Learning HIV prevention from the United States | Opinion

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By Gbadebo Odularu, TODAY NEWS AFRICA, USA


Tomorrow, 10 March, would mark the United States National Women and Girls HIV/AIDS Awareness Day.

This year’s theme for the U.S.’ National Women and Girls HIV/AIDS Awareness Day is ‘HIV Prevention Starts with Me’. This implies that everyone can make an impact in preventing new HIV infections in women and their partners, thereby encouraging women to take charge of their health through measures such as use of condoms, taking prescribed medicine called preexposure prophylaxis (PrEP) if they are at high risk of getting HIV.

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About 36.9 million people were living with HIV around the world in 2017, and 21.7 million of them receiving the Antiretroviral Therapy (ART) medicines to treat HIV. An estimated 940,000 people died from AIDS-related illnesses in 2017. For instance, in 2017, 38,739 people received an HIV diagnosis in the U.S. and 6 dependent areas of American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, the Republic of Palau and the US Virgin Islands.

The U.S. National HIV/AIDS Strategy (NHAS) aims to reduce the number of people who become infected with HIV, increase access to care and optimize health outcomes for people living with HIV, and reduce HIV-related health disparities. During the February 2019 State of the Union Address, the U.S. Government proposed the HIV elimination effort. Further and based on available data in the U.S., there is light at the end of tunnel in the sense that between 2010 and 2016, there was a 21% decrease in HIV diagnoses among all women within the U.S., representing a 25% decline among black/African American women and a 20% fall among Hispanic/Latina women, while rates have remained stable among white women.

The CDC 2016 statistics shows that HIV diagnoses among African Americans are twice as much and 10 times as much among Hispanic/Latinos and Whites respectively. Further, the 12 U.S. states with the highest number of HIV diagnoses per 100,000 in 2016 include: District of Columbia (55.6), Georgia (31.8), Louisiana (29.7), Florida (28.0), Maryland (21.7), Nevada (21.4), Texas (19.8), South Carolina (18.1), Puerto Rico (17.8), New York (17.2), Mississippi (17.1), North Carolina (16.5).

The U.S. is indubitably the world’s leader in responding actively to the global HIV/AIDS crisis. In this vein, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) is highly worthy of discussion in the sense that since it has received strong bipartisan support in Congress and through administrations, including two authorizations with significant majorities since 2003.

East African Women and Girls working at the National Coffee Nursery

From the Africa’s viewpoint, Africa is the most affected region of HIV/AIDS in the world, particularly among women and young people. SSA bears the heaviest burden of HIV / AIDS in the world, with Nigeria being the second country in the world bearing the HIV/AIDS burden. It accounts for about 66% of all new HIV infections, compared to other significantly affected regions like Eastern Europe, Central Asia, Latin America, Asia and the Pacific, and the Caribbean. However, there are declining trends in the HIV/AIDS indicators on the continent. For instance, new HIV infections for the East and Southern Africa Region were 800,000 in 2017, a 30% decrease since 2010, and the West and Central Africa also experienced an 8% decrease between the period under review. Among the 19.6 million people living with HIV in the ESA region in 2017, 1,100,000 were adolescent, including 650,000 girls; and among the 6.1 million people with HIV in West and Central Africa Region in 2017, 440,000 wee adolescents, and 250,000 adolescents were girls.

Despite the U.S. efforts in preventing HIV/AIDS in Africa, as well as concerted regional and global efforts such the Agenda 2063, the African Union Health Strategy 2016 – 2030, and the Transformation Agenda of the WHO African Region, huge inequalities in service provision still persist in Africa, with a high burden of communicable diseases such as HIV/AIDS, TB, Malaria and other numerous public health emergencies that portends potential destruction to the national economic activities and threaten peace and security amidst demographic transformation with rapid urbanization, burgeoning youth population and climate change.

In spite of these declines in new diagnoses, there is still a dose of progress to be upscaled because women still make up about 19% of diagnoses within the U.S., where black women making up 59% of HIV cases among women in 2017, implying that black and Hispanic/Latina women continue to be disproportionally at risk for HIV. Some of the CDC’s initiatives and tools towards preventing HIV/AIDS include inter alia: Learn and share the facts about HIV, Act Against AIDS, Let’s Stop HIV Together, Doing It, Prevent HIV, help people with HIV, Get Tested, Home Testing Kit, and others as follows:

Use of condoms the right way every time you have sex.

Urge people to know their HIV infection status through testing, and to access HIV prevention, treatment and care services.

If you are HIV-positive, start treatment as soon as possible after you get a diagnosis and is critically important that you take HIV medicine as prescribed by your doctor, and see your provider regularly to get a viral load test.

If you are HIV-negative but at high risk for HIV, take daily medicine – PrEP – to prevent HIV.

Talk to your doctor about post-exposure prophylaxis (PEP) if you think you have been exposed to HIV in the last 72 hours and are not on PrEP.

Limit your number of sexual partners.

Get tested and treated for other sexually transmitted diseases.

Never share needles or other equipment to inject drugs.

Remember, abstinence (not having sex) and not sharing needles or works are 100% effective ways to prevent HIV.

Urge policy-makers to promote a ‘health for all’ agenda for HIV and related health services such as tuberculosis (TB), hepatitis and noncommunicable diseases.

The roles of positive parenting practices can help adolescent girls to make healthy choices. These include staying informed about accurate sexual health facts on what our teen is learning and where she is getting the information; having series of frequent sexual health conversations with our teen over time and in private space.

As an effective institution of positive change in our community, schools can deploy evidence-based curricula to prevent the prevalence of sexual health risk behaviors and foster positive academic performance by educating students; through its school-based health centers (SBHCs), schools districts can provide on-site, private and confidential sexual health services or refer students to youth-friendly health care providers in the community; schools can provide students with effective policies and programs to prevent HIV/AIDS, STDs and pregnancy; provide healthy, safe, and supportive school ecosystems that allow girls to engage in healthy behaviors, and sharing their concerns; and universities, in collaboration with CDC, providing leadership in HIV/AIDS prevention research and surveillance towards developing biomedical interventions to reduce transmission and HIV disease progression, as well as providing gender-related evidence-based tools for HIV/AIDs policy formulation and implementation.

A few of the universities providing innovative research activities on HIV/AIDS include inter alia: Harvard University (T. H. Chan School of Public Health AIDS Initiative (HAI), Center for AIDS Research, Center for Biostatistics in AIDS Research, Fogarty HIV Research Training Program, and Botswana Harvard AIDS Institute Partnership); the Dartmouth Institute for Health Policy and Clinical Practice, Virginia Commonwealth University (VCU) School of Medicine (VCU HIV/AIDS Center); George Mason University (GMU), George Washington University (GWU) Milken Institute of Public Health, Tulane University School of Public Health and Tropical Medicine, Rutgers School of Public Health, SUNY Downstate School of Public Health, etc

HIV prevention efforts should be expanded in urban poverty areas as well as the rural poor in the Southern Region of the U.S. by scaling efforts on community-level as well as structural interventions to improve socioeconomic conditions in these areas. In addition, GIS, spatial analysis and data analytics tools should be deployed to identify areas of low socioeconomic status for targeting HIV prevention activities for heterosexuals at increased risks of HIV infection. PEPFAR’s Interagency Model for HIV/AIDS policy intervention should serve as an effective lesson learning for selected African countries in the innovation of consistently deploying the collaborative efforts of its Government Ministries, Departments and Agencies (MDAs) towards leveraging the power of a whole-of-government approach in controlling HIV/AIDS, tuberculosis, malaria, hepatitis, and similar diseases.


Gbadebo Odularu is business and development economist who is affiliated with the American Heritage University of Southern California (AHUSC), USA; as well as the Center for Research on Political Economy (CREPOL), Dakar, Senegal. His Twitter handle is @GbadeboOdularu1

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Opinion contributor
Opinion contributor
This opinion was received by Today News Africa in Washington, District of Columbia. The views expressed here are those of the writer(s) and not ours. You can send your own article to todaynewsafrica@gmail.com

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