Tuesday, January 17, 2023
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Are we close to controlling HIV in Ethiopia?

HIV/AIDS has been a major concern in worldwide public health since the 1970s. Global partners and states have dedicated substantial resources to the fight against the epidemic, which requires an abundance of financial resources, tactics, programs, and personnel. Numerous experts, models, ideas, frameworks, and techniques evolved concurrently and continue to be utilized.

The World Health Organization recently unveiled a new plan entitled “Global Health Sector Strategies on HIV, Viral Hepatitis, and Sexually Transmitted Infections for the Period 2022–2030” under the motto “Ending Epidemics in a New Global Health Era.” As a result of HIV/AIDS global programs, global data sharing, advancements in monitoring, research, human development, specialties, vast breakthroughs, and technology have all been realized.

The manufacture of illicit substances also increased. Also on the rise was opposition to ART. HIV/AIDS programs were required to incorporate social, economic, and spiritual support in addition to clinical and community surveillance. Between these dates, 73 million people were infected with HIV/AIDS. According to the most recent WHO study, 38.4 million persons worldwide are HIV-positive. HIV/AIDS is estimated to have killed between 33 and 48 million people worldwide.

In 2021, between 500,000 and 850,000 individuals died from HIV-related causes, and between 1.1 and 2 million will contract the infectioYetn.Y However, globally and locally, HIV/AIDS-related morbidity and mortality have dropped dramatically as a result of the several effective and cutting-edge therapies currently accessible.  In addition, the fields of epidemiology and behavioral sciences profited tremendously.

Through laboratory developments, revisions to testing methods, etc., it has progressed from a case study to a case series to a cross-sectional analysis, for instance. As a result, the global data servers were flooded with complex quantitative, qualitative, and statistical models for estimating incidence, prevalence, morbidity, and death, as well as HIV/AIDS systematic reviews.

Contextualized programs are revisited, redesigned, and looped to revitalize the problem and approach it in novel, empirically validated ways. In Ethiopia, new HIV infections that have occurred within the preceding year or 12 months among priority populations can now be investigated using recency tests. USAID recently hosted its worldwide conference with PEPFAR-funded and non-PEPFAR-funded partners in Johannesburg, South Africa. The global and domestic reactions have been shaped by the lessons gained, the possibilities identified, and the evidence-based, well-informed judgments. It is commonly stated that a pandemic affects an entire generation. This generation in Ethiopia has been affected by COVID-19 and HIV/AIDS.

HIV/AIDS is currently an epidemic, not a pandemic, and a multisectoral HIV/AIDS response is in place. Among adults aged 25 to 49 in Ethiopia, the oral prevalence of HIV/AIDS was 0.93 percent, compared to a documented prevalence of 0.92 percent. Less than one percent of the total population was affected, and the chart was dominated by key and priority populations.

Consequently, the frequency was 23 percent among inmates, 2.1 percent among widower couples, 12 percent among divorced couples, and 4.3 percent among commercial sex workers. In addition, a considerable number of children and adolescents have reportedly contracted the virus, and YLHIV and ALWHIV also exist. This could make the future of Ethiopia more dismal.

First and foremost, the fighting in northern Ethiopia affected nearly one-fifth of the country’s population. They are now at danger of HIV infection and those who are HIV-positive and on treatment have been displaced, their antiretroviral therapy (ART) has been discontinued, and there has been gender-based violence in the conflict-affected area. There is also a global shortage of condoms. More critically, there is a chronic shortage of condoms in Ethiopia, despite efforts to avert this.  Significant behavioral interventions and a shift in HIV’s prioritization are necessary.

Disputes and competing agendas, such as COVID-19, overridden HIV/AIDS control and prevention. As behavioral intervention activities, advocacy, communication, and community mobilization were no longer evident on the ground. According to the EPHI 2019 study, 14% of ART patients received follow-up care. Numerous reports from healthcare facilities in conflict zones, where even acquiring ART is difficult due to a high security risk, provided more data and support for this claim.

Stigma and discrimination, as well as LTFU and related conditions, will considerably facilitate silent transmission. Some Ethiopian patients who begin ART do not get viral suppression. In addition, customers have access to three stages of ART drugs in Ethiopia. Worse yet, we have clients in the third stage, where failure could result in HIV/AIDS-related antibiotic resistance. The strategy reorientation and inadequate resource allocation of the government may exacerbate the sickness. The unavailability of test kits, a common concern among healthcare workers, will also exacerbate the situation. To secure a generation free of HIV, the government, specifically the Ministry of Health, must seek to attain the three 95/95/95 targets by 2025 and eliminate epidemics by 2030. These objectives are to achieve 95 percent HCT, 95 percent ART initiations, retention, and adherence, and 95% viral suppression.

This year, World AIDS Day was commemorated on December 1 with the theme “Equalize.” It is a call to action to eliminate injustices and do all possible to eradicate AIDS. The ministry and government expect Ethiopia to be AIDS-free by 2030, with an infection and mortality rate due to AIDS of less than one per 10,000 persons. Consequently, we must address the discrepancies hampering efforts to eradicate AIDS.

Contributed by Bedilu Abebe

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