HIV/AIDS Prevention in Low and Middle Income Countries
In 2003, the World Health Organization and UNAIDS started the ‘3 by 5’ initiative to increase access of antiretroviral therapy (ART) to 3 million people by the end of 2005. In 2010, the number of people receiving ART in low and middle-income countries reached 6.65 million – representing 47% coverage 1. Despite significant improvements in the past decade towards increasing antiretroviral access, the number of deaths due to AIDS still hasn’t declined to levels we expected. In 2002, the number of deaths from AIDS was 2 million 1. In 2010, that number decreased to only 1.8 million 1. Though more is known about HIV/AIDS and how to prevent it compared to the 90s, we’ve yet to implement effective solutions worldwide to thwart its disastrous effect on populations.
Recent news concerning HIV/AIDS has mostly been positive. It was reported that a child from Mississippi was cured from HIV by receiving higher doses of drugs 2. A week later, it was found that a chemical called melittin could destroy the HIV virus if inserted into nanoparticles 3. These findings are undoubtedly positive when it comes to HIV/AIDS prevention and treatment in the future, yet it’s still unknown when or if a mass produced cure will ever reach the public. For now, the most common solutions to mitigate the spread of HIV/AIDS revolve around a two-pronged approach of prevention and treatment. Behavioral prevention strategies such as couples voluntary counseling and treatment (CVCT) have been used in Africa but are now getting less funding in favor of treatment initiatives. Educating the population and effective marketing techniques towards prevention are other strategies that have also been successful. DKT International is a non-profit organization that promotes HIV/AIDS prevention through social marketing. They’re currently the largest private provider of contraceptives in the developing world 4. Social entrepreneurship has grown in the past decade and has proven to be capable of making just as large of an impact as public organizations. Non-profit organizations such as Ashoka have been spearheading the social entrepreneurship movement by providing support and venture capital 5. Although a lot is still to be done in order to increase prevention in low and middle income countries to acceptable levels, innovative approaches are being created on a daily basis.
Antiretroviral therapy is the main method of treatment for those with HIV/AIDS. The HPTN 052 study 6 also revealed that ART also reduces HIV transmission, which places great importance on making ART universally accessible. Coverage for adults in low and middle income countries is at 51%, compared to only 23% for children 1. Since access in densely populated urban areas has peaked, innovative strategies for increasing access among children and rural areas is needed. It’s vital that ART be initiated as early as possible since it’s effectiveness is greatest if initiated early. This potentially causes a significant challenge since HIV doesn’t manifest any symptoms until potentially years. One possible strategy is to initiate ART in high risk populations (gays, drug users, and mothers) even if they’re HIV-negative. However, scaling up services to high risk populations is inherently challenging due to the stigma of HIV/AIDS. Proper approaches will need to be devised in order to reach high risk individuals despite social barriers.
Despite the lack of a cure or vaccine, enough resources are available to reduce HIV/AIDS infection and deaths to moderate levels. The key is to build effective strategies that revolve around proper marketing, optimized accessibility, and continuous iteration. Effective marketing of prevention measures and treatment options are essential towards reducing or mitigating HIV infection. Optimizing coverage of health centers and services is needed in areas where resources are scarce. Finally, solutions are rarely found on the first try, which means that health officials and change agents will have to continuously access current strategies and adapt them based on their effectiveness.
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