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Ask Dr G

Sunday, 22 May 2016 | MYT 9:43 AM

HIV and prevention

MAY 18th has been marked as the HIV Vaccine Awareness Day since 1997. This is the day that commemorates former US president Bill Clinton’s declaration that: “only a truly effective, preventive HIV vaccine can limit and eventually eliminate the threat of AIDS.”  

It is a tribute to recognise and thank the thousands of volunteers, community members, health professionals and scientists, who are working tirelessly in the quest for an effective HIV prevention.  

Despite the remarkable advances in the treatment of HIV in the last three decades, its prevention still remains a Holy Grail that seems so distant.  

Perhaps this is due to the lack of investment and innovation in HIV prevention research as a mere 3% of the research funding is allocated for it.  

This week, we answer the key questions of the risk of living with a partner with HIV and the hope of prevention.  

Dear Dr G,  

I am a 28-year-old woman and would like to be anonymous for obvious reasons.  

My fiancé and I have been engaged for more than one year and are planning to get married in August.  

Although we have already started intimacy, we have always been careful to avoid pregnancy.  

After we decided to get married, my fiancé and I went for a medical check up. 

I was shocked when I discovered that my fiancé's blood test turned out to be positive for HIV. We are both devastated.  

Although I was tested negative, I am extremely worried. I wonder how safe is condom to protect me from the virus?  

I also would like to know whether there is a chance for us to have a child in the future without the infection?  

I also heard about medications to protect me from the virus, how safe is it?  

And lastly, I heard there was suppose to be a vaccine for HIV. Is it available in the market?  

I am desperate. Please help.  

Regards

 

In the United States, there are approximately 1.2 million people living with HIV and another 50,000 are infected each year. Worldwide, AIDS has killed nearly 39 million people since the epidemic began.  

It is also estimated that 37 million people are living with HIV infection. Despite improved access to antiviral treatment in many regions, AIDS still claims about two million lives each year.  

The use of condom is predominantly a protective measure to prevent the spread of HIV. This barrier technique is also effective at preventing other sexually transmitted infections such as gonorrhea and chlamydia.  

Although highly effective, when used consistently and correctly, there is still a minimal chance of getting HIV. Therefore, adding other preventive measures may further reduce the risk of infection.   

“PrEP” stands for Pre Exposure Prophylaxis. This is a way for a person who does not have HIV, but is at high risk of getting it from an infected partner, to be protected through medication.  

The pill contains two antiviral medications that are used in the treatment of HIV. 

In recent years, one of the scientific breakthroughs in the treatment of HIV is demonstrating PrEP to be a powerful tool that has the protective effect of up to 90%.  

It is also revealed that PrEP is demonstrated to reduce the risk of transmission of the HIV virus to a child.  

In 2009, during the experimental vaccine regime tested in Thailand, the R144 trial was found to have 60% effectiveness in preventing HIV infection in the first year.  

Sadly, such efficacy had declined to 31.2 by the fourth year. Seven years after the initial trial, the new vaccine trial is planned to begin in South Africa this year.  

This intervention has been adjusted to try to increase the magnitude of protection and duration of vaccine elicited immune responses, especially in the South African population, where the virus is more pervasive than anywhere else in the world.  

An estimated 26% of all the new HIV cases occur among young people aged 13 to 24 following a recent statistic showing an increase of 10% per year in this age group. 

Although the optimism for a new HIV vaccine is diminishing, the quest for it should be pursued to protect the younger generation.

 

 

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