HIV/AIDS Project
By the end of 2007, there were over 33 million people living with HIV, with more than two million deaths in that year alone. Africa bears the brunt of these deaths and new infections, and is home to over 2/3 of the global caseload. In much of the southern tip of the continent, one in three adults is HIV positive. The HIV/AIDS Project at the Center for Global Health and Economic Development assists in building clinics where there are none, hiring nurses and doctors to staff them where needed, and introducing comprehensive HIV/AIDS prevention, care and support services.
HIV/AIDS in the Millennium Villages
All MVP sites offer the following core services for HIV/AIDS, focusing primarily on decentralizing services and bringing them closer to the client:
- Improved access to condoms and family planning services. Access to these services promote prevention of HIV infection in order to increase a woman’s control over her reproductive health.
- Household and community-level HIV education and awareness campaigns. In countries like Uganda, developing "social movements" against HIV/AIDS has played a major role in HIV infection levels, decreasing from 30% to less than 10% over the past decade.
- Access to Voluntary Counseling and Testing (VCT) using rapid tests that provide accurate results in 5 minutes. HIV testing is an entry point for accessing care, and in many settings, has been shown to raise awareness and help to prevent new infections. Efforts to expand access to VCT services to the household level have taken place in Kenya and Senegal through a home-based counseling and testing initiative.
- Prevention of mother-to-child transmission services. In partnership with UNAIDS, an initiative is underway to make all Millennium Village sites ‘MTCT free zones’ – where vertical transmission of HIV is largely eliminated. Efforts have been made in all sites to ensure HIV testing is routine during pregnancy. Among pregnant women testing HIV positive, combination antiretroviral therapy can reduce transmission rates from a mother to her unborn child from 33% to under 5%. Introducing these services at the primary care level has become a cornerstone of the PMTCT program in high HIV prevalence settings.
- Access to combination antiretroviral therapy for those with advanced stage HIV. These medications have been shown to be safe and effective in Africa, leading to fewer hospitalizations and a longer life for those living with the disease. Adherence to ARV is a community effort. In the context of the MVP, ARV treatment starts in sub-district hospitals. Follow-up is carried out at the local clinic and compliance is checked at the household level by the Village Community Health Workers. Levels of ARV uptake has been extremely high (above 80%) and large portions of the cluster population now know their HIV status. However, more work needs to be done to ensure all adults know their HIV status, and that eligible HIV positive adults are accessing ARV treatment.
With this package of services, CGHED’s HIV/AIDS project joins the international effort to significantly reduce incidence and prevalence of HIV in Africa in working to accelerate progress towards MDG6.