Overview
The Human Immunodeficiency Virus (HIV) targets the immune system and weakens people's defence systems against infections and some types of cancer. As the virus destroys and impairs the function of immune cells, infected individuals gradually become immunodeficient. Immune function is typically measured by CD4 cell count. Immunodeficiency results in increased susceptibility to a wide range of infections, cancers and other diseases that people with healthy immune systems can fight off.
The most advanced stage of HIV infection is Acquired Immunodeficiency Syndrome (AIDS), which can take from 2 to 15 years to develop depending on the individual. AIDS is defined by the development of certain cancers, infections, or other severe clinical manifestations.
The HIV/AIDS Programme contributes to the reduction of the HIV/AIDS burden in the WHO Africa Region through support to member states to adopt and implement cost effective prevention, treatment, care and support interventions.
Facts about hiv in Africa
Out of the 34 million HIV-positive people worldwide, 69% live in sub-Saharan Africa. There are roughly 23.8 million infected persons in all of Africa.
91% of the world’s HIV-positive children live in Africa.
More than one million adults and children die every year from HIV/AIDS in Africa alone. In 2011, 1.7 million people worldwide died from AIDS.
Since the epidemic of HIV/AIDS, more than 75 million people have contracted the illness, and over 36 million have died from an HIV-related cause.
71% of the HIV/AIDS-related deaths in 2011 were people living in Africa.
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Antiretroviral drug treatments can tremendously decrease the number of HIV-related deaths by delaying the progression of the virus and allowing people to live relatively healthy, normal lives.
Due to an insufficient supply of antiretroviral drugs and health care providers in 2010, only 5 of the 10 million HIV-positive patients in Africa were able to receive treatment.
Because of HIV/AIDs, the average life-expectancy in sub-Saharan Africa is 54.4 years of age. In some countries in Africa, it’s below 49.
The HIV/AIDS epidemic has drastically slowed the economic growth and social development in Africa, because hundreds of thousands of people are unable to work or receive an education.
Contraceptive use of condoms has doubled in recent years because it is an inexpensive provision to offer to both the HIV-positive and negative. However, the method is void when couples are hoping to conceive or have already engaged with infected persons.
A pregnant woman not treated with the proper drugs, has a 20-45% chance that her infant will contract the virus from pregnancy. 59% of HIV-positive people in Africa are women, the majority of children diagnosed with HIV get the virus from their mothers.
HIV testing should be voluntary and the right to decline testing should be recognized. Mandatory or coerced testing by a health-care provider, authority or by a partner or family member is not acceptable as it undermines good public health practice and infringes on human rights.
Some countries have introduced, or are considering, self-testing as an additional option. HIV self-testing is a process whereby a person who wants to know his or her HIV status collects a specimen, performs a test and interprets the test results in private. HIV self-testing does not provide a definitive diagnosis; instead, it is an initial test which requires further testing by a health worker using a nationally validated testing algorithm.
All HIV testing services must include the 5 C’s recommended by WHO: informed Consent, Confidentiality, Counselling, Correct test results and Connection (linkage to care, treatment and other services).
Lastly I would like to talk about hiv prevention;
Individuals can reduce the risk of HIV infection by limiting exposure to risk factors. Key approaches for HIV prevention, which are often used in combination, include:
Male and female condom use
Correct and consistent use of male and female condoms during vaginal or anal penetration can protect against the spread of sexually transmitted infections, including HIV. Evidence shows that male latex condoms have an 85% or greater protective effect against HIV and other sexually transmitted infections (STIs).
Testing and counselling for HIV and STIs
Testing for HIV and other STIs is strongly advised for all people exposed to any of the risk factors. This way people learn of their own infection status and access necessary prevention and treatment services without delay. WHO also recommends offering testing for partners or couples. Additionally, WHO is recommending assisted partner notification approaches so that people with HIV receive support to inform their partners either on their own, or with the help of health care providers.
Testing and counselling, linkages to tuberculosis care
Tuberculosis (TB) is the most common presenting illness and cause of death among people with HIV. It is fatal if undetected or untreated and is the leading cause of death among people with HIV- responsible for 1 of every 3 HIV-associated deaths. Early detection of TB and prompt linkage to TB treatment and ART can prevent these deaths. TB screening should be offered routinely at HIV care services. Individuals who are diagnosed with HIV and active TB should be urgently started on TB treatment and ART. TB preventive therapy should be offered to people with HIV who do not have active TB.
Voluntary medical male circumcision
Medical male circumcision, when safely provided by well-trained health professionals, reduces the risk of heterosexually acquired HIV infection in men by approximately 60%. This is a key intervention supported in 14 countries in Eastern and Southern Africa with high HIV prevalence and low male circumcision rates.
Antiretroviral (ARV) drug use for prevention
5.1 Prevention benefits of ART
A 2011 trial has confirmed if an HIV-positive person adheres to an effective ART regimen, the risk of transmitting the virus to their uninfected sexual partner can be reduced by 96%. The WHO recommendation to initiate ART in all people living with HIV will contribute significantly to reducing HIV transmission.
5.2 Pre-exposure prophylaxis (PrEP) for HIV-negative partner
Oral PrEP of HIV is the daily use of ARV drugs by HIV-uninfected people to block the acquisition of HIV. More than 10 randomized controlled studies have demonstrated the effectiveness of PrEP in reducing HIV transmission among a range of populations including serodiscordant heterosexual couples (where one partner is infected and the other is not), men who have sex with men, transgender women, high-risk heterosexual couples, and people who inject drugs.
WHO recommends PrEP as a prevention choice for people at substantial risk of HIV infection as part of combination prevention approaches.
5.3 Post-exposure prophylaxis for HIV (PEP)
Post-exposure prophylaxis (PEP) is the use of ARV drugs within 72 hours of exposure to HIV in order to prevent infection. PEP includes counselling, first aid care, HIV testing, and administering of a 28-day course of ARV drugs with follow-up care. WHO recommendsPEP use for both occupational and non-occupational exposures and for adults and children.
needle and syringe programmes;
opioid substitution therapy for people dependent on opioids and other evidence based drug dependence treatment;
HIV testing and counselling;
risk-reduction information and education;
HIV treatment and care;
access to condoms; and
management of STIs, tuberculosis and viral hepatitis.
WHO recommends options for prevention of MTCT (PMTCT), which includes providing ARVs to mothers and infants during pregnancy, labour and the post-natal period, and offering life-long treatment to HIV-positive pregnant women regardless of their CD4 count.
In 2015, 77% (69–86%) of the estimated 1.4 (1.3-1.6) million pregnant women living with HIV globally received effective ARV drugs to avoid transmission to their children. A growing number of countries are achieving very low rates of MTCT and some (Armenia, Belarus, Cuba and Thailand) have been formally validated for elimination of MTCT of HIV. Several countries with a high burden of HIV infection are closing in on that goal.
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Get more information from
I.https://www.afro.who.int/health-topics/hivaids
