HIV/AIDS control concept of Treatment for Prevention

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Human immunodeficiency virus (HIV) which causes acquired immune deficiency syndrome (AIDS) has been noticed since 1981. Globally, an estimated 35.3 (32.2–38.8) million people were living with HIV in 2012. An increase from previous years as more people are receiving the life-saving antiretroviral therapy, there were 2.3 (1.9–2.7) million new HIV infections globally, showing a 33% decline in the number of new infections from 3.4 (3.1–3.7) million in 2001. At the same time the number of AIDS deaths is also declining with 1.6 (1.4–1.9) million AIDS deaths in 2012, down from 2.3 (2.1–2.6) million in 2005(UNAIDS., 2013). From these data, it is clear that HIV still remain as big burden until now although we fight it for many years. Since many years ago, we use various methods such as prevention of transmission, behavior change communication, highly active antiretroviral therapy, prevention of mother to child transmission (PMTCT) to control it. Almost all countries have national strategic plan to control it using a lot of funding but it still exists. After 30 years of fighting against HIV, all becomes realize that we need new strategies to reach one of our latest goals “Zero new Infection”. To achieve this goal, we have 2 options, development of vaccine and treating all HIV patients with the concept of treatment for prevention. Vaccine development is the best but we still not get perfect vaccine although we are trying for many years. So people decide to develop second option which is more realistic at this moment because of available tool, antiretroviral therapy (ART). And we can see from UNAIDS report that new infection and death reduce gradually since development of ART in 2002. It did happen even without full coverage of ART to all HIV...

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...patient due to lack of systematic recording system and selling the drugs
- Losing jobs due to HIV and sell ART half dose for buying food and take once per day instead of twice
- ART taking patients moving to the other places where no ART clinic there.
These are just few examples I saw during that time. These factors can lead to serious drugs resistant problem. In addition, I had experience of taking ART (d4T, 3TC) as post exposure prophylaxis for 4 weeks and I couldn’t stand the side effects and I stopped it within 2 weeks. By implementing this concept, I am worry we don’t have drugs in the future for those who really need drugs to escape from AIDS and death. In addition, the chance of transmission with multidrug resistant HIV may be higher. Finally, I want to suggest using present prevention methods, treating those who really need ART and waiting for the vaccine.

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