In view of the reported role of parasitic infections in causing morbidity among HIV-infected patients with low CD4+ counts who are on antiretroviral therapy (ART), mainly because of immuno suppression, researchers sought to determine the extent of intestinal parasitic infection and related risk factors among HIV-infected patients attending ART clinic at Debretabor General Hospital, Northern Ethiopia. Among 383 HIV-infected patients attending the ART clinic, intestinal parasites had an overall prevalence of 25.3%, with 18% and 23.8% by direct wet-mount and formol ether–concentration technique, respectively. HIV/AIDS patients thus exhibit relatively higher prevalence of intestinal parasitic infection. Illiteracy, reduced CD4+ counts, and absence of a toilet were identified to have great influence on the distribution of intestinal parasites. Hence, they emphasize consistently diagnosing HIV/AIDS patients with low CD4+ counts for intestinal parasites with routine stool examinations, and advocate inclusion of awareness creation as an essential component of ART-monitoring strategies for improved patient care.

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Kampala, Uganda | URN | There is a rise in HIV infection among older men according to health experts. Information from Uganda Aids Commission (UAC) shows that majority of men between 45 and 49 years of age who have been seeking for health services in the past years tested positive.

This according to health experts is worrying and likely to see an increase of the disease burden among the already 1.2 million adults out of the 1.4 million people living with HIV/AIDS in the country. Victor Rwengabo the Uganda Aids Commission zonal coordinator for Gulu notes that their finding indicates older men between 45 and 49 years of age are contracting HIV/AIDS compared to young men.

Young people (between 15-24 years) are responsible for 34% of new HIV infections annually. He notes that although they are yet to get concrete reasons for the new trend, he says the key factors among them is financial stability, long travels out of home and high sexual libido among men between 45 and 49 years of age.

According to Rwengabo, this is directly contributing to the high HIV/AIDS burden among young girls who target these men adding that it’s the reason the presidential fast-track initiative is focusing on men.

Dr. Hilary Alima, an HIV/AIDS specialist says men still have low health seeking behaviors in regards to understanding their HIV/AIDS status which he said also applies to young men. He however noted that the high HIV prevalence among older persons is perturbing saying it begs answers from the target group.

“The men, the boys and children are a gap and are not testing. We have actually found out of late that older men above 49 years-old are beginning to get HIV/AIDS infection. The data is very clear. We are trying to understand what could be the driving factor,” Dr. Halima said.

He says the index and partner testing where a person who has been diagnosed with HIV brings or identifies their sexual partner for voluntary HIV/Aids testing is positively helping in the fight against the scourge in the

He however says that although such an initiative is helpful in ensuring that men of corporate class don’t miss out treatment, their efforts to scale it up are hampered by limited finance and stringent donor fund directives. Early this year, Kitgum district health officials revealed an increase in HIV/AIDS cases within Namokora, Orom and Lagoro sub counties, which stood at 3.8 per cent above the district rate of 3.4 per cent mostly among boys and men of 15-49 years old.

Kitgum district HIV/AIDS prevalence rate stands at 7.3 per cent, highest in Acholi sub region where some nearly 60,000 people are living with disease. Uganda still registers 1,000 new infections and 500 deaths every week, according to the Presidential Fast -Track Initiative on Ending HIV and AIDS in Uganda fact sheet released last year.

region. HIV/AIDS prevalence in mid north comprising of Lango and Acholi sub regions still stands at about 7.2 percent, higher than the national average of 6.2 per cent.

Dr. Michael Ochwo, an expert on HIV/Aids at The Aids Support Organization (TASO), says the high prevalence mostly among adults has now been compounded with the low response for treatment from corporates. He says many are dying silently fearing to be stigmatised while accessing some of the health facilities providing the life prolonging antiretroviral therapy while others are now purchasing drugs from Kampala or sharing with their spouses.

Dr. Ochwo explains that they launched an initiative last year that provides exclusive services to the corporate class in their comfort outside the normal times of treatment.

He says currently 64 corporate clients are receiving treatment through this arrangement which wouldn’t have been possible. At least 8,706 clients are currently enrolled on ART at Gulu TASO center. This is followed by Gulu Regional Referral Hospital with 6,000 clients and St. Mary’s hospital Lacor with 4,500 clients.

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The gap between the resources needed and those available is widening, as donors provide less funding, and domestic investments grow too slowly to compensate for inflation.

UNAIDS estimates that some $26.2 billion is needed by 2020 the 2018 amount available for the AIDS response was approximately $7.2 billion short of that figure.

‘Key populations’ at high risk

The report reveals that, from 2010 to 2018, the number of new HIV infections declined by 16 per cent, with around 1.7 million people infected in 2018. The drop is driven mostly by steady progress across most of eastern and southern Africa.

However, the picture looks very different – and far less positive – in other regions, which have seen a rising number of cases In eastern Europe and central Asia, AIDS-related deaths have risen by five per cent and, in the Middle East and North Africa, by nine per cent, since 2010.Key populations — which include people who inject drugs, gay men and other men who have sex with men, transgender people, sex workers and prisoners—now account for more than half of new HIV infections globally.

In eastern Europe and central Asia and in the Middle East and North Africa, that figure rises dramatically to around 95 per cent, which highlights that key populations are still being marginalized and being left behind in the response to HIV.

We urgently need increased political leadership to end AIDS, said Gunilla Carlsson, acting Executive Director of UNAIDS. This starts with investing adequately and smartly, and by looking at what’s making some countries so successful. Ending AIDS is possible if we focus on people, not diseases, and take a human rights-based approach to reaching people most affected by HIV.

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Australia continues to be at the forefront of reversing the increase in HIV infections, with a study released today showing that the number of new diagnoses in 2018 dropped 13% year-on-year, to 835 cases. The pace of the decline more than doubled from the previous year, according to the Kirby Institute for Infection and Immunity in Society at the University of New South Wales in Sydney. New infections are at the lowest level in 18 years and the decline is seen across the country, says Rebecca Guy, a Kirby Institute epidemiologist.

The decline in new infections is concentrated among men who have sex with men (MSM), particularly those born in Australia. But that good news is tempered by a modest drop in heterosexually acquired infections, from 238 to 189, and stubbornly persistent levels of new infections in Indigenous peoples, particularly those in remote areas. “Australia is tracking toward elimination of the transmission of HIV,” Gay says, though she and others emphasize there is still much work to be done.

The downward trend in new infections among MSM has been gathering steam for several years, thanks to aggressive promotion of condom use, widely available testing, and successful efforts to get those infected quickly started on antiretroviral drugs, which drive down viral loads, making the host unlikely to pass HIV on to partners.

This arsenal of tools got a big boost in April 2018, when the federal government added pre-exposure prophylaxis (PrEP), a daily pill that protects HIV-negative people from infection, to the Pharmaceutical Benefits Scheme that subsidizes the medicines. This cut the cost of PrEP from AU$10,000 per year to just AU$480 per year, according to the government-funded healthdirect website. Those qualifying for greater subsidies pay even less.

The number of individuals taking advantage of subsidized PrEP soared from just 1980 in April 2018 to 18,530 that December. The Kirby Institute figures that 41% of at-risk Australian men were on PrEP in 2017, says Andrew Grulich, a Kirby Institute medical epidemiologist. Coverage needs to be up to 75% “if we want to keep moving toward HIV elimination,” Grulich says. PrEP uptake is lagging among MSM not born in Australia. “Gay and bisexual men from culturally and linguistically diverse backgrounds really need to be a target for further PrEP rollout,” he says.

It will be particularly challenging to drive down infections in Indigenous groups that suffer high infection rates among those who inject drugs. And diagnoses are typically made at a later stage of infection. This “very different picture” of HIV infection requires “targeted interventions to make sure that Aboriginal and Torres Strait Islander people are not left behind,” says James Ward, an infectious disease specialist at the South Australian Health and Medical Research Institute in Adelaide.

Still, “the decline we’re seeing nationwide in Australia is being seen in very few other places in the world,” Grulich says. The combination of preventions—condom promotion, treatment as prevention, and PrEP—all “act together to decrease HIV infections,” he says. He is convinced that the critical component in the progress is Australia’s universal health care system, which provides “free or easily affordable access to testing, to treatment, and to PrEP.”

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