Zero AIDS infections, zero deaths related to this disease and zero discrimination, are among the objectives of the Cuban strategy confronting this scourge
Author: Lisandra Fariñas Acosta | email@example.com
November 30, 2014 21:11:13
A CubaNews translation.
Edited by Walter Lippmann.
The direct words of its author, Dr. Jorge Pérez Ávila, in one of the pages of his book come to mind: "Since theAcquired Immunodeficiency Syndrome emerged in the eighties it was accompanied by the syndrome of fear, stigma, discrimination…” These are elements that can be perceived in so many life stories, and the lessons they teach.
Many years have passed since the first case of HIV was diagnosed in Cuba, and the accumulated experience has strengthened the National Program for the Prevention and Control of Sexually Transmitted Infections (STIs) and HIV/AIDS, which the Ministerio de Salud Publica (MINSAP) [Ministry for Public Health] boosted from the start.
Today, current anti-retroviral therapies make this disease not synonymous with instant death, and people who have itcan live many years, especially if they comply with medical indications and strictly follow their prescribed treatment.
Official health statistics show between 1500 and 2000 HIV cases reported in the country annually. The prevalence of infection is of 0.2% in people between 12 and 49 years of age. This figure is described by the United Nations AIDS-HIV Program as "exceptionally low".
According to Maria Isela Lantero, Department Head of MINSAP’s National Program for Prevention and Control of STIand HIV/AIDS, statisticss remain stable; similar to the previous year. The most-affected group is that of young peoplebetween 20 and 29 years mostly, but men and women of all ages are diagnosed, she said. "Since the epidemic began to the present, just over 21,600 people have been diagnosed in the country," she said.
WORKING TOGETHER TOWARDS ZERO
Embracing the strategy of UN/AIDS: "Together Towards Zero", this year's World Day of Response to HIV in Cubahas been directed to make the participation of various social sectors more proactive in dealing with this disease,towards the goals of "zero infection", "zero discrimination" and "zero AIDS-related deaths," Dr. Jaqueline Sanchez,Director of the National STD Prevention Center HIV/AIDS told reporters.
"Working together to reverse the course of the epidemic involves the effort and commitment of all sectors –not onlyof the public health system– in the dissemination of educational messages to facilitate early diagnosis and treatment,and the adoption of responsible behavior," she stressed.
Today the global outlook on HIV/AIDS focuses on considering it a transmissible disease, still without a cure, butcontrollable with a group of measures. "People living with HIV receiving the benefits of these measures may stay alive for a long time without complications, and may not develop the disease. But with a very important element from both the individual point of view and that of the community: their viral load undetectable,” said Dr. Lantero.
The specialist explained that "current activism in the world –Cuba’s included– is aimed at sensitizing people to the need to know their HIV serological identity. Knowing is the first step to access the group of opportunities offered by the national health system and the country in general, namely: a special link to services, comprehensive health care, education and treatment, if required. Maintaining their viral load undetectable has proven health benefits for the person and the community. Under these conditions, we have seen that when the HIV community remains mostly withundetectable viral loads, the occurrence of new cases decreases in the country."
Dr. Lantero also stressed the importance that counseling services and movements like "Take the test" have for the program and the national response to the epidemic. Take the Test brings diagnosis closer to the community for early detection of the disease as well as to social networking sites where the most vulnerable groups are concentrated."This year we have already around two million diagnostic tests, and will close the year with more than those performed in 2013. In most cases, this has resulted in a diagnosis in the early stages of the disease. This gives patients the opportunity to quickly link to the different options of care we have in the country, and to determine if they require immediate treatment and get access to it.
This group of combined actions has also had an impact on the stability of mortality rates compared to previousyears,” she said.
Juan Raul Valdes Triguero, Head of the Vulnerable Groups Department and National Coordinator of the support linefor people with HIV, emphasized the need to acknowledge the participation of key groups in the response to HIV/AIDS, which has charactereized the Cuban strategy for confronting the epidemic. In this regard he mentioned the work of the project Prevention for Men Who Have Sex with Men, the Line for Teenagers and Young Persons, theProject Mujer [Women], the Prevention Line for People Who Practice Transactional Sex; all of which through acommunity movement and conscious voluntary action have accompanied the program in this fight.
"Their contribution is vital to ensure that training and education are delivered in the languages and ways of action ofthese groups, and in sensitizing the population to reduce stigma and discrimination against people living with HIV."
On the study of factors and social determinants of health related to the occurrence of this disease, Dr. RosaidaOchoa, Director of theHealth Promotion and Disease Prevention Unit, stressed the importance of continuing delving into the elements that make people more vulnerable. "Why are men more frequently infected than women? Whyamong men those who have sex with other men are more frequently infected? What inequalities or aspects make them more vulnerable? "
Hence, she explained, there are inter-sector working groups focused on investigating the sexual behavior of the Cuban population by age and sex, to obtain data on each of these vulnerable groups. Research tries to answer questions such as: What are the manifestations of stigma and discrimination? What do they think? What are the causes of high-risk behavior? And work on a gender strategy for the educational component for HIV/AIDS, and the promotion of friendly environments.
PREVENTION AND RESPONSIBILITY
The parameters for initiating anti-retroviral treatment have been changing in the world. Today combined prevention strategies and therapies –with emphasis on early treatment– are recommended for their many advantages in reducing mortality, increasing life expectancy, and significantly decreasing transmission. Cuba is working on these recommendations, said Dr. María Isela Lantero.
"Last December we adopted the National Strategic Plan for HIV/AIDS for the next five years. This contains the norms and policies for the program. Our lines of treatment are in keeping with those of the World Health Organization.Today in the country there are around 11,400 people in treatment –which they receive free of charge– representingmore than 1600 compared to 2013. This shows our results in diagnosis."
The country produces and guarantees a high percentage of the necessary drugs. There are others of a more advanced function –which are for those persons in greater need– that have to be acquired abroad.
According to the expert, a total of 26 municipalities –including 15 in the capital– in the country, present a highermagnitude situation in comparison to the national median.
"The lack of risk-perception remains the root cause of infections. Although there are positive changes regarding the use of condoms in younger groups, unfortunately the common history in people who are infected in Cuba is that they had unprotected sex. Hence we continue insisting ----for the sake of prevention-- in the importance of developing culture in condom use as a measure of effective protection," said the expert.
She added that in the country, the transmission of HIV from mother to child registers very low indicators. Since the epidemic began to date, only 47 children have been diagnosed. This is the result of very serious prevention work.
"International indicators say that this form of transmission has been eliminated, when for every 100 women who give birth in the year, less than two children are positive; or when less than 0. 5 per 1000 live births are diagnosed. Cubameets these indicators and we are working together with the World Health Organization (WHO) to start taking stepstoward certification of these results and declaring that Cuba has eliminated mother-child transmission of this disease," said the expert.
This December 1st will close with the traditional gala and national delivery of the Premios Esperanza [Hope Awards]to institutions, individuals, health workers or volunteers who selflessly cooperate in response to this disease.
It will be another day to raise awareness of the challenges posed to humanity by this epidemic. We will continue trying together to –from the grounds of prevention– put an end to the "Era of AIDS".
See full-page feature on back page of Granma printed edition: