Tagged: HIV/AIDS

  • What does it take to control an epidemic? Learning from Thailand’s experience

    Earlier this summer, the HIV/AIDS effort achieved a notable accomplishment that the rest of the public health community may have overlooked, missing an important learning opportunity. In June, the World Health Organization certified that Thailand achieved what was inconceivable just 20 years ago: elimination of mother-to-child transmission of HIV. Thailand is the first country with a generalized HIV epidemic to achieve this milestone, one that is crucial to epidemic control.

    Two decades ago, the HIV epidemic was expanding in Thailand. Use of antiretroviral drugs to prevent mother-to-child HIV transmission was an expensive, newly discovered intervention that had barely been implemented in areas of the world where resources were limited and the disease burden was greatest.

    Despite these challenges, only 85 children were born with HIV infection in Thailand in 2015, compared to 1,000 children in 2000. This remarkable achievement resulted from a combination of essential factors:

    • Strong national leadership
    • A solid, functional health care system
    • A commitment to extending health care services to all people in the country, including undocumented individuals

    Continue reading

  • A world without AIDS? A promising approach is bringing Vietnam closer

    For those of us who work in the field of HIV, words like “eradication” or “elimination” are not commonly used. Yet, new evidence and tools suggest that getting to zero might just be possible if we look at HIV through a fresh lens and focus our limited resources in strategic ways. As World AIDS Day nears, an example in Vietnam shows one promising approach.

    Vietnam is at a tipping point. The country is working hard to scale up methadone maintenance treatment for injecting drug users and to provide antiretroviral (ARV) treatment for those living with HIV. External resources, however, are declining and every dollar (or Vietnamese dong (VND)) makes a difference. The cascade of HIV care — an approach that links prevention outreach, testing and treatment services across a continuum of care — helps identify the key opportunities to improve services to stop the spread of HIV. This tool has come to Vietnam at a critical time. Vietnam’s HIV epidemic is still in a concentrated phase, with the highest seroprevalence among populations at higher risk. These include injecting drug users, female sex workers and men who have sex with men.

    Using the cascade — in every facility, commune, district and province — helps Vietnam monitor HIV service system performance and focus its remaining human, financial and programmatic resources on the ultimate aim of the HIV response: viral suppression. The cascade approach identifies “leaks” in the system to target resources on interventions that diagnose people with HIV, initiate ARV treatment quickly and sustain those individuals with continued care. Knowing where the drop-offs are most pronounced can assist decision makers and service providers in implementing system improvements and service enhancements that make the greatest impact on individuals, communities and Vietnamese society.

    Continue reading

  • Partner reduction to avoid HIV risk is the focus for a new publication

    Promoting Partner Reduction title page

    Having multiple sexual partners, particularly when relationships overlap in time, is a major driver of the HIV epidemic. Overlapping, or concurrent, relationships increase the number of people who are connected in a “sexual network,” and HIV spreads more quickly the larger the sexual network. Although young people report having multiple sexual partners, few HIV prevention programs for youth tackle this topic.

    FHI 360, on behalf of USAID’s Interagency Youth Working Group, recently helped address this gap with a new publication, Promoting Partner Reduction: Helping Young People Understand and Avoid HIV Risks from Multiple Partnerships. The late Dr. Doug Kirby of ETR Associates was a major contributor.

    Continue reading