For close to twenty five years the typical HIV prevention strategy was the ABC s.exual behaviour change strategy: Abstain, be Faithful, and utilize Condoms. Today, this tactic has all but faded into the background, with only condoms remaining on the tick-list of ‘to do’s’. The evidence was clear: New infections continued to increase gradually year after year, irrespective of ABC.
Re-focusing upon the Facts and Rules of Transmission – One of the failings from the old why not try these out ABC approach would be to have the exceptions the rule, as well as focus upon these exceptions to handle preventing HIV transmission inside the general population: Multiple partners, infidelity, high frequency of intercourse, and early age of commencement of s.exual activity, for example assumptions.
Research during the past decade said that individuals are not (by and large) overly se.xually active: Studies by Durex show that the normal South African is average in terms of se.xual activity, in comparison to the rest of the world. The identical was found for age first se.xual activity. In addition, it turned out that multiple partners – although a high risk for HIV transmission – is not as widespread as previously thought, and cannot explain rapid increases in overall HIV transmission in a community. The ‘AB’ (abstain and stay faithful) strategy failed because people were (in general, excluding high specific risk group) already pretty conservative in this regard.
Condoms, although a logical solution, was without the impact that was expected. At first, the reason for this failure was blamed on lack of education and availability. However, when these were corrected very little changed, aside from youth and workers. Others resisted condoms for relationship reasons (trust issues; evidence of love and commitment) and because it just prevented having babies. The desire to have babies beats the risk of death, for many people. Count the number of pregnant peer educators in the event you question the mismatch in between the ABC message and what individuals are really doing.
Focusing upon the typical rules, not the exceptions – There always continues to be – and constantly will likely be – people, behaviours, resources and circumstances which are beyond the range of what is considered average or normal. These would require target-specific methods. However, for the great most of people and circumstances, the A2B4CT approach is quite straightforward and within the current government health guidelines and protocols. It’s time for you to get caught up, refocus, and spend our energies and resources with a higher-level of read this article efficiency and impact.
The A2B4CT (A-BB-CCCC-T) Approach – Fortunately, a completely different prevention strategy has emerged within the last several years, which include eight various methods which we term – for the lack of a better acronym – the A2B4CT approach: Antiretrovirals (with emphasis upon access and adherence); Breastfeeding (Exclusive, with ART for PMTCT); Barriers (condoms, microbicides); Circumcision (voluntary male medical circumcision); Co-infection prevention/reduction (TB, STIs; fungal, bacterial and parasite infections; Couples counseling (including multiple partners); Community viral load reduction; Testing (HIV).
The A2B5CT approach is situated upon biology, not morality. You don’t need to change your personal beliefs: Instead, you must know how it works, and put it on. The nature of the required behaviour changes is additionally different, and therefore are connected to economics, gender equity, and mental health problems, including motivation towards an improved future, communication within relationships, stress and depression, and substance use (especially alcohol).
The final results of the A2B4CT approach are dramatic. A selection of results illustrates the impact of such prevention methods:
For couples where one person has HIV and is also taking ARVs, as well as the other is HIV-negative, the possibilities of transmitting HIV for the uninfected partner is near to zero (99.9%) right after the treated partner achieves an undetectable viral load (and where the individual is adherent towards the ART);
With the new PMTCT (Prevention of Mother-to-Child Transmission) protocols – when applied as intended – mother-to-child transmission rates are reduced from 20 to 25% levels to close to 1%. This can be a 95% decrease in transmission;
Voluntary Male Medical Circumcision (VMMC) reduces the chances of a male becoming infected with HIV by about 50%, and the probability of him later infecting his regular partner by about 50% (WHO).
Condoms have re-emerged as an effective prevention method, although having a different emphasis and application in the new A2B5C approach. For instance, being a short-term protective measure while a few waits for the infected partner’s viral load to drop to safer levels, to ensure that conception of babies can occur without risk of transmission in one partner to another one. Microbicides are now being developed as another form of barrier against HIV transmission.
New opportunities require new understanding – The brand new A2B4CT is situated upon great post to read biology: The character of HIV and how the viral load is key to understanding risk of transmission. Three biological terms have to be thoroughly understood: Viral Load (VL), co-infections, and Langerhans Cells. When these ogvmdy terms are understood and logically applied, a variety of prevention methods become obvious, including individual, couples, and community interventions. Knowing the general length of HIV viral load is essential in developing effective prevention strategies. Many medical experts suggest that the viral load is much more important that the CD4 count in determining the medical and wellbeing of any person.