Blunting of AIDS epidemic: It’s time for zero-complacency and stronger action
India too has bent the HIV curve but challenges remain. Are we at the milestone of blunting the AIDS epidemic?
India too has bent the HIV curve but challenges remain. Are we at the milestone of blunting the AIDS epidemic?
Article based on an interview with Dr Glory Alexander who has dedicated her life to helping HIV-positive pregnant women deliver HIV-negative babies and taking care of people living with HIV.
According to the article published in The Lancet last year, “transgender-specific data could benefit efforts in Asia to identify gaps in HIV response for transgender people.” Despite alarming evidence of high HIV incidence among key affected populations, such as transgender people, transgender-specific data related to the HIV care cascade are scarce (and often merged with data for gay and other men who have sex with men). Countries like Thailand, Cambodia, and Malaysia, that have used integrated biological and behavioural surveillance, show an increase in HIV prevalence among transgender people. While countries improve data on the full range of HIV care cascade for key populations, people themselves are rising up to improve responses from the ground up. Transgender people in Thailand have led by example in demonstrating leadership in setting up gender-affirming healthcare services for their communities – the first of its kind in the entire Asia Pacific region. Ahead of the 24th International AIDS Conference (AIDS 2022), CNS (Citizen News Service) spoke to one of the featured plenary speakers of the conference, Rena Janamnuaysook, who is one of the co-founders of Thai Transgender Alliance, the first transgender-owned human rights organisation in Thailand. Who is Rena Janamnuaysook? Rena Janamnuaysook is a transgender woman advocate. She works as a program manager for transgender health at the Institute of HIV Research and Innovation (IHRI) in Bangkok, Thailand, where she established the Tangerine Community Health Clinic as the first transgender-led health clinic in the region. Rena is also credited to have established the Tangerine Community Health Clinic, the first transgender-led health clinic in the Asia Pacific region. Gender-affirming care for transgender populations in Asian countries “Currently, in Thailand, like in many other Asian countries, gender-affirming care for transgender populations has not yet been supported or subsidised under universal health coverage. But since the past five years we have been actively working closely with the Thai Ministry of Public Health and the National Health Security Office to include gender-affirming care for transgender populations in the universal health coverage,” said Rena, who also serves as Programme Manager for Transgender Health at the Institute of HIV Research…
This is an old adage that signifies the importance of taking precautionary steps to prevent a problem from happening rather than fixing it after it occurs. It is a fundamental principle of healthcare to avoid/reduce the occurrence of any disease. Prevention is especially crucial to control the spread of infectious diseases, be they COVID-19, TB or HIV/AIDS. Unless we break the chain of transmission we will not be able to prevent new infections from occurring and we will not be able to #endTB or #endAIDS by 2030. This message was clearly brought out during the recently concluded 13th National Conference of AIDS Society of India (ASICON) under the theme of “Confronting pandemics with Proficiency, Precision and Persistence.” According to Dr Dilip Mathai, Dean and Professor of Medicine at Apollo Institute of Medical Sciences and Research, Hyderabad, “We have preventive measures, including vaccines, and yet we are failing on primary prevention to break the chain of transmission of many infectious diseases. We are even failing to roll out the existing 19 vaccines against a host of diseases in the elderly. Unless we increase the healthcare spend, we will not be able to improve the health of our people”. In the case of HIV/AIDS, 1.5 million people globally, became newly infected with the human immunodeficiency virus (HIV) in 2020. 100,000 of these infections occurred in South East Asia, out of which 69220 (69%) were in India alone. With an estimated 2.35 million of its people infected with this virus, India bears the second-highest burden of people living with HIV in the world (after South Africa) and the highest burden of the disease in South East Asia. Although India’s National AIDS Control Programme has made tremendous progress in bringing about a reduction of 66% in AIDS-related deaths and a 37% reduction in yearly new infections as compared to 2010, we are still lagging behind in achieving the global UNAIDS 90-90-90 targets for 2020. With 190 new HIV infections occurring every day (or 8 new infections occurring every hour) in India, we do not seem to be doing very well in preventing the spread…
Washington DC. 26th May 2020. In a new study, an alternative treatment regimen that is less toxic than standard dose-intensive chemotherapy was found to be highly effective for adults with Burkitt lymphoma across all age groups and independent of HIV status. In addition to being better tolerated, the regimen, called dose-adjusted (DA) EPOCH-R, is already an option for diffuse large B-cell lymphomas and can be administered in an outpatient setting. The findings were published May 26, 2020, in the Journal of Clinical Oncology. The study was led by researchers in the Center for Cancer Research at the National Cancer Institute (NCI), part of the National Institutes of Health, and sponsored by NCI’s Cancer Therapy Evaluation Program. It was conducted at 22 research centres across the country. The DA-EPOCH-R regimen was originally developed by NCI researchers led by Wyndham Wilson, M.D., Ph.D., at the NIH Clinical Center in Bethesda, Maryland. “We knew Burkitt lymphoma is curable with dose-intensive chemotherapy, but that treatment can be acutely toxic for adult patients,” said Mark Roschewski, M.D., of NCI’s Lymphoid Malignancies Branch, who was one of the lead authors on the study. “With this finding, we not only have a potentially curative treatment option for these patients that are less toxic, but one that appears effective for most adults, including elderly patients and those with HIV and other comorbidities who might not be able to receive standard treatment.” Burkitt lymphoma is a rare but aggressive B-cell lymphoma that is more common in children than adults. The dose-intensive chemotherapy that’s been developed to cure Burkitt lymphoma in pediatric patients is much better tolerated by children than adults, who can have severe side effects, especially if they are older or have other serious health conditions, such as being infected with HIV. People living with HIV/AIDS have an increased risk for Burkitt lymphoma. NCI researchers have tested several approaches to determine whether less toxic treatments could still be effective for Burkitt lymphoma in adults. In an earlier pilot study with 30 adult patients treated only at NCI, the DA-EPOCH-R chemotherapy regimen was effective. The DA-EPOCH-R regimen is tailored…
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