Faith-based groups can help stem AIDS in Africa, say UN official

Faith-based groups can help stem AIDS in Africa, say UN official

Religion and faith-based groups play a very important role in many poor countries — especially in sub-Saharan Africa–in the fight to stem the global HIV/AIDS epidemic, senior United Nations health officials said on July 18.

In countries such as Zambia, Malawi, Kenya, and Tanzania, they provide up to 40 per cent of health services, said Paul De Lay, deputy executive director of the Joint UN Program on HIV/AIDS (UNAIDS).

Organisations run by Adventists, Catholics, Lutherans, and the Salvation Army specialise in hospitals and the delivery of healthcare services, said De Lay in an interview ENInews.

“They can also play a very powerful role in dealing with stigma and discrimination that surround the AIDS epidemic, welcoming people who are HIV positive — people who disclose their status within their congregations — rather than excluding them,” he added.

Though there have been examples of faith groups giving confusing information about condoms, or practicing discrimination, these have been exceptions, said De Lay.

“We see religion and faith-based organisations as a strong ally in the AIDS response. We need to work better with them,” he concluded.

Dr Gottfried Hirnschall, director of the HIV department at the World Health Organisation, told ENInews that faith-based health facilities in sub-Saharan Africa play a “tremendous role” in providing services, especially where efforts from the government and the private health sector are weak.

Sally Smith, partnership adviser and focal point for faith and religion organisations at UNAIDS, said there is a “huge potential to scale-up” faith-based services, and noted the service they deliver far outweighs the number of grants they receive from the Global Fund to Fight AIDS, Tuberculosis, and Malaria.

A new UNAIDS study, “Together We Will End AIDS,” released on July 18 ahead of the upcoming XIX International AIDS Conference to be held in Washington, D.C. from 22-27 July, says Sub-Saharan Africa has the highest number of people living with HIV (23.5 million), new infections (1.7 million), and deaths due to AIDS (1.2 million).

By John Zarocostas, Ecumenical News International

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  1. Early brain biopsy may be indicated in HIV patients with focal brain lesion. This study aimed to evaluate and compare the safety and diagnostic value of brain biopsy in HIV patients in the pre-highly active antiretroviral therapy (HAART) versus post-HAART era via meta-analysis. Appropriate studies were identified per search criteria. The local database was retrospectively reviewed to select a similar patient cohort. Patient demographics, brain biopsy technique, histopathology and patient outcomes were extracted from each study. Study-specific outcomes were combined per random-effects model. Outcomes were compared between the pre-HAART and post-HAART era. Correlations between outcomes and baseline characteristics were assessed via meta-regression analysis. The proportions of histopathological diagnosis were tabulated and compared between the pre- and post-HAART era. Survival analysis was performed for patients in the post-HAART era. A total of 26 studies (including the local database) with 1209 patients were included in this meta-analysis. The most common indications for brain biopsy were diagnosis unlikely to be toxoplasmosis (n=8, 42.1%), focal brain lesion (n=5, 26.3%) or both (n=3, 15.8%). The weighted proportions for diagnostic success were 92% (95% CI 90.0% to 93.8%), change in management 57.7% (45.9% to 69.1%) and clinical improvement 36.6% (26.3% to 47.5%). Morbidity and mortality were 5.7% (3.6% to 8.3%) and 0.9% (0.3% to 1.9%), respectively. Diagnostic success rate was significantly higher in the post-HAART than the pre-HAART era (97.5% vs 91.9%, p=0.047). The odds ratio (OR) for diagnostic success in patients with contrast-enhanced lesions was 2.54 ((1.25 to 5.15), p<0.01). The median survival for HIV patients who underwent biopsy in the post-HAART era was 225 days (90-2446). Brain biopsy in HIV patients is safe with high diagnostic yield. Early brain biopsy should be considered in patients without classic presentation of toxoplasmosis encephalitis

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