For close to twenty five years the typical HIV prevention strategy was the ABC s.exual behaviour change strategy: Abstain, be Faithful, and use Condoms. Today, this strategy has all but faded into the background, with only condoms remaining on the tick-list of ‘to do’s’. Evidence was clear: New infections continued to go up gradually every year, irrespective of ABC.
Re-focusing upon the details and Rules of Transmission – One of many failings from the old read this article ABC approach ended up being to have the exceptions the rule, as well as focus upon these exceptions to deal with 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 in the past decade said that folks are not (generally) overly se.xually active: Studies by Durex show that the normal South African is literally average with regards to se.xual activity, compared to the rest of the world. The identical was discovered for age of first se.xual activity. In addition, it proved that multiple partners – although a high risk for HIV transmission – is not really 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 (generally, excluding high specific risk group) already pretty conservative in connection with this.
Condoms, although a logical solution, did not have the impact that was expected. Initially, the reason for this failure was blamed on absence of education and availability. However, when they were corrected not much changed, with the exception of youth and workers. Others resisted condoms for relationship reasons (trust issues; evidence of love and commitment) and since it simply prevented having babies. The drive to have babies beats the potential risk of death, for many individuals. Count the number of pregnant peer educators should you question the mismatch in between the ABC message and what folks are very doing.
Focusing upon the overall rules, not the exceptions – There always has become – and also is going to be – people, behaviours, resources and circumstances which can be beyond all the different precisely what is considered average or normal. These would require target-specific methods. However, for your great majority of people and circumstances, the A2B4CT approach is fairly straightforward and inside the current government health guidelines and protocols. It’s time to get caught up, refocus, and spend our energies and resources with a higher level of directory efficiency and impact.
The A2B4CT (A-BB-CCCC-T) Approach – Fortunately, a totally different prevention strategy has emerged in the last several years, which includes eight different 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 based upon biology, not morality. You don’t need to change your personal beliefs: Instead, you must understand the way it works, and use it. The character in the required behaviour changes can also be different, and therefore are linked to economics, gender equity, and mental health problems, including motivation towards a much better 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 those prevention methods:
For couples where a single person has HIV and is also taking ARVs, and the other is HIV-negative, the probability of transmitting HIV for the uninfected partner is close to zero (99.9%) following the treated partner achieves an undetectable viral load (and where individual is adherent for the ART);
Using the new PMTCT (Protection against Mother-to-Child Transmission) protocols – when applied as intended – mother-to-child transmission rates are reduced from 20 to 25% levels to seal to 1%. It is a 95% reduction in transmission;
Voluntary Male Medical Circumcision (VMMC) reduces the chances of a male becoming infected with HIV by about 50%, and the odds of him later infecting his regular partner by about 50% (WHO).
Condoms have re-emerged as a good prevention method, although with a different emphasis and application inside the new A2B5C approach. For instance, as being a short-term protective measure while a few waits for that infected partner’s viral load to drop to safer levels, so that conception of babies can happen without chance of transmission in one partner to another. Microbicides are being developed as another kind of barrier against HIV transmission.
New opportunities require new understanding – The brand new A2B4CT is based upon click to read more biology: The type of HIV and just how the viral load is key to understanding chance of transmission. Three biological terms need to be thoroughly understood: Viral Load (VL), co-infections, and Langerhans Cells. When these ogvmdy terms are understood and logically applied, an array of prevention methods become obvious, including individual, couples, and community interventions. Understanding the general length of HIV viral load is important in developing effective prevention strategies. Many medical experts claim that the viral load is much more essential that the CD4 count in determining the and wellbeing of the person.