For close to twenty five years the typical HIV prevention approach was the ABC s.exual behaviour change strategy: Abstain, be Faithful, and use Condoms. Today, this plan 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 go up gradually year in year out, regardless of ABC.
Re-focusing upon the Facts and Rules of Transmission – One of the failings of the old Get More Info ABC approach ended up being to have the exceptions the rule, as well as focus upon these exceptions to cope with preventing HIV transmission inside the general population: Multiple partners, infidelity, high frequency of intercourse, and young age of commencement of s.exual activity, to name a few assumptions.
Research during the past decade revealed that individuals are not (by and large) overly se.xually active: Studies by Durex show that the typical South African is literally average when it comes to se.xual activity, when compared with the remainder of the world. The same was discovered for age of first se.xual activity. In addition, it turned out that multiple partners – although a very high risk for HIV transmission – is not as widespread as previously thought, and cannot explain rapid increases in overall HIV transmission within a community. The ‘AB’ (abstain and become faithful) strategy failed because individuals were (by and large, excluding high specific risk group) already pretty conservative in connection with this.
Condoms, although a logical solution, did not have the impact which was expected. Initially, the reason for this failure was blamed on lack of education and availability. However, if they were corrected not a whole lot changed, aside from youth and workers. Other people resisted condoms for relationship reasons (trust issues; proof of love and commitment) and because it just prevented having babies. The desire to get babies beats the chance of death, for most people. Count the number of pregnant peer educators if you question the mismatch involving the ABC message and what people are really doing.
Focusing upon the overall rules, not the exceptions – There always has been – and also is going to be – people, behaviours, resources and circumstances that are beyond the plethora of what exactly is considered average or normal. These would require target-specific methods. However, for your great greater part of people and circumstances, the A2B4CT approach is quite straightforward and in 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 i thought about this efficiency and impact.
The A2B4CT (A-BB-CCCC-T) Approach – Fortunately, a totally different prevention strategy has emerged within the last couple of years, which include eight different methods which we term – for lacking a much 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 relies upon biology, not morality. You don’t need to change your personal beliefs: Instead, you must know the way it works, and put it on. The character from the required behaviour changes can also be different, and they are connected to economics, gender equity, and mental medical issues, including motivation towards an improved future, communication within relationships, stress and depression, and substance use (especially alcohol).
The outcomes of the A2B4CT approach are dramatic. A selection of results illustrates the impact of these prevention methods:
For couples where a single person has HIV and it is taking ARVs, and also the other is HIV-negative, the possibilities of transmitting HIV towards the uninfected partner is near to zero (99.9%) following the treated partner achieves an undetectable viral load (and where person is adherent towards the ART);
Using the new PMTCT (Prevention of Mother-to-Child Transmission) protocols – when applied as intended – mother-to-child transmission rates are reduced from 20 to 25% levels to seal to 1%. This is a 95% decrease in transmission;
Voluntary Male Medical Circumcision (VMMC) reduces the chances of a male becoming contaminated 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 with a different emphasis and application within the new A2B5C approach. For instance, being a short-term protective measure while a few waits for your infected partner’s viral load to decrease to safer levels, so that conception of babies can occur without chance of transmission in one partner to a different. Microbicides are now being developed as another form of barrier against HIV transmission.
New opportunities require new understanding – The brand new A2B4CT is situated upon you can try this out biology: The character of HIV and exactly how the viral load is key to understanding chance of transmission. Three biological terms need to 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. Comprehending the general course of HIV viral load is essential in developing effective prevention strategies. Many medical experts claim that the viral load is more essential that the CD4 count in determining the medical and wellbeing of the person.