HIV and RZHRG

Hey campers,
I dont really have too much exciting to report. I spend most of my time either at work, grocery shopping, walking around, or cooking and cleaning. I've actually started enjoying cooking since I have to do it. There just aren't too many local eateries around here with a wide array of vegetarian dishes. Or really too many eateries with a wide array of anything. But what I did want to write about was HIV in Rwanda and my employer, the Rwanda Zambia HIV Research Group (RZHRG). I realized that for many of my family and friends, HIV and AIDS may not be quite as familiar as for students of public health. You see, for MPH students, we spend more of our time learning about HIV than many of us would like because it is one of the greatest, and certainly one of the most sensational, public health problems of the present. And although the epidemic is much too difficult to explain in one blog, I wanted to try to explain a little more about what is happening and give a couple links to sites that have information on AIDS, particularly in Rwanda.

The first is UNAIDS, the program of the UN which deals exclusively with researching, preventing, and combating HIV and AIDS. Specifically, I have provided a link to the country specific report for Rwanda. The link is http://www.unaids.org/en/CountryResponses/Countries/rwanda.asp. However, unaids.org will bring up their larger site and provide much more information on the state of the epidemic worldwide and current efforts.

Rwanda, as in much of East Africa, has a fairly low prevalence rate, which is the percent of people living with HIV or AIDS compared to the total population. In Rwanda, it is estimated that about 2.8% of the population between the ages of 15-49 has HIV. Compared to South Africa, where almost 30% of the population has HIV or AIDS, that number is extremely low. But compared to the United States, which has a prevalence of about .28%, that number is pretty high. And in Zambia, the other country where the particular study that I am working for is located, the prevalence among 15-49 is 15.2%.
http://www.unaids.org/en/CountryResponses/Countries/zambia.asp

Although there is much debate about why Southern Africa (not South Africa specifically, but the region in general) is particularly hard-hit by the AIDS epidemic, while East Africa remains less affected, no one really knows. Perhaps its issues of prevention compliance (e.g. using condoms, delaying sexual debut) , gender inequity, polygamy, access to health services, or poverty. Likely its these reasons and more. But no one knows for sure why the AIDS epidemic is so bad in Africa and no one really knows the best way to prevent it.

However, people are trying. Many people and organizations, and one of them is RZHRG. Dr. Susan Allen started doing AIDS research in Rwanda in 1986, very shortly after HIV was "discovered". Dr. Allen is a proponent of couples voluntary counseling and testing, wherein couples are counseled about HIV in general together, are tested and given their results together, and are counseled regarding their results, whether they be positive or negative, together. Currently, almost 67% of new HIV cases are spread between married or cohabitating parters. This is not specific to Africa. The world over, the largest risk group for HIV transmission, is married women. Yet, until recently, HIV testing and prevention efforts focused primarily on testing only one person. Get one person in, test them, give them their results. Better than nothing, yes of course. But if that man or woman chooses not to tell their partner their results, and that is extremely common, then that testing doesnt really do much. How will a man explain to his wife that he needs to wear a condom if he doesnt want to tell her he has HIV? How will a woman explain that she shouldnt have any more children at the risk of passing on the virus without explaining why? These are the issues that direct couple counseling avoids. Couples come together and are tested together with the understanding that they will develop a prevention plan together, that they will live with the virus if one or both of them has it together, and that all decisions must be made together. Its pretty common sense, but has only recently been accepted as the standard for prevention among the public health world. Anyway, that is what Dr. Allen pioneered. The website for RZHRG is www.rzhrg.org. There are several publications on the website, in addition to general information, site photos, and information about the impact of AIDS on children, an entirely different ballgame.

I know that that was a quick and dirty discussion of HIV and RZHRG. If people have more questions, please let me know. As someone pointed out to me recently, I tend to talk about stuff without realizing that a lot of the time, other people dont have the background to really know what I am talking about. So please, if anyone wants to know anything about HIV, Rwanda, RZHRG, anything, please ask. If I dont know, I will at least post or email a link. And Im sure I didnt come close to providing enough information, so please let me know what other information would be useful.

On that note, I hope that everyone is doing well and is safe, happy, and healthy. Care packages appreciated (particularly including books, nuts, dried fruit, cheese if thats possible somehow, cereal, and cereal bars) and Go Obama!