For close to twenty five years the conventional HIV prevention approach was the ABC s.exual behaviour change strategy: Abstain, be Faithful, and use 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 year after year, regardless of ABC.
Re-focusing upon the Facts and Rules of Transmission – One of many failings from the old official site ABC approach ended up being to create the exceptions the rule, as well as focus upon these exceptions to deal with preventing HIV transmission inside the general population: Multiple partners, infidelity, high frequency of intercourse, and early age of commencement of s.exual activity, to name a few assumptions.
Research during the past decade said that folks are not (by and large) overly se.xually active: Studies by Durex reveal that the typical South African is literally average in terms of se.xual activity, compared to all of those other world. Exactly the same was discovered for age first se.xual activity. It also been found that multiple partners – although a high risk for HIV transmission – will not be as widespread as previously thought, and cannot explain rapid increases in overall HIV transmission in a community. The ‘AB’ (abstain and stay faithful) strategy failed because individuals were (by and large, excluding high specific risk group) already pretty conservative in this regard.
Condoms, although a logical solution, was without the impact which had been expected. Initially, the explanation for this failure was blamed on absence of education and availability. However, when they were corrected not much changed, except for youth and workers. Other people 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 chance of death, for many people. Count the amount 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 continues to be – and also is going to be – people, behaviours, resources and circumstances which are beyond the plethora of what is considered average or normal. These would require target-specific methods. However, for that great greater part of people and circumstances, the A2B4CT approach is quite straightforward and inside the current government health guidelines and protocols. It’s time for you to get caught up, refocus, and spend our energies and resources with a higher-level of Get More Information efficiency and impact.
The A2B4CT (A-BB-CCCC-T) Approach – Fortunately, a totally different prevention strategy has emerged over the past several years, which include eight various methods which we term – for lacking 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 situated upon biology, not morality. You don’t need to change your personal beliefs: Instead, you must understand how it works, and put it on. The character in the required behaviour changes can also be different, and are connected to economics, gender equity, and mental health issues, including motivation towards an improved future, communication within relationships, stress and depression, and substance use (especially alcohol).
The results in the A2B4CT approach are dramatic. A variety of results illustrates the impact of those prevention methods:
For couples where one individual has HIV and is taking ARVs, and also the other is HIV-negative, the odds of transmitting HIV for the uninfected partner is near to zero (99.9%) after the treated partner achieves an undetectable viral load (and in which the person is adherent towards the ART);
With 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%. This is a 95% decline in transmission;
Voluntary Male Medical Circumcision (VMMC) reduces the probability of a male becoming infected with HIV by about 50%, and the odds 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 within the new A2B5C approach. As an example, being a short-term protective measure while a few waits for that infected partner’s viral load to decrease to safer levels, to ensure that conception of babies can take place without risk of transmission from a single partner to a different. Microbicides are now being developed as another form of barrier against HIV transmission.
New opportunities require new understanding – The new A2B4CT relies upon view publisher site biology: The nature of HIV and exactly how the viral load is key to understanding probability 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 essential in developing effective prevention strategies. Many medical experts suggest that the viral load is more important that the CD4 count in determining the health and wellbeing of a person.