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Spread of HIV in Africa Outpacing Treatment Efforts

Washington Post
June 25, 2007

Although "billions of dollars are spent" on expanding access to antiretroviral drugs in Africa, the "goal of controlling" the spread of HIV on the continent "remains remote," the Washington Post reports. The "problem is not the medicine, which is among the most powerful in the world," according to the Post. Prevention programs in places like the U.S. and Europe already were successful against smaller-scale HIV/AIDS epidemics when antiretrovirals became available and created a "turning point in the battle against AIDS," the Post reports. However, prevention programs in sub-Saharan Africa "have mostly failed to curb the behavior -- especially the habit of maintaining several sexual partners at a time -- that drives the epidemic," according to the Post.

International health officials and HIV/AIDS advocates "once predicted" that expanding treatment access would improve prevention efforts by promoting openness about the disease and facilitating education efforts, the Post reports. But among the African countries most affected by the disease, only Zimbabwe -- which has one of the region's smallest treatment programs -- has reported a recent decrease in HIV cases.

Expanded Treatment Access - According to the Post, the positive results seen among HIV-positive people who began taking antiretrovirals around 1997 "spurred a wave of optimism about treatment that eventually swept away political resistance to a mass rollout" of the drugs in Africa. Francois Venter, president of the Southern African HIV Clinicians Society, said that although antiretrovirals became increasingly available relatively quickly, he never saw signs that expanded treatment access contributed to a decrease in new HIV cases. According to Venter, who works at Johannesburg Hospital's AIDS clinic in South Africa, sex drives often return as antiretrovirals begin to work. He added that an increasing proportion of women at the clinic became pregnant, which he interpreted to mean that the clinic's efforts to distribute condoms were not effective.

Although access to antiretrovirals has increased, waiting lists for the drugs in South Africa and other countries often are months long. Stigma also means that many people die of AIDS-related illnesses without acknowledging that they have the disease, the Post reports. In addition, people living in remote areas often "struggle to find doctors who have access to antiretrovirals," according to the Post. Promoting adherence to treatment regimens, many of which require taking drugs twice daily, also has proven more difficult than health officials predicted.

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