|Dr Health: Antiretrovirals help reduce HIV transmission|
|Saturday, 28 July 2012 00:00|
“Scientific breakthroughs have opened exciting opportunities for prevention as well as treatment. But these opportunities are tempered by the demands of sustainability,” said Dr Margaret Chan, Director-General, WHO.
The International Aids Conference will help assess where we are, evaluate recent scientific developments and lessons learnt, and collectively chart a course forward according to World Health Organisation officials.
Antiretrovirals reduce HIV transmission
In 2011, a study by the HIV Prevention Trials Networks showed antiretrovirals (ARVs) cut the transmission of HIV by 96 percent within couples where one partner is HIV-positive and the other is not.
“When people take antiretrovirals, the amount of HIV in their body is decreased, making them much less likely to pass the virus to others,” says Dr Gottfried Hirnschall, director of the HIV Department at WHO. “If we can get, and keep, more people on treatment, and reduce their virus levels, we can reduce the number of new people who are infected.”
Strategic use of ARV’s
“Every year, more than a million more people in low- and middle-income countries start taking antiretroviral drugs,” said Dr Chan. “But for every person who starts treatment, another two are newly infected.”
WHO’s advice on strategic use of ARVs:
l New treatment guidelines for people with HIV who have uninfected partners. Up to 50 percent of HIV-positive people in on-going relationships are estimated to have HIV-negative partners.
l A recommendation to consider modifying current practices to prevent mother-to-child transmission of HIV. Malawi, for example, now offers ARVs to all HIV positive pregnant women to reduce the risk of transmission to their children and partner.
l WHO currently recommends that people diagnosed with HIV start taking ARVs when the strength of their immune system drops to a CD4+ count of 350 cells/mm3 or lower.
How is HIV transmitted?
A person who has HIV carries the virus in body fluids such as blood, semen, vaginal secretions and breast milk. The virus can be transmitted only if HIV-infected fluids enter the bloodstream of another person.
HIV can be transmitted in three ways
— sexual transmission
— exposure to infected blood
— mother to child transmission
The most common form of transmission is from unprotected sexual intercourse. There are fewer cases of transmission from oral sex but the risk significantly increases if either partner has oral cuts or sores. Sharing one’s toothbrush, cancer sores or bleeding gums will significantly increase one’s risk.
HIV transmission can occur during pregnancy, childbirth and breastfeeding. Consult with your doctor immediately if you suspect that you are pregnant. Active steps can significantly reduce the risk of transmitting HIV to the unborn child. As HIV is transmitted through breast milk, mothers are counselled to not breastfeed.
The use of needles has significantly increased over recent years. Lifestyle factors such as poor diet and lack of physical activity has increased rates of obesity, heart disease and diabetes. It is very common for a diabetic to use needles to inject insulin. This can significantly increase the risk of transmission of HIV.
Tattoos and piercings also increase the risk of transmission. Studies have shown that HIV can survive in used needles for a month or more.
How is HIV not transmitted?
HIV is not transmitted through food, air or general contact. A person cannot get HIV through re-using washed eating utensils, toilet seats, bathroom sinks, shaking hands or even hugging.
Sweat, tears, vomit, feces and urine can contain HIV but are the least likely mechanisms of transmission. Insects and mosquitoes are not able to transmit HIV.
How can I reduce my risk?
If you are sexually active, protect yourself against HIV by practising safer sex. Whenever you have sex, use a condom. When used properly and consistently, condoms are extremely effective. But remember:
l Use only latex condoms
l Use protection each and every time you have sex.
l If necessary, consult a nurse, doctor, or health educator for guidance on the proper use of latex barriers.
How can I prevent HIV-related weight loss?
Energy requirements vary according to the age and stage of the disease according to WHO. Energy requirements are likely to increase by 10 percent to maintain body weight and physical activity in asymptomatic HIV-infected adults and growth in asymptomatic children.
During symptomatic HIV, and subsequently during Aids, energy requirements increase by approximately 20 to 30 percent to maintain adult body weight. Energy intakes need to increase by 50 to 100 percent over normal requirements in children experiencing weight loss.
HIV and sex education
Sex education is about developing young people’s skills to make informed decisions about their behaviours. The purpose is to create a confident and knowledgeable younger generation that takes responsibility for their actions. It is not meant to encourage or condemn individuals or their choices.
Sex education brings about awareness of the significant health risk and negative impact that HIV/Aids has on one’s family, community and country. It helps to equip young people with the skills needed to differentiate between accurate and inaccurate information regarding the condition. It also allows for cultural discussion on the moral and social perspectives on sex.
Attitudes and beliefs contributes to HIV
One of the problems young people are exposed to is the wide range of attitudes and beliefs in relation to sex. For example, health messages that emphasise the risks and dangers in comparison to the media that promotes sexual activity.
People commonly do not like to be told what to do. They want to make their own decisions and only presenting one side of the story is not helping the individual make an informed decision.
Many times people are looking to others to make the changes or improvements that are needed, but in reality it is up to the person. The choices that we make collectively are the health of this nation.
If you have ever thought “we need a better educational programme”, that could be your calling to make a difference. Become the educational programme that we need. We cannot wait for others to do it.
You may think you do not have the education or the resources to do such a programme — become a leader without a title. One person is not going to improve our health status; it’s the group of people that work in unity.
This column is directed by your questions, comments and inquiries. The health advice provided is in collaboration with the World Health Organisation’s and the International Diabetes Federation’s goals of prevention, maintenance and natural treatment of disease. The advice is for educational purposes and does not necessarily reflect endorsement.
Visit their websites: www.who.int www.idf.org
“Like” our Facebook page: The Dr Health Show