We went to the “Annual Workshop on Advanced Clinical Care – AIDS” which was held on September 30 and October 1, 2010 in Durban.
Here are some interesting facts that we learned:
· The current antiretroviral s (ARVs) available to treat HIV in South Africa are now more effective, better tolerated and less prone to developing resistance than previous ones.
· In South Africa, the CD4 count in adults must be less than 200 to start ARVs except in certain cases where the threshold is less than 350. In the United States, ARVs are started at a CD4 of 500.
· Lower CD4 counts at the onset of ARV treatment are associated with a worse prognosis. The average CD4 count at the start of ARV treatment in South Africa is 87.
· The life span after infection with HIV-1 in an untreated person is 9 – 12 years.
· Knowing HIV status, reducing risky sexually behaviours, good nutrition and seeking medical care can increase life span by up to five years.
· A person in South Africa on ARVs can expect to live more than 20 years after the time of infection with HIV.
· A non-infected baby on ARV prophylaxis can safely be breastfed by an HIV infected mother.
· South Africa has the highest number of people infected with HIV in the world – 5.7 million.
· South Africa has the highest number of people on ARVs in the world – 1.2 million.
· Our province of KwaZulu-Natal has the highest number of cases of HIV in South Africa
· Treating HIV infected pregnant mothers can reduce the level of transmission to their babies from 30% to almost 0%.
· About 40% of pregnant women in the province of KwaZulu-Natal (KZN) are infected with HIV.
· In KwaZulu-Natal, 30% of women are HIV positive by age 21. This prevalence is reached by age 25 among the men. In some rural areas in KZN, HIV tests are positive in 50% of young women.
· The alarmingly high rise in rural women may be due to high rates of co-infection with genital herpes. The ulcerated areas of broken skin result in a much higher chance of infection. Additionally, during a genital herpes flare- up, an HIV infected person has a transiently higher level of HIV virus which also increases the HIV transmission rate. The prevalence of genital herpes infection in people with HIV in South Africa is 90%.
· Male circumcision can reduce HIV in men by 60% during heterosexual encounters.
· TB is the number one cause of death in HIV positive persons.
· It is estimated that rapid tests for TB will be available in 2015.
We can train and equip nurses and lay health builders in the following ways to medically address the above problems:
· We can produce educational videos about HIV and TB including prevention and treatment in English, Zulu and other African languages. These can be used by health builders and others doing health education.
· We can make videos that can be used to train lay people to do rapid HIV tests in their communities.
· We can diagnose people as soon as possible by training health builders to screen in churches, homes and at large gatherings of people.
· Even if a newly diagnosed person is ineligible to receive ARVs based on their CD4 count, we can instruct them on lifestyle changes that they can make that can extend their lives up to five years. Such changes include good nutrition to boost the immune system and encouraging them to take isoniazide if prescribed to them to prevent TB.
· We can stress the importance for an HIV positive person who is not yet eligible for ARVs to go for a CD4 count every six months at their clinic so that they can start ARVs as soon as they are eligible.
· By doing the above, more parents and caregivers can have those precious additional years to raise their children.
· We can emphasize the importance of testing children so that they can get the benefits of ARV treatment as soon as they are eligible.
· Health builders can provide long-term follow-up and encouragement to HIV infected persons.
Through your support of World Mission Offering, we can bring love, healing and hope to the people of South Africa.
Blessings,
Rick and Anita Gutierrez