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9 Organizations And Advocates Fighting For Underserved People With HIV
HIV and AIDS advocacy organizations and individuals play a critical role in helping those in underserved communities. They help expand access to the medical and social supports people with HIV need.
HIV and AIDS are treatable medical conditions, but people living with these diagnoses can face many barriers. Unmet needs for housing and employment can compound the effects of stigma and make it harder to access medical care and treatment.
Advocacy organizations and individuals are working on the ground to remove these barriers, in particular among underserved communities such as those of Black people and other People of Color, LGBTQIA+ folks, low-income groups, and women.
Their work has resulted in people getting more access to the medical and social supports they need.
Activism and advocacy have a long history, going back to the early days of the HIV epidemic in the United States.
In the early 1980s, people living with HIV and AIDS were often isolated socially and had little or no access to medical treatment for a poorly understood, incurable disease. Early advocacy focused on breaking the stigma and improving medical care.
Today, scientific advancements have made HIV and AIDS manageable conditions, but people with the diagnosis still face social stigma and barriers to care.
A 2021 study found unmet care needs for people living with HIV included housing, food security, employment assistance, and emergency financial help.
Individual advocates and organizations play a critical role in raising awareness about HIV and AIDS and increasing treatment access to members in underserved communities.
Here's a sampling of some people and groups doing this essential work.
Many HIV and AIDS advocacy organizations offer a mix of informational and educational campaigns while running programs to deliver supports to people living with the diagnosis. The focus is often on an underserved community whose members face systemic barriers to health equity.
Raising awareness Black AIDS InstituteThe mission of the Black AIDS Institute is to stop AIDS in Black communities, specifically by mobilizing Black people and institutions.
It focuses on Black empowerment, equity, self-determination, and integrity while striving for measurable effect on the lives of Black people. The Institute runs a number of educational and advocacy programs, as well as a Los Angeles-based health clinic for Black, Latinx, and other people from underserved communities.
The Well ProjectFounded in 2002, The Well Project focuses on the needs of women living with and vulnerable to HIV. The Project increases access to women-focused, culturally responsive HIV information.
It also encourages women in leadership and HIV advocacy positions and advances the cause of women-focused HIV-research.
Increasing access to treatment San Francisco AIDS FoundationThe San Francisco AIDS Foundation strives for health justice for anyone living with or at risk of contracting HIV. It has a wide spectrum of services, including integrated supports for sexual health and substance use.
While serving those with HIV, LGBTQ+ folks, and those who inject drugs, the organization also prioritizes people of color, people experiencing homelessness, and people with mental health care needs, among others.
Housing WorksHousing Works serves low-income people and people experiencing homelessness affected by HIV and AIDS. The organization states that "stable housing is healthcare" and offers supportive services in the areas of housing, healthcare, nutritional counseling, and meals.
Mental health and substance use treatment are also part of its mandate. The organization works throughout New York City and has advocacy offices in Washington, D.C., and Haiti.
NMACHealth equity has been the focus of NMAC, formerly known as the National Minority AIDS Council, for people and Communities of Color, specifically those living with and affected by HIV and AIDS. Its treatment division has programs to increase health literacy among those with HIV and AIDS so they can participate fully in treatment.
NMAC also focuses on those over the age of 50 living with HIV and AIDS, with an additional focus on co-occuring mental health concerns such as post-traumatic stress disorder (PTSD) and substance use.
Damien CenterThe Damien Center provides healthcare services to people with HIV and AIDS across Indiana. The organization offers financial assistance programs for those who are uninsured or underinsured.
It also has housing assistance programs, a food pantry, and youth services to support those living with HIV and AIDS.
Individuals also perform essential work on behalf of people living with HIV and AIDS. Their roles in service organizations, in the arts, or in politics help advance the cause of members of underserved communities.
Raising awareness Cecilia ChungCecilia Chung is a long-time advocate for HIV and AIDS awareness and LGBTQ+ equality. She currently serves on the San Francisco Health Commission and is a past member of the Presidential Advisory Council on HIV and AIDS.
Chung is an immigrant from Hong Kong and has worked with organizations promoting Asian Pacific Islander wellness. Chung broke new ground when she chaired the San Francisco Human Rights Commission, as she was the first person living openly with HIV to hold the position.
Khafre Kujichagulia AbifKhafre Kujichagulia Abif is a writer, artist, and advocate. Abif was a co-founder of Bi+ Georgia, an organization that strives to build a safe community for bi+ people in the state.
As a writer, Abif raises the voices of others living with HIV. A recognized activist, Abif is a noted speaker and author.
Increasing access to treatment Kathie HiersKathie Hiers holds the position of CEO of AIDS Alabama. The nonprofit has a variety of initiatives to support low-income people living with HIV and AIDS, including housing and supportive services. AIDS Alabama also works on HIV and AIDS testing and outreach.
Hiers' work with AIDS Alabama began in 2001, before which she was executive director of Mobile AIDS Support Services in Mobile, Alabama.
Hiers continues to advocate for people living with HIV and AIDS in the southern U.S. States, and in 2010, was the only Southerner to sit on the Presidential Advisory Council on HIV and AIDS. She was co-chair of the council's Disparities Committee.
There are ways for anyone interested in HIV and AIDS advocacy and activism to make a difference. Here are some options:
Another way to get involved is to just ask the organization. They might be able to tell you where they have the most need and how what you have to offer might be a good fit.
Advocacy and activism are critical to improving the lives of people in underserved communities living with HIV and AIDS. You can get involved by giving your time, donating, or spreading the word about their important work.
HIV/AIDS
HIV (human immunodeficiency virus) is a viral infection transmitted through the sexual route. Intravenous needle sharing, infected blood transfusions and transmission from mother to child during birth and breastfeeding can also cause HIV infection. The symptoms become manifest two to four weeks after HIV infection. Symptoms can also be delayed for as long as ten months. HIV causes acquired immunodeficiency syndrome (AIDS) and can cause complications. Treatment of HIV / AIDS comprises antiretroviral drugs and lifestyle management. The patient may suffer from opportunistic infections, which are usually fatal. Hence control of infection in an HIV positive patient is a crucial part.
TypesHIV is classified into two different types:
The stages and progression of HIV infection is as following:
Asymptomatic phase: HIV infection initial stages without any significant symptoms. However, changes in the immune system are noted. This phase can last up to 3 months. Primary infection to develop into HIV disease and immunosuppression takes many years.
Primary infection: The patient replicates the HIV in his bloodstream and lymph nodes in this phase of the disease.
Symptomatic stage: this is known as the late phase of HIV disease, also known as acquired immunodeficiency syndrome. The patient is at risk of developing opportunistic infections such as tuberculosis, candidiasis during this phase of infection.
SymptomsPatients may remain asymptomatic initially after infection. Symptoms progress over two to three weeks after infection, the delay in symptoms for ten months has also been noted in many patients. Non-specific symptoms of HIV may occur during the Acute retroviral phase of the illness. Symptoms pointed out during this phase are as following-
Chronic HIV infection without AIDS
Following are the routes of acquiring HIV/AIDS infection:
The following measures can prevent the spread of HIV infection:
Screening test and confirmatory test are the mainstays for the diagnosis of HIV infection. A complete blood count is performed to assess thrombocytopenia, leukopenia or anaemia. CD4 cell count and viral load are also essential in the diagnosis of HIV infection. Differential diagnosis also plays a significant role in testing for HIV infection. For example, considering cardiovascular disorders, order cardiac biomarkers.
In the case of acquired immunodeficiency syndrome, pneumonia is a significant complication. Planning of chest X-Ray may be valuable to detect pulmonary infiltrates. Arterial blood gases provide essential information about an HIV infected person. Tuberculosis testing should be done. Sputum cultures are necessary for detecting bacterial infections. Other diagnostic tests such as CT scan may be crucial if disseminated TB is a possible diagnosis, especially in patients with acquired immunodeficiency syndrome. Individual with AIDS and decreased cd4 cell counts are at risk for pancreatitis and cholecystitis. Industries diagnostic tests such as bilirubin, transaminase and light base are functional.
Esophagogastroduodenoscopy is essential in patients with dysphagia. Diarrhoea is a common symptom in patients with AIDS. In these patients testing for bacteria, parasite, and ova should be performed. In severe refractory cases, colonoscopy is essential. Neurological complaints of HIV and AIDS should be detected using CT scan, CSF analysis, and lumbar puncture.
TreatmentAntiretroviral drugs: Antiretroviral drugs are the mainstay of treatment in HIV infected patients. Nucleoside/ nucleoid reverse transcriptase inhibitors in many combinations available. Along with this, CCR5 inhibitors and protease inhibitors are also used in the treatment of HIV infected patience.
Highly active antiretroviral therapy (HAART) is a vital part of HIV treatment.
Dolutegravir 50mg once or twice a day, Raltegravir 400mg tablet twice a day should be taken.
Protease Inhibitors
Prognosis
The progress of a patient suffering HIV with CD4 count greater than 500 lives a normal life compared to a person with a low CD4 level. Patients with AIDS who have untreated opportunistic infections have a low life expectancy.
Complications
A major complication to HIV is its progression to AIDS. It can be recognised when there is a low CD4 count with signs of opportunistic infections.
AIDS usually occurs when the lymphocyte count is below a specific level, and one of the following infections is present:
Mitochondrial dysfunction is blamed for some comorbidities associated with chronic HIV infection. MitoQ reduced mitochondrial dysfunction in HIV infected mice on ART.
World AIDS Day 2022: Advancements In The Treatment Of HIV/AIDSMultiple neutralizing antibodies for the treatment of HIV are being tested and developed by scientists at the NIAID Vaccine Research Center (VRC).
5 HIV Myths Proven False: Know Everything About Prevention ChoicesDr Atul Patel shares 5 myths about HIV/AIDS that have been proven false by facts and prevention options.
World AIDS Day 2022: HIV Infection Doesn t Always Lead To AIDS, Facts You Should KnowPeople detected with HIV-AIDS are still looked down upon by society. Let's dispel the myths surrounding HIV-AIDS.
20-Year-Old HIV-Positive Mother Left Unattended In Labour For Over Six Hours, Baby Dies Soon AfterStudies show the lack of knowledge about the routes of transmission of the virus among medical students and a strong association of HIV with unethical behaviour are two major reasons why these patients might suffer discrimination at their hands
HIV prevention lessons for Chennai's migrant workersHIV/AIDS is a disease that affects the human immune system. AIDS is the final stage of Human Immunodeficiency Virus (HIV) infection.
UNITAID To Roll Out Long-Lasting HIV Injection In South Africa, Brazil: All About This New Preventive MethodThe injection, developed by ViiV Healthcare, has been found to be more effective than daily oral PrEP in reducing the risk of HIV infection.
HIV Patients At 68 Per Cent Higher Risk Of Developing Heart Failure; Look Out For These SymptomsHeart failure is a common problem and can be triggered by many health complications, including HIV. Research has shown that people suffering from HIV are at higher risk of heart failure.
World AIDS Day 2021: Can HIV Spread Through Hugging or Kissing? Doctor Debunks Common MythsOn World AIDS Day, TheHealthSite.Com spoke to Dr. Deepak Verma, consultant internal medicine, Manipal Hospital, Ghaziabad to understand everything about this condition and myths that one can now put at rest.
World AIDS Day 2021: Rapid HIV Testing Kits In India -- How To Get Tested At HomeHIV test kit -- How to use it, what is the cost, how to read the results and more on this HIV testing kit answered.
World AIDS Day: Chronic Cough And Other Warning Signs of An HIV Infection That You Shouldn t IgnoreThe world marks AIDS Day on December 1 to highlight the work done to eliminate the epidemic. Today, on this day let's understand the various symptoms of HIV/AIDS infection that one should never ignore.
First Long-Acting Injection For HIV Approved, Patients Would Need Treatment Only For 6 DaysIn a breakthrough, a long-acting injection for HIV patients got a green light that will help reduce the time period for the treatment to just 6 days in a year.
The Importance Of Premarital Health CheckupsYou may be preoccupied with your wedding planning and spending a fortune on your wedding attire, food and decor. Along with that, make sure you are enrolling for some health tests too.
Good News For People With HIV! Lifelong Medication May Not Be Needed To Control The VirusLike most medicines, antiretroviral drugs for HIV can also cause side effects. Scientists explain how HIV patients can still keep the virus in remission after stopping ART.
Oxford Scientists Begin Clinical Trial For HIV VaccineVaccines are seen as a powerful tool to control and ultimately end HIV globally. Read on to know more about this Oxford HIV vaccine.
Beta Blockers May Put HIV Patients at Higher Risk of Heart Disease, Stroke and Heart FailureHIV patients taking beta blockers had 90 per cent higher risk of developing heart disease, heart failure or stroke for the first time compared to those who were taking ACEi/ARBs -- the most frequently prescribed type of high blood pressure medication, found a study.
This diabetes drug may be used as adjunct therapy for treating HIVCurrently, doctors use combinations of antiretroviral drugs to suppress HIV replication. But many patients taking ART treatment show signs of residual viral replication and immune impairment. A new study has indicated that a widely used diabetes drug may be the new weapon against HIV.
World AIDS Vaccine Day 2020: Can we hope for an effective shield against HIV soon?On the occasion of World AIDS Vaccine Day today, let us see if there is any hope of finding a cure of this disease in the near future.
Side Effects of HIV Drugs: MitoQ Supplement May Reverse Organ Damage Caused By HIV, Antiretroviral TherapyMitochondrial dysfunction is blamed for some comorbidities associated with chronic HIV infection. MitoQ reduced mitochondrial dysfunction in HIV infected mice on ART.
World AIDS Day 2022: Advancements In The Treatment Of HIV/AIDSMultiple neutralizing antibodies for the treatment of HIV are being tested and developed by scientists at the NIAID Vaccine Research Center (VRC).
5 HIV Myths Proven False: Know Everything About Prevention ChoicesDr Atul Patel shares 5 myths about HIV/AIDS that have been proven false by facts and prevention options.
World AIDS Day 2022: HIV Infection Doesn t Always Lead To AIDS, Facts You Should KnowPeople detected with HIV-AIDS are still looked down upon by society. Let's dispel the myths surrounding HIV-AIDS.
20-Year-Old HIV-Positive Mother Left Unattended In Labour For Over Six Hours, Baby Dies Soon AfterStudies show the lack of knowledge about the routes of transmission of the virus among medical students and a strong association of HIV with unethical behaviour are two major reasons why these patients might suffer discrimination at their hands
HIV prevention lessons for Chennai's migrant workersHIV/AIDS is a disease that affects the human immune system. AIDS is the final stage of Human Immunodeficiency Virus (HIV) infection.
UNITAID To Roll Out Long-Lasting HIV Injection In South Africa, Brazil: All About This New Preventive MethodThe injection, developed by ViiV Healthcare, has been found to be more effective than daily oral PrEP in reducing the risk of HIV infection.
HIV Patients At 68 Per Cent Higher Risk Of Developing Heart Failure; Look Out For These SymptomsHeart failure is a common problem and can be triggered by many health complications, including HIV. Research has shown that people suffering from HIV are at higher risk of heart failure.
World AIDS Day 2021: Can HIV Spread Through Hugging or Kissing? Doctor Debunks Common MythsOn World AIDS Day, TheHealthSite.Com spoke to Dr. Deepak Verma, consultant internal medicine, Manipal Hospital, Ghaziabad to understand everything about this condition and myths that one can now put at rest.
World AIDS Day 2021: Rapid HIV Testing Kits In India -- How To Get Tested At HomeHIV test kit -- How to use it, what is the cost, how to read the results and more on this HIV testing kit answered.
First Long-Acting Injection For HIV Approved, Patients Would Need Treatment Only For 6 DaysIn a breakthrough, a long-acting injection for HIV patients got a green light that will help reduce the time period for the treatment to just 6 days in a year.
The Importance Of Premarital Health CheckupsYou may be preoccupied with your wedding planning and spending a fortune on your wedding attire, food and decor. Along with that, make sure you are enrolling for some health tests too.
Good News For People With HIV! Lifelong Medication May Not Be Needed To Control The VirusLike most medicines, antiretroviral drugs for HIV can also cause side effects. Scientists explain how HIV patients can still keep the virus in remission after stopping ART.
Oxford Scientists Begin Clinical Trial For HIV VaccineVaccines are seen as a powerful tool to control and ultimately end HIV globally. Read on to know more about this Oxford HIV vaccine.
Beta Blockers May Put HIV Patients at Higher Risk of Heart Disease, Stroke and Heart FailureHIV patients taking beta blockers had 90 per cent higher risk of developing heart disease, heart failure or stroke for the first time compared to those who were taking ACEi/ARBs -- the most frequently prescribed type of high blood pressure medication, found a study.
This diabetes drug may be used as adjunct therapy for treating HIVCurrently, doctors use combinations of antiretroviral drugs to suppress HIV replication. But many patients taking ART treatment show signs of residual viral replication and immune impairment. A new study has indicated that a widely used diabetes drug may be the new weapon against HIV.
World AIDS Vaccine Day 2020: Can we hope for an effective shield against HIV soon?On the occasion of World AIDS Vaccine Day today, let us see if there is any hope of finding a cure of this disease in the near future.
New HIV vaccine coming soon: 5 ways to prevent the condition till thenAre you at higher risk of getting HIV infection? Don't worry. The HIV vaccine is on its way. But till the vaccine arrives, here are some ways to keep the condition at bay.
World AIDS Day: Chronic Cough And Other Warning Signs of An HIV Infection That You Shouldn t IgnoreThe world marks AIDS Day on December 1 to highlight the work done to eliminate the epidemic. Today, on this day let's understand the various symptoms of HIV/AIDS infection that one should never ignore.
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World AIDS Day 2017: Does HIV/AIDS spread by kissing, touching and ...You might know about unprotected sex and HIV/AIDS but not the ways the HIV Virus can't spread.
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Daily Sex Tip: 7 STDs you can get from having unprotected sex (Slide Show)These diseases should serve as a warning to you to not have unprotected sex.
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World AIDS Day 2014: It's Not Over -- watch an inspiring tale of 3 HIV+ peopleThis documentary on HIV/AIDS shares 3 inspiring tales of HIV+ people from across the globe.
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Vaginal Sex And The Risk Of HIV Transmission
Key pointsIf the HIV-positive partner is taking antiretroviral treatment and has a fully suppressed viral load ('undetectable'), the risk of HIV transmission through condomless vaginal intercourse is zero.
The PARTNER study recruited 548 heterosexual couples where one partner had HIV and fully suppressed viral load on antiretroviral treatment. During a median follow-up period of 1.3 years, the couples reported over 36,000 vaginal sex acts without condoms. No HIV transmissions occurred. The investigators concluded that the risk of HIV transmission through vaginal intercourse in these circumstances was effectively zero (Rodger).
When HIV is not suppressed by antiretroviral treatment, vaginal intercourse without a condom is a highly efficient route of HIV transmission because high concentrations of HIV can occur in semen and vaginal fluids, and because the genital tissues are very susceptible to infection. HIV can pass through the cells of the vaginal lining (epithelium) by migrating through specific cells and/or by passing through non-intact tissue. This allows the virus to reach the inner vaginal lining, which is rich in immune cells through which it can establish systemic infection.
Cells located beneath the surface of the cervix are particularly vulnerable to HIV infection, especially during adolescence and during a woman's first pregnancy, or due to infection with human papillomavirus and chlamydia.
A meta-analysis of studies of heterosexual HIV transmission found that, in high-income countries prior to the introduction of combination therapy, the risk per sexual act was 0.04% if the female partner was HIV positive and the male partner was HIV negative. The risk was 0.08% when the male partner was HIV positive and the female partner HIV negative. However, these rates were considerably higher when the source partner was in either the very early or the late stage of HIV infection, when one partner had a sexually transmitted infection that causes genital sores, and also in studies done in lower-income countries (Boily).
A woman is usually at greater risk of HIV infection from an HIV-positive man than vice versa. This may be due to several factors. Compared with the penis, the amounts of tissue cells susceptible to infection and/or damage are likely higher within the vagina. A woman may often take large quantities of semen into her vagina, which quickly comes into contact with the more vulnerable tissue of the cervix and may remain there for a period of time.
While women are at greater risk of infection from an HIV-positive male partner, condomless vaginal intercourse is also high risk for men, because damaged penile tissue and the mucous membranes in the urethra and on the head of the penis – particularly underneath the foreskin – form a point of infection.
Many other factors affect the level of risk associated with vaginal intercourse, including recent infection, sexually transmitted infections and male circumcision.
Recent infectionThe first few weeks or months after HIV has entered a person's body, their viral load is usually extremely high and they are very infectious.
Viral load is the term used to describe the amount of HIV circulating in the body. As viral load rises, so does infectiousness. On the other hand, when viral load is so low as to be undetectable, there is no risk at all of HIV transmission.
For example, a study of heterosexual couples in Rakai, Uganda, where one partner was HIV positive and the other HIV negative at the start of the study, showed that the likelihood of HIV transmission is highest in the first two and a half months following initial infection with HIV, and that this correlated with higher viral load levels in early HIV infection. The researchers estimated that relative to chronic infection, infectiousness during primary infection was enhanced 26-fold (Hollingsworth).
As people are usually unaware of their infection at this stage, they are not taking treatment and may inadvertently expose sexual partners to HIV. People who have HIV without realising it are much more likely to be involved in HIV transmission than people who know they have HIV, as the latter can receive treatment.
Sexually transmitted infectionsMost sexually transmitted infections, especially those which cause ulceration, including herpes simplex 2 (HSV-2), syphilis, gonorrhoea, and chlamydia, increase HIV-negative partners' risk of acquiring HIV during vaginal intercourse. HIV-negative people with recurrent STIs may be at increased ongoing risk of HIV infection.
In people living with HIV who are not taking HIV treatment, STIs also lead to increased genital shedding of HIV, which increases the risk of transmitting HIV to others. Nonetheless, STIs do not increase the risk of HIV transmission from people who are taking effective HIV treatment and have an undetectable viral load. In the PARTNER study, there was not a single HIV transmission even though many study participants had STIs.
There are two main reasons for the effect of STIs on HIV transmission. Firstly, many (although not all) STIs can cause ulcers, sores or lesions. They provide a direct physical route of entry for HIV in an uninfected person. Secondly, immune cells that are, themselves, prone to HIV infection – such as activated T-cells and dendritic cells – are prone to be present in greater numbers at the site of an infection.
Glossary sexually transmitted infections (STIs)Although HIV can be sexually transmitted, the term is most often used to refer to chlamydia, gonorrhoea, syphilis, herpes, scabies, trichomonas vaginalis, etc.
circumcisionThe surgical removal of the foreskin of the penis (the retractable fold of tissue that covers the head of the penis) to reduce the risk of HIV infection in men.
viral loadMeasurement of the amount of virus in a blood sample, reported as number of HIV RNA copies per milliliter of blood plasma. Viral load is an important indicator of HIV progression and of how well treatment is working.
The strongest evidence is for herpes simplex virus type 2 (HSV-2). A meta-analysis found that having HSV-2 was associated with an increased risk of acquiring HIV both in the general population (an increase of 270%) and in higher risk groups such as sex workers and men who have sex with men (170%). Having a recent HSV-2 infection was associated with an almost five-fold (470%) increased risk of acquiring HIV, probably because genital ulceration, viral shedding and inflammation in the genital tract are most severe in new HSV-2 infections and tend to decrease over time (Looker).
Gonorrhoea, chlamydia and trichomoniasis have been shown to increase risk of HIV infection in women (Laga). Trichomonas vaginalis increases the risk of HIV acquisition for women (Masha).
Human papillomavirus, the cause of genital warts, is associated with an increased risk of HIV infection in women regardless of whether it is an HPV type that causes genital warts or a type associated with cervical cancer (Houlihan). The presence of human papillomavirus in cells in the penis also increases the risk of acquisition in men (Rositch).
Male circumcisionMen are less likely to acquire HIV through vaginal intercourse if they are circumcised. There is strong biological and epidemiological evidence for this.
Circumcision is believed to reduce the risk of male infection because it removes the vulnerable tissue inside the foreskin, which contains Langerhans cells (a type of cell particularly vulnerable to HIV infection). The area under the foreskin is also vulnerable to trauma, and is more likely to become abraded if sufficient lubrication is not present. Also, uncircumcised men may be more vulnerable to sexually transmitted infections (STIs), because the area under the foreskin can retain bacteria acquired during sex, thus increasing the chance that an infection will become established.
Three randomised controlled trials of circumcision demonstrated that circumcision lowers HIV-negative men's risk of acquiring HIV by between 51 and 60%. They also showed benefits in terms of lowering rates of sexually transmitted infections. The studies were conducted in South Africa (Auvert), Kenya (Bailey) and Uganda (Gray).
The World Health Organization recommends that circumcision programmes should be an integral part of HIV prevention programmes in countries with generalised HIV epidemics. In the United States, the Centers for Disease Control and Prevention (CDC) recommends that healthcare providers can inform their patients that medical male circumcision "male circumcision reduces, but does not eliminate, the risk of acquiring HIV" by men during vaginal sex.
Male circumcision does not reduce the risk of HIV transmission from men to female partners.
SchistosomiasisSchistosomiasis (also known as bilharzia) is a widespread infection in sub-Saharan Africa and other tropical countries. Schistosomiasis is caused by a parasitic worm that lives in fresh water and is acquired by bathing in infested water. The infection can cause a localised immune response and genital lesions, increasing the risk of HIV transmission and acquisition.
In a study of over 1000 HIV-serodiscordant couples in Zambia (Wall), women who had schistosomiasis had an 40% increased risk of acquiring HIV. In addition, when an HIV-positive man or woman had schistosomiasis, there was a greater risk of HIV transmission to their sexual partner.
Bacterial vaginosisBacterial vaginosis is a type of vaginal inflammation caused by the overgrowth of bacteria naturally found in the vagina, which upsets the natural balance. Signs and symptoms may include a discharge, an odour, itching and burning during urination.
It appears that bacterial vaginosis is associated with an increased risk of acquiring HIV. A meta-analysis of four prospective studies conducted in sub-Saharan Africa found a 61% increased risk of HIV acquisition in women (Atashhili). In a Kenyan study, bacterial vaginosis and HSV-2 infection were the two strongest risk factors measured for HIV acquisition over a 20-year period (Masese).
Practices such as douching, washing and drying the vagina may undermine the body's innate defences and make bacterial vaginosis more common.
Withdrawal before ejaculationThe chances of infection may be lessened during condomless vaginal intercourse if ejaculation does not take place. An early study found that after 20 months, none of the heterosexual couples who had consistently practised withdrawal experienced the seroconversion of the HIV-negative partner (De Vincenzi).
Vaginal drynessRougher sex and/or vaginal dryness may lead to vaginal or penile abrasions, which may increase the chances of infection.
Reduction of vaginal lubrication becomes more common with age, possibly increasing risk in post-menopausal women. Younger women in early puberty may also produce less vaginal and cervical secretions, perhaps increasing their vulnerability to HIV infection and contributing to the disproportionate prevalence of HIV amongst adolescent women (Holmberg).
How you can reduce the riskEffective protective measures are:
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