HIV research Zimbabwe, Africa and Global


 Some Relevant books and researches in our Library Collection

Complexities of HIV/AIDS in Zimbabwe and around the world

 

Key facts

  • HIV continues to be a major global public health issue, having claimed more than 34 million lives so far. In 2014, 1.2 [980 000–1.6 million] million people died from HIV-related causes globally.
  • There were approximately 36.9 [34.3–41.4] million people living with HIV at the end of 2014 with 2.0 [1.9–2.2] million people becoming newly infected with HIV in 2014 globally.
  • Sub-Saharan Africa is the most affected region, with 25.8 [24.0–28.7] million people living with HIV in 2014. Also sub-Saharan Africa accounts for almost 70% of the global total of new HIV infections.
  • HIV infection is often diagnosed through rapid diagnostic tests (RDTs), which detect the presence or absence of HIV antibodies. Most often these tests provide same day test results; essential for same day diagnosis and early treatment and care.
  • There is no cure for HIV infection. However, effective antiretroviral (ARV) drugs can control the virus and help prevent transmission so that people with HIV, and those at substantial risk, can enjoy healthy and productive lives.
  • It is estimated that currently only 54% of people with HIV know their status. In 2014, approximately 150 million children and adults in 129 low- and middle-income countries received HIV testing services.
  • By mid-2015, 15.8 million people living with HIV were receiving antiretroviral therapy (ART) globally.
  • Between 2000 and 2015, new HIV infections have fallen by 35%, AIDS-related deaths have fallen by 24% with some 7.8 million lives saved as a result of international efforts that led the global achievement of the HIV targets of the Millennium Development Goals.
  • Expanding ART to all people living with HIV and expanding prevention choices can help avert 21 million AIDS-related deaths and 28 million new infections by 2030.

 extracted from http://www.who.int/mediacentre/factsheets/fs360/en/

HIV complexities in Zimbabwe

HIV cases continue to rise in some areas in Zimbabwe

Recently there was a out cry by the national aids council (NAC) over the increase in HIV cases in Biga.According to Nqobile Tshili, Chronicle Correspondent,BINGA District recorded a 100 percent increase in HIV prevalence in the first three months of this year, compared to the same period last year.
The National Aids Council (NAC) has raised a red flag over the sudden increase. The district used to have the lowest HIV prevalence in the country.

This increase in HIV cases ha been attributed to increased interaction with outsiders as HIV hot spots are in areas where fishing is done. Those fishing hot spots are the ones that make us suspect that maybe people coming to buy fish could be contributing to this.” However, more research was recommended to find the reasons for the increase.






‘HIV infections rate not slowing down by p Mbanje’





The rate of new HIV infections is not slowing down as it should and countries most affected like Zimbabwe would need to make greater strides in expanding access to antiretroviral treatment (ART) which is now the leading preventive method. A new report from the Lancet Commission and the UNAIDS warned that if new infections were not stopped, there was a risk the epidemic would rebound as the rate of new HIV infections is not falling fast enough and will as a result increase the number of people needing ART treatment to stay alive.

The report is critical to countries that have become complacent, highlighting that some countries with previously stable or declining HIV epidemics have shown trends of increasing risky sexual behaviours, among at-risk groups over the past five years, with new HIV infections on the rise.
This has been the case in Zimbabwe which despite the prevalence rate falling from an all high of 33% to around 14 %, there were still reports of risky sexual behaviour.

 extracted from https://www.newsday.co.zw/2015/07/01/hiv-infections-rate-not-slowing-down/

HIV in Zimbabwe: Is condom use really working?

Despite Zimbabweans being the highest condom users in the world, the HIV/Aids prevalence rate still remains one of the highest in the world, and one wonders whether promoting condoms use is as effective as the world has been made to believe.

The latest HIV/Aids statistics in Zimbabwe show that the prevalence rate is still very high at 15% as in 2014, whilst in the same year condom usage was reported to have been 104 million male, and 5.2 million female condoms – the highest in the world.


In their report entitled ‘Condom Promotion for Aids Prevention in the Developing World: Is it working?’, Norman Hearst, a professor at the University of California, and Sanny Chen, an epidemiologist with the San Francisco Department of Health, noted that, ‘in many sub-Saharan African countries high HIV transmission rates have continued despite high rates of condom use’. The report said that ‘no clear examples have emerged yet of a country that has turned back a generalised epidermic primarily by means of condom promotion’.
This is disturbing in light of the over-emphasis on condom use as an effective measure in the prevention of HIV/Aids that has taken root in most campaigns in this country, and indeed, the rest if the Southern African region.

Helen Epstein, a visiting research scholar at the Centre for Health and Wellness at Princeton University, said that efforts aimed at stopping the spread of HIV had had disappointing results because of ignoring fidelity, by promoting condom use, and that this ‘may well have undermined efforts to fight the epidermic’.

extracted from  http://www.thezimbabwean.co/2016/01/hiv-in-zimbabwe-is-condom-use-really-working/


 56 Percent of Sex Workers HIV+ in Zimbabwe according to NAC Research

As reported by Thupeyo Muleya, Research by the National Aids Council indicates that although the national HIV and Aids prevalence has been declining in the past two years, prevalence is four times high in other community groups like commercial sex workers. NAC monitoring and evaluation director Mr Amon Mpofu told parliamentarians that although the prevalence rate nationally stood at 13,8 percent as of December 31 last year, down from 15,3 the previous year, indications were that 56,4 percent of commercial sex workers were infected.
Those in densely populated areas like growth points where also facing an incidence rate increase said Mr Mpofu.High risk areas identified include  Bulawayo, Matabeleland South and Manicaland provinces.
 Research on 1 000 sex workers shows that prevalence rate on sex workers aged between 18 and 24 years stands at 36 percent, 25 to 29 (55 percent), 30 to 39 (69 percent) and those aged 40 years and above its 77 percent," he said.

extracted from  http://www.nac.org.zw/news/zimbabwe-56-percent-sex-workers-hiv-says-nac

 Developments in HIV



HIV Isn't As Deadly As It Used To Be, But It Still Speeds Up Aging

For those who have reliable access to combination antiretroviral therapy (c-ART), HIV has become a chronic and manageable condition.  Scientists have noticed a particular trend in these patients of having  a greater prevalence of age-related conditions like heart disease and bone fractures than in the general population, and at a younger age than normally seen.
A study in  Molecular Cell results suggest that the prevailing theory that HIV infection prematurely ages its sufferers,  is likely possible and by a likely average of five years. The researchers in the study used emerging method of DNA analysis on the blood samples of 137 patients living with HIV from an earlier long-running study and compared them to 44 control subjects. They found that, on average, HIV-positive patients had a biological age five years older than their chronological age. The aging effect appeared stable regardless of whether the person had lived with HIV for less than five years or more than 12, indicating the changes occur early on in infection or drug treament and aren’t significantly worsened by lengthy bouts of c-ART.
Jin however noted that their current findings only point to an association between the two factors, not a direct cause-and-effect relationship. More likely, for the time being at least, is that the epigenetic changes could be used to track how fast the disease is progressing and allow doctors to plan ahead accordingly. Authors have suggested that  patients deemed more likely to suffer from HIV-mediated aging effects might be placed on alternative schedules for preventive care, including early screening and further testing if warranted
.
Source: Gross A, Jaeger P, Kreisberg J, et al. Methylome-Wide Analysis of Chronic HIV Infection Reveals Five-Year Increase in Biological Age and Epigenetic Targeting of HLA. Molecular Cell. 2016.
extracted from Molecular Cell Journal 
 http://www.medicaldaily.com/hiv-premature-aging-five-years-382848





South Africa Faces Uphill Battle To Reduce HIV Infection Rates Among Young Women

May 10, 2016 09:40 AM By Reuters
South Africa recorded half of the 5,000 new infections a week among young women out of 14 southern and Eastern African countries, the health minister said on Tuesday.
"When it comes to the area of socio-behavioral interventions, it is an uphill battle, especially in the age group 15-24 year old girls and young women," Health Minister Aaron Motsoaledi told parliament.
http://www.medicaldaily.com/pregnant-women-hiv-infection-fetal-development-374853



Dating Apps blamed for Rising HIV Rates

UNICEF says dating apps are partly responsible for the rise in HIV rates among adolescents in the Asia-Pacific region. A new report from UNICEF suggests that the rise of mobile dating apps, like Tinder and Grinder, is one of the key driving factors of the epidemic growing fastest among young gay and bisexual men in the Asia-Pacific region. 
While the rate of new HIV infections among adolescents has been on the decline globally, the number of new HIV cases among teenagers in the Asia-Pacific region seems to be rising. For example, in the Philippines alone, new HIV cases among adolescents rose from an estimated 800 in 2010 to 1,210 in 2014 and 1,403 in 2015. What's more is an estimated 220,000 young people between the ages of 10 and 19 lived with HIV in the region in 2014, with the burden of new infections falling heaviest on major cities like Bangkok and Hong Kong.
"Everybody has a smartphone, everybody has access to the internet. People are setting up fake Facebook profiles where groups are formed purely to arrange for sex. The internet now provides for unlimited sexual opportunities," Niluka Perera, coordinator at Youth Voices Count, told Al Jazeera.
The uptick in new HIV infections has been attributed to risky sexual behavior, a higher number of partners, unprotected sex with an HIV-positive partner, and a low uptake of HIV testing. However, many suggest the explosion of mobile dating apps can be linked to rising rates across the globe. Earlier this year, The Rhode Island Department of Health said its rising rates of syphilis and gonorrhea correlated with the national trend of popular hookup apps, like Tinder.
This technology has "expanded the options for casual spontaneous sex as never before" by connecting adolescents to a larger network of potential sexual partners and enabling any HIV infections to spread further and faster, according to the UNICEF. The organization added this generation of adolescents has been neglected in terms of education on the ways to prevent HIV transmission, as well as how to prolong life among adolescents who have already been diagnosed.
"In order to tackle this issue, governments need better data on adolescents, strategies for HIV prevention, and adolescent-specific laws and policies," Shirley Mark Prabhu, HIV specialist for UNICEF East Asia and Pacific, explained in a UNICEF blog post. "These should include sex education in schools, condom distribution, and HIV testing and treatment services designed for adolescents."
Source  http://www.unicef.org/eapro/Adolescents_Under_the_Radar_final.pdf
extracted from 


http://www.medicaldaily.com/asia-blames-dating-apps-rising-hiv-rates-among-gay-bisexual-teens-365158


Some HIV Drugs May Negatively Affect Fetal Development

Study authors aimed to estimate the effect ARV regimens, including atazanavir, had on neurodevelopment in infants aged nine to 15 months compared to all other ARV regimens.
The analysis included 917 pregnant women living with HIV already enrolled in The Surveillance Monitoring for ART Toxicities (SMARTT), a cohort of women who were not on ARVs during their last menstrual period but were during pregnancy between October 2006 and April 2013. Three ARV regimens were included: Two or more ARVs from at least two drug classes; three nucleoside reverse transcriptase inhibitors; one protease inhibitor; or one nonnucleoside reverse transcriptase inhibitor.
Study authors assessed several neonatal outcomes associated with infant development, including low birth weight, gestational age, premature birth, neonatal hearing, and head circumference in order to understand how infants were affected by ARVs in utero. When infants turned one year old, they were also given the Bayley Scales of Infant and Toddler Development-Third Edition (Bayley-III) test, which was designed to assess problem-solving, language, fine- and gross-motor skills, as well as social-emotional development and adaptive behavior.
Of the 282 mothers who initiated ARVs with atazanavir during their first trimester, 30 percent switched to a different regimen before delivery compared to 22 percent of mothers who initiated ARVs during the second or third trimester. And the results showed infants scored about 3.4 points lower on language and 5.9 points lower on social-emotional development only when mothers initiated their regimen during the second and third trimester. However, adverse language effects seemed to be relevant regardless of when mothers initiated their chosen regimen, the authors wrote.
Study authors explained ARVs "must cross the placenta to impact fetal development, and must further penetrate the fetal blood-brain barrier to have an effect on neurodevelopment." Given that atazanavir has an especially "poor transplacental passed and low central nervous system penetration," authors said they were surprised to arrive at this conclusion.
"However, the development of the blood-brain barrier is a gradual process and its integrity can be compromised by inflammation, toxins, or maternal substance abuse, especially if exposure occurs during the early stages of development," the authors added. "Another possibility is that the effect of prenatal atazanavir exposure might be mediated by hyperbilirubinemia, which has been associated with increased risk of suboptimal developmental outcomes and hearing impairment, a risk factor for delays in language and social-emotional development."
That said, the authors acknowledged their study has several limitations, most notably that atazanavir is commonly prescribed in conjunction with another ARV, tenofovir (Truvada) — 75 percent of regimens included the two ARVs together. The combination made it hard to isolate atazanavir's effects, so authors can't say definitively if ARV regimens with atazavanir alone affect fetal development.
Extracted from http://journals.lww.com/aidsonline/Abstract/publishahead/Atazanavir_exposure_in_utero_and_neurodevelopment.97839.aspx



0ther links to articles and more HIV information

·  HIV/AIDS
27 November 2015 http://www.who.int/features/qa/71/en/index.html
http://www.who.int/features/2015/hiv-self-testing/en/index.html
22 July 2015
·  HIV prevention: offering hope to victims of sexual violence http://www.who.int/features/2014/pep-antiretrovirals/en/index.html
27 November 2014
·  Reaching those at high risk of HIV: how WHO learns from experiences on the ground
14 July 2014 http://www.who.int/features/2014/high-risk-hiv/en/index.html
·  Young people’s views guide WHO advice on HIV prevention and care for those most at risk
14 July 2014 http://www.who.int/features/2014/hiv-prevention/en/index.html

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