For close to 25 years the standard HIV prevention approach was the ABC s.exual behaviour change strategy: Abstain, be Faithful, and use Condoms. Today, this tactic 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 rise steadily every year, irrespective of ABC.
Re-focusing upon the Facts and Rules of Transmission – Among the failings in the old HIV prevention ABC approach would be to make the exceptions the rule, as well as focus upon these exceptions to handle preventing HIV transmission inside the general population: Multiple partners, infidelity, high frequency of intercourse, and early age of commencement of s.exual activity, to name a few assumptions.
Research during the past decade said that people are not (in general) overly se.xually active: Studies by Durex show that the average South African is literally average when it comes to se.xual activity, compared to the remainder of the world. Exactly the same was found for age of first se.xual activity. Additionally, it proved that multiple partners – although a high risk for HIV transmission – is not as widespread as previously thought, and cannot explain rapid increases in overall HIV transmission in a community. The ‘AB’ (abstain and stay faithful) strategy failed because people were (in general, excluding high specific risk group) already pretty conservative in this connection.
Condoms, although a logical solution, did not have the impact that was expected. Initially, the reason for this failure was blamed on absence of education and availability. However, if they were corrected very little changed, with the exception of youth and workers. Other people resisted condoms for relationship reasons (trust issues; evidence of love and commitment) and because it really prevented having babies. The desire to get babies beats the risk of death, for many individuals. Count the amount of pregnant peer educators in the event you question the mismatch involving the ABC message and what people are really doing.
Focusing upon the typical rules, not the exceptions – There always has become – and constantly will be – people, behaviours, resources and circumstances which are beyond the range of what exactly is considered average or normal. These would require target-specific methods. However, for the great majority of people and circumstances, the A2B4CT approach is quite straightforward and within the current government health guidelines and protocols. It’s time to get caught up, refocus, and spend our energies and resources with a higher-level of Homepage efficiency and impact.
The A2B4CT (A-BB-CCCC-T) Approach – Fortunately, a totally different prevention strategy has emerged in the last couple of years, including eight various ways which we term – for the absence of a 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 is situated upon biology, not morality. You don’t need to change your personal beliefs: Instead, you must know how it operates, and use it. The character of the required behaviour changes is additionally different, and are linked to economics, gender equity, and mental health problems, including motivation towards a much better future, communication within relationships, stress and depression, and substance use (especially alcohol).
The results of the A2B4CT approach are dramatic. A wide range of results illustrates the impact of those prevention methods:
For couples where one person has HIV and is taking ARVs, and also the other is HIV-negative, the possibilities of transmitting HIV to the uninfected partner is near to zero (99.9%) right after the treated partner achieves an undetectable viral load (and in which the individual is adherent towards the ART);
With 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 close to 1%. It is a 95% decline in transmission;
Voluntary Male Medical Circumcision (VMMC) reduces the probability of a male becoming contaminated with HIV by about 50%, and the probability of him later infecting his regular partner by about 50% (WHO).
Condoms have re-emerged as a good prevention method, although having a different emphasis and application inside the new A2B5C approach. For instance, as a short-term protective measure while a couple waits for your infected partner’s viral load to lower to safer levels, to ensure that conception of babies can happen without probability of transmission in one partner to another. Microbicides are being developed as another type of barrier against HIV transmission.
New opportunities require new understanding – The newest A2B4CT is situated upon official site biology: The type of HIV and just how the viral load is key to understanding risk 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. Understanding the general span of HIV viral load is essential in developing effective prevention strategies. Many medical experts suggest that the viral load is more important that the CD4 count in determining the medical and wellbeing of any person.