Today I helped provide a “VCT on campus” presentation for a graduate class and learned a few new things which got me thinking/writing…
- Before doctors put you on ARVs your CD4 count must drop below 200. This (I believe) is a WHO standard and based upon the rationale that giving ARVs too early increases the chances of poor adherence or viral resistance. However, what makes this interesting is that cost likely does factor in, even if it isn’t a blatant reason for setting the line at 200. Like many health care issues, health economics is absolutely necessary, but still, when there is the possibility that somebody is balancing human life/quality of life against monetary cost, I can’t help to feel a little uneasy. I don’t actually know how much cost does factor in, but I do wonder.
- I didn’t realize it, but today I found out that all pregnant women are required to undergo mandatory HIV testing. It’s such a double edged sword, because it is a descent (and common) means of calculating the national average, but seems like such an intense measure (i.e. an intrusion on individual rights not commonly tolerated in a country like Canada). What makes it particularly intense is that even if the pregnant woman doesn’t want to know her status she is still informed. Overall, it seems like an ‘efficient’ or necessary idea, but I can only imagine the stress of finding out you are HIV positive just as you begin your pregnancy.
- About a year ago two African trials proved that male circumcision can reduce HIV transmission by approximately 50%. This is huge (!) and certainly caused a major stir (although most people were skeptical as to where grown men could be convinced to undergo the procedure). Well well well, much to my surprise they are now offering the procedure in Zambian hospitals! When you get tested for HIV the counselor rattles off: abstain, be faithful, use condoms, oh, and if you’re not circumcised? You really ought to go get it done. It’s so commonplace now! Really, I’m thrilled to see such a quick translation of research into practice, and curious to see how successful the program actually is. Any volunteers? ;)
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1 comment:
no thanks :P
i sorta find those studies hard to believe, but i ain't no scientist. how can circumcision make a difference? there must be some logic to it but it doesn't make sense to me.
also, I imagine that limiting treatment until the count goes below 200 (you may have to explain what all that means to us layfolk) is most definitely a financial decision.
the WHO and other NGOs struggle to get enough money to fund HIV treatment in africa, any way they can save cash they'll take, even if it only means treating the most ill.
sad, but true.
I'm assuming, then, that you'll join my activism streak when you come home?
also, one more thing, are you guys going to travel around when the six months are up?
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