The Impact of the TRIPS Agreement on the Access to Antiretroviral Therapy in Sub-Saharan Africa

The impact of the widespread availability of antiretroviral therapy (ART) on the human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) related attitudes, behaviours and practices of the general population in Sub-Saharan Africa is understudied. We assessed the impact of ART availability on the fear of HIV/ AIDS (measured at both community and personal levels) and HIV prevention practices in Rwimi, Uganda using a cross-sectional survey. The fear of HIV/AIDS was described as a perceived threat to either self and/or community regarding the risk of contracting the disease, whereby the higher the perception of the threat, the greater the fear. We assessed associations between the outcomes of the dependent variables on both the community and personal fear of HIV/AIDS, and the independent variables of HIV/AIDS-related knowledge and demographics. Qualitative data was also generated from focus group discussions (FGD) on the context of the fear of HIV/AIDS and HIV pre- vention practices. The majority of participants (89.4%; males - 86.8%; females - 90.8%) felt that ART availability has reduced the fear of HIV/AIDS in the community. In contrast, fewer participants (22.4%; males - 24.4%; females – 21.2%) mentioned that their personal fear of HIV/AIDS has been reduced with the availability of ART. From the qualitative study, factors identified as influencing the fear of HIV/AIDS included stigma, fear of infection, and the inconvenience of being on ART. Although fear of HIV/AIDS persists, the fear is reduced because of the availability of life-prolonging ART. HIV prevention practices are influenced by socio-cultural norms (gender roles, relationship dynamics, power and trust), which, we argue, should be considered when de-signing sustainable HIV/AIDS prevention programs.

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A systematic review evaluating the impact of task shifting on access to antiretroviral therapy in sub-Saharan Africa

African Health Sciences ◽

10.4314/ahs.v12i3.11 ◽

2013 ◽

Vol 12 (3) ◽

Cited By ~ 1

Author(s):

CA Emdin ◽

P Millson

Keyword(s):

Systematic Review ◽

Antiretroviral Therapy ◽

Task Shifting ◽

Sub Saharan Africa ◽

Sub Saharan ◽

The Impact

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Associations between highly active antiretroviral therapy and the presence of HPV, premalignant and malignant cervical lesions in sub-Saharan Africa, a systematic review: current evidence and directions for future research

BMJ Open ◽

10.1136/bmjopen-2016-015123 ◽

2017 ◽

Vol 7 (8) ◽

pp. e015123 ◽

Cited By ~ 11

Author(s):

Sonia Menon ◽

Rodolfo Rossi ◽

Natasha Zdraveska ◽

Mbabazi Kariisa ◽

Sushama D Acharya ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Highly Active Antiretroviral Therapy ◽

Invasive Cervical Cancer ◽

Cd4 Count ◽

Sub Saharan Africa ◽

Current Evidence ◽

Cervical Lesions ◽

Highly Active ◽

Sub Saharan ◽

The Impact

ObjectivesIn sub-Saharan Africa, substantial international funding along with evidence-based clinical practice have resulted in an unparalleled scale-up of access to antiretroviral treatment at a higher CD4 count. The role and timing of highly active antiretroviral therapy (HAART) in mediating cervical disease remains unclear. The aim of this article is to systematically review all evidence pertaining to Africa and identify research gaps regarding the epidemiological association between HAART use and the presence of premalignant/malignant cervical lesions.MethodFive databases were searched until January 2017 to retrieve relevant literature from sub-Saharan Africa. Publications were included if they addressed prevalence, incidence or clearance of human papillomavirus (HPV) infection in women undergoing HAART as well as cytological or histological neoplastic abnormalities.Results22 studies were included, of which seven were prospective studies. Women receiving HAART are less likely to develop squamous intraepithelial lesions (SILs). There is evidence that duration of HAART along with the CD4 count may reduce the prevalence of high-risk HPV (HR-HPV), suggesting that without HAART, severe immunosuppression increases the risk of becoming or remaining infected with HR-HPV. Furthermore, according to existent literature, the CD4 count, rather than HAART coverage or its duration, plays a central role in the prevalence of cervical intraepithelial neoplasia (CIN) 2 and CIN 3.ConclusionOur findings suggest a positive impact of HAART duration, in conjunction and interaction with CD4 count, on reducing the prevalence of HR-HPV. The greatest treatment effect might be seen among women starting at the lowest CD4 count, which may have a more instrumental role in cervical oncogenesis than either HAART use or the treatment duration on the prevalence of CIN 2 and CIN 3. There is still insufficient evidence to show a clear association between HAART coverage and the incidence of invasive cervical cancer. Enhanced surveillance on the impact of HAART treatment is crucial.

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Estimating the impact of expanded access to antiretroviral therapy on maternal, paternal and double orphans in sub-Saharan Africa, 2009-2020

AIDS Research and Therapy ◽

10.1186/1742-6405-8-13 ◽

2011 ◽

Vol 8 (1) ◽

pp. 13 ◽

Cited By ~ 12

Author(s):

Aranka Anema ◽

Christopher G Au-Yeung ◽

Michel Joffres ◽

Angela Kaida ◽

Krisztina Vasarhelyi ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Sub Saharan Africa ◽

Expanded Access ◽

Sub Saharan ◽

The Impact

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Conflicts in Biafra, Katanga and Cabinda as a result of the geopolitical legacy of colonialism

OOO Zhurnal Voprosy Istorii ◽

10.31166/voprosyistorii202010statyi60 ◽

2020 ◽

Vol 2020 (10-3) ◽

pp. 238-246

Author(s):

Olga Dzhenchakova

Keyword(s):

Democratic Republic ◽

Economic Factor ◽

Colonial Period ◽

Sub Saharan Africa ◽

Negative Consequences ◽

Post Colonial ◽

Republic Of The Congo ◽

Sub Saharan ◽

The Republic ◽

The Impact

The article considers the impact of the colonial past of some countries in sub-Saharan Africa and its effect on their development during the post-colonial period. The negative consequences of the geopolitical legacy of colonialism are shown on the example of three countries: Nigeria, the Democratic Republic of the Congo and the Republic of Angola, expressed in the emergence of conflicts in these countries based on ethno-cultural, religious and socio-economic contradictions. At the same time, the focus is made on the economic factor and the consequences of the consumer policy of the former metropolises pursuing their mercantile interests were mixed.

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