Indicators of Target 7

18. HIV Prevalence Among Pregnant Women Aged 15-24-years

19. Condom Use Rate of the Contraceptive Prevalence Rate

19a. Condom Use at Last High-Risk Sex

19b. Percentage of Population Aged 15-24 with Correct Knowledge of HIV/AIDS

19c. Contraceptive Prevalence Rate

20. Ratio of School Attendance of Orphans to School Attendance of non-orphans Aged 10-14

Indicators of Target 8

21. Prevalence and Death Rates Associated with Malaria

22. Proportion of Population in Malaria Risk Areas Using Effective Malaria Prevention and Treatment Measures

23. Prevalence and Death Rates Associated with Tuberculosis

24. Proportion of Tuberculosis Cases Detected and Cured Under Directly Observed Treatment Short Course

Status and Trends

The incidence of sexually transmitted infections (STIs) and the prevalence of HIV/AIDS in Turkey are at a reasonable level; rates of prevalence for both are higher in Eastern Europe, which has the fastest-growing HIV epidemic in the world. Central Asia also has a high incidence of the HIV/AIDS virus and Turkey's position between these two regions means that the risk of an increase in the incidence of both STIs and HIV/AIDS is high.

Malaria is an infectious disease caused by a parasite. Humans contract malaria from the bite of a malaria-infected mosquito. The most dangerous type, Plasmodium falciparum, is not indigenous to Turkey, and consequently, there is no recorded death due to malaria. However, this does not mean that Turkey's fight against malaria is complete. Every year thousands of people are infected with the disease.

Tuberculosis (often called TB) is an infectious disease that mostly attacks the lungs, but may also affect other organs such as the brain, the uterus etc. This serious disease is spread from person to person by airborne bacilli. Turkey's long-term efforts to combat tuberculosis have had considerable success during the last few decades, and the country is well equipped for both the prevention and treatment of the disease.

Target 7: Have Halted by 2015, and Begun to Reverse, the Spread of HIV/AIDS

Indicator 18: HIV Prevalence Among 15-24 Year-Old Pregnant Women

The first case of HIV infection was reported in 1985, and by the end of 2004 a total of 1,922 cases had been identified. As reported by the Ministry of Health, 1,155 were in the 15-39 age group, 490 in the 40+ age group, and less than 50 in the 0-14 age group (Table 15).

The Turkey Demographic and Health Survey 2003 indicates that even though 88% of married women (according to the TDHS-1998, 93% of married men) overall had heard of HIV/AIDS, awareness of how to prevent infection was poor. Regional variations were also reported, with 69.1% of married women in the eastern regions of the country having heard of HIV/AIDS, compared to 93.5% in the central region.

Table 15: Distribution of AIDS Cases and Carriers by Age Group and Sex (*)

Source: MoH (http://www.saglik.gov.tr)
(*): 1 Oct.1985-31 December 2004

Though the number of HIV-positive and AIDS cases is low in comparison to international rates, the steady increase in the number of cases suggests that there is a potential risk requiring immediate attention. The officially reported cumulative number of HIV/AIDS cases in Turkey between 1985 and 2004 is 1,922.

Table 16: Reported HIV (+) and AIDS Cases by Possible Routes of Transmission (*)

Source: MoH (http://www.saglik.gov.tr)
(*): 31.12.2004

Among the reported HIV-positive and AIDS cases, males between 15 and 39 years of age appear to be at the highest risk. The officially reported cumulative number of HIV/AIDS cases in Turkey between 1985 and 2004 is 1,922.

Indicator 19: Condom Use Rate of the Contraceptive Prevalence Rate

According to the TNSA-2003, the use of any contraceptive method among currently married women aged 15-49 is 71%. The proportion of married women in the same age group using modern contraceptive methods is 42.5%. Among modern contraceptive users, condom use accounts for only 10.8% for the same group. Knowledge of any contraceptive methods among currently married women aged 15-49 is 99.8%.

Table 17: Condom Use Rate of the Contraceptive Prevalence Rate (For married women aged 15-49)

Source: HUIPS, TDHS
(*) A different counting method was used in the research of 1993.

19a: Condom Use at Last High-Risk Sex:

More comprehensive data will be available towards the end of "Turkey HIV/AIDS Prevention and Support Programme" in 2007.

19b: Percentage of Population Aged 15-24 with Correct Knowledge of HIV/AIDS

According to 1998 UN Statistics Division data, (UNICEF, UNAIDS, WHO) HIV knowledge among men aged 15-24 years of age who know that a healthy-looking person can transmit HIV is 76%. This percentage is 73% for women of the same age group. The exact number of children in Turkey who are infected with AIDS is unknown; but 78 cases in under-18-year-olds were officially reported during the period 1985-2003.

19c: Contraceptive Prevalence Rate

Table 18: Contraceptive Prevalence Rate

Source:   TDHS, HUIPS
(*): A different counting method was used in the research of 1993

Indicator 20: Ratio of School Attendance of Orphans to School Attendance of Non-Orphans Aged 10-14

No reliable data is available.

Target 8: Have Halted by 2015, and Begun to Reverse, the Incidence of Malaria and Other Major Diseases

Indicator 21: Prevalence and Death Rates Associated with Malaria

Table 19: Prevalence Rate of Malaria per 100,000 population

Source: MoH. Health Statistics            

In 1998 there were 36,842 reported cases of malaria-infection; by 2004 this number had decreased to 5,302. Also, there There are have been no recorded deaths associated with malaria in Turkey.

Indicator 22: Proportion of the Population in Malaria-Risk Areas Using Effective Malaria Prevention and Treatment Measures

Malaria is widespread in the southeastern parts of Turkey, especially in Diyarbakir and Batman, as well as the Adana region. In 2004, the number of malaria patients in Batman was 1,687 and in Diyarbakir 2,364.

Table 20: Number of Malaria Cases, by Province 1998-2004

Source: MoH Health Statistics.            

Indicator 23: Prevalence and Death Rates Associated with Tuberculosis

In the 1950s around 5,000 people died of tuberculosis each year. By 2002, this figure had declined to 722. However, the actual number may be higher than estimated given the nature of the disease. Since tuberculosis can attack parts of the body other than the lungs, the recorded death rates may not represent the total number of fatalities associated with the disease. For example, in a case where tuberculosis leads to meningitis and the patient dies, official records may indicate meningitis as the cause of death.

Indicator 24: Proportion of Tuberculosis Cases Detected and Cured Under Directly Observed Treatment Short Course

Table 21: Number of Patients with Tuberculosis and the Incidence of TB

Source: MoH Health Statistics.  

Relevant Policies

The National AIDS Commission (NAC), established in 1996, is a multi-sectoral body made up of 32 members from public institutions such as the Ministry of National Education, Ministry of Justice and universities; and from Civil Society Organizations (CSOs) such as the AIDS Prevention Society and the Human Resources Development Foundation. It is convened by the Prime Ministry and is chaired by the Undersecretary of the MoH. NAC has a leading role in coordinating the national response to HIV/AIDS, guiding the national strategic planning process and advising on all national policy matters related to HIV/AIDS. Its core group, a technical committee consisting of NAC members, monitors and evaluates the implementation of the National Action Plan (NPA). Under the organisational structure of NAC there is the National Coordination Board, chaired by the MoH, whose members are representatives of the organisations implementing the "Turkey HIV/AIDS Prevention and Support Programme," funded by the Global Fund.

NAC has prepared a national action plan for 2004-2006 being implemented by related bodies nationwide for years 2004-2006, composed of national targets and strategies on protection, prevention, diagnosis and treatment, increasing accessibility to HIV Voluntary Counselling Services, regulations, monitoring and evaluation, social support and advocacy, targeting the general population.

Through the "Turkey HIV/AIDS Prevention and Support Programme," between 2005-2007, in four big cities where HIV/AIDS prevalence is very high, vulnerable populations such as commercial sex workers, homosexuals, intravenous drug users and people living with HIV/AIDS (PLWHA) will have better access to HIV/AIDS Prevention Services. Again, through the mentioned program the number of VCT counsellors will increase and also the legal national framework addressing HIV issues will be improved.

In 2004, within the scope of the "Strengthening of STI (Sexually Transmitted Infections)/HIV/AIDS Surveillance" project under the Turkey Reproductive Health Program between the MoH and the EC, workshops on the standardization of STI/HIV/AIDS laboratory services, HIV/AIDS standardization of diagnosis and treatment, standardization of in-services training, STI/HIV/AIDS surveillance and a National Consensus Meeting on the Second Generation Surveillance of STI/HIV/AIDS have been organised. A rapid assessment of the population at the highest risk of contracting HIV/AIDS has taken place and the first National STI/HIV/AIDS Situational Analysis report has been prepared. Moreover, a HIV/AIDS prevalence study on pregnant women will be carried out in 2006-2007 through the Turkey Reproductive Health Program.

HIV/AIDS prevention activities among young people are targeted at increasing the awareness of adolescents and young people about the potential spread of the HIV/AIDS virus, as well as its social and psychological consequences, by integrating HIV/AIDS into the education system. Peer education on HIV/AIDS will be offered by CSOs and the MoH to adolescents.

Another program on aimed at adolescents will be the preparation of a Life Skills Based Education (LSBE) Curriculum.

Peer education on HIV/AIDS will be given to orphans through the collaboration of the MoH and the Institution of Social Services and Child Protection.

HIV/AIDS/STI peer education for the uniformed services (i.e. military, police) will be given countrywide.

A network among HIV/AIDS treatment centers will be established to reach better PLWHA when they move from one location to another, as well as to strengthen the surveillance of HIV/AIDS.

In the National Action Plan (NAP) for 2006-2009 indicators will be prepared in line with its targets and activities to monitor and better evaluate better the activities and their impact to on society.

The struggle of the Directorate of Malaria Control (DMC) against the disease is extensive. The DMC, which tests thousands of blood samples every year, examined 1,320,010 people across the nation in 2002.

Creating awareness among the young population on such diseases and sexual health is the target of the 8th Five-Year Development Plan. As part of the efforts to reach this target, CSOs and public institutions are conducting projects focusing on reproductive and sexual health.

Benchmarks and Monitoring Capabilities

The main sources of data are the MoH's Health Statistics, the Demographic and Health Surveys of Hacettepe University Institute of Population Studies and Reforming the Health Sector for Improved Access and Efficiency (WB-2003).

Monitoring Capability

Challenges

•  Although the number of HIV/AIDS cases are number of HIV/AIDS cases is comparatively low in Turkey, the risk is still significant given the increase in incidence and the highly contagious nature of the disease.

•  Few youth-friendly health care services focus on young people's sexual health.

•  Women, particularly adolescent girls, are at increased risk of infection because they are more vulnerable to the consequences of unprotected and premature sexual relations.

•  Stigma and discrimination play an important part in the under-reporting of HIV/AIDS cases.

•  The population of Turkey is vulnerable to the threat of infection because of the high incidence of STIs and HIV/AIDS in neighboring CEE/CIS countries.

•  Problems in the surveillance system lead to difficulties in obtaining reliable information about the number of AIDS patients and AIDS-related mortalities.

• Half of the population is under the age of twenty-five and is highly mobile - the demographic group most open to liberal lifestyles and unsafe sexual practices. Therefore, a comprehensive information-education-communication program on the nature of the virus and the necessity for tolerance in the face of fear needs to be developed.

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