Palliative care and HIV: Prevention, care – or both?

Categories: Care.

According to the U.S. President’s Emergency Plan (PEPFAR) latest global results, the AIDS epidemic is becoming controlled in a number of key African countries, namely: Malawi, Zambia, and Zimbabwe. 

PEPFAR’s recent population-based HIV Impact Assessments showed a validated decline in infection rates in adult HIV incidence of (51-76%) in these three African countries.

Even so, according to a report in Uganda’s Daily Monitor newspaper, “progress on prevention has stagnated” — an issue that Dr Emmanuel Luyirika, Executive Director of the African Palliative Care Association, emphasises as requiring attention from the palliative care community in Africa, and globally. 

For palliative care providers in Africa, Dr Luyirika highlights the two-pronged approach of care and prevention: 

“As we celebrate World AIDS Day, palliative care providers need to be aware of their role in care. But also the prevention responsibility that comes with HIV,” Dr Luyirika noted. 

Globally, 18.2 million people are on antiretroviral treatment, however young women between 15-24 years are at a higher risk of becoming infected with HIV due to low rates of testing, and difficulty accessing and staying on treatment, according to a video statement by UNAIDS Executive Director, Michele Sidibe’. 

While prevention should be central to treatment, Mr Sidibe’ noted in the video report, it should not be working against treatment.

The recent UNAIDS report Get on the Fast-Track: The Life Cycle Approach to HIV also warns of the risk of drug resistance and the need to reduce the costs of second- and third-line treatments. 

The statement also highlights the need for more synergies with tuberculosis (TB), human papillomavirus (HPV) and cervical cancer, and hepatitis C programmes in order to reduce the major causes of illness and death among people living with HIV.

In 2015, 400 000 of the 1.1 million people who died from an AIDS-related illness died from TB, including 40 000 children, according to a UNAIDS press statement

“We cannot care for HIV patients without addressing the disease prevention needs of the family for HIV itself, TB and other opportunistic infections,” Dr Luyirika said. 

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