,

The Success of HIV Assisted Partner Services in Kenya

HIV in KenyaBetween 2018 and 2020, Kenya housed 31 health care clinics across the country which provided HIV Assisted Partner Services (APS), according to the Lancet Global Health. HIV Assisted Partner Services (APS) is a trial facility available to females who have tested positive for HIV and their male partners. Through the APS Program, these women termed “index clients,” and their male partners, underwent routine HIV testing via various referral processes.

The program ensured the follow-up of index clients and their partners through on year with a 90% participation rate. The follow-up and eagerness of the candidates led to an increase in HIV care procedures as well as the suppression of viral HIV.

APS Methodology

Before commencing the trial, health care staff in the clinics got training on the subject, which was essential for the smooth flow of the trial. The focus of the trial was to “assess the impact of APS in reaching male individuals in sub-Saharan Africa, who have lower rates of HIV testing than female individuals.”

Women aged 18 and above as well as emancipated minors who tested positive for HIV in sub-Saharan Africa were eligible for HIV Assisted Partner Services. Females who participated in the trials consented to give the contact information of all their male sexual partners in the past three years and the staff informed those partners about their potential exposure to HIV. The staff offered the partners to choose between community-based or facility-based HIV testing. The former includes testing at home, at select venues, or as a part of a workplace campaign whereas the latter meant that all testing would be done at medical facilities.

All the candidates for the trial went through testing periodically at six weeks, six months and then 12 months after enrollment. It evaluated the success of the antiretroviral treatment that had been provided.

The Outcome of the Trial

Having a very high participation rate of 1,724 female candidates out of a total of 1,910 opting to take part, the trial was an enormous success. This targeted HIV Assisted Partner Service Methodology was twice as successful as any other randomized trial in Kenya. The trial found that 95% of all HIV-affected male candidates were virally suppressed — due to the positive effects of the medication. In addition, their viral load of HIV was so low that tests could not detect it.

Reported Success

  • Due to this trial, APS has been identified as a viable and efficient method by which people unaware of their HIV status can be tested and treated appropriately. Within a set of approximately three females diagnosed with HIV, at least one of their male partners tested positive for HIV as well.

  • Another reason that the trial was successful was that it did not rely on a client-driven approach and instead of asking the female clients to contact their sexual partners. Skilled staff contacted the potential candidates and inform them of the situation.

  • This process avoided much hesitation and shame on the end of the female index clients. Also, it guaranteed that all the potential male candidates got the information about the potentially life-threatening situation that they were in.

  • The anonymity of the entire operation was the key to its substantial success. The staff did not inform potential male candidates about the female index client the clinic staff was calling on behalf of. This led to fewer issues and altercations between the female index clients and the potential male candidates that took part in HIV Assisted Partner Services.

After the success of this trial, “APS has been fully integrated into the national HTS procurement and logistics systems,” according to the PLOS Global Public Health Journal. The HIV Assisted Partner Services has been noted to be a sustainable program to detect HIV on a larger scale and medical clinics that run the program have been set to receive a routine supply of HIV test kits and gloves. As a result, it helps further reduce the burden of HIV in Kenya and other countries in sub-Saharan Africa.

– Vahisté Sinor
Photo: Flickr

,

Mother-to-Child Transmission of HIV In Haiti 

Mother-to-Child Transmission of HIV In Haiti Mother-to-child transmission of HIV remains a significant public health challenge in Haiti. According to UNAIDS, an estimated 5,700 children were living with HIV in Haiti as of 2021. Additionally, an estimated 86,000 Haitian women over age 15 were living with HIV. This suggests the need for more work in the fight against mother-to-child transmission of HIV in Haiti.

Challenges in Preventing Mother-to-Child Transmission of HIV in Haiti

One of the critical challenges in preventing mother-to-child transmission of HIV in Haiti is the lack of maternal care. According to the World Economic Forum, more than 60% of pregnant women in Haiti give birth at home with an attendant. Furthermore, one-third of Haitian women do not attend antenatal care (ANC) visits that can identify high-risk pregnancies. Therefore, many women “do not know whether they have signs of complications and if it is safer for them to deliver at a hospital.” This means that many pregnant women in Haiti are not receiving the necessary medical care and information needed to prevent the transmission of HIV to their children.

Poverty and gender inequality are also significant factors contributing to the spread of HIV in Haiti, where ongoing violence and recent fuel shortages have further restricted access to health care. According to the United Nations Population Fund (UNFPA), a sexual and reproductive health agency, Haitian women and girls are particularly affected by the multiple crises that the country faces. As of October 2022, an estimated 30,000 pregnant women were “at risk of being unable to access essential health care,” increasing the risk of HIV transmission. UNFPA also estimated that, by the end of 2022, “around 7,000 survivors of sexual violence could be left without medical and psychosocial support.” As such figures suggest, Haitian women and girls are particularly vulnerable to HIV due to gender-based violence, lack of education and limited economic opportunities.

Addressing These Challenges

To combat these challenges, the Haitian government and its partners are implementing several initiatives to prevent mother-to-child transmission of HIV. A noteworthy example is the U.S. President’s Emergency Plan for AIDs Relief (PEPFAR), which provides antiretroviral therapy (ART) to people living with HIV in Haiti, including pregnant women, to reduce the risk of transmission to their children.

Initiatives like the Determined, Resilient, Empowered, AIDS-free, Mentored and Safe (DREAMS) partnership are also helping to increase women’s and girls’ access to HIV testing and counseling in high-risk countries. Led by USAID, DREAMS aims to reduce HIV rates among adolescent girls and young women by partnering with public and private organizations at the national and local levels to address the gender-based inequities that increase their vulnerability to HIV. Simultaneously, The World Bank is collaborating with the Ministry of Public Health and Population to increase access to antenatal care services and improve the quality of care provided.

Finally, the Fondation pour la Santé Reproductrice et l’Education Familiale (FOSERF) is a non-governmental organization that has been serving the Haitian population since 1988. It offers reproductive and maternal health services and programs to support the prevention and treatment of HIV and other infectious diseases. The organization also reaches women in other ways, including providing counseling services for rape victims, spreading awareness among sex workers and offering training to give sex workers alternatives to prostitution.

Hope for the Future

Mother-to-child transmission of HIV remains a significant public health challenge in Haiti. Yet, many efforts are underway to improve access to health care and education in Haiti, with a specific focus on reducing HIV transmission and providing on-the-ground support for the vulnerable and infected. These initiatives are making positive impacts while inspiring hope for the future of Haitian mothers and children.

– Nathalie Altidor
Photo: Flickr

, , , , , , ,

HIV/AIDS in Japan: Addressing Testing and Awareness

Japan is an affluent country with an industrious workforce and is one of the world’s largest consumer markets. However, with a 15.4% poverty rate, poverty does exist in the East Asian country. In addition to poverty, HIV/AIDS in Japan is a major concern. Specifically, a significant portion of HIV cases still goes undetected until they progress to AIDS. Japan is working with the United Nations Programme on HIV/AIDS (UNAIDS) to rectify that and to improve HIV/AIDS treatments.

Background on HIV/AIDS

Human immunodeficiency virus (HIV) attacks and weakens the body’s immune system by destroying CD4 cells, which leads to a higher risk of contracting other infections, viruses and diseases, such as tuberculosis and specific cancers. In 2021, 38.4 million people around the world were living with HIV, but only 75% had access to treatment therapy. Of those who were tested in 2021, 15% were unaware of having HIV or symptoms. A key problem in Japan is that the number of people unaware of their HIV status is at least double that rate.

Symptoms of HIV may not be noticeable within the first few months and could be mistaken for influenza. However, as the symptoms progress to having possibly swollen lymph nodes, weight loss, diarrhea, fever or cough, people should take a test to determine the diagnosis. HIV spreads through unprotected intercourse, the sharing of needles and blood transfusions, all due to the sharing of specific bodily fluids.

By using protection during intercourse and not sharing needles, people can prevent HIV spread. If infected people take antiretroviral treatment (ART), they can keep their viral load low and prevent transmitting HIV to others. If they do not use ART, their viral load will rise and HIV progresses to (Acquired Immunodeficiency Syndrome) AIDS. People with AIDS have extremely low immunity and are vulnerable to life-threatening infections. Mothers can take ART to prevent mother-to-child transmission through pregnancy, delivery and breastfeeding.

The State of HIV/AIDS in Japan

The annual number of new cases of  HIV/AIDS in Japan remained relatively flat or slightly declining from 2006 to 2019 at about 1300 cases. Still, HIV/AIDS in Japan is a concern because from 1985 to 2019, physicians diagnosed 19,216 men and 2,523 women with HIV. During the same period, physicians diagnosed 9,646 people with AIDS, and they reported 720 deaths.  In 2019, 72% of the new 903 cases were men who had sex with other men. The majority of these men were 20 to 40 years old.  In the same year, heterosexual contact contributed to 11% of new male cases and 27 of 29 new female cases.

The number of cases undiagnosed as HIV and diagnosed as AIDS is a key concern for HIV/AIDS in Japan. Annually, about 30% of new cases nationwide are diagnosed through AIDS onset which means that they were not diagnosed as HIV cases before they progressed to AIDS. Further, the discrepancy between the number of rural versus urban cases of HIV that have progressed to AIDS before diagnosis has been a concern. In 2009, the discrepancy in rural areas of the Aichi region was almost double that of the region as a whole.  In Sapporo in the Hokkaido region cases diagnosed as AIDS were 27.3% in urban areas and 87.3% in rural areas where tests are less accessible. These discrepancies led the Ministry of Health, Labour and Welfare to call on local governments to implement more HIV testing programs in rural areas.

Progress to Date

In December 2020, UNAIDS launched new HIV/AIDS prevention goals. The 95-95-95 goals aim to ensure that 95% of people living with HIV know their status, 95% of them are on ART and 95% of those on ART to have viral suppression by 2025. Japan is currently working to meet UNAID’s 95-95-95 target. In fact, UNAIDS and Japan’s National Center for Global Health and Medicine (NCGHM) entered into an agreement in 2020 to promote awareness of HIV symptoms and prevention, including a campaign during the 2022 Summer Olympic and Paralympic Games. There is also health insurance and social support in Japan. Third, Japan is testing treatments to find the most effective one. One such drug is Dovato, which is an oral drug available for both adults and children over 12.

While Japan offers doctors and patients a host of the original ART, many of the newer medicines that are available in Western countries and generic ART are not available in Japan at this time. Also, mouth ulcers are one of the first signs of HIV infection, and patients with mouth ulcers have trouble swallowing pills. Pharmaceutical Technology underlined that due to the need to run clinical trials in Japan versus just accepting the results of trials run elsewhere, the Japanese market does not have enough injectable medicines available for these HIV/AIDS patients.

Looking Ahead

It is clear that there is a need to raise awareness of HIV/AIDS in Japan. Early diagnosis and treatment are key. The government’s work with UNAIDS and its treatment testing campaign should help Japan get on track with the 95-95-95 goal.

– Deanna Barratt
Photo: Flickr

, , , , ,

HIV/AIDS in Venezuela

HIV/AIDS in Venezuela
Efforts to address HIV/AIDs in Venezuela are facing barriers as the country is grappling with limited access to medications, health care and products to maintain sexual health. Due to the Venezuelan economic and political crisis, medical workers are pouring out of the country. Additionally, the Pharmaceutical Federation of Venezuela has estimated that the country has had an 85% shortage of medicine as of 2018, making HIV/AIDs in Venezuela difficult to prevent and treat.

Venezuela’s Health Care System

Venezuela’s collapsing medical system has led to dire sexual education and limited condom access; many citizens have claimed that condoms are scarce at clinics, or egregiously expensive. In 2019, a pack of condoms was about $170 in Venezuela and people had to wait in long lines to purchase them.

The cost of condoms is a huge burden, as more than three-quarters of Venezuelans have been living in extreme poverty as of 2021. This has made Venezuela very vulnerable to sexually transmitted disease (STDs) transmission, including HIV, the deadliest STD there is. Therefore, HIV/AIDS in Venezuela has become an urgent humanitarian concern.

Understanding HIV/AIDS Treatment and Prevention

To prevent the spread of HIV, which is an STD that is highly preventable through condom use, individuals can get tested to limit the spread of the infection. In the case of treatment, antiviral drugs, or so-called “anti-HIV cocktails,” are highly successful in keeping HIV at bay so people do not subsequently contract AIDS.

AIDS is quite deadly and emerges at the point where the HIV virus has destroyed its host’s immune system. Although HIV is impossible to eliminate from the human body, a patient with the virus has about the same expected life expectancy as a patient without it. However, this is only true if the HIV-positive patient is receiving proper access to health care and HIV antiretroviral therapy. Otherwise, 90% of patients with the virus can expect to contract AIDS, which is fatal in eight to 10 years on average.

Venezuela’s HIV Crisis

Thus, HIV/AIDS in Venezuela has become a crisis precipitously with the country’s economic crisis. In a proper contagious disease protocol, citizens would have proper access to HIV testing. However, in a country with a medicine and health care shortage, this is hard to come by. Additionally, since many people with HIV experience discrimination, they often experience embarrassment at the possibility of testing. As of 2020, UNAIDS estimated that approximately 120,000 Venezuelans were HIV positive, which is about 0.3% of the country’s population.

HIV-Positive Refugees

HIV/AIDS in Venezuela is forcing citizens to leave to save their lives and obtain access to antiviral drugs elsewhere. The Venezuelan Network of Positive People has estimated that 10,000 Venezuelans had to leave due to poor HIV treatment options as a result of the economic crisis that has been ongoing since 2019. The only option HIV-positive Venezuelans have is to leave their homes to get the health care they need.

HIV and Venezuela’s Economic and Political Crisis

This situation is quite new for Venezuela. In fact, the country used to be a leading place for HIV treatment in the early 2000s. Since 1999, those with HIV/AIDS in Venezuela had access to free, government-funded treatment. Its public health system specifically targeted citizens that often experienced discrimination such as sex workers and other minority groups. However, under the political control of Hugo Chavez and his successors, such a program does not exist any longer. Unfortunately, political stability may be necessary before HIV-positive Venezuelans can receive treatment again.

Infected Venezuelan Refugees Find Hope in Colombia

About 1.7 million Venezuelans, or 37% of all Venezuelans, were living in Colombia as of 2021. Since Colombia has the highest Venezuelan refugee population, Colombian HIV/AIDS organizations are specifically targeting HIV-positive Venezuelans immigrating to the country.

The nonprofit Colombia AIDS Health care Foundation, founded in 2018 is one such example. Since its founding, it has provided HIV testing, condom delivery, outreach and treatment for HIV-positive persons. The organization provided antiretroviral drugs to 1,850 Colombians, mostly Venezuelan migrants, at a time as of 2021. The nonprofit works with the Colombian government, which provides free HIV treatment to documented migrants and undocumented migrants in emergency situations.

It is inspiring to see a country do so much to help its neighbors during an emergency. With other countries being not only willing to take in Venezuelan refugees but also to give them the medical care they need, there is hope for many Venezuelans.

– Mikaela Marinis
Photo: Unsplash

, , , ,

Initiatives Against HIV in Haiti

HIV in Haiti
With an estimated “2.2% of adults” noting an HIV-positive status in 2010, Haiti faces “the largest [HIV] epidemic in the Caribbean.” In 2020, 150,000 children and adults in Haiti lived with HIV. People older than the age of 15 made up 93% of this population. In addition, 20% of Haitians living with the disease are unaware that they are HIV-positive. To help reduce the prevalence of HIV in Haiti, several initiatives are currently underway, run by the Centers for Disease Control and Prevention (CDC), UNAIDS and the Elizabeth Glaser Pediatric AIDS Foundation.

CDC Initiatives

Since the CDC’s Division of Global HIV & TB opened its office in Haiti in 2002, the CDC has launched several initiatives to address the country’s HIV epidemic. The first aim is to strengthen health systems by training medical personnel, supporting staffing needs and strengthening the Haitian Ministry of Health’s governance. The CDC has also aided in the development of the iSanté national electronic medical record (EMR) software to better monitor and track HIV patient data. These innovative tools help inform evidence-based treatment for this disease. In 2018, iSanté, “along with two other EMR systems,” could monitor the data of “96% of HIV care and treatment sites.”

Another goal of the CDC office in Haiti helps improve laboratory resources. Through a collaboration with the National Public Health Laboratory and GHESKIO, a medical treatment, research and training center in Port-Au-Prince, Haiti, the CDC has helped develop and expand several HIV testing methods. In addition, the CDC assisted in developing “an external quality assurance program and a training curriculum” to support lab accreditation.

Community-led Monitoring

With support from UNAIDS, the Ministry of Public Health and Population and the U.S. government via the United States President’s Emergency Plan for AIDS Relief (PEPFAR), Haiti’s Civil Society Forum Observatory has initiated “community-led monitoring,” a program through which people living with HIV hold each other accountable throughout treatment. Community members are familiar with HIV patients from their community, and when patients do not follow through on treatments or follow-ups, community members know how to best communicate with them and encourage them to return. Community-led monitoring can provide valuable feedback on service delivery from a patient perspective, helping to improve on existing issues “to retain people in care.”

Community-led monitoring reveals the weaknesses of treatment plans for HIV in Haiti and brings corresponding solutions to light. For example, due to insight from community-led monitoring, the Civil Society Forum Observatory brings to light a need to increase the window of service hours and decrease patient wait times. It also recommends that stable HIV patients receive a six-month supply of antiretroviral medication. Through community-led monitoring and other resources, Haiti was able to allocate multiple months’ supplies of antiretroviral medicines to 88% of HIV patients during the COVID-19 pandemic.

Elizabeth Glaser Pediatric AIDS Foundation

The Elizabeth Glaser Pediatric AIDS Foundation strives to combat pediatric HIV worldwide through advocacy, research and initiatives for prevention and treatment. Although most HIV patients in Haiti are adults, 8,000 children younger than 15 lived with HIV in Haiti in 2020. Thus, addressing pediatric HIV in Haiti is an important health initiative.

Toward the latter part of 2020, the Foundation began its work in Haiti with the Delivering Technical Assistance Project. The project offers “cost-effective technical assistance (TA), capacity building and program implementation services” to HIV reduction programs. The technical assistance includes program management training, mentorship, consultations and workshops for health care workers.

These strategies, and many others throughout the country, are successfully helping lower HIV rates in Haiti. As organizations continue to implement HIV reduction plans, the severity of the HIV epidemic in Haiti may see a decline in the years to come.

– Aimée Eicher
Photo: Flickr

, , , , , , , ,

How HIV/AIDS in Africa Contributes to Violent Conflict

HIV/AIDS in Africa
The HIV/AIDS epidemic remains a significant public health problem in southern Africa. In the last decade, infections have drastically dropped while awareness of HIV status and availability of treatment has increased. This progress aligns with the UNAIDS 90-90-90 goal. Meeting this goal means that at least 90% of people with HIV are aware of their status, 90% are receiving antiretroviral drug treatments and 90% are virally suppressed. Viral suppression means that the virus will not negatively affect a person and that that person will not be able to transmit it to another person. Some of the most HIV-afflicted countries in Africa have met and even exceeded the 90-90-90 goals. Eswatini has the highest HIV prevalence in the world today at 26.8%. It has reached 95% in all categories and is on its way to reducing new infections.

HIV/AIDS and Conflicts

Despite recent progress, international aid has been focusing on HIV/AIDS less and less, especially as the COVID-19 pandemic has become a more imminent global threat. Sub-Saharan Africa still has the highest rates of HIV/AIDS in the world. It is also one of the most conflict-ridden regions in the world.

HIV/AIDS has a history of destabilizing political and social institutions in countries and leaving them vulnerable to violent conflict. The International Crisis Group estimated that one in seven civil servants, including government employees, teachers and the armed forces in South Africa were HIV-positive in 1998.

How Does HIV/AIDS Affect Civil Servants in Africa?

  1. The disease affects the productivity of the military and its ability to respond to armed conflicts. In 2003, the Zimbabwe Human Development Report estimated that the Zimbabwe Defense Forces had an HIV prevalence rate of 55%. With such a high rate of illness, the military has high training and recruitment costs, as soldiers get sick and are unable to work. In addition to this, HIV can transmit through sexual contact. It disproportionately affects younger populations which typically make up the bulk of the armed forces.
  2. The HIV/AIDS epidemic breaks down political institutions by limiting their capacity to govern. According to former president Robert Mugabe in 2001, AIDS had a significant presence in his cabinet, killing three of his cabinet ministers in the span of a few years and infecting many more. The disease wipes out workers essential to the function of a state, like policymakers, police officers and judicial employees.
  3. HIV/AIDS threatens the quality and accessibility of education. A UNICEF report found that more than 30% of educators in Malawi were HIV positive. If children cannot receive a quality primary education, they are less likely to receive secondary education and start professional careers. Instead, crime may open up opportunities for security that education could not provide. With increased antiretroviral use and awareness of the disease, HIV rates and deaths among educators have likely dropped along with overall rates in the last decade.

Civil Servants

The impact of HIV/AIDS on civil servants in Africa has been immense. The disease affects vulnerable populations such as gay men, sex workers and young women disproportionately. However, it has also affected those who work as civil servants. Civil servants are integral to the functioning of governments. Without them, countries are vulnerable to conflict and violence. Furthermore, HIV/AIDS prolongs conflict in countries already experiencing it.

While there are many other causes of violent conflict, the breakdown of political and social institutions fueled by HIV/AIDS only exacerbates conflict. War can also be a vector for the further spread of the disease. According to UNHCR, both consensual and non-consensual sexual encounters happen more often during the conflict. Rape has been a weapon of war in conflicts in Rwanda, the Democratic Republic of Congo (DRC) and Liberia in recent years and has likely contributed to the spread of HIV.

Solutions

Combating HIV and AIDS is a very important step in stabilizing economic, political and social structures across Africa. USAID programs like PEPFAR have had a significant role in combating HIV and AIDS. PEPFAR has invested nearly $100 billion in the global AIDS response in various ways. Most notably, it has provided 18.96 million people with much-needed antiretroviral treatment.

PEPFAR also aids in prevention care. For example, it has supported more than 27 million voluntary medical male circumcisions as well as testing services for 63.4 million people. In 2012, there was a government campaign in Zimbabwe to promote circumcision, in which at least 10 members of parliament participated.

These campaigns and USAID programs have had tangible results. In 2013, a study by the South African National Defense Forces showed an 8.5% HIV prevalence rate among its soldiers, much lower than the 19% prevalence in the general population. Given the successes in decreasing HIV/AIDS infections across Africa, perhaps economic, political and social stability is to follow.

– Emma Tkacz
Photo: Flickr

, , , , , , , , ,

HIV/AIDS in Ukraine

HIV/AIDS in UkraineUkraine has one of the highest rates of HIV/AIDS in the world, with an estimated 260,000 people living with the disease. Odessa, the third-most populous city in Ukraine, has “the highest concentration of HIV/AIDS of anywhere in Europe.” Poverty exacerbates HIV/AIDS in Ukraine and links to injected drug use, threats to government funding, lack of access to antiretroviral treatment and social discrimination.

Poverty and HIV/AIDS in Ukraine

In 2019, Ukraine and Moldova stood as the two most impoverished countries in Europe. The poverty rate in Ukraine increased during the COVID-19 pandemic, from 42.4% in 2020 to 50% as of February 2021. There is a strong connection between poverty and the spread of diseases; disease could be both a cause and a result of poverty.

HIV/AIDS causes conditions of poverty when working adults become ill and can no longer support their families. The disease becomes a result of poverty when the conditions of poverty put people at greater risk of contracting it. As an example, women and girls who live in poverty are more vulnerable to sexual exploitation. They are more likely to resort to working in the sex trade, which could put them at high risk of contracting HIV.

HIV/AIDS in Ukraine’s Women and Girls

UNAIDS estimates that out of all people with HIV/AIDS in Ukraine, 120,000 are women older than 15 and 2,900 are children aged 14 or younger. Gender inequality, poverty and violence against women and girls are significant factors in the spread of HIV. Women and girls who live in fear of violence may be reluctant to advocate for safe sex, receive testing or seek treatment for HIV and other diseases.

Gender inequality inhibits women’s access to resources for sexual and reproductive health. In rural Ukraine, where the poverty rate is highest, 36% of women do not participate in community or family decision-making. Only 46% of these women are competent with a computer or the internet. Furthermore, almost 48% do not have access to medical services.

The Lack of Access to Antiretrovirals

As Sky News reported, access to antiretrovirals is a major problem for many people living with HIV/AIDS in Ukraine. Although a law stipulates that antiretroviral therapy should be free to all citizens, limited national resources have resulted in restricted access.

Antiretrovirals are crucial for preventing the spread of HIV to children. The use of antiretrovirals during pregnancy and administered to an infant for four to six weeks after birth can result in a transmission rate of 1% or less. According to U.N. Women, the majority of women living with HIV/AIDS in Ukraine fell between 18 and 45 years old. Out of these women, 39% discovered that they were HIV-positive during pregnancy.

Social Discrimination Against People Living With HIV/AIDS

According to the World Health Organization (WHO), discrimination against people who use drugs and people living with HIV presents a serious challenge to identifying those who need treatment. Harsh drug laws, fear of HIV/AIDS and systematic police abuse undermine efforts to provide HIV information and services such as testing and safe needle exchanges. In addition, the law requires drug treatment centers in Ukraine to register drug users and share the information with law enforcement. This protocol keeps people who use drugs from seeking medical help, which subsequently prevents them from testing and receiving treatment for HIV/AIDS.

The War in Donbas

The war in Donbas has made it difficult for people to receive treatment in a region that previously had one of the highest rates of HIV/AIDS in the country and was home to nearly one-quarter of all antiretroviral recipients. When the war began in March 2014, it displaced 1.7 million people. To compound this, unsafe sex has resulted in an increase of HIV/AIDS within the military. Combined with ongoing military conflict and a shortage of antiretrovirals, Ukraine is experiencing a crisis: the government has failed to keep up with infection rates.

Solutions

In July 2021, Ukraine received a grant of $35.8 million from the Global Fund to Fight AIDS, Tuberculosis and Malaria. According to the Ukrainian government, the nation would use the funds to purchase personal protective equipment (PPE), reduce risks associated with COVID-19 and strengthen the health care system.

Ukraine is collaborating with the Centers for Disease Control and Prevention (CDC), USAID and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). The country wants to implement prevention campaigns, increase access to antiretroviral treatment and target key risk groups, such as people who inject drugs, sex workers and men who have sex with men.

On September 1, 2021, President Biden announced that the United States would provide more than $45 million in additional assistance for Ukraine. The aid would help people facing the impacts of the COVID-19 pandemic and the war in Donbas. The U.S. is working with USAID-supported programs to provide supplies for Ukrainian health care centers, training for health care workers and psychosocial support for the most vulnerable populations.

– Jenny Rice
Photo: Flickr

, , , , , , ,

Low Health Literacy in Developing Countries

Low Health Literacy in Developing Countries
While developing countries often face pressing issues such as inadequate health care, a less obvious but equally threatening problem is low health literacy rates. In comparison to developed nations, health literacy rates in developing nations are significantly low. However, if society as a whole works to educate and empower individuals to make better choices regarding their health, low health literacy, also known as the “silent killer,” will see a drastic reduction. Here is some information about low health literacy in developing countries.

Defining Health Literacy

The World Health Organization (WHO) defines health literacy as an individual’s ability to adequately comprehend health information and to implement this knowledge into their everyday life in order to “maintain or improve quality of life.” An individual with lower health literacy is more likely to make questionable health choices and is less likely to take preventative action against manageable diseases.

Limited health literacy also correlates with unhealthy lifestyle choices, increased hospitalization rates and higher mortality rates. These impacts make it clear to understand how inadequate health literacy serves as a “silent killer,” especially within developing nations where these rates are prominently low.

The Situation in Developing Countries

Low health literacy rates link to inadequate education systems and health systems because these structures hold the responsibility of relaying health information to the general public. Thus, nations that lack these proper systems are more likely to have insufficient health education levels.

A survey of adult citizens in Isfahan, Iran, indicates that almost 80% of respondents did not have sufficient health literacy. Most of the respondents with inadequate health literacy were females with “low financial status” and limited education. This data suggests that an overwhelming number of individuals in developing nations lack satisfactory health education, particularly women. The reason for this is likely issues of gender equality — women lack access to education, essential services and employment opportunities. Furthermore, poverty disproportionately impacts women all over the world.

Taking Action

There are several ways to improve health literacy rates, and therefore, improve global health. It is crucial to educate the population on their health and to empower them to effectively manage their well-being. Several interventions have proven effective. In South Africa, providing individuals with informative yet easy-to-read pamphlets that include graphics is improving health education in the country. Meanwhile, in China, findings determined that “periodic training of health educators is essential for improving health knowledge” among the general public.

Media is yet another way to improve health education. In Uganda, “more than one in three used the internet to search for health information.” In Iran, secondary school students cited television as their most helpful source of information on HIV/AIDS. In Israel, “a model of Media Health Literacy (MHL)” showed potential in improving health literacy among younger citizens.

Across Asia, the Asian Health Literacy Association (AHLA) works to understand and improve health literacy rates. This organization aims to raise awareness of this issue “among researchers, officials, healthcare organizations as well as experts in health and education, corporations and media” in order to formulate effective interventions to improve these rates in Asia. AHLA sees this as an essential  part of improving the quality of healthcare “and reducing health disparities between communities, groups and nations.” Ultimately, the AHLA aims to improve global health, starting with Asia.

Moving Forward

Increasing health literacy rates in developing countries is an effective way to improve global health and eliminate inequalities. Through education programs, improved communication and dedicated organizations,  these rates can improve. By educating individuals on matters of health, people all over the world can live an improved quality of life.

– River Simpson
Photo: Flickr

, , , ,

How the Coup Impacts Myanmar’s Healthcare System

Myanmar's Healthcare System Post Coup

On February 1, 2021, Myanmar’s military seized control of the country in a coup. Following a series of raids, several democratically-elected government officials were arrested, including the president, Aung San Suu Kyi. Since the coup, many protesters have taken to the streets, resulting in more than 100 deaths on March 27 alone. Even before the coup, Myanmar’s healthcare system was in shambles. However, NGOs and other groups believe that the coup, as well as the COVID-19 pandemic, will exacerbate conditions in the country. The situation is compounded by the return of 100,000 migrant workers to Myanmar in March 2021.

Effect on COVID-19 and Immunizations

Healthcare workers were among some of the first to join the pro-democracy movements. However, this has led to shortages of staff, significantly impacting healthcare service delivery. According to The New Humanitarian, “Soldiers have also occupied major public hospitals and attacked healthcare workers, including emergency responders trying to help injured protesters.” With limited healthcare services available, some doctors are volunteering their time and community groups are stepping in to bridge the gap in healthcare. “The public health system has practically collapsed,” said Andrew Kirkwood, the senior U.N. official in Myanmar, during a briefing in March 2021.

Additionally, the coup has stalled routine vaccinations for children. Due to healthcare workers joining the movement, as well as continued fighting in the remote regions, many refugees and citizens are unable to get their children vaccinated. By July 2021, close to one million children were unable to receive their vaccinations since the coup began.

Due to the fragility of Myanmar’s healthcare system, COVID-19 testing and treatment also came to halt, producing uncertainty regarding Myanmar’s vaccination rollout amid the coup. The coup and the counter-protests induced outbreaks, worsening COVID-19 and causing shutdowns. With the economic strain as well as the risk of the virus, Myanmar’s impoverished families are struggling. Fortunately, in July 2021, the U.N. Country Team in Myanmar stepped in to scale up “the provision of critical health services and COVID-19 vaccination efforts.” The U.N. Country Team is also working to increase testing rates and accelerate the COVID-19 vaccination rollout while tackling the oxygen shortage.

Effect on HIV/AIDS

The coup also led to the shut down of HIV treatment programs and testing, putting many lives at risk. Before the coup and the COVID-19 pandemic, Myanmar implemented several programs to tackle HIV/AIDs in impoverished areas. With the ongoing conflict, it has become harder to access anti-retroviral drugs and there are concerns of shortages due to disrupted supply chains.

ICAP, a global public health NGO, with funding from the U.S. President’s Emergency Plan for AIDS Relief  (PEPFAR), is “collaborating with the community-based organization Myanmar Positive Group (MPG) to build its capacity to deliver HIV care services.” During the COVID-19 pandemic, ICAP provided “virtual conferencing software for community self-help groups” to host virtual support meetings as these services are crucial to controlling HIV in Myanmar. ICAP also provided training on using virtual software and conducting tele-counseling. During the coup, these established tools will ensure these services continue.

The Good News

Several NGOs stepped up to help Myanmar. The Myanmar Red Cross is intensifying its efforts for humanitarian assistance and healthcare. The organization reported in June 2021 that nearly 236,000 people require assistance as COVID-19 shutdowns and the coup exacerbate poverty. About 2,000 Red Cross healthcare volunteers provided frontline assistance to those injured during the protests and others in need of healthcare services. The organization also provided ambulance services.

The EU also stepped in to assist with a donation of “€9 million in emergency humanitarian aid” in April 2021. The funding will go toward “emergency health support, protection, food security and multi-sector emergency assistance” in Myanmar.

With organizations taking a stand to help Myanmar’s most vulnerable people during the coup, citizens will receive the aid they need while the country awaits the end of the widespread violence and instability.

– Lalitha Shanmugasundaram
Photo: Wikimedia Commons

, , , , ,

The Effects of HIV/AIDS in Israel

HIV/AIDS in Israel
With the marvels of medical technology, medical professionals can now cure most infections and diseases with a combination of treatments and pharmaceutical drugs. However, it is challenging for them to treat some viruses still. Amongst the stubborn viruses that still elude the medical communities’ ability is the HIV/AIDS virus, a diagnosis that for too many means the end of living a normal life. The effects of HIV/AIDS in Israel have been profound and COVID-19 may worsen the situation.

The Effects of HIV/AIDS in Israel

Following the first case of AIDS in the 1980s, the world bore witness to an epidemic that swept the globe in an unprecedented manner. From 1981 to 2010, Israel reported nearly 10,000 cases, with around 7,000 of them still ongoing in the country. People living with HIV/AIDS in Israel fall into some of the most vulnerable groups in society. This includes injecting drug users and immigrants. Israeli immigrants, often from countries like Sudan, China and Eritrea, often face obstacles receiving treatment for AIDS. While testing is free, the pathway to HIV/AIDs drugs remains expensive and out of reach for many. This creates a socioeconomic divide on who has access to treatment and who does not. According to a report by the Israeli Task Force, many immigrants are unaware of their access to free testing.

COVID-19 Compounding Consequences

Since the beginning, nation-states have strived to mitigate the effects of the HIV/AIDS virus on their populations. Communities most at risk often face marginalization and are disproportionately at risk of poverty. The COVID-19 pandemic has halted services to help these groups. This has caused many to fall into poverty. The Health Ministry of Israel worries that poverty and food and housing insecurity will rise due to the COVID-19 pandemic.

In addition, the Health Ministry of Israel is collaborating with other government sectors to create and strengthen initiatives to fight HIV/AIDS. For example, needle exchange programs, homeless shelters and meals all function as efforts to combat the effects of HIV/AIDS in Israel. Health officials in these programs are now essential as the government prepares for a rise in cases.

The Good News

As a result, Israel is taking steps in the right direction to fight HIV/AIDS. Within society, a conservative outlook on sex and the religious practice of circumcision keep the numbers relatively low. In addition regional cooperation inside of Israel with IGOs like the UN and WHO have made workshops and collaboration with Israeli NGOs and the Jerusalem AIDS Project. Israeli researchers are some of the world’s foremost pioneers and drivers of HIV/AIDS vaccine research and in 2019 introduced a ‘mosaic’ vaccine that identifies and responds to more variant strains of the HIV virus. Though HIV/AIDS is still a prevalent issue, Israel is making great strides in combating the virus.

– Alex Pinamang
Photo: Flickr