For close to twenty-five years the conventional HIV prevention method 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 rise gradually year in year out, regardless of ABC.
Re-focusing upon the important points and Rules of Transmission – One of many failings in the old pop over to these guys ABC approach would be to create the exceptions the rule, and also to focus upon these exceptions to cope with preventing HIV transmission in the general population: Multiple partners, infidelity, high frequency of intercourse, and young age of commencement of s.exual activity, for example assumptions.
Research in the past decade revealed that people are not (generally) overly se.xually active: Studies by Durex demonstrate that the typical South African is average when it comes to se.xual activity, in comparison to the rest of the world. Exactly the same was discovered for the age of first se.xual activity. In addition, it proved that multiple partners – although a higher risk for HIV transmission – will not be as widespread as previously thought, and cannot explain rapid increases in overall HIV transmission within a community. The ‘AB’ (abstain and stay faithful) strategy failed because individuals were (in general, 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. In the beginning, the explanation for this failure was blamed on insufficient education and availability. However when they were corrected very little changed, with the exception of youth and workers. Other individuals resisted condoms for relationship reasons (trust issues; evidence of love and commitment) and because it just prevented having babies. The need to get babies beats the potential risk of death, for many people. Count the amount of pregnant peer educators should you question the mismatch involving the ABC message and what individuals are very doing.
Focusing upon the overall rules, not the exceptions – There always has been – and always will be – people, behaviours, resources and circumstances which are beyond the range of what exactly is considered average or normal. These would require target-specific methods. However, for that great greater part of people and circumstances, the A2B4CT approach is fairly straightforward and in the current government health guidelines and protocols. It’s time for you to get caught up, refocus, and spend our energies and resources having a higher-level of official site efficiency and impact.
The A2B4CT (A-BB-CCCC-T) Approach – Fortunately, a totally different prevention strategy has emerged within the last couple of years, including eight various methods which we term – for the absence 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 how it operates, and put it on. The type in the required behaviour changes is additionally different, and therefore are associated with economics, gender equity, and mental health issues, including motivation towards an improved future, communication within relationships, stress and depression, and substance use (especially alcohol).
The outcomes from the A2B4CT approach are dramatic. A selection of results illustrates the impact of these prevention methods:
For couples where one individual has HIV and is taking ARVs, and the other is HIV-negative, the probability of transmitting HIV towards the uninfected partner is near zero (99.9%) right after the treated partner achieves an undetectable viral load (and where the individual is adherent for the ART);
With all 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 close to 1%. This is a 95% reduction in transmission;
Voluntary Male Medical Circumcision (VMMC) reduces the likelihood 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 using a different emphasis and application within the new A2B5C approach. As an example, as being a short-term protective measure while a couple of waits for your infected partner’s viral load to lower to safer levels, in order that conception of babies can take place without chance of transmission from a single partner to another. Microbicides are developed as another kind of barrier against HIV transmission.
New opportunities require new understanding – The new A2B4CT is based upon browse this site biology: The type of HIV and how the viral load is the key to understanding probability of transmission. Three biological terms must 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 professionals claim that the viral load is a lot more important that the CD4 count in determining the medical and wellbeing of any person.