HIV in few words
I haven’t really explained anything about HIV yet so I am going to run through some of the basics that I have learned since participating in this programme. HIV (Human Immunodeficiency Virus) is a virus that results in the progressive deterioration of the immune system. A person is diagnosed with AIDS when their immune system is too weak to fight off infections. Being HIV positive or having the HIV virus is not the same as having AIDS. Many people with HIV do not get sick for many years. Over the years HIV weakens the immune system to a point where it can no longer fight off infection. In developed countries this can take more than 10 years and depends on many other health factors such as adequate nutrition. The infections associated with AIDS are called opportunistic because they take advantage of the bodies weakened immune system. It is the opportunistic infection, not AIDS that causes death.
The cell that HIV targets are called the CD4 cells. Once HIV enters the cell it goes through a series of steps before the new HI viruses are produced. Each type of ARV (antiretroviral) works at a different step of the HIV cycle. When a person tests positive for HIV a CD4 test is carried out to see what stage the virus is at in the body. Once a persons CD4 count falls at or below 350, the person is then put on ARVs. When a person starts on the ART it must be continued at regular 12 hour intervals for the rest of their lives. A baby or child diagnosed positive starts on anti- retroviral therapy straight away regardless of their CD4 count. The CD4 test measures the number of CD4 cells(in a cubic millimetre of blood). Someone who is HIV negative has between 500 and 1200 cells per mm cubed. The goals of the ARVs is to ensure maximum and long lasting control of the amount of HIV in your body, to restore and protect the immune functioning of the body by allowing the CD4 cells to replenish their numbers, to reduce HIV related illnesses and deaths and to generally improve the quality of life. At the moment only about 37% of people have access to ARVs in Sub Saharan Africa.
We attended a two day course in Stellenbosch University last weekend where we learned some interesting facts about HIV here in South Africa. The HIV prevalence rate here is 10.9%. This is the average rate and varies significantly in the different areas of South Africa. This rate was concluded from the South Africa National HIV prevalence incidence, behaviour and communication household survey carried out in 2008. The results of the 2012 survey have not been released yet. On average the female testing rates are about 70%, which means there are a lot of men who are not getting tested. The PMTC (prevention from mother to child transmission) treatment has an 80% coverage and if you have a sexually transmitted infection it increases your chances of contracting HIV by 10-15%. In 2010 a HIV and Syphilis prevalence survey was carried out. The sample only included pregnant ladies attending clinics. The results varied depending on what areas the ladies were from. In the Eastern Cape the prevalence rate was 29.9%, North/Western Cape was 18.5% and the Kwazulu Natal region had a prevalence rate of 39.5%. This means that 39.5% of the women tested in this region tested positive for HIV. Overall 30% of pregnant women in South Africa were HIV positive. The facilitator also mentioned that, similar to Ireland, there has been an increase in older women testing positive. Most of the previous campaigns here targeted the 15- 24 year olds so clearly new interventions are needed. Some of the drivers of HIV include, age mixing (inter-generational sex) concurrency and transactional sex. Three groups were identified as very high risk; these include MSM (men who have sex with men - this is a behavioural term, not an identity) IDUs and casual sex workers. These are also the high risk groups in Ireland. I also never realized that unprotected sex between 2 HIV positive people is not risk free, there are many different strains of HIV and it is possible to become infected with more than one type which can complicate treatment.