TAILIEUCHUNG - báo cáo khoa học: " The increasing chronicity of HIV in sub-Saharan Africa: Re-thinking “HIV as a long-wave event” in the era of widespread access to ART"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: The increasing chronicity of HIV in sub-Saharan Africa: Re-thinking “HIV as a long-wave event” in the era of widespread access to ART | Nixon et al. Globalization and Health 2011 7 41 http content 7 1 41 H2 globalization 7 AND HEALTH COMMENTARY Open Access The increasing chronicity of HIV in sub-Saharan Africa Re-thinking HIV as a long-wave event in the era of widespread access to ART Stephanie A Nixon1 2 Jill Hanass-Hancock2 Alan Whiteside2 and Tony Barnett3 4 Abstract HIV was first described as a long-wave event in 1990 well before the advent of antiretroviral therapy ART . The pandemic was then seen as involving three curves an HIV curve an AIDS curve and a curve representing societal impact. Since the mid-2000 s free public delivery of life-saving ART has begun shifting HIV from a terminal disease to a chronic illness for those who can access and tolerate the medications. This increasing chronicity prompts revisiting HIV as a long-wave event. First with widespread availability of ART the HIV curve will be higher and last longer. Moreover if patterns in sub-Saharan Africa mirror experiences in the North people on ART will live far longer lives but with new experiences of disability. Disability broadly defined can result from HIV its related conditions and from side effects of medications. Individual experiences of disability will vary. At a population level however we anticipate that experiences of disability will become a common part of living with HIV and furthermore may be understood as a variation of the second curve. In the original conceptualization the second curve represented the transition to AIDS in the era of treatment we can expect a transition from HIV infection to HIV-related disability for people on ART. Many such individuals may eventually develop AIDS as well but after a potentially long life that includes fluctuating episodes of illness wellness and disability. This shift toward chronicity has implications for health and social service delivery and requires a parallel shift in thinking regarding HIV-related disability. A model providing guidance .

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