The road towards universal access to antiretroviral treatment is now more easily viable since the WHO changed the eligibility criteria for this treatment, especially for HIV-positive pregnant women.
However, the new problem that emerged from the scientific world is how to retain patients in treatment programs that last a lifetime. The treatment for HIV / AIDS is in fact a treatment that can never be interrupted, so not to allow the virus to regain the upper hand. This adherence to the treatment program is called retention in care. In a recent report, the WHO defines retention as a complete package including preventive services, treatment and support that keep the patient connected successfully to care programs, since the test for HIV through the eligibility to treatment up to administration in the life of antiretroviral therapy. Retention is the key to reduce mortality and morbidity related to HIV, to reduce the incidence of new infections among adults and among children and to reduce the development of resistance to therapy. The period from diagnosis to beginning of treatment appears particularly delicate, when losses of patients are greater...
DREAM, the acronym for Drug Resource Enhancement against AIDS and Malnutrition, is a programme based on a holistic approach of treating AIDS in Africa, launched in February 2002 by the Community of St Egidio.
Today, the programme is present in Mozambique, Malawi, Tanzania, Kenya, the Republic of Guinea, Guinea Bissau, Nigeria, Angola, the Democratic Republic of Congo and Cameroon...
Mi chiamo Cacilda Massango. Sono Mozambicana e ho 36 anni. Sono madre di una bambina di 11 anni . Nell’ottobre del 2002, decisi di sottopormi al test per l’HIV presso l’ospedale Generale di Machava. Per me fu un grandissimo dolore trovarmi davanti al risultato: era positivo! Mi disperai e pensai a tutte le peggiori soluzioni possibili. Quelli furono giorni di sofferenza enorme, perché le informazioni che avevo all’epoca erano che per ogni persona con l’AIDS non c’e’ che la morte. E cosi’, anch’io, come gli altri, aspettavo di morire.
Ma ho avuto la fortuna di incontrare il programma DREAM della Comunita’ di Sant’ Egidio. Per me fu veramente una buona notizia, che cambiò completamente la mia vita. Cominciai così il trattamento antiretrovirale e già dopo pochi mesi mi ripresi, tanto che non avevo più segni della malattia. . Tornai ad essere la protagonista principale della mia vita, una vita reale in cui potevo avere dei sogni e dei desideri. In Mozambico si dice che tornai ad essere “proprietaria del mio naso”. Ho ritrovato la mia dignità e ho scoperto di avere un futuro
Alla fine del 2003, con altre donne positive, e in trattamento antiretrovirale, decidemmo di fondare l’Associazione Eu DREAM, una rete di donne e uomini che aiutano altri pazienti a fare bene il trattamento.
Sono orgogliosa di essere stata una delle prime attiviste, in un periodo di grande lotta, quando alla malattia si accompagnavano la discriminazione e lo stigma, e di poter dare il mio contributo soprattutto alle madri sieropositive e ai loro figli dei centri DREAM di Maputo...
Prof.ssa Maria Cristina Marazzi
Comunity of Sant’Egidio - LUMSA University
By the end of the 1990s the AIDS epidemic in Africa was outlined as a real humanitarian catastrophe :an impressive number of infected subjects, a high rate of mortality mainly in the fertile age and an increasing population of little orphans.
In those years big international agencies and most of the non-government organizations have applied, in the fight against AIDS in Africa, only a prevention model ,based on sanitary education campaigns: it has been mainly persisted on the correct use of condoms, as an essential aid and almost always the only one in the fight against AIDS.
The lacking of effectiveness of this exclusively preventive approach has not been only under the experts’ eyes but also under the world’s public opinion.
The current 22mln of infected in Africa are ,unfortunately, a proof.
The failure is due to the lack of education towards the respect for the human being and the absence of an effective therapy which are inseparable from a real prevention.
Indeed, the Hiv/AIDS in developed countries started decreasing in 1996,when an effective therapy was introduced: the Haart-( Highly active anti-retroviral therapy).
Why should it have been different in Africa? Obviously there were not scientific reasons but merely misinterpreted economic ones.
The subject infected hardly undergoes a test, because of the social stigma linked to seropositive , which, with no treatment ,corresponds to an inevitable death sentence.
Besides, following the reductively preventive approach ,among populations where the infection affects one person out of five, other relevant ways of transmission are disregarded :from mother to child ,from poor sanitary practice (iatrogenic) or connected to traditional medicine.
To S.Egidio’s Community, which has a huge number of African members ,the containment of the infection has immediately appeared being not adequate to save the millions of infected Africans’ lives left hopelessly...
A workshop on Prevention of HIV Mother-To-Child-Transmission organized by the DREAM program was held in Maputo from March 11thto the 15th, 2013. Attendees included medical doctors and medical practitioners, nurses, and public health expert representatives from a number of sub-Saharan African countries. The development of new international guidelines and a model of care based on the administration of Antiretroviral Triple Therapy to ALL HIV-positive pregnant women from early pregnancy until at least the weaning process, brings us closer to the goal of eliminating HIV vertical transmission. The results of our consensus workshop summary have been published.
In the last decade we have seen big developments in the field of Prevention of HIV Mother-To-Child Transmission. There is increasing awareness for the need of interventions that are broadly effective in preventing vertical transmission from pregnancy until the end of breastfeeding. The superiority of Combination Antiretroviral Therapy in lowering vertical transmission rates when compared to mono or dual therapy approaches has been clearly documented. The benefits of using Highly Active Antiretroviral Therapy (HAART) from pregnancy until the end of breastfeeding have also been demonstrated in multiple studies...