalence and epidemiological status

HIV prevalence among IDUs and FSWs, 2005-2007 60 Sources: Prepared by www.aidsdatahub.org based on 1. University of California - San Diego. (2008). High-Risk Behaviors Could Lead to HIV Epidemic In Afghanistan, and 2. South Asia Human Development Sector: Mapping and Situation Assessment of Key Populations at High Risk of HIV in Three Cities of Afghanistan. %

Risk Behaviours

Trend of cultivation of opium poppy and production, 1990-2006 62 Source: UNODC. (2007). 2007 World Drug Report. In Afghanistan, increasing production of opium has resulted in the availability of a greater quantity of both opium and heroin in the local market. It is estimated that as many as 25,000 drug-dependents in Afghanistan are injecting drugs.

HIV expenditure

National AIDS spending and financing, 2008-2009 64 Domestic AIDS spending by categories Funding Sources Total amount raised and spent -8.5 million USD Sources: Prepared by www.aidsdatahub.org based on National AIDS Control Program Afghanistan. (2010). UNGASS Country Progress Report: Afghanistan used information from MIS Data of Afghan National AIDS Control Programme

National response

Afghanistan’s Project Result Framework for HIV and AIDS Prevention, 2007-2010 66 Source: Prepared by www.aidsdatahub.org based on World Bank. (2007). Technical Annex for a Proposed Grant in the Amount of SDR 6.60 Million (US$lO.O Million Equivalent) to the Islamic Republic of Afghanistan for a HIV/AIDS Prevention Project.

67 THANK YOU slides compiled by www.aidsdatahub.org Data shown in this slide set are comprehensive to the extent they are available from country reports. Please inform us if you know of sources where more recent data can be used. Please acknowledge www.aidsdatahub.org if slides are lifted directly from this site