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Four things we need to do to stop the spread of HIV in young women

Professor Salim Abdool Karim is a rockstar epidemiologist and infectious diseases specialist. We spoke to him to find out what the global community must do to reduce the rate of HIV infections in young women.

1. Promote the ABCs of condom use
The first thing that needs to be done is to teach people the ABCs of condom use, especially young people in schools. While this is being done, treatment needs to be scaled up by having everyone tested and treated. According to UNAIDS, globally, only three in 10 adolescent girls and young women (between the ages of 15 and 24 years) have correct and comprehensive knowledge about HIV. This is why it’s important to teach young women about the use of condoms and HIV.

HIV 11 SMC

2. Using circumcision to prevent men from acquiring HIV
Young women have the highest rates of HIV infections in Eastern and Southern Africa. The reason for this is because a large number of young women, teenagers and women in their early 20s, are getting infected by men in their 30s. These men get infected with HIV but they don’t know they have it, so they go on to expose young women. This is why circumcision needs to be encouraged to prevent men from getting HIV in the first place.

3. Roll out PrEP
PrEP, or Pre-Exposure Prophylaxis, is anti-HIV medication that helps keep people who are HIV negative from becoming infected. It is important that this is given to young women to curb the spread of infection. Recent statistics from UNAIDS show that 2014, only 57% of countries (of 104 countries) had an HIV strategy that included a budget specifically for women. This means that, globally, many women did not have access to this kind of preventative treatment.

AIDS2016 SMC 64. Link PrEP to sexual and reproductive health services
If we’re going to start young women on PrEP then we also need to link it to sexual and reproductive health services. This is because if a woman has bacterial vaginosis (BV), then PrEP won’t be as effective. BV is vaginal discharge that results from an overgrowth of atypical bacteria in the vagina. The test for the bacteria is a simple PH test that can be done at any clinic, and BV can be treated with tablets or gel. If women know to test for this before they start on PrEP, it won’t cut down on the efficacy of the PrEP treatment.

Prof Abdool Karim says that if we don’t take these measures, women, especially those in rural areas, will die. We all need to do what it takes to provide treatment to women, and he believes his role is to show what will work and how to do it.

Featured image courtesy of the International AIDS Society/Steve Forrest/Workers’ Photos

 

1 Comment
  1. Ronald Goldman, Ph.D. says

    Claiming that circumcision prevents a health problem is a compulsion of circumcised men to have done to others what was done to them. Historically, this compulsion has led to over 200 potential health claims for circumcision. All have been refuted. Thirteen national and international organizations recommend against circumcision.

    Many professionals have criticized the studies claiming that circumcision reduces HIV transmission. The investigators did not seek to determine the source of the HIV infections during their studies. They assumed all infections were heterosexually transmitted.

    Many HIV infections in Africa are transmitted by contaminated injections and surgical procedures. The absolute rate of HIV transmission reduction is only 1.3%, not the claimed 60%. Even if the claim were true, based on the studies, about 60 men had to be circumcised to prevent one HIV infection.

    Authorities that cite the studies have other agendas including political and financial. All other national and international organizations that have positions on circumcision oppose it. Research shows that circumcision causes physical, sexual, and psychological harm, reducing the sexual pleasure of both partners. This harm is ignored by circumcision advocates. Other methods to prevent HIV transmission (e.g., condoms and sterilizing medical instruments) are much more effective, much cheaper, and much less invasive. Even HIV/circumcision studies advise using condoms. With condoms circumcision adds no benefit to HIV prevention.

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