Why Is Hiv In Africa So Severe
Many people have noticed that HIV in Africa appears to be extremely severe, and some have wondered why this is. There are a number of reasons why HIV in Africa is such a serious problem, ranging from interactions with other diseases present in Africa to social and cultural issues unique to Africa. It is important to remember that HIV/AIDS in Africa is not a single epidemic, as some African nations are managing the situation better than others, and different HIV clades are present in different regions, suggesting that several distinct epidemics are going on.
One of the main reasons that HIV in Africa is so prevalent is that the disease probably originated in Africa, according to the latest genetic research. Obviously, the longer a disease is present in a region, the more likely it is to infect a large proportion of the population. Especially since HIV can have a very long incubation period, Africans could be infected for years without knowing it until the disease emerged, spreading HIV all the while.
Does Hiv Viral Load Affect Getting Or Transmitting Hiv
Yes. Viral load is the amount of HIV in the blood of someone who has HIV. Taking HIV medicine daily as prescribed can make the viral load very lowso low that a test cant detect it .
People with HIV who take HIV medicine daily as prescribed and get and keep an undetectable viral load have effectively no risk of transmitting HIV to an HIV-negative partner through sex.
HIV medicine is a powerful tool for preventing sexual transmission of HIV. But it works only as long as the HIV-positive partner gets and keeps an undetectable viral load. Not everyone taking HIV medicine has an undetectable viral load. To stay undetectable, people with HIV must take HIV medicine every day as prescribed and visit their healthcare provider regularly to get a viral load test. Learn more.
History Of Hiv In South Africa
The HIV epidemic emerged in South African around 1982. However, as the country was in the midst of the dismantling of apartheid, the HIV problem was, for the most part, largely ignored. Silently, while political unrest dominated the media, HIV began to take hold, both in the gay community and the vulnerable black population.
By 2000, the South African Department of Health outlined a five-year HIV/AIDS plan but received little support from South African President Thabo Mbeki. After consulting a group of AIDS denialists headed by Dr. Peter Duesberg, Mbeki rejected conventional HIV science and instead blamed the growing AIDS epidemic on poverty, colonialism, and corporate greed.
Without government support, the five-year plan did not get off the ground as quickly as planned, with few showing up to receive from free antiretroviral medication. In the meantime, HIV among pregnant South African women soared from eight-tenths of 1% in 1990 to over 30% by 2000.
It was only with the removal of Mbeki from office in 2008 that the government took steps to rein in the catastrophe, ramping up efforts to become what is today the largest HIV drugs program in the world.
However, increasing pressure to expand outreach has been undermined by a deteriorating public health infrastructure and the weakening of the South African currency under President Jacob Zuma. To date, less than 30 of people with HIV are on therapy, while infection rates among young adults continue to rise, unheeded.
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Children: An Important Reason
HIV transmission among young people entering sexually active ages in SSA began at prevalence levels dozens of times higher than in Western countries. If children in Western countries had similar HIV prevalence rates as children in SSA, HIV prevalence among adults would be comparable to that in SSA.
Thus, high infection rates among young children are an important reason why HIV prevalence is disproportionately high in SSA. The infected girls would infect their male counterparts after entering sexually active ages. The infected males further infect females, and so on. However, strategies for HIV prevention have focused on adults, adolescents, and new borns.
Having multiple sexual partners is a high-risk factor for HIV transmission. A positive individual can infect his/her multiple sexual partners, and each infected partner further pass their infection on to their partners and so on. Although having multiple sexual partners is common both in SSA and in western countries, HIV effectively jumps from adults to children in SSA, but not in Western countries.
Condom Availability And Use
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Condom availability varies widely by country, with only five countries meeting the United Nations Population Fund regional benchmark of 30 male condoms distributed per man per year between 2011 and 2014.76 Overall in 2015 in sub-Saharan Africa , the estimated condom need was six billion male condoms, but only about 2.7 billion condoms were distributed.77
Condom use at last sex among adults with more than one sexual partner in the past 12 months is low, estimated at 23% among men and 33% among women in 2015. 78 However, condom use varies substantially among countries. In 2018, it ranged from 13% among men in Madagascar to 85% among men in Zimbabwe. Among women, it ranged from 5% in Madagascar to 76% in Lesotho.79 Condom use among men who pay for sex is generally higher, at about 60%.80
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The History Of Aids In Africa
It all started as a rumour Then we found we were dealing with a disease. Then we realised that it was an epidemic. And, now we have accepted it as a tragedy. – Chief epidemiologist in Kampala, Uganda
There is now conclusive evidence that HIV originated in Africa. A 10-year study completed in 2005 found a strain of Simian Immunodeficiency Virus in a number of chimpanzee colonies in south-east Cameroon that was a viral ancestor of the HIV-1 that causes AIDS in humans.
A complex computer model of the evolution of HIV-1 has suggested that the first transfer of SIV to humans occurred around 1930, with HIV-2 transferring from monkeys found in Guinea-Bissau, at some point in the 1940s .
Studies of primates in other continents did not find any trace of SIV, leading to the conclusion that HIV originated in Africa.
The 1960s- Early cases of AIDSExperts studying the spread of the epidemic suggest that about 2,000 people in Africa may have been infected with HIV by the 1960s. Stored blood samples from an American malaria research project carried out in the Congo in 1959 prove one such example of early HIV infection.The 1970s The first AIDS epidemicIt was in Kinshasa in the 1970s that the first epidemic of HIV/AIDS is believed to have occurred. The emerging epidemic in the Congolese capital was signalled by a surge in opportunistic infections, such as cryptococcal meningitis, Kaposis sarcoma, tuberculosis and specific forms of pneumonia.
Confusion, stigma and despondence
Roll Out
Fighting The Stigma Around Hiv
The stigma towards those who are HIV positive has been a major barrier for the global fight against HIV and AIDS. This stigma has hindered scientific research, government intervention and seeded a culture of discrimination around the world. Although less prominent than in the 80s, the HIV stigma still exists and steps need to be taken to reduce it. In the US, systemic racism feeds into the ongoing HIV epidemic. According to a report in The Lancet,43% of HIV deaths in 2018 happened in the Black community.
Nora D Volkow, Director of the National Institute on Drug Abuse , said: Scientific advances have transformed the course of HIV in individuals. To transform the course of the epidemic, we need to expand care and prevention strategically to those who need it most.
That means taking a hard look at who has been excluded from services and take immediate steps to overcome systemic barriers like stigma, structural racism, and other forms of discrimination to connect hardly reached people such as individuals with substance use disorders with HIV testing, prevention, and treatment.
The stigma surrounding HIV positive status has resulted in negative attitudes and beliefs that need to be dismantled, to stop the spread of the virus.
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Programmes For Young Women
In 2013 ministers of health and education from countries across the region committed to bringing in a raft of programmes to address the barriers that prevent girls and young women from accessing services. Focuses include keeping girls in school, comprehensive sexuality education, girl-friendly sexual and reproductive health services, eliminating gender-based violence and female genital mutilation, and economic and political empowerment.69
DREAMS
DREAMS aimed to reduce HIV infections among adolescent girls and young women by 40% in Kenya, Lesotho, Malawi, Mozambique, South Africa, Eswatini, Tanzania, Uganda, Zambia, and Zimbabwe between 2015-2017/18.. The programme focused on social isolation, economic disadvantage, discriminatory cultural norms, orphanhood, gender-based violence and education.70
In 2016, the South African government created She Conquers, a national campaign to implement the DREAMS programme beyond the districts already being supported. Also in 2016, Eswatini partnered with the Global Fund and the National Emergency Response Council on HIV/AIDS, resulting in close to national coverage on HIV prevention for adolescent girls and young women.71
Hiv Prevention Programmes In Eswatini
In 2018, 7,800 people were newly infected with HIV. Of these, 4,100 were women and 2,800 were men, meaning adult women are twice as likely to acquire HIV as their male counterparts. Overall, new infections are declining significantly, falling by 31% since 2010.47
Eswatinis current HIV prevention strategy is outlined in its National Multisectoral HIV and AIDS Strategic Framework 2018-2023.48 This focuses on high impact, combined interventions, some of which are outlined below, and targets populations and geographic areas where new infections are highest.
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Antiretroviral Treatment In East And Southern Africa
Antiretroviral treatment programmes have been scaled-up dramatically in East and Southern Africa over the past decade.
In 2018, there were an estimated 13.8 million people on ART in region. This is more than a three-fold increase from 2010 numbers and represents 67% of all people living with HIV in East and Southern Africa.9798
More women than men are on treatment as men are less likely to test for HIV and are more likely to interrupt or drop out of treatment. In 2018, 72% of all adult women living with HIV were on treatment, compared to 59% of HIV positive men.99 Consequently, men in the region are more likely than women to die of AIDS-related causes despite being less likely than women to acquire HIV.100
This disparity is partly due to harmful gender norms that prevent men from seeking help, accepting care or admitting to having a highly-stigmatised condition such as HIV.101
In 2018, the proportion of children living with HIV on treatment increased to 62% from 22% in 2010. In the same year, 60% or more of children living with HIV were on ART in Eswatini, Kenya, Lesotho, Malawi, Mozambique, Namibia, Rwanda, South Africa, Uganda, Tanzania, Zimbabwe and Zambia. At the other end of the scale, only 5% of HIV positive children in Madagascar, 9% in South Sudan and 13% in Angola were on treatment.102
Tuberculosis And Hiv Co
Eswatini has a dual epidemic of tuberculosis and HIV, with 65% of all people who have TB also living with HIV. 90 Men are more likely to be affected due to their lack of access to HIV and TB testing and treatment.91 In 2016, 79% of people co-infected with HIV and TB were found to have drug resistant TB strains.92
TB preventive therapy should be offered to all people initiating HIV treatment, but not all those eligible in Eswatini receive the service. WHO reports that only 10% of people newly diagnosed with HIV were put on appropriate TB therapy in 2018 , and only 3.7% of those newly enrolled on preventative therapy were expected to complete it.93
Eswatini is in the process of strengthening and integrating its TB/HIV services. These services have been decentralised and are now offered in a one-stop-shop where people can seek screening for TB and HIV testing, as well as being able to pick up their treatment for both at the same time.
As of 2017, around 80% of people with TB were on treatment. This is below the coverage required to control the countrys TB epidemic, with people who are HIV-positive particularly in need of better access to TB treatment. However these efforts are significantly reducing TB transmission. In 2010, around 11,050 people developed active TB in Eswatini in 2018 this figure had fallen to 2,845. Still, more needs to be done to ensure all people with TB are diagnosed and put on treatment in order to reduce transmission further.94
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Hiv Statistics In South Africa
Estimates suggest that 7.7 million South Africans are living with HIV, representing about 14% of the population . Additional statistics are as follows.
- The HIV rate among adults is more than 20% .
- One in five people aged 15 to 49 years is believed to be infected with HIV.
- 45% of all deaths in the country can be attributed to HIV.
- 13% of South African blacks are infected with HIV versus 0.3% of South African whites.
- It is estimated that there are 600,000 orphaned children as a result of AIDS.
The Worlds Largest Hiv Epidemic In Crisis: Hiv In South Africa
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In some communities of KwaZulu-Natal Province, South Africa, 60 percent of women have HIV. Nearly 4,500 South Africans are newly infected every week one-third are adolescent girls/young women ages 15-24. These are staggering figures, by any stretch of the imagination. Yet, the HIV epidemic is not being treated like a crisis. In February, we traveled to South Africa, to understand what is happening in these areas with hyper-endemic HIV epidemics, where prevalence rates exceed 15 percent among adults. We were alarmed by the complacency toward the rate of new infections at all levels and the absence of an emergency response, especially for young people.
This is no time for business as usual from South Africa or its partners, including the U.S. government through the U.S. Presidents Emergency Plan for AIDS Relief . The epidemic is exacerbated by its concentration in 15-49-year-olds, those of reproductive and working age who are the backbone of South Africa. Without aggressive action to reduce the rate of new infections in young people, HIV will continue to take a tremendous toll on the country for years and generations to come. Collective action is needed to push beyond the complacency and internal barriers to implement policies and interventions that directly target HIV prevention and treatment for young people. PEPFAR should ensure its programs support those efforts.
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The Fluctuating Relationship Between Hiv Sex Work And Climate Change
The relationship between sex work and HIV rates is one that a number of reports have drawn attention to. Climate change, HIV and sex work are all inherently linked to one and other. An increase in global temperature will affect food security, therefore, increasing the number of people engaging in sex work to support themselves and others, while lacking access to appropriate contraceptive methods. The changing climate will literally increase HIV transmission, especially in the Global South.
Women seeking temporary relief, shelter and amenable living conditions in acutely insecure contexts, making them potential targets for exploitation and human trafficking. Sex work is a profession that is disproportionately held by women, and one that has the ability to place women in dangerous situations.
The disparity between the number of men and women involved in sex work is reflected in the numbers of HIV cases between men and women. As of 2020, 53% of all people living with HIV were women and girls.
As of 2020, 53% of all people living with HIV were women and girls
Ways Hiv Cannot Be Spread
HIV is not spread by:
- Air or water
- Mosquitoes, ticks or other insects
- Saliva, tears, or sweat that is not mixed with the blood of a person with HIV
- Shaking hands hugging sharing toilets sharing dishes, silverware, or drinking glasses or engaging in closed-mouth or social kissing with a person with HIV
- Drinking fountains
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How Does Hiv Jump From Adults To Children
How does HIV jump from adults to children? A meta-analysis study reported sexual abuse of girls was highest in Australia, Africa and North America . HIV prevalence among girls in Australia and North America were low despite high childhood sexual abuse rates, suggesting that, sexual abuse contributed to only a limited portion of infections among girls in SSA. Blood perfusion and careless medical use of syringes likely also contributed to a limited number because infection rates among older adults were low despite greater likelihood of being exposed to the two factors. Injection drug use was not relevant for young children.
Children in SSA are often exposed to such blood. A common eating habit in SSA is sharing food, cups, etc. SSA was one of the most impoverished regions in the world. Traces of food left out by parents could easily be consumed by hungry children. Girls would be hungrier, because of gender inequality. Girls were required to care for their diseased elders, thus, were more likely exposed to blood through aforementioned activities. In some of Asian countries, although these observations are also common, having multiple sexual partners is much less common due to many reasons .