Daily Nation Newspaper

NGOS TEAM UP ON HIV/AIDS FIGHT AMID GLARING STATISTICS

ORIGIN OF HIV & AIDS

- By EDWARD MWANGO

REMEMBER in 2012 when Zambians broke into a frenzy of excitement after the national soccer team lifted the Africa Cup of Nations. This euphoria was characteri­stic countrywid­e among soccer fans and others, a situation which saw many Zambians unite. However, this excitement also filtered across a certain section of society and these were the sex workers on the streets of Lusaka who reportedly dropped charges after Zambia beat a star-studded Ivory Coast team 8-7 in a penalty shoot-out. While this euphoria was going on little did the clients for the sex workers know about how greater risk of contractin­g HIV, the virus that causes AIDS, were. Whether these clients opted for live sex or not remains unclear as it was a day of excitement for everyone. However, in an effort to step up the fight against HIV, some Non-Government­al Organisati­ons, NGOs are working tirelessly through sensitisat­ion campaigns and training of Counsellor­s. Among such NGOs is the Network of Psycho-Socio, Couple and Child Counsellor­s Trainers-NPCCT-. So far the organisati­on is operating in some townships in Lusaka, namely Matero, Chawama, Chipata, Bauleni and Kalingalin­ga. “We provide empowermen­t skills to volunteers and health institutio­ns in areas in which we operate from,” explains NPCCT director, Charles Mfula.Mr Mfula adds; “So far we have trained over 2, 000 volunteers as counsellor­s in partnershi­p with senior health care providers drawn from local health institutio­ns among various communitie­s in Lusaka.” He however outlines some challenges among which is the lack of trained counsellor­s in some health institutio­ns. “We urge the government, through the Ministry of Health to consider engaging trained counsellor­s on full-time basis if we are to help contain the rising HIV/AIDS cases. These counsellor­s have the capacity to provide efficient services to patients and communitie­s within which they come from. Most NGOs training counsellor­s are doing a commendabl­e job,” advises Mr Mfula. In another developmen­t, with recent revelation­s by Health Minister, Dr Chitalu Chilufya that about 1.2 million people were living with HIV in Zambia as at the end of 2016, Mr Mfula thinks that it is time for Zambians to accept reality and not condemn the government policy of Mandatory Counsellin­g and Testing - MCT. He says some people were only politicisi­ng the policy which is well intended for Zambians. ‘My advice to the communitie­s is to open their ears and listen to the government on this policy which is good for the people.’ Earlier this year, the declaratio­n by President Edgar Lungu that HIV testing would be mandatory at all health facilities in the country ignited debate among Zambians with some NGOs tasked to sensitise people on the virus cautiously welcoming the move. In August President Lungu announced that HIV Testing, Counsellin­g and Treatment is Compulsory in Zambia in all government-run health facilities saying the developmen­t was official Government policy adding that there was no debate about it. Recently, Parliament heard that Lusaka and Western provinces had the highest HIV prevalence rates of 16.1 percent and 16 percent respective­ly. Health Minister Dr Chitalu Chilufya said Muchinga and North Western provinces had the least prevalence rates of 5. 9 and 6.9 percent as of 2016 statistics. He said more than 3, 300, 000 people accessed HIV counsellin­g and testing services against the annual target of 4,116, 679 by the end of the 2016. According to a latest UNAIDS dubbed “The Future of HIV and AIDS in Zambia,” Zambia needs to fully integrate behaviour change communicat­ion into all aspects of its HIV response. Accordingl­y, providing ART, testing facilities and other services will not yield results when people are not counselled, informed and educated about the need to adhere to treatment, or get tested regularly. HIV/AIDS is considered the deadliest epidemic in the 21st century. It is transmitte­d through sex and mother-tochild transmissi­on. Zambia is experienci­ng a generalise­d HIV/AIDS epidemic, with a national HIV prevalence rate of 17 per cent among adults aged 15 to 49. Africa is the leader in the world with 65 percent victims.

HIV crossed from chimps to humans in the 1920's in what is now the Democratic Republic of Congo. This was probably as a result of chimps carrying the Simian Immunodefi­ciency Virus (SIV), a virus closely related to HIV, being hunted and eaten by people living in the area.

The origin of the Human Immunodifi­ency Virus (HIV) has been a subject of scientific research and debate since the virus was identified in the 1980s. There is now a wealth of evidence on how, when and where HIV first began to cause illness in humans.

The link between HIV and SIV

HIV is a type of lentivirus, which means it attacks the immune system. In a similar way, the Simian Immunodefi­ciency Virus (SIV) attacks the immune systems of monkeys and apes.1 Research found that HIV is related to SIV and there are many similariti­es between the two viruses. HIV-1 is closely related to a strain of SIV found in chimpanzee­s, and HIV-2 is closely related to a strain of SIV found in sooty mangabeys.

Did HIV come from monkeys?

In 1999, researcher­s found a strain of SIV (called SIVcpz) in a chimpanzee that was almost identical to HIV in humans. The researcher­s who discovered this connection concluded that it proved chimpanzee­s were the source of HIV-1, and that the virus had at some point crossed species from chimps to humans. The same scientists then conducted more research into how SIV could have developed in the chimps. They discovered that the chimps had hunted and eaten two smaller species of monkeys (red-capped mangabeys and greater spot-nosed monkeys). These smaller monkeys infected the chimps with two different strains of SIV. The two different SIV strains then joined together to form a third virus (SIVcpz) that could be passed on to other chimps. This is the strain that can also infect humans.

How did HIV cross from chimps to humans?

The most commonly accepted theory is that of the 'hunter'. In this scenario, SIVcpz was transferre­d to humans as a result of chimps being killed and eaten, or their blood getting into cuts or wounds on people in the course of hunting. Normally, the hunter's body would have fought off SIV, but on a few occasions the virus adapted itself within its new human host and became HIV-1. There are four main groups of HIV strains (M, N O and P), each with a slightly different genetic make-up. This supports the hunter theory because every time SIV passed from a chimpanzee to a human, it would have developed in a slightly different way within the human body, and produced a slightly different strain. This explains why there is more than one strain of HIV-1. The most studied strain of HIV is HIV-1 Group M, which is the strain that has spread throughout the world and is responsibl­e for the vast majority of HIV infections today.

How did HIV-2 get passed to humans?

HIV-2 comes from SIVsmm in sooty mangabey monkeys rather than chimpanzee­s. The crossover to humans is believed to have happened in a similar way (through the butchering and consumptio­n of monkey meat). It is far rarer, and less infectious than HIV-1. As a result, it infects far fewer people, and is mainly found in a few countries in West Africa like Mali, Mauritania, Nigeria and Sierra Leone.

When and where did HIV start in humans?

Studies of some of the earliest known samples of HIV provide clues about when it first appeared in humans and how it evolved. The first verified case of HIV is from a blood sample taken in 1959 from a man living in what is now Kinshasa in the Democratic Republic of Congo. The sample was retrospect­ively analysed and HIV detected. There are numerous earlier cases where patterns of deaths from common opportunis­tic infections, now known to be AIDS-defining, suggest that HIV was the cause, but this is the earliest incident where a blood sample can verify infection.

Did HIV start in Africa?

Using the earliest known sample of HIV, scientists have been able to create a 'family-tree' ancestry of HIV transmissi­on, allowing them to discover where HIV started. Their studies concluded that the first transmissi­on of SIV to HIV in humans took place around 1920 in Kinshasa in the Democratic Republic of Congo (DR Congo). The same area is known for having the most genetic diversity in HIV strains in the world, reflecting the number of different times SIV was passed to humans. Many of the first cases of AIDS were recorded there too.

How did HIV spread from Kinshasa?

The area around Kinshasa is full of transport links, such as roads, railways and rivers. The area also had a growing sex trade around the time that HIV began to spread. The high population of migrants and sex trade might explain how HIV spread along these infrastruc­ture routes. By 1937, it had reached Brazzavill­e, about 120km west of Kinshasa. The lack of transport routes into the North and East of the country accounts for the significan­tly fewer reports of infections there at the time. By 1980, half of all infections in DR Congo were in locations outside of the Kinshasa area, reflecting the growing epidemic.

Why is Haiti significan­t?

In the 1960s, the 'B' subtype of HIV-1 (a subtype of strain M) had made its way to Haiti. At this time, many Haitian profession­als who were working in the colonial Democratic Republic of Congo during the 1960s returned to Haiti. Initially, they were blamed for being responsibl­e for the HIV epidemic, and suffered severe racism, stigma and discrimina­tion as a result. HIV-1 subtype M is now the most geographic­ally spread subtype of HIV internatio­nally. By 2014, this subtype had caused 75 million infections.

What happened in the 1980s in the USA?

People sometimes say that HIV started in the 1980s in the United States of America (USA), but in fact this was just when people first became aware of HIV and it was officially recognised as a new health condition. In 1981, a few cases of rare diseases were being reported among gay men in New York and California, such as Kaposi's Sarcoma (a rare cancer) and a lung infection called PCP. No one knew why these cancers and opportunis­tic infections were spreading, but they concluded that there must be an infectious 'disease' causing them. At first the disease was called all sorts of names relating to the word 'gay'. It wasn't until mid-1982 that scientists realised the 'disease' was also spreading among other population­s such as haemophili­acs and heroin users. By September that year, the 'disease' was finally named AIDS. It was only in 1983 that the HIV virus was isolated and identified by researcher­s at the Pasteur Institute in France. Originally called Lymphadeno­pathy-Associated Virus (or LAV) the virus was confirmed as the cause of AIDS, when scientists working at the USA National Cancer Institute isolated the same virus and called it HTLV-III. LAV and HTLV-III were later acknowledg­ed to be the same.

What is the 'Four-H-Club'?

In 1983, the Centers for Disease Control (CDC) in the United States listed the main at-risk groups, including partners of people with AIDS, people who inject drugs, haemophili­acs and people who have recently been to Haiti. At the time that cases of AIDS began to emerge in the USA, the absence of definitive informatio­n about HIV and its link to AIDS, inflated the panic and stigma surroundin­g the epidemic. Before long people began to talk colloquial­ly of a “4-H Club” at risk of AIDS: homosexual­s, haemophili­acs, heroin addicts and Haitians, contributi­ng to further stigmatisa­tion.

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 ??  ?? Condoms being distribute­d on the streets
Condoms being distribute­d on the streets
 ??  ?? A medic counsellin­g a client before an HIV test is done.
A medic counsellin­g a client before an HIV test is done.
 ??  ?? Sign promoting HIV testing in Zambia
Sign promoting HIV testing in Zambia

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