Montenegro is among the countries with the lowest rate in Europe: About one percent of citizens are tested for HIV

In Montenegro, only about one percent of citizens are tested for HIV, which ranks it among the countries with the lowest testing rate in Europe.

HIV testing week begins tomorrow in Montenegro, when Counseling Centers for confidential and voluntary testing will work every day.

As the Institute for Public Health (IJZ) informed the MINA agency, the testing rate, excluding voluntary blood donors, is 10,1 per thousand inhabitants.

Specialist in social medicine, Aleksandra Marjanović, said that, according to data submitted to the Institute by health institutions, 2016 people were tested for HIV in 23.144.

"Of the total number of people tested, 18.046 people were tested in transfusion units, 4.751 people were tested in the Center for Medical Microbiology of the Institute of Public Health, and 960 people were tested in Counseling Centers for Confidential Counseling and Testing (DPST)," specified Marjanović.

According to her, data on all tested pregnant women is not available. "The only information available is that since the beginning of the epidemic, antibodies to HIV have been found in four children of HIV-positive mothers".

Marjanović said that there is no data on the number of people tested for HIV in private laboratory institutions in Montenegro.

She assessed that testing in Montenegro has been significantly improved over the past few years with the establishment of a network of eight regional Counseling Centers for confidential counseling and testing in Bar, Kotor, Herceg Novi, Podgorica, Nikšić, Bijelo Polje, Berane and Pljevlja.

The Institute, as she stated, does not have reliable data as to why the testing rate in Montenegro is one of the lowest in Europe.

"The assumption is that there is a reduced awareness of possible HIV infection because there is no clear perception of belonging to a community where infection occurs more often due to risky behavior. It is also thought that the small environment, taboos related to sexuality, prejudices and stereotypes are the reason why people don't come for testing," said Marjanović.

To that, she believes, distrust in the institutions of the system and fear regarding the disclosure of personal data could be added.

"All this, along with a certain clinical picture (which is not typical for HIV infection and almost seven to ten years from the existence of the infection can pass without any symptoms, and the person looks completely healthy) makes people rarely, and after much thought, decide to testing," added Marjanović.

She believes that, in order to raise awareness about the importance of testing, counseling with testing should be promoted as an effective preventive measure against HIV infection.

"Through counseling, risk reduction and the recognition of risky behavior are influenced, as well as the strengthening of a person's capacity in order to engage all their strengths in reducing risk and changing behavior," said Marjanović.

As she stated, it is also necessary to spread knowledge while renewing the existing one with the latest evidence-based research.

Marjanović emphasized that people who detect HIV infection earlier can be included in the treatment process even earlier. On that occasion, she explained, they allow themselves a significantly high quality of life and health, and also prevent the transmission of infection.

"The latest scientific research shows that if a person has an unmeasurable level of viral copies in the blood, the so-called undetectable level, he cannot transmit HIV, that is, he cannot infect another person," said Marjanović.

Preventive activities related to HIV/AIDS, as well as related to all preventable diseases, are the responsibility of preventive medical branches, and the responsibility, as Marjanović said, lies with those who strengthen, that is, develop preventive programs.

"However, I believe that in order to raise awareness of the importance of testing, the joint activity of those who make decisions in health care and health professionals, regardless of whether they are in the preventive or curative field, is very important," said Marjanović.

Also, as she stated, it is very important and necessary to educate the general citizenry, especially in the working and sexually active age, with a special emphasis on educating key population communities that are at increased risk (men who have sex with men, injecting drug users, sex workers and workers).

Marjanović reminded that citizens can be tested for HIV at Counselors located in seven health centers - in Bar, Berane, Bijelo Polje, Nikšić, Kotor, Herceg Novi and Pljevlja, as well as in the Institute for Public Health.

"In those places, testing and counseling can be done without a doctor's prescription, so it is a matter of voluntary counseling and testing. Also, only testing can be done in the reception laboratory of the IJZ without an interview, and that according to the instructions of the chosen doctor, as well as in transfusion centers." she clarified.

As she said, counseling and testing implies a confidential conversation between the client and the counselor with the aim of enabling the client to take responsibility and be ready to change his risky behavior.

After the pre-test counseling, the testing is done, and then the post-test counseling. What kind of conversation will be held depends on the test results. During this conversation, the factors for risky behavior can be identified and guidelines for its change can be determined for those people whose HIV test is negative. For those whose test is positive, a conversation in the form of providing support and education to a newly infected person and/or a family member, spouse or sexual partner is a very important component in order to prevent the transmission of HIV infection," specified Marjanović.

Executive Director of Juventas Ivana Vujović believes that Montenegro has reason to be concerned when it comes to HIV, especially because mostly young people, who do not know that they are living with this infection, often find out their status in an advanced stage of AIDS.

"If the infection is detected in time, HIV does not significantly affect the quality of life, while people who receive ARV therapy and have an undetectable number of copies of the virus - cannot transmit HIV to their partner sexually. Therefore, testing is very important," she said. Vujović to the MINA agency.

She said that 34 cases of HIV were registered in Montenegro last year, which is 16 more than in 2015, when 19 cases were recorded, assessing that this is an alarming increase.

Vujović said that Montenegro is still far from the UNAIDS goal that by 2020, 90 percent of people living with HIV know their status, of which 90 percent receive ARV therapy, which in 90 percent leads to suppression of the virus.

"The reason why we are still far from that goal is mainly due to the absence of testing, which, although anonymous and confidential, is rarely practiced," Vujović said.

She believes that this example shows one of the basic shortcomings of the Montenegrin system, where the creators of health policies have not put prevention in the foreground for a long time.

Vujović said that in Montenegro there are eight centers for voluntary, confidential HIV counseling and testing, but that they are not sufficiently promoted, and most citizens are not aware of their existence.

"We have Counseling Centers for young people in all Health Centers, where experts of various profiles work, but rarely do they visit each Health Center enough. "We have a Healthy Lifestyles course, but it is not mandatory, and it is not available in all schools," Vujović said.

She said that the consequence of such a situation is that young people do not know enough about sexual and reproductive health and widespread risky sexual practices.

"We are not aware that in order to preserve the health of all of us individually, and then the entire Montenegrin population, prevention should be placed at a higher level of importance. In this particular case, the recommendations are that testing should be promoted more often through the media, education, through health institutions and community work ", Vujović said.

She said that even in previous years, Juventus pointed out the importance of mobile testing, especially for groups that are at increased risk of HIV, based on successful stories from the region and Western Europe.

"Taking into account the latest progress in order to achieve sustainable prevention services among groups at risk, which is coordinated by the Ministry of Health, we hope for concrete improvement in the area of ​​testing and promotion of good health practices among young people," Vujović said.

She announced that in the next two weeks, Juventas will promote testing with the Union of High School Students, primarily among that population, in order to bring them closer to the functioning of the counseling center, break down the barriers they may have when establishing contact with counselors, and refer them to services they can use and to which, if necessary, they can refer their peers.

"In cooperation with the IJZ and Counseling Centers for voluntary and confidential counseling and testing, forums will be organized in high schools with the topic of HIV prevention," announced Vujović.