HIV no longer a death sentence

Wider access to antiretroviral treatment has decreased the number of AIDS-related deaths and new HIV infections. Still, improved access to medical treatment is not enough, as NAI researcher Maylin Meincke points out. Safer sex, food security and early testing are equally important.

Over the last ten years, new HIV infections and AIDS-related deaths have steadily decreased. One reason is the improved access of antiretroviral (ARV) treatment. Worldwide, almost 13 million out of the 35 million people living with HIV in 2013 had access to ARV. In the most seriously affected regions, Southern and Eastern Africa, 41 per cent of the infected are now on treatment.

Previously, antiretroviral drugs were only given to patients once their immune system had reached a critical stage. Today, UNAIDS recommends that drugs should be offered as soon as an HIV infection has been diagnosed. Early treatment - when the immune system is still strong - has been shown to be an effective HIV prevention method as ARV treatment reduces the risk of infecting the partner and of mother-to-child transmission.

People are not scared of HIV anymore
“A positive HIV test is no longer the death sentence it used to be. However, at the same time, it is still important to continue promoting safer sex. As we can observe in Europe, for instance, there has been an increase of sexually transmitted infections in recent years. This can partly be explained by people not using condoms. It seems like people are not as afraid of being infected with HIV anymore,” NAI researcher Maylin Meincke says.

Even though there are medicines available, it is a prerequisite for people to get tested. To effectively prevent further HIV infections, medication should be provided as soon as possible.  In Southern Africa men often are reluctant to get tested.  However, sometimes they don’t have physical access to antiretroviral treatment and counselling, especially if they live in remote areas in sub-Saharan Africa. The availability of food is another factor that is important for HIV and AIDS prevention. Doctors advise to take the ARV medication together with food.

“This is why successful ARV treatment is connected to food security. If you don’t eat properly while taking the drugs, you are likely to experience adverse side effects. This can actually hamper a sustained treatment. And an interruption is a serious issue. It not only affects the patient’s health condition negatively. An inconsistent drug take-in also enables the virus to develop resistances to the drugs”, Maylin Meincke says.

Male circumcision as a prevention method
She has conducted field work in South Africa and, more recently, in Namibia. With Namibia being declared as a priority country by the international community, voluntary medical male circumcision is promoted as an HIV prevention method. Research indicates that the risk of getting infected decreases by 60 percent if the man is circumcised. However, in Namibia only one ethnic group practices male circumcision and adult men of other ethnic groups generally fear a negative impact on their sexual experience. Similarly, mothers do not want their young sons to be “crippled” for life.

“It has to be clear that this is only a prevention method for non-HIV positive men. If a man is HIV positive, the risk of transmitting the virus to his partner is not reduced when circumcised. Alarmingly, men also often say that they don’t have to use condoms anymore once circumcised. Such misinformation can actually be counterproductive to other HIV prevention efforts in Namibia. Hence, medical interventions like ARV treatment or voluntary medical male circumcision is not enough. Health promotion and information campaigns still need to be included in any successful HIV strategy”, Maylin Meincke stresses.

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