Editorial
So often, with the doom and gloom attitude by which HIV and AIDS is portrayed in our newspapers, it is easy for us to feel despondent. Yet there is some good news. There are things we as health workers can do that can make a real difference.
Good sex and life skills health promotion is an essential component to promoting healthy behaviour. A multi-centre study undertaken by the World Health Organisation has conclusively shown that such education does not encourage promiscuity. In fact it is seen to delay the onset of first sexual activity. Recent research from KwaZulu-Natal has also shown that most parents are in support of such sex education for their children. This dispels some of the myths that have jeopardised some health promotion initiatives in the past.
While most people have heard of HIV and AIDS, there are many myths that surround transmission. For example most people know that it can be transmitted by unprotected sex or blood but many people do not know that it cannot be transmitted by kissing, hugging, sharing of cups, plates and cutlery. In fact in cannot be transmitted by any means of everyday social contact. Maybe once we get this message across, the fear and the discrimination that we see, and which is itself a contributory factor to the spread of HIV, may begin to diminish.
Just over two years ago, important research came out of Mwanza, a small town in Tanzania. The research showed that through the syndromic management of sexually transmitted diseases (STDs,) HIV transmission could be reduced by over 40%. The syndromic management approach entails the client being asked their symptoms (discharge or ulcers), then treated for all likely causes of these symptoms (as stated in a standard flow chart). This type of approach has been found the be highly effective in the treatment of STDs as well as contribution to the prevention of HIV transmission as seen in Mwanza. Often the simplest answers are the best!
Given the immense implications of good STD management on the control of HIV, we need to ensure that we utilise every opportunity we have to treat an STD. This means that STD treatment should be available not only for those who come to the STD clinic, but also for pregnant women and those who come for family planning. In fact for any services! We cant afford to miss any opportunities! Good STD management also entails that we ensure that our patients complete their treatment, that we encourage partners to come for treatment and that we promote the use of condoms. We also need to make sure that everyone knows that sticking to one partner is the best form of protection. This requires counselling skills and the caring attitudes of health workers. In many instances, clients may be concerned about coming to a clinic for STD treatment because they fear the lack of confidentiality or are scared of being told off! This is particularly true of adolescents, and research from Northern Province has shown that health workers negative attitudes are the major barrier preventing adolescents from seeking reproductive health services. We have to remember that all this time while they wait for treatment, they may be infecting more people with STDs and possibly HIV, or maybe catching these diseases. Overall, we must work towards developing health services that are places where people want to come.
We know that many people are already infected with HIV, and at some time will develop AIDS. AIDS is a chronic disease lasting months or years, and a person with AIDS may move several times from home to hospital and back again. Much of the care of those with AIDS therefore occurs in the home. In addition, many people prefer to be cared for at home, especially when they know that they cannot be cured in hospital. Care at home also prevents hospitals from becoming over crowded. However care at home requires that the family and community accept the person with AIDS without discrimination. It also relies on health workers stimulating and utilising the strengths of the family and the community.
Although the number of people with HIV has increased over the last year we can all play a part in ensuring that the numbers of new infections are as few as possible. |
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