The first case of HIV was reported in 1987 in an expatriate, while the first Maldivian national with HIV was reported in 1991 [1]. The estimated total number of people living with HIV in the Maldives has remained at less than 100 since 2001, when HIV screening was initiated [2]. HIV prevalence has remained at less than 0.1% in the general population of adults aged 15-49 [2]. As of 2007, 14 HIV cases ad 10 AIDS deaths had been reported [3].  

The first Biological and Behavioral Survey (BBS) was carried out in 2008 among key affected populations - female sex workers (FSWs), men who have sex with men (MSM), injecting drug users (IDUs), sea farers, resort workers, construction workers and youth. HIV was detected only among male resort workers at 0.2% [4], with a syphilis prevalence of 1.2%. Hepatitis B was found in resort workers, MSM, sea farers, construction workers and IDUs [4],  while Hepatitis C in IDUs was detected in both Male’ and Addu [4].

The survey findings revealed the occurrence of high risk behaviours among key affected populations, which include unprotected sex with steady/permanent and non-regular partners, buying and selling sex, and injecting drug use as well as the use of non-sterile injecting equipment.

More than two-fifths (41%) of the total population of the Maldives comprised young people under 25 years of age [5]. According to the 2009 Demographic and Health Survey (DHS), less than 1% of young women aged 15-24  had sex by age 15, while 6% had sex by age 18 (higher in women from urban areas and in the capital city of Male, both at 8%) [6]. The 2008 BBS revealed high numbers of youth having ever had sex (34% in Male’ and 50% in Laamu) [7]. The BBS also found that in Male’, 17% of young people aged 15-24 had pre-marital sex.  This figure was higher, at 34%, among young people in Laamu.

Among the vulnerability factors include the following: geographical barrier that prevents access to HIV prevention interventions by targeted populations thus contributing to their low HIV knowledge; the great influx of foreign tourists (numbering 655,842 in 2009 alone) [8] that could potentially introduce and increase risk behaviours, and then HIV [9]; sexually transmitted infections (STIs) among key affected populations [4], and the weak recording and reporting systems of STIs [3]; gender issues and cultural/religious barriers that prevent condom promotion, and the absence of specific programmes for women injecting drug use [3]; and stigma and discrimination against people living with HIV within health care settings [3].

Sources:

[1] World Bank. HIV/AIDS South Asia. Available from: http://go.worldbank.org/MZ344HCFE0

[2] UNAIDS, Report on the Global AIDS Epidemic, 2010

[3] Maldives UNGASS Country Progress Report, 2010

[4] Maldives, Biological and Behavioral Survey, 2008, October 2008

[5] UNFPA, The case for investing in young people: as part of a national poverty reduction strategy, 2010

[6] Maldives, Demographic and Health Survey (DHS), 2009

[7] Maldives, Biological and Behavioral Survey, 2008, October 2008

[8]  Maldives, Ministry of Tourism, Arts and Culture, Tourism Yearbook 2010

[9] The World Bank, HIV & AIDS South Asia: Maldives, http://web.worldbank.org