SOUTH AFRICA: Experts recommend HIV/AIDS prevention in treatment expansion

JOHANNESBURG, 23 Feb 2005 (PLUSNEWS) - Although South Africa has been widely criticised for its slow rollout of anti-AIDS drugs, experts believe this presents a "unique" opportunity for government and organisations to implement HIV prevention strategies.

In their latest report, 'HIV Prevention in the Era of Expanded Treatment', the Global HIV Prevention Working Group, a panel of experts convened by the Bill and Melinda Gates Foundation and the Henry J Kaiser Family Foundation, warns that in the absence of prevention interventions, the rapid expansion of antiretroviral (ARV) treatment could fuel the pandemic.

Drawing on the experience of industrialised nations, the group argues that readily available treatments usually also lead to increased risky sexual behaviour, as people become more complacent about the dangers of infection.

"In addition, because ARVs can significantly increase the longevity and health of people living with HIV, the number of opportunities for transmission to occur can also increase," the report pointed out.

However, with an estimated 5.3 million South Africans, or one in five adults, living with the virus, the AIDS lobby group, Treatment Action Campaign (TAC), maintains that not enough is being done by the government.

The group accuses the government of being "asleep on HIV/AIDS", since only 30,000 people are currently accessing medication - far short of the official target of having 53,000 people on antiretroviral therapy (ART) by March 2005.

As activists continue their struggle for the rapid provision of free ARVs in developing countries, experts stress that prevention and treatment complement each other.

"Unless the incidence of HIV is sharply reduced, HIV treatment will not be able to keep pace with all those who will need therapy. For example, while the WHO/UNAIDS '3 by 5' initiative establishes the goal of having 3 million people on ART by 2005, 5 million new infections occur every year," said the working group's report.

However, the South African government is satisfied with progress in implementing its national comprehensive HIV and AIDS strategy, which began last year.

"We continue with our prevention campaign by encouraging abstinence, being faithful and using condoms. The distribution of condoms rose from an average of 17 million a month to 36 million a month [during the past year]," the Ministry of Health said in a recent statement.

Nevertheless, the report estimates that fewer than one in five people worldwide are currently able to access proven prevention initiatives, such as condom promotion campaigns and voluntary counselling and testing, and access to anti-AIDS drugs in developing countries is even lower, with treatment available to only 7 percent of people.

This represents an ideal environment for implementing the recommended prevention strategies, and an aggressive expansion of both treatment and prevention programmes is urged in order to achieve a "truly comprehensive approach" to tackling the pandemic.

"The [developing] world has a unique opportunity, as ARV programmes are launched and expanded, to simultaneously bolster prevention efforts. If we fail to act now to expand access to HIV prevention during this critical time of growing ARV access, we could repeat the mistakes of the industrialised world," the report cautioned.

Access the complete report at: www.kff.org

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