By Mazhar Shahen – Art in Tanzania internship
Africa is a heavily affected region by HIV and AIDS disease, with majority of cases being localized in the eastern and southern sides of Africa. In 2018 there were 1.1 million new cases in Africa of HIV according to World Health Organization (WHO). In 2018 there were 37.9 million cases of HIV patients with 1,7 million of these cases being newly infected in 2018 globally. Out of the 1.7 million new cases globally 1.1 million were majorly located in the sub-Saharan Africa region. 770,000 patients lost their lives to HIV-related illnesses in 2018, 470,000 out of them were people died due to AIDS related diseases in 2018 and 25.7 million people are living with HIV disease.
Human immunodeficiency virus (HIV) is an immune system compromising virus. Acquired immunodeficiency syndrome (AIDS) can be developed if HIV infected patients are not treated. Currently we do not have a cure for HIV, once contracted the person is going to have HIV for the rest of their life. HIV positive patients that do not go under treatment usually go under three stages of progression.
Stage 1 is acute HIV infection; acute condition means severe and sudden. Patients are very contagious with a very large amount of HIV in their blood. Bodies natural response to the virus is flu like symptoms, however this is not all cases as some people do not get sick after the infection, or ever. In the case that a patient is suspecting being HIV positive, an antigen/antibody tests or nucleic acid tests (NATs) only can help confirm the infection.
Stage 2 is chronic HIV infection; chronic condition means long-lasting persisting effects. HIV reproduces at very low levels; however, it is still active. It could be also called asymptomatic HIV infection stage as patients may not have any symptoms during this phase. Without treatment this stage can last a decade or even longer, however some patients might progress at a faster rate. In this stage HIV can be transmitted to others without proper medical treatment. Signs of this stage ending is an increase the HIV in the blood, the viral load, and a decrease in CD4 cell count. People who have access to proper medication may never reach stage 3.
Stage 3 is acquired immunodeficiency syndrome (AIDS). This is the most severed immune system phase, the most critical part of the HIV infection. When the patients develop opportunistic infections (OIs) or have CD4 cell count below 200 cells/mm they are diagnosed with AIDS. AIDS patients have a very badly damages immune system that increases the risk of severe illnesses, OIs. Without treatment AIDS patients usually survive three years.
Although there is no cure for HIV with proper treatment with antiretroviral therapy (ART) medicine the HIV virus can be controlled. Majority of patients are able to control the virus within six-month period. This treatment with ART helps prevent the transmission of the HIV disease to others. The viral load, the amount of HIV in the blood, can be reduced using antiretroviral therapy. ART can reduce the viral load to very low levels, to viral suppression levels. Viral suppression is achieved by having less than 200 copies of HIV per milliliter of blood. If HIV patients skip their medications, they will give room for the disease to multiply in a more rapid form, which could lead to compromising the immune system and getting sick. If an HIV positive individual is inconsistently receiving ART medication drug resistance might develop. The HIV can mutate, change, and will develop resistance to responding to certain HIV medication. This will limit the patient’s options for successful HIV treatment. If the HIV is developed into a drug resistant form it will be able to transmit to others. Taking medication consistently as prescribed helps prevent drug resistance.
hiv and babies
HIV-positive mother with an undetectable viral load will help prevent transmission of HIV to her offspring. If a mother with HIV is taking her ART medicine as prescribed consistently throughout the pregnancy, labor, and delivery and supplies the baby with ART medicine for 4-6 weeks after birth, there is less than 1% chance of the baby transmitting HIV disease.
Currently the United States do not recommend mothers which are HIV positive to breastfeed even if they were on their medication. Being on HIV medication does help reduce the risk of transmission to the baby through offspring, however it does not eliminate the risk.
HIv prevention success in Eswatini
Governments and people have the ability to turn around the prevalence of the HIV infection in the region. Eswatini is the first African country to have 95% of people living with HIV know their status, with 95% of them on life-saving ART. The country managed to achieve this 10 year ahead of its 2030 goal. This was done by the government providing counselling, educating the public and mainly providing free ART drugs for HIV patients. This was a very strategic and well thought out plan that could be adapted in several others high risk countries in Africa.
HIv Status in tanzania
As of 2019, 1.7 million people in Tanzania are living with HIV. Currently reports reveal show that 5% of adults are living with HIV in Tanzania, with 40% being unaware of being positive for HIV disease. That is much lower than the UNAIDS target of 90% awareness of people living with positive HIV.
Tanzania is currently undergoing the fourth Health Sector HIV and AIDS Strategic Plan (HSHSP IV) which started in 2017 and ends in 2022. The plan goal is to help increase the access to prevention services to the general public in order to reduce the transmission of HIV. Currently 93.6% of the adults in Tanzania that are aware of their infection are on ART medication, and 87% of those adults on medication are in the viral load suppression stage. There is a significant progress, but there is more work that need to be done in order to meet the UNAIDS criteria in Tanzania. Being aware of the disease and suppressing the viral load is the key to prevent transmission to other individuals. Most common ways to prevent HIV/ADIS transmission: avoiding drug use, sharing needles, having unprotected sex, be monogamous, and vaccination if available.
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