Accurate data on HIV and AIDS prevalence does not exist for River Cess or any of Liberia’s rural counties. The National Aids Control program (NACP) deliberately guides against publishing County specific information/data of HIV and AIDS in order to prevent the stigmatization of particular tribal groups.

HIV and AIDS prevalence analyses are instead done by health facilities, age groupings and sex. The closest thing to County-level information is health center records, which do not give a true picture of the prevalence rate.

The County is in dire need of a Voluntary Counselling and Testing Center (VCT) and services for people living with HIV and AIDS (PLWHA). The Global Fund on HIV has expressed its intention to help strengthen health systems and HIV programs; building the capacity of public and private health facilities at the County and district levels, increasing care and support for PLWHA and their families, expanding VCT services, sexually transmitted infection (STI) services, antiretroviral (ARV) treatment and services to prevent mother-to-child transmission (PMTCT).

HIV and AIDS is a major challenge because the epidemic has the potential to slow the progress of many initiatives meant to build much-needed human capital and revitalize the economy. Ensuring that this does not happen requires that the citizens be empowered with the appropriate skills to arrest the spread of HIV and to minimize the impact. Integrating HIV and AIDS into poverty reduction strategies helps to create the necessary policy and planning environment for a comprehensive, multi-sectoral response.

While no County-specific data is available, a 2007 DHS estimates national HIV prevalence at 1.5 percent, or 1.8 percent for females and 1.2 percent for males. A previous estimate of 5.7 percent was based on the results of sentinel surveillance among pregnant women and girls attending ten antenatal care (ANC) clinics in urban areas. Future studies will seek to reconcile these seemingly disparate findings.

In any event, the war left most of the population severely challenged in meeting their social, cultural and economic needs, thereby making them vulnerable to a sharp increase in HIV prevalence, the likely result of which would be a negative impact on development: increased child and adult morbidity and mortality, increased absenteeism at the workplace and in schools, and lower economic output, among other effects.

HIV and AIDS-related vulnerability impacts a broad spectrum of the population, especially young people and females in particular, such that in Liberia as elsewhere, there is an increasing feminization of the epidemic. By strengthening the health infrastructure at the County level, the CDA works to promote human development by reducing the impact of HIV and AIDS vulnerability, morbidity and mortality.

County health and social welfare authorities will participate in the development and implementation of a new national multi-sectoral strategic framework led by the NAC, reducing new HIV infections through the provision of information, and scaling up access to treatment and care services, mitigating the impact of the epidemic on those already infected and affected.