Public Health Analyst, Mitchellville, Maryland 20721, USAUnited States
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The human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) response has made significant strides in preventing the spread of the epidemic globally. Many of the achievements could not have happened without the resilience of the people living with HIV/AIDS (PLHIV) community, the funding and technical support of the donor community including public/private partnerships, the tenacity of the Governments (national response), the relentless outreach of the Non Governmental Organization (NGO) community and their networks, the untiring efforts of health care providers, and the activism of grassroots movements.
Open Journal PUBLISHERS Commentary Towards a More Sustainable Response: Strengthening the Social Agenda in the Human Immunodeficiency Virus Infection and Acquired Immune Deficiency Syndrome Epidemic * Jennifer Knight-Johnson, MA, MPH, PhD* Public Health Analyst, Mitchellville, Maryland 20721, USA * *Corresponding author Jennifer Knight-Johnson, MA, MPH, PhD Public Health Analyst, Mitchellville, Maryland 20721, USA;Tel. 1-240-273-8173; E-mail: jennic4@yahoo.com Article information th th th th Received: March 25 , 2020; Revised: June 11 , 2020; Accepted: June 13 , 2020; Published: June 18 , 2020 Cite this article Knight-Johnson J.Towards a more sustainable response: Strengthening the social agenda in the human immunodeficiency virus infection and acquired immune defi- ciency syndrome epidemic. HIV/AIDS Res Treat Open J. 2020; 7(1): 3-4. doi: 10.17140/HARTOJ-7-132 he human immunodeficiency virus infection and acquired im- A greater emphasis on the social imperatives that impact mune deficiency syndrome (HIV/AIDS) response has made HIV prevention care and treatment should be further explored. T significant strides in preventing the spread of the epidemic global- The social agenda can play a greater role in the policy directives ly. Many of the achievements could not have happened without the and the operationalization of our interventions. It provides a stra- resilience of the people living with HIV/AIDS (PLHIV) commu- tegic framework and a conduit for the intersection with how hu- nity, the funding and technical support of the donor community man beings behave in society and the wider social context in which including public/private partnerships, the tenacity of the Govern- people live.4 The social includes, how we circumvent personal rela- ments (national response), the relentless outreach of the Non Go- tionships; engage in social institutions; and cultural configurations; vernmental Organization (NGO) community and their networks, our role in our of families and households; relationships with men, the untiring efforts of health care providers, and the activism of women, and children; response to HIV/AIDS discrimination and grassroots movements. The focus has shifted from an emergency its impact on the individual5 (the patient); the social interactions response to achieving epidemic control1 and the 95-95-95 targets, of the individual and the group; and the welfare of human beings, set globally. We are not there yet. The gains have been slowing, as as members of society. Social also means targeting our interven- declines in new infection rates are not consistent across countries,2 tions to society or in the way society is organized. Here are also the capability to retain patients in care is suboptimal, antiretrovi- the structural interventions in prevention which include address- ral treatment (ART) coverage has not reached established targets, ing gender inequalities, homophobia, stigma, and discrimination.6 and viral suppression rates are struggling to attain optimal levels in These are critical interventions. In addition, there are the social many countries.
determinants of health and by extension the social determinants of HIV/AIDS which incorporates lifestyle factors, social support There has been a dramatic shift in emphasis towards a systems, living and working conditions.
more targeted approach to reach geographic locations, and the populations most likely to transmit the disease. There has also been Addressing the social norms, processes and structural ap- an increased emphasis on combination prevention, case finding, proaches are no accident of history.
contact tracing, diagnostic testing, and expanded treatment regi- mens which are scientifically proven to improve the efficacy and Reflecting on the beginning of the epidemic reminds us tolerability for the patients in care.3 The question is how far will that there was a greater emphasis on the “modes of transmission” these interventions help to accomplish the gold standard in which rather than the social contexts around HIV prevention, care, and individuals, communities, the society, is sustainable and self-suffi- treatment. This was a missed opportunity as relationships, patterns cient?
cc Copyright 2020 by Knight-Johnson J. This is an open-access article distributed under Creative Commons Attribution 4.0 International License (CC BY 4.0), HIV/AIDS Res Treat Open J. 2020; 7(1): 3-4. doi: 10.17140/HARTOJ-7-132 of marriage, family life, the sexual socialization of children, inter- March 10, 2020.
generational modalities, gender imperatives, race, ethnicity, social class, inequities, power dynamics are embedded in communities 3. PEPFAR 2019 Country Operational Plan Web site. https:// that give the HIV virus a strong position for rapid transmission. www.state.gov/wp-content/uploads/2019/08/PEPFAR-Fiscal- Year-2019-Country-Operational-Plan-Guidance.pdf. Accessed Multiple interventions exist to address HIV/AIDS, and March 8, 2020.
only a minority pays sufficient attention to the social processes. These are the ones most likely to prompt the lasting changes 4. Harlambos M, Holborn M, Chapman S, Moore S. Haralambos needed to protect communities against the consequences of the th And Holborn - Sociology Themes And Perspectives. 8 ed. London, UK: disease. These are the ones that promulgate lasting changes that Collins; 2013.
5. Danziger R. The social impact ofHIV/AIDS in developing