What HIV/AIDS is and What it is Not

Posted: January 29, 2017 by PaanLuel Wël in Ajang Barach-Magar, Health, Opinion Articles, Opinion Writers

By Ajang Barach-Magar, Dar es Salaam – Tanzania

images-of-hiv-aids

January 29, 2017 (SSB) — There is no law that prohibits publishing of false or bogus information. In a civilized society, however, doing this should attract dire retributions for those who indulge in it. The nature of punishment can range from constant questioning of the integrity of the culprit’s research to premature termination of their careers.

As they say, my desire is not to track the fall of every sparrow. I have seen a few remarks made in the past and it looks like time is nigh to set the record straight regarding a few factors surrounding the Human Immunodeficiency Virus (HIV/AIDS). The origin of HIV/AIDS is a controversial one. One account holds that it originally plagued monkeys.

The simian immunodeficiency virus or SIV which is the Chimpanzee equivalent of HIV is believed to have mutated into the virus we know it today. Humans might have come into contact with the infected blood of the hunted chimpanzees mainly via accidental cuts. Not much was known about it until 1981 when it was first reported among gay couples in the United States.

In a few moments, we must get down to verified facts. We are allowed to infinitely debate certain hypotheses where personal perceptions rule the roost. Is Islam or Christianity the true God’s message? Did God create us and everything in the universe in six short days? Who represents his image ~ the white, black or the yellow man?

This approach does not apply to scientific matters. There is a period in history when philosophy meant everything, including science. But through time, especially the last 400 years, the later has rapidly grown independent and has become far more technical so much that Philosophers have not been able to keep pace with scientific advancements (paraphrased from Stephen Hawking in the “Brief History of Time” – emphasis mine).

Why should you listen to me? For one, and undoubtedly the most important reason, the information presented here is a fairly accurate reflection of research inferences made in the recent past and is readily verifiable via the bibliographic references that are provided at the end of the article.

Some phenomena are facts written in stone. Whether we repeat them does not add the slightest jot of scientific credence to their truth value. Everybody knows the natural locus of the Sun is in such a way that it must rise from the compass direction that we call the East each morning. In Biology, we longer debate whether evolution is true or whether great apes like the chimpanzees or Orang-Utans are our legitimate close primate relatives.

Extolling well-established facts is sometimes an unwelcome repetition. However, it helps to revisit them in order to keep a sense of proportion and to put the matter into the appropriate perspective. This is why some of what you may encounter in my work is not entirely new.

There is virtually no vaccine to prevent HIV/AIDS. While the virus has no known cure, it has an effective treatment. Bodily fluids where HIV/AIDS is transmitted are: blood, semen (including pre-cum), rectal fluid, breast milk and vaginal fluid. Transmission typically occurs when one of the above fluids finds its way into the bloodstream of another person via sexual intercourse between serodiscordant individuals, sharing of unsterilized cutlery or faulty transfusion of improperly screened blood.

It should be noted that contact with saliva or other bodily secretions outside the above mentioned fluids pose no genuine risk of infection. There are reported cases of people who accidentally ingest fruits injected with HIV-infected blood, but no infection occurs via such contacts. This is because the gut environment almost certainly inactivates the virus. That is why HIV/AIDS sufferers should not be stigmatized by those who are supposed to care for them for fear of contracting the disease.

HIV/AIDS Research:

There has been a heightened global commitment to the fight against HIV/AIDS in recent times. Several countries have rapidly achieved significant milestones in curbing its transmission. This is exemplified by nations such as Thailand which has a 100% condom program, Uganda’s remarkable decrease in HIV prevalence and the community-based syndromic management of sexually-transmitted infections (STIs) in Mwanza, Tanzania.

If we hope to emulate these success stories and effectively control the HIV/AIDS prevalence, we must undertake a rigorous research. This can take various forms – for instance, establishing well-defined control or comparison groups necessary in the identification of contextual factors that are essential for appropriately tailoring therapeutic interventions to the diverse regional settings and the myriad microenvironments in which HIV transmission occurs.

Perpetual absence of reliable evidence to guide the selection of actions for specific areas or populations hampers objective fight against the scourge. Generation of reasonably accurate estimates greatly facilitates a more nuanced understanding of the disease trends, because HIV/AIDS affects populations differently. Otherwise taking action under uncertainty would likely be futile.

HIV/AIDS and the Law:

The law stipulates that if you have HIV/AIDS and are aware of your serostatus, it is your legal responsibility to notify your sex partner(s) in advance in order to avoid exposing them to any “significant risk” of contracting it.

The law does not go on to clearly explain what amounts to a “significant risk”, but it is widely assumed that unprotected vaginal sex almost certainly constitutes one. One important step towards the attainment of this is to encourage people to get tested. There is evidence that those who have been diagnosed with HIV/AIDS take actions to protect their partners from being exposed to the virus.

Recommendations:

More Support for Combination Antiretroviral Therapy; this is by far a more effective treatment than monotherapy where the patient only relies on Zidovudine (also called Azidothymidine or AZT).

Prioritize and promote research to fill knowledge gaps in the HIV/AIDS care continuum.

Administration of short course of Nevirapine to mothers during labour and to newborns post-partum. This reduces the risk of perinatal transmission by as much as 47% (Guay et al, 1999).

Effective use of highly sensitive and specific HIV screening algorithms. This virtually eliminates infection from the blood supply.

Comprehensive Sex Education; increased open communication about sexual activities and HIV/AIDS reduces the risk of transmission and positively affects sexual behaviours (Kim et al, 1999). This is not to be confused with “Abstinence-Only Education”. The later has been shown to be ineffective in promoting healthy sexual conduct. Programs that promote both postponement of intercourse and use of contraceptives are more effective in altering behaviours than those that recommend abstinence alone (Kirby, 1997).

Population-based programs aimed at changing social norms. This would weed out practices such as cases where a widow is coerced into inheritance by her husband’s next of kin even when the individual could be infected or when the woman is infected. In addition, more concerted efforts should be put into fighting stigmatization and discrimination of people suffering from HIV/AIDS. Every adult member of the society ought to accept that AIDS sufferers deserve unfettered care and support like anyone else. We must devise means to intensify prevention efforts in communities and areas where the virus is most heavily concentrated.

Multi-sectoral Approach; this can be done through alliance of medical professionals, civil society, religious and public sectors to adopt a holistic approach to the disease. There are incidences where the government recommends a given therapeutic regimen, for instance, administration of a vaccine only for the clergy to rise against it and “decree” a counter-recommendation of their own.

Enormous advances in HIV/AIDS treatment interventions have sharply reduced HIV-related morbidity and mortality in countries where conscious steps to make them accessible have been taken. Ask your nearest doctor and he/she is likely to tell you that death is a painful experience to anyone, even the poor. It cannot be prevented, but in medicine, we mimic nature and so far, all evidence shows that it can be considerably delayed.

Sufficient commitment is therefore required to curtail the spread of the pandemic and to extend the lifespan of the majority of those infected. Even though South Sudan is a nascent country where the HIV/AIDS phenomenon is fairly new, we must not delude ourselves that we can permanently reverse the situation to its previous state. But I am entirely convinced that we can successfully immobilize the scourge.

Disclaimer: The information above was obtained from numerous sources, including (but not limited to); World Health Organization Guidelines on HIV/AIDS; National Institute of Health, United States and CATIE; Canada’s Source for HIV and hepatitis C information

You can reach the author via his email: Ajang Magar <ajangmagar@gmail.com>

The opinion expressed here is solely the view of the writer. The veracity of any claim made are the responsibility of the author, not PaanLuel Wël: South Sudanese Bloggers (SSB) website. If you want to submit an opinion article or news analysis, please email it to paanluel2011@gmail.com. SSB do reserve the right to edit material before publication. Please include your full name, email address, city and the country you are writing from.

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