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Da finden wir alte Bi Tri- mann und Wagner sind hier vertreten. The value of Assimilation present in white European society aids prevention and control essay contest the time the play is aids prevention and control essay contest is both revealed and challenged through the way that character Billy Kimberley is marginalised and considered Other by both cultural groups. Chemoprophylaxis in exposed, uninfected people may reduce transmission. In addition, availability of treatment may destigmatize the disease and make prevention programs more effective Castro and Farmer However, these benefits in relation to reduced transmission may be offset by a "disinhibition" of risk behavior that is associated with greater availability of antiretroviral therapy, by the spread of drug-resistant HIV, or by increases in the incidence of exposure to partners with HIV infection because of increased survival.
These sometimes opposing effects of offering therapy may differ to such a degree that the net effects of widespread therapy on transmission rates may vary among risk groups and across geographic regions. Table The information in the table suggests that widespread therapy using currently available combination regimens will provide a net benefit in relation to the transmission of HIV.
However, because confidence in this prediction is not high, the population consequences of therapy programs must be evaluated and monitored with active surveillance of prescribing patterns, sexual risk behavior, STI prevalence, HIV incidence and prevalence, and prevalence of primary drug resistance and sexual networks of risk behavior. Effect of Antiretroviral Therapy on Transmission Dynamics.
Until relatively recently, the majority of HIV clinical care in resource-limited countries was confined to managing the terminal stage of infection, including extremely late diagnosis of opportunistic infections and cancers, use of basic palliative symptom management, and short-term hospitalization just before death.
Few people were aware of their HIV status until the onset of severe HIV-associated illness, and most did not seek help from the health care system until they were already terminally ill. The advent of primary prophylaxis and treatment for opportunistic infections, including tuberculosis, prolonged survival to a limited extent but did nothing to restore immune function.
Such restoration was not possible until the advent of antiretroviral therapy. Because clinical intervention in HIV is so recent in resource-limited settings, few cost-effectiveness studies are available.
Those that are available on the treatment of and prophylaxis for opportunistic infections were largely conducted before the availability of antiretroviral therapy and therefore need to be reestimated to be relevant for decision making today. Fortunately, because the determinants of biological responses are better conserved across countries and cultural settings than the determinants of behavior, effectiveness data from high-income countries can help inform decisions about treatment in resource-limited settings.
Unlike drugs for many other high-burden health conditions in developing countries, antiretroviral therapy for HIV and drugs for some of its associated opportunistic infections depend on medications that are still under patent protection. Nevertheless, generic drug makers in India and Thailand have produced a range of effective antiretroviral therapies that combine multiple drugs into single tablets and reduce the pill burden to one tablet twice daily.
A World Trade Organization decision also made it easier for low- and middle-income countries LMICs to import cheaper generics made under compulsory licensing if the countries are unable to manufacture the medicines themselves WTO As a result, some countries, including Brazil, India, and Thailand, have begun to produce generic versions of antiretroviral drugs to be sold at greatly reduced prices. The TRIPS provision has also improved developing countries' bargaining power with large pharmaceutical companies, to the point that some countries have been able to secure drugs from the original manufacturers at substantially reduced prices.
As a result, the relative cost-effectiveness of different drug combinations has been in rapid flux, increasing the importance of updating recommendations frequently. Infection is diagnosed in two ways: by a biological test that detects the presence of HIV antibodies or by diagnosis of an opportunistic infection that is a clear sign of HIV disease.
The most widely used biological test in high-income countries, conducted in a laboratory on a blood sample, is called an ELISA enzyme-linked immunosorbent assay. Obtaining a result may take several days. Rapid tests that can provide results in 20 minutes are being used more widely as their costs fall.
However, in a high-prevalence environment where the prior probability is high and resources are scarce, such an approach is almost certainly not cost-effective. Each additional confirmatory test decreases the number of false positive results, thereby averting the costs associated with such a result.
These results suggest that LMICs should not use a second confirmatory test unless the prevalence among patients is extremely low. Palliative Care Palliative care has traditionally focused on patients in the terminal stages of disease. More recent definitions of palliative care, including WHO's definition, have been broadened to encompass quality-of-life issues of patients and their families throughout the course of a life-threatening illness WHO b. The control of pain and other symptoms is the crux of any palliative care model, but the WHO model also addresses patients' and their families' psychological, social, and spiritual problems.
In the face of a growing epidemic of historic dimensions, the provision of comprehensive palliative care represents a critical, but neglected, global priority. Health care professionals have promoted community home-based care as an affordable way to expand the coverage of palliative care Hansen and others , but the great heterogeneity among home-based care programs complicates comparisons. Most programs for which data are available are community-based outreach programs administered by local clinics or hospitals.
These programs can consist of simple home visits to provide basic care for AIDS patients or may be comprehensive schemes that provide care, palliative medications, meals, psychosocial support and counseling, and links to primary and secondary health care. Although a Zimbabwe study found that home visits were associated with extensive travel time and costs Hansen and others , little research has examined the extent to which home-based care can be used to substitute for hospitalization, nor is evidence available to determine the most cost-effective combination of palliative care strategies.
In one South African study, primary care clinic and hospital costs accounted for 39 and 18 percent, respectively, of the costs of care in the last year of life, whereas community home-based care accounted for 42 percent Uys and Hensher Higginson and others' meta-analysis concludes that overall evidence demonstrates a positive effect of home-based palliative care, especially its effect on pain management and symptom control.
Available data do not permit estimating a cost per DALY of community-based palliative care programs, but a review of available studies suggests that palliative care provided by health professionals in the home is unlikely to be cost-effective in low-income countries.
However, low-cost, community-based models have been developed that require minimal external resources and function almost like care cooperatives among affected households. These models are likely to be highly cost-effective. Diarrhea, nausea, vomiting, and skin problems are all symptoms that are targeted for treatment in palliative care. Oral rehydration for diarrheal treatment costs pennies per episode.
Approximately 90 percent of people with HIV suffer from some form of skin condition. These conditions include infections, drug reactions, scabies, pressure sores, and cancers. Skin often becomes dry in the middle and late stages of AIDS because of dehydration caused by persistent diarrhea, vomiting, and malabsorption. No estimates are available on the benefits of providing such care in terms of DALYs, especially to terminally ill patients. Psychosocial Support Psychosocial support is an integral component of the multidisciplinary management strategies that care providers regard as essential for people with HIV Murphy and others Support for patients and families can have a positive effect on adherence to therapies and can contribute to the critical aim of integrating prevention with treatment and care.
Cook's study of U. Although few data are available on the costs of various strategies, interventions for psychosocial support appear to be cost-effective—especially where innovative solutions, such as group counseling sessions, are implemented.
Although studies indicate an improved quality of life for these patients, little information is available on the cost of the interventions. Additional evaluation research is needed to guide decisions about how much to invest in psychosocial support. Nutrition Programs and Food Security Strong evidence indicates that malnutrition and AIDS work in tandem at both the individual and the societal levels.
This reciprocity must be considered when planning specific program responses. Protein deficiency is a well-known cause of cell-mediated immunodeficiency Vanek HIV-infected individuals need to consume more energy than uninfected individuals: as much as 10 percent greater consumption for asymptomatic individuals and 20 to 30 percent more for symptomatic individuals.
Malnutrition alters the susceptibility of individuals to HIV infection and their vulnerability to its various sequelae, increases the risk of HIV transmission from mothers to babies, and accelerates the progression of HIV infection Gillespie, Haddad, and Jackson Small studies of adults with AIDS, including those on anti-retroviral therapy, have shown that daily micronutrient supplementation increases bodyweight, reduces HIV RNA levels, improves CD4 counts, and reduces the incidence of opportunistic infections.
The guidelines cite three types of nutrition supplements: food rations to manage mild weight loss and nutrition-related side effects of antiretroviral therapy and to address nutritional needs in food-secure areas; micronutrient supplements for specific HIV-positive risk groups; and therapeutic foods for addressing moderate and severe malnutrition in HIV-positive adults and children. Cost-effectiveness data in support of these recommendations are not available, but the low costs of supplementation, coupled with the likely benefits to other malnourished household members, suggest that such interventions will be highly cost-effective.
The epidemic is stunting progress in rural development and causing significant increases in rural poverty and destitution in the countries most affected by the epidemic Bonnard Thus, interventions must consider the epidemic's impact on the broader community and not solely on people living with the disease. Care-related household and community-level interventions include school feeding with special take-home rations for families caring for orphans, food for training programs that promote income-generating activities, and food for work to support homestead production activities Van Liere Such programs targeted at communities at especially high risk are likely to be even more cost-effective World Food Programme Treatment of Opportunistic Infections and Secondary Prophylaxis Even as the availability of antiretroviral therapy increases in many developing countries, appropriate diagnosis and management of life-threatening opportunistic infections, including HIV-associated cancers, remain the most important aspects of the care of patients with HIV disease.
Opportunistic infections usually begin five to seven years after infection Munoz, Sabin, and Phillips and occur progressively as uncontrolled HIV replication destroys the immune system Colebunders and Latif Figure They are organized around the pursuit of sex Seidman, Fischer, and Meeks This is not happening on one state, but it is happening in every state and country you could name.
It has been a major cause of death in the world, which results in the situation becoming a public health concern. It poses a risk to future generations. The disease has been plaguing South Africa as well as other countries throughout the continent. The initialism HIV stands for human immunodeficiency virus. This disease attacks and destroys the infection-fighting CD4 cells of the immune system. Loss of these cells makes it difficult for the body to fight infections.
We hear about its ravages on young men and women; on the gay and transgender populations; on the homeless and the intravenous drug user. The most common method to become infected is through anal or vaginal sex without a condom HIV and Aids. Of those 33 million, 1. HIV is the acronym for human immunodeficiency virus and it causes the immune system to become weak. As a result, this causes the body to be terrible at protecting itself against diseases and other viruses.
HIV causes damage by harming the immune cells in the body. AIDS is caused by the Human Immunodeficiency Virus HIV , which weakens a person 's immune system causing them to be more susceptible to infectious diseases such as meningitis, pneumonia, the flu, and many other diseases. These diseases attack the immune system making them incapable of fighting off diseases.
Specifically, HIV,human immunodeficiency virus, attacks the immune system, weakening it, and slowly making it produce more HIV-cells. Proved to be originally from Sub Saharan Africa S. Africa, but it eventually becomes the global disaster in the late 20th century Gus. They later found out that the disease was transmitted to humans and created into HIV when people hunted these animals for food and came in contact with their infected blood. It originated from a chimpanzee and was likely transmitted to humans when the chimpanzee was hunted down for food and the hunters came into contact with the infected blood.
This is a result of unprotected sex, ignorance and the reluctancy to get tested and treated. Many Bahamians engage in sexual intercourse without the use of contraceptives.
Ignorant to the dangers of AIDS, they believe that nothing will happen. When and if there is a slight belief that one is infected with AIDS, Bahamians tend to hesitate to get tested or treated because of appearances.
As of , approximately 34 million people have contracted HIV globally. Remember the Human It can seem easy to get away with moral and ethical essay competitions in ghana or with law-breaking online.