Since the first reported case of AIDS in Guyana in 1987, the HIV epidemic has been a significant threat to health and development in Guyana, with an estimated 6,200 adults and children living with HIV at the end of 2011. Guyana's HIV epidemic is categorized as a low level generalized epidemic. Statistics at the end of 2011 show HIV prevalence among the general population steadily decreasing, from 2.4% in 2004 to 1.1% in 2011. This equates to an estimated 5,900 adults living with HIV, a considerable burden for a population of less than one million. Similarly, prevalence among pregnant women decreased from 2.3% in 2004 to 1.0% at the end of 2011. Although general population prevalence may be low, surveillance data for key populations from both the 2005 and 2009 Biological and Behavioral (BBSS) studies reveals a concentrated epidemic among high-risk populations, including men who have sex with men (MSM) (21.2%, 2005; 19.4%, 2009) and female commercial sex workers (FCSWs) (26.6%, 2005; 16.6%, 2009). A 2011 surveillance study among members of the military revealed a low HIV prevalence (0.2%), but the prevalence of other sexually transmitted infections (STIs) was significant (21.4%). Similar to the trend in HIV prevalence, the percentage of deaths attributable to HIV/AIDS and the estimated number of new HIV infections have also declined. In 2009, 4.2% of all deaths in Guyana were attributable to HIV/AIDS, a reduction from 9.5% in 2002. New HIV infections were fewer than 1,000 in 2002, and in 2011 estimates projected the number of new infections to be fewer than 200. The rapid scale-up of the HIV response saw increases in the numbers tested, reached and treated. In 2011, of the estimated 4,444 adults and children in need of anti-retroviral treatment (ART), 77.2% were receiving it. Among women who gave birth in the two years preceding the 2009 Demographic and Health Survey (DHS), almost eight in ten were offered and accepted an HIV test during antenatal care and 75% received their test results. Despite advances and expansion of HIV services, more than 25 years after the first reported case of AIDS in Guyana, HIV/AIDS remains the leading cause of death among 25-44 year-olds, as of 2009. While HIV services have expanded across the country, many gaps still exist. The 2009 DHS reported almost universal knowledge of AIDS in Guyana and that almost nine in ten women and men knew where to get an HIV test; however, only 53% of women and 38% of men age 15-49 had ever been tested for HIV. Guyana has made significant strides in addressing and monitoring its HIV epidemic. Sustaining this momentum as external donor resources contract will be critical in ensuring an adequate response to the public health and socio-economic challenges that HIV presents. The Government of Guyana (GOG) is currently finalizing its new national HIV strategy, HIVision2020, shaped by a series of consultative reviews with government, civil society, private sector, and target populations, such as MSM, FCSWs, and people living with HIV/AIDS (PLHIVs). HIVision2020 delineates five priority areas for guiding the HIV/AIDS program in Guyana in the coming years: Coordination; Prevention, Care, Treatment and Support; Integration of HIV into Other Services; and Strategic Information. The aims of HIVision2020 are to "fully fund Guyana's HIV response through country ownership and shared responsibility; to put knowledge, experience, lessons learned and innovation forward to make effective program decisions and life-saving choices; and to invest resources wisely to obtain optimal results for all Guyanese."