For close to twenty five years the standard HIV prevention strategy was the ABC s.exual behaviour change strategy: Abstain, be Faithful, and utilize Condoms. Today, this tactic 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 steadily year in year out, regardless of ABC.
Re-focusing upon the Facts and Rules of Transmission – Among the failings from the old my company ABC approach was to create the exceptions the rule, as well as focus upon these exceptions to deal with preventing HIV transmission within the general population: Multiple partners, infidelity, high frequency of intercourse, and young age of commencement of s.exual activity, to name a few assumptions.
Research during the past decade said that people are not (generally) overly se.xually active: Studies by Durex reveal that the typical South African is average in terms of se.xual activity, when compared with the remainder of the world. The same was discovered for age of first se.xual activity. It also proved that multiple partners – although a high risk for HIV transmission – is not as widespread as previously thought, and cannot explain rapid increases in overall HIV transmission in a community. The ‘AB’ (abstain and become faithful) strategy failed because individuals were (by and large, excluding high specific risk group) already pretty conservative in connection with this.
Condoms, although a logical solution, did not have the impact which had been expected. Initially, the explanation for this failure was blamed on insufficient education and availability. However, when these were corrected very little changed, except for youth and workers. Others 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 risk of death, for most people. Count the number of pregnant peer educators should you question the mismatch in between the ABC message and what people are actually doing.
Focusing upon the typical rules, not the exceptions – There always has become – and also will be – people, behaviours, resources and circumstances which can be beyond the range of precisely what is considered average or normal. These would require target-specific methods. However, for the 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 pop over to these guys efficiency and impact.
The A2B4CT (A-BB-CCCC-T) Approach – Fortunately, an entirely different prevention strategy has emerged within the last couple of years, including eight various ways which we term – for the absence of an improved acronym – the A2B4CT approach: Antiretrovirals (with emphasis upon access and adherence); Breastfeeding (Exclusive, with ART for PMTCT); Barriers (condoms, microbicides); Circumcision (voluntary male medical circumcision); Co-infection prevention/reduction (TB, STIs; fungal, bacterial and parasite infections; Couples counseling (including multiple partners); Community viral load reduction; Testing (HIV).
The A2B5CT approach is based upon biology, not morality. You don’t need to change your personal beliefs: Instead, you must understand the way it works, and put it on. The character from the required behaviour changes is additionally different, and are associated with 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 outcomes from the A2B4CT approach are dramatic. A variety 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 possibilities of transmitting HIV for the uninfected partner is near zero (99.9%) right after the treated partner achieves an undetectable viral load (and where the individual is adherent towards the ART);
Using the new PMTCT (Prevention of 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 chances of a male becoming infected 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 using a different emphasis and application inside the new A2B5C approach. As an example, being a short-term protective measure while a couple waits for the infected partner’s viral load to drop to safer levels, to ensure that conception of babies can take place without chance of transmission from a single partner to another. Microbicides are being developed as another kind of barrier against HIV transmission.
New opportunities require new understanding – The new A2B4CT relies upon hiv dating sites 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, an array of prevention methods become obvious, including individual, couples, and community interventions. Knowing the general span of HIV viral load is important in developing effective prevention strategies. Many medical experts claim that the viral load is a lot more crucial that the CD4 count in determining the health and wellbeing of any person.