HIV/AIDs in the United Kingdom
HIV/AIDS in the United Kingdom frequently affects those in poverty or with limited socioeconomic status. The National AIDS Trust and the Terrence Higgins Trust on Poverty and HIV performed research to determine why HIV-positive people in the U.K. are frequently poor. According to the findings of the inquiry in October 2009, the U.K. government cut single asylum seekers’ weekly assistance from £64.30 to £35.13 or £5 a day. Another 17% of applications cited issues with the compensation system as the root of their dissatisfaction. The concerns included waiting for a benefit decision, changes to the benefit plan and delays in receiving benefits for those who had entitlement to them.

The Relationship Between HIV/AIDS in the United Kingdom and Poverty

The National Survey of Sexual Attitudes and Lifestyles (Natsal-3) is the most comprehensive scientific study of sexual wellbeing and lifestyles in the U.K. Researchers examined the effect of poverty in significant depth in the Natsal-3 review. It found that women who live in low-income areas have a greater prevalence of chlamydia than other women. Poverty affects some people more than others; for example, one out of every three people living with HIV is poor. Entry to healthcare for HIV-positive people is still a big challenge.

The connection between HIV and poverty is complex, but the subject requires more attention. According to the Natsal-3 survey, almost half of U.K.-based black British people (47%) live in the poorest areas, while only 4% live in the richest. More research is necessary to better understand how socioeconomic status and ethnicity interact. Researchers have also found that socioeconomic status and ethnicity are key factors in the rise of STIs rates among black British people in the U.K.

HIV/AIDS and COVID-19

According to a U.K.-based study, over 17 million HIV-positive people are more vulnerable to COVID-19 than HIV-negative individuals. The Lancet HIV report also confirmed that COVID-19 death is more than twice as likely in HIV-positive individuals. The researchers compared patients with and without HIV infection who had a primary care record. To estimate the link between HIV infection and COVID-19 death, the researchers used Cox regression models. The study included a total of 17,282,905 adults, with 27,480 of them having HIV. During the study period, 14,882 COVID-19 deaths occurred, with 25 of those being HIV-positive people. After adjusting for age and sex, the researchers found that people with HIV had a greater risk of COVID-19 death. After accounting for deprivation, ethnicity, smoking and obesity, they discovered that the link was weaker, but the risk remained high. Sharing HIV/AIDS information has a positive influence on people’s lives.

The Consortium for Street Children

Unfortunately, HIV/AIDS also presents a challenge to U.K. children who live on the street. However, the Consortium for Street Children is attempting to make a difference.

The Consortium for Street Children is a coalition of 37 organizations dedicated to the rights of street children based in the U.K. According to the Consortium for Street Children, up to 9,500 children spent Christmas 2018 in makeshift shelters or hostels. The Consortium for Street Children’s mission is to protect children from sex trafficking on the streets. It ensures legal protection and access to justice for children on the streets. The Consortium for Street Children is undertaking research to develop a common approach that the sector can use to increase data quality on how many children there are living on the streets. Children may migrate to the streets for a variety of reasons, including:

  • Engaging in criminal activity
  • Experiencing rejection from their family due to perceptions of morality
  • Contracting HIV/AIDS
  • Mental health challenges
  • Engagement in substance abuse
  • Gender identity and sexual orientation
  • Abuse of a Sexual, physical or emotional nature
  • Urbanization

Looking Ahead

Despite the challenges of HIV/AIDS in the United Kingdom, studies are encouraging an understanding of it in relation to poverty. Moreover, the efforts of the Consortium for Street Children should continue providing aid to U.K. street children and reduce the prevalence of HIV/AIDS among them.

– Monwabisi Mpepe
Photo: Flickr

HIV/AIDS in Lesotho  Africa may not have the densest population; nonetheless, it is the continent with the most HIV-afflicted occupants. Lesotho, a small country in Africa, currently has the highest HIV prevalence in Africa and second in the world with 340,000 infected habitants. From mountain ranges to river valleys, the division of regions causes the country to face issues regarding giving access to healthcare in every village. Women experiencing exposure to HIV/AIDS in Lesotho, which endangers health and safety. Moreover, they can pass it on to their offspring while pregnant. Phelisanang Bophelong, a South African initiative, works in “improving young people’s access to HIV friendly services to engage in sexual health and working with prison inmates to ensure they have access to HIV prevention and care services.”

Healthcare in Lesotho

Lesotho, a developing nation in the south of Africa, has seen improvements in the health sector. Nonetheless, some civilians do not receive healthcare services. Rural areas are most affected because of the lack of infrastructure, such as roads between villages. The public sector has compromised to expand the healthcare sector to reach the rural population. Between the 2000s-2010, Lesotho reported having 62 nurses and five doctors per 100,000 habitants. In 2011, the government built new hospitals, and more doctors joined the workforce. Lesotho sees a bright future ahead of it with the support of NGOs like Phelisanang Bophelong and an emergency relief plan on behalf of the United States.

Rural Health Initiatives

HIV/AIDS in Lesotho has become an alarming problem, yet the government has relentlessly increased human resources. Other countries have contributed to emergency relief aid, such as the United States through UNAIDS, which aims to help test citizens and provide antiretroviral therapy. Currently, the mission has covered 81% of the communities across Lesotho.

In 2006, Lesotho’s government launched a healthcare program in rural areas that served 90,000 people. The Ministry of Health launched a new program that involves testing and counseling. It introduced mobile clinics to rural areas which have shown positive results.

Phelisanang Bophelong in Lesotho

In Lesotho, about 23.6% of people between the ages of 15 and 24 currently have HIV. A big problem in countries such as Lesotho is the lack of information about sexual health. Phelisanang Bophelong works to encourage young people to become aware of HIV and its effects. Phelisanang Bophelong is motivating the young population to prevent HIV. It is also incentivizing prison inmates to access care services to prevent the spread of HIV/AIDS. The NGO managed to diagnose and provide treatment to 200 people with HIV while raising awareness. It has also helped 6,113 young individuals reach out to healthcare services.

While there is always room for improvement, the situation surrounding HIV/AIDS in Lesotho has exponentially improved. NGOs such as Phelisanang Bophelong have promoted sexual health in young adults. This incentive has led to millions of citizens receiving testing for HIV/AIDS while preventing the expansion of it in the country. Meanwhile, relief aid from the United States has prevented illnesses, malnutrition and death in Lesotho. Additionally, the implementation of mobile clinics has given people medical access in harder-to-reach areas.

– Ainara Ruano
Photo: Flickr

HIV/AIDS in Mozambique
The East African country of Mozambique has struggled to control the spread of the human immunodeficiency virus (HIV) and the acquired immunodeficiency syndrome (AIDS). Since its introduction to southern Africa in the late 1980s, the adult prevalence of HIV/AIDS in Mozambique is around 12.10% – the seventh-highest rate in the world. However, there is good news. Infection rates and deaths that relate to AIDS are decreasing and the country is feeling a surge of international support. Here are three ways in which Mozambique is currently fighting against the epidemic.

Grants

In February 2021, the Government of Mozambique, the Global Fund and other medical partners launched six new grants to expand treatment and service options for HIV, TB and malaria. Actions like this are causing HIV/AIDS in Mozambique to experience a downward trend in cases and deaths.

With greater funds, HIV treatment will become more available. In fact, one can attribute greater access to treatment to the “29% decrease in the number of AIDS-related deaths” from 2006 to 2019. These particular grants are significant because they are worth $773,913,131, a figure that is 49% larger than the previous allocation amount.

The financial assistance aims to reach vulnerable populations, especially adolescent girls, and to make testing widespread. Mozambique is working towards creating strong, sustainable health systems. Health officials are hopeful that these grants will put the country on the path to self-sufficiency where external help is no longer necessary.

Medicine

There have also been recent developments in the world of pharmaceuticals. Mozambique launched a new preventative drug for tuberculosis (TB) on March 24, 2021, which is World Tuberculosis Day. Although this drug does not specifically treat people with HIV/AIDS in Mozambique, the two ailments inextricably connect. HIV greatly weakens the body’s immune system and puts people at high risk for diseases like TB.

The Mozambique Health Minister, Armindo Tiago, explicitly stated, “this programme is aimed at people living with HIV/AIDS.” The new system reduces pill intake from nine to three pills a week and the treatment duration from up to 36 months to just three months. According to Unitaid, “up to 3 million patients are expected to be made available for eligible countries this year.” These countries include Mozambique, Ethiopia, Ghana, Kenya and Zimbabwe.

This shorter, less invasive treatment intends to attract more people seeking medical therapy. If proven successful, it is likely that the number of HIV-related deaths will drop. As a result, Mozambique should gain the upper hand in the fight against communicable diseases.

Clinics

The U.S. NGO, the Elizabeth Glaser Pediatric AIDS Foundation, is helping combat HIV/AIDS in Mozambique. This organization focuses on preventing pediatric HIV and ending pediatric AIDS all over the world. On March 15, 2021, the NGO donated two mobile clinics that will serve the cities of Maputo, Matola and the district of Marracuene.

The organization intends to provide primary care as well as sexual and reproductive health services to 3,000 young people. It chose the areas of Matola, the district of Marracuene and Maputo because of the high number of teenagers who need “more accurate information” about sexual health and sexually transmitted diseases. The mobile clinics have services for HIV/AIDS testing, tuberculosis, cancer screening, counseling and more.

Implementing these three forms of aid furthers the country’s efforts to make healthcare more accessible for those who need it most. Mozambique is a demonstration of how people across the world are still passionately fighting against HIV/AIDS.

– Lucy Gentry
Photo: Flickr

HIV/AIDS in SenegalHIV/AIDS is an epidemic that is most prevalent in Africa. Many countries across the continent are acutely affected or struggle to control the disease. One country that has handled the crisis expertly is Senegal. A low-income country in West Africa, Senegal would look to be a prime candidate for a difficult path regarding HIV/AIDS. However, HIV/AIDS in Senegal is relatively low in cases and in damage.

HIV/AIDS in Senegal

Senegal has become a model for controlling HIV/AIDS across the developing world. The country of 16 million people manages to keep the prevalence and spread of HIV/AIDS low while providing many methods to increase knowledge of the disease. There are only 41,000 people in Senegal living with HIV/AIDS as of 2019.

The prevalence rate of people living with HIV/AIDS stands at 0.4 among adults between 15 and 49, with men having a 0.3 prevalence rate and women having a 0.4 prevalence rate. There were only around 1,400 new cases of HIV/AIDS in Senegal in 2019 and 1,200 deaths. There has been a 37% decrease in HIV/AIDS cases since 2010 and a 26% decrease in deaths. Roughly 70% of people with HIV/AIDS receive antiretroviral treatment. Senegal was the first sub-Saharan country to establish an antiretroviral treatment program in 1998 and is one of the few countries in Africa that provides such treatment for free.

Smart Senegalese Strategies

Senegal’s success is due to several methods of raising awareness about HIV and increasing treatment and prevention plans. Senegal took HIV/AIDS very seriously even in the earliest days of the spread. In 1986, Senegal was one of the first African nations to develop a National Council Against AIDS, which has remained effective and stable. The country was also one of the first to focus on securing antiretroviral drugs and negotiated deals with pharmaceutical companies in order to provide them for free or at a low cost.

The Senegalese government has continued to make HIV/AIDS a priority. In 1992, Senegalese president, Abdou Diouf, showed leadership by asking other leaders to make a commitment to addressing HIV/AIDS at a summit for the Organization of African Unity. This attitude has led to sustained success. Since 1997, Senegal’s HIV/AIDS prevalence rate has remained below 1%, a remarkable achievement as prevalence rates across Africa have frequently soared above 10%.

Senegal’s basic strategy has remained consistent. The country emphasizes awareness, provides medical resources and works with the powerful local regional communities to stop the spread. Public health initiatives including blood screenings, education programs in schools and condom distribution are common. NGOs also provide a lot of help in health initiatives and raising awareness.

Crucial in the success of preventing HIV/AIDS in Senegal is the support of religious leaders and the role of religion. Senegal is a 95% Muslim-based country, and generally, strict adherence to the religion leads to fewer incidents of casual sex and infidelity. In a largely religious country, the words of religious leaders are very important, especially as conspiracy theories around HIV/AIDS are common. Many religious figures talk openly about HIV/AIDS and promote solutions, which lends credibility to the danger of the disease and the government’s efforts to combat the disease.

A Role Model

HIV/AIDS in Senegal is well under control, which should be a great source of pride for the country. Senegal has taken HIV/AIDS seriously since the beginning and has a consistent and effective strategy that keeps the disease largely at bay.

Clay Hallee
Photo: Flickr

UNAIDS’ Treatment Initiatives for HIV/AIDS in BotswanaAccording to a UNAIDS report in 2019, 380,000 children and adults in Botswana are living with HIV/AIDS. The deadly disease has made a prominent appearance in Botswana, which is currently one of the most affected countries in the world. However, with the help of UNAIDS treatment initiatives for HIV/AIDS in Botswana, the country has managed to establish valuable antiretroviral treatment (ART) and raise awareness for HIV/AIDS.

HIV/AIDS: The disease and its symptoms

Human Immunodeficiency Virus (HIV) is a deadly virus that is spread through bodily fluids and targets human immune cells. When the virus fuses with white blood cells, it hijacks the immune system and leaves the victim highly susceptible to disease. Acquired Immune Deficiency Syndrom (AIDS) occurs when HIV goes without treatment and a person’s immune system is weak as a result of the virus.

Properly monitoring and managing the disease is important in slowing down the progression of the virus in its early stages. Symptoms of HIV include skin rashes, a sore throat, a fever and swollen glands. When doctors diagnose and test for HIV, they look for the appearance of HIV antibodies in the bloodstream. International Training and Education Center for Health (I-TECH) in Botswana is a program that conducts HIV testing and posts information about the spread and transfer of the disease.

Prevalence and Primary Modes of Communication

HIV/AIDS is most commonly spread through broken wounds and contaminated bodily fluids. Participating in sexual activities without protection or HIV-prevention medicine can result in the transmission of the virus. HIV/AIDS cannot pass through saliva, sweat or urine unless they contain traces of infected blood. Using needles with HIV-contaminated blood, as well as rare cases of blood transfusions present a risk of being exposed to the virus. Less common ways of contracting HIV/AIDS include infection during birth and pregnancy from mother to child.

In Botswana, female sex workers and youth are at the biggest risk of contracting HIV/AIDS. A 2012 study by the Ministry of Health found that 61.9% out of 4,000 female sex workers in Botswana have HIV. Additionally, of those surveyed, 18.6% of female sex workers did not wear condoms out of force, and 23.9% for money. Similarly, a lack of awareness and information about HIV/AIDS transmission has caused youth under the age of 15 to participate in sexual activities without protection. This has created even more HIV/AIDS cases among the youth of Botswana.

UNAIDS’s Approach to HIV/AIDS Treatment

Receiving treatment for HIV early on plays an important role in stopping the progression of the virus before it develops into AIDS. Early treatment can increase life expectancy and make living with the virus more manageable. In the United States, HIV does not often progress into AIDS. This is because frequent treatment at correct intervals can significantly slow down the rate at which the virus replicates. However, treatment is not easily accessible or cheap in many developing countries such as Botswana. This is a challenge that UNAIDS is currently helping to overcome.

In response to Botswana’s move to offer free treatment to non-citizens, UNAIDS Executive Director Gunilla Carlsson stated, “This measure will save lives and help the entire country progress toward ending the AIDS epidemic — it is another example of Botswana’s leadership and its determination to leave no one behind in the response to HIV.”

UNAIDS Treatment Initiatives for HIV/AIDS in Botswana

UNAIDS has maintained a plan to end the HIV/AIDS epidemic by 2030 through the implementation of ART for all Botswanians and collaborative work with the government of Botswana. As of 2017, 320,000 people of the 380,000 inhabitants of Botswana living with HIV now have access to treatment. Carlsson asserted that “the main challenge that Botswana is facing in its AIDS response is complacency. If the country can overcome this challenge, then it will show the whole world that it can be done.”

UNAIDS’s goal is to prevent the spread of the virus by educating the public and obtaining funding. Due to the combined effort of the government of Botswana and UNAIDS, Botswana was the first country in Eastern and Southern Africa to offer free HIV treatment regardless of living status or citizenship. It has also adopted a strategy that allows immediate treatment for those who test positive for the virus. This has decreased the cases of AIDS and improved the quality of life for those living with the disease. Among other exemplary HIV/AIDS programs, UNAID treatment initiatives for HIV/AIDS in Botswana are helping save millions of lives.

– Esha Kelkar
Photo: Flickr

Dr. Angeli Achrekar
On January 20, 2021, President Joe Biden appointed Dr. Angeli Achrekar as the new U.S. Global AIDS Coordinator and Special Representative for Global Health Diplomacy, which means she will be leading the President’s Emergency Plan for AIDS Relief (PEPFAR).

Who is Dr. Angeli Achrekar?

Dr. Achrekar is remarkably qualified for her position. She has earned her doctorate from UNC-Chapel Hill, a master’s degree from Yale and her bachelor’s degree from UCLA. In addition to her academic accomplishments, Dr. Achrekar has a career of public service under her belt, involving combating HIV/AIDS around the globe, public health development and women and girls’ health. She originally worked in India and with UNICEF. She then started working with the CDC starting in 2001, where she led the National Initiative to Improve Adolescent Health. This initiative spanned across multiple agencies and consisted of professionals from a variety of disciplines in more than 100 organizations.

Following her leadership of the National Initiative to Improve Adolescent Health, Dr. Achrekar started her work with PEPFAR to fight HIV/AIDS around the world in 2003. In working with PEPFAR, she traveled to South Africa. There, she coordinated with local governments to assess risk patterns that occur through drug use and among sex workers. Dr. Achrekar then became Senior Public Health Manager for the CDC in its Division of Global HIV/AIDS. Lastly, she started in 2011 with the U.S. State Department where she helped come up with and develop the Saving Mothers program, as well as the Giving Life program.

Developments Since Her Appointment

Since her appointment, Dr. Achrekar has already made strides in her position to fight AIDS and other diseases around the world. Notably, under her leadership, PEPFAR has been part of a joint effort with other organizations and agencies including USAID which will bring a new treatment to TB patients in Ghana, Ethiopia, Kenya, Mozambique and Zimbabwe. Rather than patients needing to take a combination of drugs for treatment, the new treatment will combine two drugs so patients will be able to take fewer drugs in total. The new development is a big leap forward and Dr. Achrekar said, “The availability of a shorter, more easily tolerated, and safer regimen for TB prevention that is also affordable is critical for accelerating the fight against TB. The new development is big news as latent tuberculosis is said to affect up to a quarter of the world’s population.”

The Importance of Fighting AIDS in Relation to Global Poverty

PEPFAR’s work to fight AIDS holds much significance to the fight against global poverty because the two interconnect considerably. AIDS disproportionately affects those in poverty. Considering that the prevalence of AIDS has been commonly linked with poverty, a critical component of fighting the disease is fighting poverty. In his article “Is HIV/AIDS Epidemic Outcome of Poverty in Sub-Saharan Africa?” Noel Dzimnenani Mbirimtengerenji wrote, “Unless and until poverty is reduced or alleviated, there will be little progress either with reducing transmission of the virus or an enhanced capacity to cope with its socio-economic consequences.”

Sean Kenney
Photo: Wikipedia Commons

HIV/AIDS In LiberiaAround 4.9 million people are currently living with HIV in western and central Africa, including a percentage of those living in the small African country of Liberia. With a population of 5.1 million, roughly 1.5% of Liberians aged 15-49 live with HIV/AIDS. While this sounds like a small percentage, this equates to an estimated 47,000 people currently living with HIV/AIDS in Liberia, including 3,600 children.

HIV/AIDS in Liberia

While the percentage of HIV/AIDS in Liberia is lower than in surrounding countries and other regions of Africa, the country still struggles with treatment plans, education on the disease and breaking down stigma that could help prevent further spread. In 2019, UNAIDS released a comprehensive report detailing the spread and effect of HIV/AIDS in the country. The report states that only 33% of those living with HIV are receiving ART treatment. This amounts to 15,000 people currently receiving antiretroviral therapy (ART), a daily medication that reduces HIV in the system. Persons with HIV who do not receive ART treatment are more likely to develop AIDS and spread the virus. Of the 15,000 receiving treatment, 763 are children, which amounts to only 21% of all infected children in the country.

Additionally, only 58% of those living with HIV know their status. Lack of education on HIV testing and little access to testing centers has led to only a little more than half of those infected knowing their status through accurate testing. This lack of education heightens the threat of further spread, putting the health and safety of the entire population at risk. HIV/AIDS is not limited to sexual encounters. It also spreads through shared drug injections and even spreads to infants through breastfeeding. Unfortunately, stigma and discrimination continue to prevent progress.

According to UNAIDS’ 2019 report, roughly 53% of those surveyed in Liberia answered no when asked if they would purchase produce from a vendor who was HIV positive. This kind of stigma and cultivated ignorance around HIV and AIDS further inhibit people from getting tested as they may fear public ridicule. The fear of a positive test prevents the country from creating accurate and beneficial response plans.

Programs and Progress

In 2017, the African Union, in partnership with UNAIDS and others, implemented a series of “catch-up plans” for countries in western and central Africa to combat these issues. These plans included a 90-90-90 goal by 2020, meaning 90% of the people will know their HIV positive status, 90% of HIV positive people will have access to ART treatment and 90% will have viral suppression. The UNAIDS’ full 2020 report for Liberia is not available yet but the 2019 report already showed improvements in the country’s fight to eradicate the disease.

Compared to a 2016 report, the percent of children receiving ART treatment rose from about 17% to 21% in 2019.  Additionally, the percentage of HIV-positive pregnant women receiving ART treatment has increased from 19.3% in 2015 to 90% in 2019. This massive increase helps prevent infants born with HIV and decreases the risk of spread through sexual partnerships. The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) has supported the African Union and UNAIDS’ efforts in Liberia and significantly aided in the reduction of HIV-related issues. Therefore, PEPFAR supports health and treatment facilities in four Liberian counties and supported ART treatment for 15,000 HIV-positive persons in 2020.

All these improvements show progress toward the eradication of HIV/AIDS in Liberia. These advancements bring optimism as hope for an HIV/AIDS-free country remains strong.

– Kendall Couture
Photo: Flickr

HIV/AIDS in South Africa
Since the human immunodeficiency virus (HIV) first evolved into the acquired immunodeficiency syndrome (AIDS) in the early 1980s, the virus has rapidly spread to every corner of the globe. It has infected over 65 million people worldwide. With no cure in sight, over 25 million victims have perished at the hands of the virus to date. HIV/AIDS predominantly plagues regions in Africa, Asia and the Pacific. Though cases have dropped since the epidemic heights of the 1990s, this disease continues to afflict 38 million people today and remains a leading cause of death. Here is a summary of HIV/AIDS in South Africa.

What is HIV/AIDS?

The human immunodeficiency virus (HIV) infiltrates and takes over the cells that protect against infections. As the body’s ability to fight viruses disappears, HIV makes the individual extremely vulnerable to additional infections or diseases. Spread through the transmission of bodily fluids, transmission most commonly occurs during the communal use of drug injection syringes and unprotected sexual activity. When left untreated, HIV can devolve into a lifetime condition called acquired immunodeficiency syndrome (AIDS). No cure exists for HIV or AIDS, but there are preventative measures that an individual can take, as well as treatment, drugs and therapy.

HIV/AIDS in South Africa

In 1982, South Africa was battling the apartheid that had dominated its governance for decades. This landmark transformation created tumultuous political strife that distracted national attention away from the HIV virus that was silently taking root in the gay and impoverished black communities. With drastic changes occurring in the South African government, insufficient measures failed to halt the initial handful of HIV infections from growing by 60% by 1995.

By the time that South African President Nelson Mandela first spoke about the virus, the epidemic had escalated into a public health crisis. South America became the most infected country in the world. Virus deniers and negligent governing officials let the situation further devolve throughout the 1990s and early 2000s. It was not until 2008 and a change in administrations that South Africa treated HIV/AIDS as a public health threat. The new government implemented a plan to distribute medicines and drugs, the largest step South Africa had taken since the virus outbreak 30 years prior.

Currently, efforts to fight HIV/AIDS face infrastructural and monetary difficulties. Public health resources have become sparse as the South African currency lost value. Consequently, HIV/AIDS therapy and antiretroviral treatment declined even while virus rates continue to rise.

In 2019, HIV/AIDS infected an estimated 7.7 million South Africans. That totals 20.4% of the population, with new cases occurring daily. Additionally, more than 72,000 HIV/AIDS-related deaths have occurred in South Africa. Over 70% of South African adults and 41% of minors undergo antiretroviral treatment.

Preventing the Spread

The HIV/AIDS epidemic that continues to plague South Africa may find its match in antiretroviral treatment (ART). This preventative measure is highly popular since the South African government progressed the ART program since the early 2000s. UNAID reported that 70% of South Africans living with HIV/AIDS received ART treatment in 2019, up by 50% since 2010. If an individual tests positive for HIV, they can receive ART to forestall or fully prevent the further devolution of HIV symptoms and the onset of AIDS. South Africans have invested themselves in taking advantage of the free testing. A guaranteed treatment for those testing positive increases the number of South Africans willing to obtain testing.

ART therapy particularly helps mothers with HIV by curbing mother-to-child transmission. This preventative measure has resulted in a strengthening of both mother and child health, and a decrease in birthing mortality and childhood HIV/AIDS infection.

While HIV/AIDS in South Africa remains a massive issue, one can find hope in new and evolving preventative measures. ART treatment offers an avenue to health for many infected individuals. It prevents further spread, curbs symptoms and can make healthy populations resistant to the virus. With South Africa expanding its diagnostic and treatment capabilities, people living with HIV/AIDS may live longer and healthier lives.

– Caroline Largoza
Photo: Flickr

HIV/AIDS in Iran
Iran discovered its first case of HIV/AIDS in 1987. Now, over 30 years later, UNAIDS estimates that more than 59,000 people are living with HIV/AIDS in Iran. While Iran has had success managing its HIV/AIDS epidemic in the past, shifting conditions surrounding the spread of the disease has made prior prevention plans obsolete. Iranian non-governmental organizations (NGOs) are taking a new approach to help tackle the present crisis.

HIV/AIDS in Iran

Avert is an organization working in HIV/AIDS education. According to its reports, the Middle East and North Africa (MENA) region, the area where Iran is located, has the fewest HIV/AIDS infections in the world. However, a concerning aspect of the region’s HIV/AIDS epidemic is that so few people are aware of their infected status. Of the estimated 59,000 people living with HIV (PLHIV) in Iran, UNAIDS estimates that only 22,000, or 37%, know that they are carrying the disease. By comparison, only about 15% of PLHIV in the United States are unaware of their status.

This lack of awareness amongst Iranian PLHIV is concerning both in its implications for the quality of life of those individuals, but also in its potential to increase the spread of the virus. This is part of the reason why Iran continues to see the steady spread of HIV/AIDS. According to UNAIDS, while new infections are down from a spike in 2004, Iran saw more than 4,000 new infections in 2019. The AP reports that this increase could be due to the rising prevalence of sexually transmitted cases of HIV/AIDS in Iran, where infection by contaminated drug injection has traditionally fueled the country’s crisis.

Knowledge and Perceptions of HIV/AIDS in Iran

The unknown status of many Iranian PLHIV results from larger issues surrounding Iran’s attitude towards the virus. Specifically, a lack of education regarding HIV/AIDS and prevailing cultural stigma towards PLHIV impacts how Iranians treat the virus and those living with it.

A 2013 survey showed that public education about HIV/AIDS in Iran is limited. The survey included 4,950 participants, each of whom had to fill out a questionnaire regarding their understanding of and attitudes towards HIV/AIDS.

The results of this survey showed that more than 80% of participants were aware that HIV/AIDS could spread through sexual contact or the sharing of a needle with a person with HIV/AIDS. In addition, 70% of participants knew that the use of a condom decreases the likelihood of contracting the virus during sex. However, despite this understanding, only 21.8% of respondents consistently used a condom during sex. This is particularly concerning given the rising role of sexual transmission in the spread of the disease in Iran.

The survey also revealed high stigmatization of PLHIV by respondents. Among respondents, 43% believed that HIV was a “fair punishment,” for “sins of the past,” and 48.6% said that they would stop interacting with somebody who contracted HIV.

Stigma towards PLHIV in Iran results from numerous factors. Misunderstandings about the spread of HIV/AIDS are part of the equation. Due to cultural norms, the association of HIV/AIDS with drug use, homosexuality and premarital sex have led to the widespread nonacceptance of PLHIV, a sentiment echoed in the aforementioned survey.

A New Approach to HIV/AIDS in Iran

Fortunately, NGOs in Iran exist that are advancing a more compassionate and effective approach to HIV/AIDS. The Tehran Positive Club is one such organization. The club devotes itself to assisting Iranian PLHIV, educating the public about HIV/AIDS and reducing the stigma against PLHIV. It provides services to PLHIV including counseling, group therapy, material support and vocational training.

Based out of Iran’s capital, the Tehran Positive Club has thousands of members and multiple branches throughout the country, including in populous cities like Isfahan, Kermanshah and Qom.

By providing material support, the Tehran Positive Club hopes to alleviate the social and psychological trauma that societal stigmatization causes PLHIV. And by increasing public understanding about the disease, it seeks to eliminate the prevailing cultural stigmata that result from misinformation. Reducing stigmatization creates empathy for PLHIV and raises the likelihood that more Iranians will receive testing for the disease, thereby reducing its spread and increasing the chances of survival for the unwittingly infected.

In 2016, the Tehran Positive Club received the Red Ribbon Award from UNAIDS for its work with the HIV/AIDS epidemic in Iran. Though the organization already has powerful allies at home and abroad, including the Iranian Research Center for HIV/AIDS and the United Nations Development Program, increased foreign aid would undoubtedly help further its mission and turn the tide of Iran’s HIV/AIDS epidemic.

– Joseph Cavanagh
Photo: Creative Commons

HIV/AIDS in The Dominican Republic
HIV/AIDS in the Dominican Republic is on the agenda of the Pan American Health Organization (PAHO) and HIV/AIDS has been the focus of the Plan of Action for the Prevention and Control of HIV and Sexually Transmitted Infections 2016-2021. The goal of the plan is to end HIV/AIDS in many regions of the Americas, including the Dominican Republic, by 2030.

From 2010 to 2019, HIV cases have reduced to 13 a year and the number of deaths has gone down by 4,000 over the years. Female sex workers are a portion of the population the epidemic affects; they accounted for 37% of new infections in 2019. Less than 30% of individuals do not know they have an infection and about one-third receive a late diagnosis. Over 200,000 were getting antiretroviral treatment in 2019.

HIV Diagnosis Decline

HIV/AIDS in the Dominican Republic has seen an advancement in health through more testing and the option of antiretroviral treatments. The options of PrEP, pre-exposure prophylaxis, and PEP, post-exposure prophylaxis, have contributed to the decline of infections. The COVID-19 pandemic has put a dent in the success of the decline of HIV/AIDS.

The pandemic is changing the social landscape and interaction of people through social distancing measures. Access to medical personnel has also experienced strain because of rising and new COVID-19 infections. When comparing 2019 to the current pandemic, the diagnosis of HIV has reduced by the thousands in the Dominican Republic. According to PAHO, “Self-testing is a key strategy for reaching the U.N. goal of having 90% of people with HIV know their status.”

PrEP and PEP

PrEP and PEP are two types of antiretroviral treatments that people can use to prevent HIV transmission. Individuals can take the antiretroviral treatment PrEP before HIV infection and it is available through two brands. Meanwhile, one can take PEP after an HIV infection and must take more than one medication. The CDC suggests that individuals consult with a doctor for more information. While both treatments are important, PEP offers more because sexual assault victims can use PEP or those who had a workplace accident. Advisories state that one should take PEP within three days of a dire situation and complete treatment within a month. Both treatments are highly effective with PrEP reducing HIV transmission from sex by 90% and PEP reducing risk by 80%.

HIV Self-Testing Market

The HIV self-testing market looks promising on a global scale especially with  HIV/AIDS in the Dominican Republic. Globally, there is a necessity and high demand for rapid diagnosis of HIV in many regions including Latin America. Self-testing is a better alternative because one can do it privately and it is less risky because it will prevent exposure to the COVID-19 pandemic. The self-testing market will grow more between 2020 and 2025. Self-testing will experience a great impact through government investments in healthcare worldwide. The HIV self-testing kit collects samples through blood, saliva and urine. In HIV testing, blood samples provide the most accurate read. According to MarketWatch, “The self-testing market in Latin America is anticipated to reach a value of 51.24 million USD in the year 2025.”

The COVID-19 pandemic has undoubtedly impacted the fight against HIV/AIDS in the Dominican Republic. However, despite HIV/AIDS’ prevalence, antiretroviral treatments and opportunities to self-test should result in improvements.

– Amanda Ortiz
Photo: Flickr