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Improving the Response to HIV/AIDS in The Gambia
December 23, 2025 - The Borgen Project
The Gambia implemented many initiatives, programs and policies to improve its HIV/AIDS response. The country is focusing its prevention efforts on key populations experiencing higher prevalence rates of HIV and improving the accessibility of treatment services to these populations. The integrated and comprehensive approach empowers girls and young women through secondary education, development of training for health care workers on prevention and treatments and specialized nutritional services for breastfeeding women with HIV/AIDS in the Gambia.
The Background
The Republic of the Gambia experienced its first detection of HIV/AIDS in 1986. In response, they created a new department within the Ministry of Health called the National AIDS Control Programme (NACP). While the HIV/AIDS prevalence in the general population remains relatively low, at less than 2%, key subpopulations such as men who have sex with men (MSM) and female sex workers (FSW) experience disproportionately high prevalence rates. While the country continuously progresses in its treatment services for HIV/AIDS since 1986, progress stalled during the COVID-19 pandemic. Many resources, skills, personnel and medical equipment essential to HIV/AIDS treatment were repurposed during the pandemic to treat COVID-19 patients. In response to the dual HIV and COVID-19 epidemics, the Gambia improved its HIV/AIDS reduction strategies by investing in better prevention services, especially targeting key subpopulations and increasing the utilization and accessibility of treatment services.
Key Statistics:
- In 2020, more than half (55%) of the estimated 27,000 people living with HIV/AIDS in the Gambia were females aged 15 years and older.
- In 2020, among people aged 15-24, three out of four new HIV infections were females.
- In 2018, the HIV prevalence among FSW was more than 10%.
- In 2018, the HIV prevalence among MSM was more than 35%.
National HIV/AIDS Policy 2022-2027
UNAIDS and the Gambia created a Joint Programme in 2022 to develop the National HIV/AIDS Policy 2022-2027. The policy advances the prevention and treatment of HIV/AIDS and diminishes societal and legal barriers limiting access to treatment services. The Joint Programme prioritizes the revision and implementation of stronger National HIV prevention policies and strategizing preventive measures targeting key populations to improve the response to HIV/AIDS in the Gambia.
Key Results:
- The Programme delivered a total of 100,000 HIV testing kits and more than 724,000 condoms for distribution into health care systems in 2022-2023.
- On World AIDS Day in 2022, more than 110,000 Gambians accessed HIV testing and counseling services due to community outreach initiatives.
- In 2022-2023, 122 professional health workers across the country shared best practices for improving access and quality of HIV services.
Education Plus Initiative
The Education Plus Initiative (2021-2025) is a preventative effort against HIV/AIDS specifically in girls and young women in sub-Saharan Africa. This joint Initiative includes UNAIDS, UNESCO, UNFPA, UNICEF and UN Women in response to the startling amount of young women and girls infected with HIV and dying from AIDS in sub-Saharan countries. The Gambia joined eight other countries in 2022 by launching the Education Plus Initiative. The initiative integrates expanded access to secondary education for adolescent girls as an entry point for comprehensive health education, HIV prevention strategies and women empowerment.
Key Results:
- Completing secondary education contributes to a significant reduction in HIV among adolescent girls and young women, such as drops in new cases by one-third to one-half in some countries.
Prevention of Mother-to-Child Transmission Programme
The Gambia initiated the Prevention of Mother-to-Child Transmission Programme (PMTCT) in the early 2000s to prevent the transmission of HIV from HIV-positive mothers to their infants during pregnancy, childbirth and breastfeeding. The programme outlined several strategies and objectives to reduce mother-to-child transmission. Strategies to increase the utilization of services and testing included establishing Voluntary Confidential Counseling and Testing (VCCT) sites in health facilities, dissemination of information on the programme to the community and offering VCCT services to all women attending antenatal clinics. Strategies for effective treatment included providing antiretroviral (ARV) therapy to HIV-positive women, Cotrimoxazole to exposed children and counseling for infant feeding to HIV-positive mothers.
Key Results:
- By 2009, 35% of facilities with antenatal, delivery and postnatal services offered PMCTC services.
- By 2009, 51% of HIV-positive pregnant women completed a course of ARV prophylaxis.
HIV Training Services for Maternal and Health Facilities
With support from the Joint Programme, the Gambia improves the treatment of mothers and pregnant women with HIV and the prevention of vertical transmission. Training on providing comprehensive HIV services such as counseling, ARV treatment and infant feeding became accessible to health care workers working in maternal and health facilities. Advancements in HIV training for health workers is an important strategy to improve the response to HIV/AIDS in the Gambia.
Key Results:
- In 2022-2023, 115 HIV-positive mothers and pregnant women accessed HIV counseling and testing services.
- In 2022-2023, 116 health care workers from five different regions completed training supported by the Joint Programme on improved early infant HIV diagnosis and delivery practices to prevent mother-to-child transmission.
Nutrition Education and Services for People Living With HIV
The Ministry of Health and the National Nutrition Agency in the Gambia collaborated to provide a three-month period of specialized nutritious food for breastfeeding women with HIV to optimize health status and outcomes. The National AIDS Control Programme (WFP) partnered with the Joint Programme to create a social and behavioral change communication training empowering community members to inform HIV-positive people on nutrition and breastfeeding with HIV.
Key Results:
- More than 3,000 pregnant and breastfeeding HIV-positive women in three regions received specialized nutritious food in order to improve health outcomes.
- In 2022, 103 HIV-positive people attended community groups providing education on nutrition and health.
Poverty and HIV/AIDS
Living in extreme poverty increases the risk of contracting HIV, and living with HIV/AIDS only exacerbates the burden of poverty. Basse is a region with one of the highest HIV/AIDS prevalence rates within the Gambia. The Basse region also has the highest rate of food insecurity, at 19%, in the country. Gender inequality and poverty make women in Africa especially vulnerable to infection due to lack of access to information, health care, formal education, financial opportunity and increased exposure to sexual violence. Furthermore, financial insecurity and violence against women lead to more FSW in impoverished communities. Indeed, FSW are a key population disproportionately affected by HIV/AIDS in the Gambia.
Conclusion
The Gambia has taken various innovative measures to improve HIV/AIDS response. The focus on key subpopulations while developing prevention initiatives improved access to services and distribution of resources to those who need it most. Women and girls benefit from the integration of secondary education and HIV/AIDS information and enhanced nutritional services for breastfeeding women with HIV. The country used lessons learned from the halt in progress during the COVID-19 pandemic to reform and improve their reduction and prevention strategies to eliminate the HIV/AIDS epidemic.
– Sarah Merrill
Sarah is based in Matthews, NC, USA and focuses on Good News and Global Health for The Borgen Project.
Contact:
Lynsey Alexander
Chief of Staff
openings@borgenproject.org
The Borgen Project
Source: https://borgenproject.org/hiv-aids-in-guatemala-2/
"Reproduced with permission - The Borgen Project"
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