HIV – Rising menace

By Dr. Ananya Mandal, MDJul 20 2010

Babies in need of HIV prevention drug

Nevirapine is considered to be an effective drug that can prevent HIV infection in babies born to mothers with HIV. However a new study shows that only about half of babies born to mothers with HIV receive the drug. The study appeared in the July 21 HIV/AIDS themed issue of the Journal of the American Medical Association.

The study included mother and baby pairs from clinics in Cameroon, Ivory Coast, South Africa and Zambia and found that only around 51% received this minimal protection. The researchers also found that many HIV positive mothers who were prescribed Nevirapine before delivery did not have the drug in the samples of their umbilical cord blood.

Study author Dr. Elizabeth Stringer, an associate professor of obstetrics and gynecology at the University of Alabama at Birmingham said, “What this study shows us is that there are programmatic failures and common problems that occur along the path to mother-to-child transmission prevention.” These problems may range from low availability to failing to take medications and lack of HIV testing. She explained, “We know that true mother-to-child transmission prevention begins with HIV testing, with finding those who are infected and getting them into a program helps them adhere to the single-dose nevirapine and other care guidelines.”

Drug users in need of support to prevent HIV spread

In a proceeding at the 18^th world AIDS conference in Vienna, it was revealed that less than 10 percent of injecting drug users (IDUs) receives adequate support to prevent them from spreading HIV to others. The researchers found that of the nearly 16 million IDUs around the world, nearly three million are infected with HIV. This group is often marginalized and criminalized and this prompts them to turn to prostitution to feed their drug need. There is a lot of shared needles and this allows the disease to spread unwatched.

Louisa Degenhardt of the National Drug and Alcohol Research Centre at the University of New South Wales, Australia led a study where she found –

• Only five percent of all IDUs have actual access to a programme that allows them to exchange used syringes for sterile ones.
• Only eight percent IDUs use safer and more legal drugs like methadone.
• Only four percent of IDUs with HIV receive antiretroviral drugs. These drugs can also help preventing the spread of HIV if given in adequate doses.

When used together, these measures can prevent spread of the disease by more than 50%. According to UNAIDS statement last year, 19 percent of resources needed for preventing HIV should be earmarked for IDUs. Only one percent has actually been allocated.

The researchers also revealed at the conference the situation of pandemic of HIV/AIDS in the countries of the former Soviet bloc. There is a rise in drug use and prostitution in these countries. According to the UN agency UNAIDS, the HIV infected population has risen by two-thirds from 2001 to 2008 to reach 1.5 million. Two thirds of these live in Russia. 90% of the region’s infected population lives in Ukraine and Russia. Two thirds of the total 33 million HIV infected people reside in sub-Saharan Africa, where the pandemic is driven especially by sexual intercourse.