Amita Maibam
The public health impact of early initiation of antiretroviral therapy in Africa
Background:
Since the arrival of AIDS on the horizon of mankind in 1981, the deadly epidemic has affected almost 70 million people and it has claimed about 35 million lives so far.1 Despite showing variable distribution among different countries and regions, Sub-Saharan Africa remains the worst hit region, with nearly 1 in every 20 adults (4.9%) living with HIV which accounts for 69% of the people living with HIV worldwide.1
The attempts to treat AIDS started in 1986 with the first trial using Zidovudine was conducted.2 Subsequently, other nucleoside medications were introduced with application of dual therapy but the outcomes were mostly frustrating.3 The era of multiple drugs regimen (Highly active antiretroviral therapy, HAART) broke into the scene in 1996 with a number of clinical studies and endorsements.4 Since then, the therapy has revolutionized the management of HIV/AIDS.
With the explosion of knowledge in the field of HIV and antiretroviral therapy (ART), it has become clear that persistent viremia leads to significant adverse effects, which in turn can be mitigated by the use of modern advanced ART. The adverse effects were identified as accelerated clinical disease progression, and increased rate of the clinical events along with higher mortality.5 Subsequently, HIV treatment guidelines have increasingly endorsed the earlier commencement of ART.6 Previous guidelines of starting ART only when CD4 count falls below 200 have gradually given way to more aggressive treatment guidelines, which recommend initiating therapy much earlier during the course of disease.
In this article, current situation of HIV and ART coverage in Afri...
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...y). This approach would help to perform different activities for varied diseases with minimal resources.
4. Key populations and people in humanitarian crises (as mentioned earlier) should be approached with unbiased, non-judgmental ways and without prejudices.
5. Treatment services should be prioritized according to the degree of need (children and adolescents, men and pregnant females, communities under pressure, key population etc.), which should be determined beforehand.
6. Confidentiality of patients should be guaranteed to encourage the people to come forward for testing and treatment. Basic human rights should be respected.
7. Decentralization of HIV services should be adopted with emphasis upon the training of community health workers, nurses, and paramedics.
8. Healthcare services should be organized with enhanced capacity building.
The proliferation of crises around the world has led to a prominent increase in the amount of humanitarian aid needed. Humanitarian aid work represents not only compassion, but commitment to support innocent populations that have experienced sudden or on-going tragedies. Some of these tragedies include: malnutrition, genocide, diseases, torture, poverty, war, natural disasters, government negligence, and unfortunately much more. There is no doubt that these tragedies are some of the world’s toughest problems to solve as they are often complex, multifaceted and require diligence and patience. For this reason, being a humanitarian aid worker is more than a profession, it is a lifestyle that requires a sharp distinction between one’s work and
Different people define success in many different ways. What is considered success by one person may be viewed as failure by another person. Randy Shilts, a homosexual newspaper reporter / author, attempts to make fundamental changes in America’s opinion on AIDS. In Randy Shilts’s essay, "Talking AIDS to Death," he speaks of his experiences as an "AIDS celebrity." At the core of Shilts’s essay is the statement, "Never before have I succeeded so well; never before have I failed so miserably"(221). Shilts can see his accomplishments from two points of view- as a success and as a failure. Despite instant fame, Shilts is not satisfied with the effects his writings has on the general public. Shilts’s "success" and reasons for failure can both be considered when one decides whether or not his efforts were performed in vain.
The spread of aids threatens our population daily. Lives lost to it number over 12 million, including 2 mil...
Everyday researchers have proposed new methods of how to control the HIV virus from turning into AIDS. A combination of effective HIV medicines help stop the formation of new copies of HIV as it reproduces in your body. This technique helps to keep your CD-4 cell count up and your viral load down. CD-4 cells are one type of immune cells that assist to fight off the virus, the higher your count the stronger your immune system (Nakashima 77). Whereas, your viral load is a measure of HIV in your blood and your treatment goal is to have the lowest viral load possible. People with higher viral loads tend to progress to AIDS and become sick sooner than those with lower viral loads (Nakashima 80). Successful HIV medications can prevent other infections common with AIDS and can help you live longer.
Masur H, H. L. (2007). Treatment of human immunodeficiency virus infection and acquired immunodeficiency syndrome. In A. D. Goldman L, Cecil Medicine (p. Chap 412). Philadelphia, PA: Saunders Elsevier.
Acquired Immune Deficiency Syndrome (AIDS) was first recognized as a new disease in 1981 when increasing numbers of young homosexual men succumbed to unusual opportunistic infections and rare malignancies (Gallant49).During this time, many people were contacting this disease because it was not discovered yet and people did not have knowledge about it.Scientists believe HIV came from a particular kind of chimpanzee in Western Africa. Humans contracted this disease when they hunted and ate infected animals. A first clue came in 1986 when a morphologically similar but antigenically distinct virus was found to cause AIDS in patients in western Africa (Goosby24). During this time, scientists had more evidence to support their claim about this disease. Once discovered this disease was identified as a cause of what has since become one of the most devastating infectious diseases to have emerged in recent history (Goosby101). This disease was deadly because it was similar to the Black Death, it was killing majority of the population. Since its first identification almost three decades ago, the pandemic form of HIV-1 has infected at least 60 million people and caused more than 25 million deaths ...
HIV is a battle that has existed for a long time and is still an uphill battle for those affected. This sickness has not only hurt the people but it has grown to affect the economy and politics of numerous countries and regions like America and South Africa. Therefore, the stance on the resilience has grown over the past forty years. It has existed and grown and has come to be one of the biggest social issues in the world. It has become so intertwined with society that it has had lasting affects on all divisions of the world and those divisions are economic divisions, political division, and social divisions within Africa, America, and Asia.
Finally , Healthcare professionals should take appropriate action if patients right is been abused or discriminated against. Discrimination issues or problems must be treated equally and appropriate action should be taken . If healthcare professionals witness any sort of discrimination or patients report any discriminatory practices , immediate action should be taken as discrimination can have an adverse effect on the individual such as low self esteem and a sense of not belonging.
HIV and AIDS have affected millions of people throughout the world. Since 1981, there have been 25 million deaths due to AIDS involving men, women, and children. Presently there are 40 million people living with HIV and AIDS around the world and two million die each year from AIDS related illnesses. The Center for Disease Control estimates that one-third of the one million Americans living with HIV are not aware that they have it. The earliest known case of HIV was in 1959. It was discovered in a blood sample from a man in Kinshasa, Democratic Republic of the Congo. Looking further into the genetics of this blood sample researchers suggested that it had originated from a virus going back to the late 1940’s or early 1950’s. In 1999, researchers had discovered that HIV is derived from chimpanzees native to west equatorial Africa. This epidemic is spreading throughout countries and infecting 14 thousand victims every day. Learning about HIV includes knowing how to contract the virus, understanding most of the people it affects, how to prevent the spread of it, and knowing what treatments are available.
Patient confidentiality is one of the foundations of the medical practice. Patients arrive at hospitals seeking treatment believing that all personal information will remain between themselves and the medical staff. In order to assure patients privacy, confidentiality policies were established. However, a confidentiality policy may be broken only in the case the medical staff believes that the patient is a danger to themselves or to others in society. Thesis Statement: The ethics underlying patient confidentiality is periodically questioned in our society due to circumstances that abruptly occur, leaving health professionals to decide between right and wrong.
The AIDS virus is the most common disease, and with no cure, an infected person will die. It is estimated that 90 to 95 percent of AIDS infections occur in developing countries where the world’s worst living conditions exist.
Acquired Immunodeficiency Syndrome (AIDS) first came to light in 1981. There has been a long and arduous global effort on the prevention of HIV/AIDS. HIV is a virus that is spread through body fluids that affect the specific T-cells of the immune system. Without treatment HIV infection leads to AIDS and there is no cure for AIDS. HIV infection can be controlled and the importance of primary pre...
One of the biggest issues the Joint United Nations Program on HIV/AIDS (UNAIDS) addresses is the stigma attached to HIV/AIDS and the need to fight it. Many public health experts believe that stigma, along with the high cost of treatment, the lack of infrastructure, and the la...
patient’s right is protected by the law. In the healthcare system, all the rights listed on the form given by providers is protected and if violated can be punishable by fines if found guilty in a court of law. All providers must abide by the patient’s rights. A responsibility would be the
The emergence of HIV/AIDS is viewed globally as one of the most serious health and developmental challenges our society faces today. Being a lentivirus, HIV slowly replicates over time, attacking and wearing down the human immune system subsequently leading to AIDS (Acquired Immunodeficiency Syndrome) at which point the affected individual is exposed to life threatening illnesses and eventual death. Despite the fact that a few instances of this disease have been accounted for in all parts of the world, a high rate of the aforementioned living with HIV are situated in either low or medium wage procuring nations. The Sub-Saharan region Africa is recognized as the geographic region most afflicted by the pandemic. In previous years, people living with HIV or at risk of getting infected did not have enough access to prevention, care and treatment neither were they properly sensitized about the disease. These days, awareness and accessibility to all the mentioned (preventive methods, care etc.) has risen dramatically due to several global responses to the epidemic. An estimated half of newly infected people are among those under age 25(The Global HIV/AIDS Epidemic). It hits hard as it has no visible symptoms and can go a long time without being diagnosed until one is tested or before it is too late to manage.