For close to twenty-five years the conventional HIV prevention method was the ABC s.exual behaviour change strategy: Abstain, be Faithful, and utilize Condoms. Today, this strategy 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 go up gradually every year, regardless of ABC.
Re-focusing upon the important points and Rules of Transmission – One of the failings of the old see this here ABC approach was to create the exceptions the rule, and to focus upon these exceptions to deal with preventing HIV transmission within the general population: Multiple partners, infidelity, high frequency of intercourse, and early age of commencement of s.exual activity, to name a few assumptions.
Research in the past decade revealed that individuals are not (generally) overly se.xually active: Studies by Durex demonstrate that the normal South African is literally average in terms of se.xual activity, compared to the remainder of the world. The same was found for age first se.xual activity. Additionally, it proved that multiple partners – although a very high risk for HIV transmission – is not really as widespread as previously thought, and cannot explain rapid increases in overall HIV transmission inside a community. The ‘AB’ (abstain and become faithful) strategy failed because people were (generally, excluding high specific risk group) already pretty conservative in this connection.
Condoms, although a logical solution, was without the impact which had been expected. At first, the reason for this failure was blamed on lack of education and availability. However when these were corrected not much changed, aside from youth and workers. Other people resisted condoms for relationship reasons (trust issues; proof of love and commitment) and furthermore, as it really prevented having babies. The desire to get babies beats the risk of death, for most people. Count the quantity of pregnant peer educators should you question the mismatch involving the ABC message and what folks are actually doing.
Focusing upon the general rules, not the exceptions – There always has become – and always will likely be – people, behaviours, resources and circumstances which are beyond the plethora of what exactly is considered average or normal. These would require target-specific methods. However, for the great most of people and circumstances, the A2B4CT approach is pretty straightforward and within the current government health guidelines and protocols. It’s time and energy to catch up, refocus, and spend our energies and resources with a more impressive range of HIV prevention research efficiency and impact.
The A2B4CT (A-BB-CCCC-T) Approach – Fortunately, a totally different prevention strategy has emerged in the last couple of years, which include eight various methods which we term – for the lack of a much 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 modify your personal beliefs: Instead, you must understand how it works, and use it. The type in the required behaviour changes is additionally different, and are connected to economics, gender equity, and mental health problems, including motivation towards a better future, communication within relationships, stress and depression, and substance use (especially alcohol).
The final results in the A2B4CT approach are dramatic. A wide range of results illustrates the impact of these prevention methods:
For couples where one person has HIV and is taking ARVs, and the other is HIV-negative, the possibilities of transmitting HIV for the uninfected partner is close to zero (99.9%) right after the treated partner achieves an undetectable viral load (and where individual is adherent to 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%. This can be a 95% reduction in transmission;
Voluntary Male Medical Circumcision (VMMC) reduces the probability of a male becoming contaminated 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 inside the new A2B5C approach. As an example, as a short-term protective measure while a couple of waits for your infected partner’s viral load to decrease to safer levels, in order that conception of babies can happen without chance of transmission in one partner to a different. Microbicides are developed as another kind of barrier against HIV transmission.
New opportunities require new understanding – The newest A2B4CT is based upon Bonuses biology: The character of HIV and how the viral load is the key to understanding probability 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, a wide range of prevention methods become obvious, including individual, couples, and community interventions. Understanding the general span of HIV viral load is essential in developing effective prevention strategies. Many medical professionals claim that the viral load is a lot more essential that the CD4 count in determining the and wellbeing of any person.