Controlling the HIV and AIDS epidemics requires a complex public health approach that would meet various challenges. These challenges are separated into two main categories: timely identification of people with HIV infection in order to prevent its spread and introduction of more effective treatment mechanisms for the existing cases. Therefore, this review focuses on the scholarly articles dedicated to HIV identification, prevention, and treatment strategies.
Mixed‑Method Evaluation of Social Media‑Based Tools and Traditional Strategies to Recruit High‑Risk and Hard‑to‑Reach Populations into an HIV Prevention Intervention Study
The existing statistical data on HIV allows identifying several groups of risk which are exposed to the disease to a greater extent. However, the members of those groups are often reluctant to participate in research and monitoring programs. According to Iribarren et al. (2018), recruitment among the men who have sex with men (MSM) and transgender women (TGW) is time-consuming and costly due to persistent discrimination. As a solution to that issue, Iribarren et al. (2018) suggested using social media-based recruitment strategies to attract volunteers from the high-risk and hard-to-reach populations. Using a filtered search in various social media, the recruiting team managed to screen and recruit the highest number of eligible participants — 117 persons out of 226 (Iribarren et al., 2018). That method yielded better absolute results than the other ways of recruitment, such as in-person one-time events, referrals, and printed materials (Iribarren et al., 2018). Overall, social media proved their potential in HIV prevention by aiding to find people from high-risk groups and raise their awareness of HIV.
However, social media-based recruitment to HIV screening and prevention programs appeared to have several weaknesses. Most importantly, the process of search and communication remained time-consuming and labor-intensive (Iribarren et al., 2018). In addition, the recruiters often found it challenging to create a needed rapport with the participants online. Lastly, the recruiters’ profiles were often suspended or banned either by the platforms or the users themselves (Iribarren et al., 2018). All of those issues led to only 26% of successful recruitment attempts in social media (Iribarren et al., 2018). Therefore, social media recruitment for HIV identification and prevention needs appears effective but not the most efficient method. The researchers have to prepare for monotonous labor and multiple failures if they want to achieve decent results.
The WHO Public Health Approach to HIV Treatment and Care: Looking Back and Looking Ahead
The timely identification of HIV cases remains vital for combating the spread of disease. However, health care systems must also provide medical treatment to people already diagnosed with HIV. Ford et al. (2018) conducted a retrospective analysis of the World Health Organization’s (WHO) effort in HIV treatment and stated that it led to significant progress. More precisely, in 2006, WHO introduced a new public approach to antiretroviral therapy (ART) to support its scale-up in resource-poor settings (Ford et al., 2018). According to Ford et al. (2018), WHO guidance helped achieve the progress in following ART aspects:
- Standardized regimens and simplified formularies:
- Simplified clinical decision making and standardized monitoring;
- Decentralized, integrated delivery of care;
- Task shifting and specialist support;
- Free provision at the point of care;
- Procurement and supply management.
The evidence in favor of the new public approach to ART is strong. However, Ford et al. (2018) outlined several guidelines to improve the WHO effort further. Arguably, the most important suggestion is linking HIV testing and treatment to HIV prevention (Ford et al., 2018). This insight is directly connected with HIV prevention since the improvement of HIV screening and testing coverage is necessary for the identification and treatment of HIV-positive individuals.
Overall, HIV prevention and treatment have made significant progress over the past years. However, room for improvement of HIV treatment coverage still exists. Modern digital and communication technologies could provide a necessary solution for identifying HIV-positive individuals from the high-risk and hard-to-reach groups of the population. By linking HIV prevention and treatment efforts in a complex public health approach, the medical professionals would be enabled to provide adequate care for HIV-positive patients and improve their quality of life.
References
Ford, N., Ball, A., Baggaley, R., Vitoria, M., Low-Beer, D., Penazzato, M., Voinov, L., Bertagnolia S., Habiyambere, S., Doherty, M., & Hirnschall, G. (2018). The WHO public health approach to HIV treatment and care: Looking back and looking ahead. The Lancet Infectious Diseases, 18(3), e76-e86.
Iribarren, S. J., Ghazzawi, A., Sheinfil, A. Z., Frasca, T., Brown, W., Lopez-Rios, J., Rael, C.T., Balan, I.C., Crespo, R., Dolezal, C., Gicuere, R., & Carballo-Diéguez, A. (2018). Mixed-method evaluation of social media-based tools and traditional strategies to recruit high-risk and hard-to-reach populations into an HIV prevention intervention study. AIDS and Behavior, 22(1), 347-357.