For close to twenty five years the conventional HIV prevention approach 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’. The evidence was clear: New infections continued to rise gradually every year, irrespective of ABC.
Re-focusing upon the details and Rules of Transmission – One of many failings of the old look at this site ABC approach ended up being to have the exceptions the rule, and to focus upon these exceptions to cope with preventing HIV transmission inside 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 stated that individuals are not (in general) overly se.xually active: Studies by Durex demonstrate that the typical South African is average with regards to se.xual activity, compared to the remainder of the world. The identical was discovered for the age of first se.xual activity. Additionally, it been found that multiple partners – although a very high risk for HIV transmission – will not be 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 individuals were (in general, excluding high specific risk group) already pretty conservative in connection with this.
Condoms, although a logical solution, was without the impact which was expected. Initially, the reason behind this failure was blamed on insufficient education and availability. However when these were corrected very little changed, aside from youth and workers. Other individuals resisted condoms for relationship reasons (trust issues; proof of love and commitment) and furthermore, as it just prevented having babies. The desire to get babies beats the risk of death, for many individuals. Count the quantity of pregnant peer educators in the event you question the mismatch involving the ABC message and what individuals are very doing.
Focusing upon the general rules, not the exceptions – There always has been – and constantly is going to be – people, behaviours, resources and circumstances which can be beyond the range of what exactly 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 pretty straightforward and in the current government health guidelines and protocols. It’s time and energy to get caught up, refocus, and spend our energies and resources having a higher level of a fantastic read efficiency and impact.
The A2B4CT (A-BB-CCCC-T) Approach – Fortunately, an entirely different prevention strategy has emerged within the last couple of years, which include eight different methods which we term – for the lack of a better acronym – the A2B4CT approach: Antiretrovirals (with emphasis upon access and adherence); Breastfeeding (Exclusive, with ART for PMTCT); Barriers (condoms, microbicides); Circumcision (voluntary male medical circumcision); Co-infection prevention/reduction (TB, STIs; fungal, bacterial and parasite infections; Couples counseling (including multiple partners); Community viral load reduction; Testing (HIV).
The A2B5CT approach is based upon biology, not morality. You don’t need to modify your personal beliefs: Instead, you need to understand how it works, and put it on. The character in the required behaviour changes is also different, and they are connected to economics, gender equity, and mental health issues, including motivation towards a much better future, communication within relationships, stress and depression, and substance use (especially alcohol).
The results of the A2B4CT approach are dramatic. A wide range of results illustrates the impact of those prevention methods:
For couples where one person has HIV and is also taking ARVs, as well as the other is HIV-negative, the probability of transmitting HIV to the uninfected partner is close to zero (99.9%) following the treated partner achieves an undetectable viral load (and where the person 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 close to 1%. It is a 95% decline in transmission;
Voluntary Male Medical Circumcision (VMMC) reduces the likelihood 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 a good prevention method, although using a different emphasis and application inside the new A2B5C approach. For example, as being a short-term protective measure while a few waits for that infected partner’s viral load to drop to safer levels, in order that conception of babies can occur without risk of transmission in one partner to another one. Microbicides are now being developed as another form of barrier against HIV transmission.
New opportunities require new understanding – The brand new A2B4CT relies upon original site biology: The type of HIV and just how the viral load is vital to understanding chance of transmission. Three biological terms must be thoroughly understood: Viral Load (VL), co-infections, and Langerhans Cells. When these ogvmdy terms are understood and logically applied, a wide range of prevention methods become obvious, including individual, couples, and community interventions. Understanding the general span of HIV viral load is important in developing effective prevention strategies. Many medical experts state that the viral load is a lot more essential that the CD4 count in determining the medical and wellbeing of the person.