The fact that HIV replicates at an overwhelmingly alarming rate, combined with difficulties encountered by scientists questing for a treatment for the virus, has been a serious public health issue for years. Whether or not premarital screening for HIV and other dreadful disease should be done, has been highly contested for years, especially since the discovery that HIV can be transmitted through sexual contact. However, most experts argue that this might well be one of the surest ways to bring the spread of the virus under control. Since the discovery of the HIV, significant advances have been made into deciphering its internal structural components, especially the genome, with a view to fashioning effective antiretroviral drugs.
The vast majority of HIV-infected people across the globe live in developing countries, where access to sophisticated medical care and costly medications is far beyond the reach of nearly all of those infected. Although the spread of the disease is leveling off or even declining in most industrialized countries and a few developing nations, the epidemic is spreading dramatically in most poor countries, reflecting a gap in preventive efforts. AIDS-related death rates are also at a steady decline in industrialized countries but rising alarmingly in developing nations, underlining an enormous gap between rich and poor societies in their ability to provide life-prolonging treatment. More than 30 million people throughout the world are currently living with HIV and AIDS, with some 16,000 people been newly infected by the virus each day according to estimates by the Joint United Nations Program on HIV/AIDS (UNAIDS). The area most devastated by the disease is sub-Saharan Africa, where nearly 21 million people are living with HIV infection. Infection rates are soaring in much of Asia and Eastern Europe, with many countries tripling their AIDS rates between 1994 and 1997. Overall, about 6.4 million people in Asia and the Pacific island nations are thought to be living with HIV-more than one in five of the world's total HIV cases.
Preventive measures have actually led to a decrease in HIV infection rates in Western Europe. In the United States new HIV diagnoses have leveled off at about 40,000 cases per year, according to a 1998 report by the Centers for Disease Control and Prevention (CDC).
Some of the public health importance of HIV includes increasing
- Structuring a preventive stealth
- Prevention of mother to child transmission
- Control of the incidences of opportunistic infection
- Early initiation of HIV vaccination
- Immediate initiation of counseling
- Reducing heterosexuality
All these will on the long run reduce the
- number of orphans and widows
- incidence and prevalence of tuberculosis and other opportunistic infection
- incidences of Kaposi's sarcoma and other dermal complications
- other infectious diseases resulting in increased bed occupancy by HIV infected persons
- chances of trasmissibilty of the virus between unsuspecting couples
Premarital screening if holistically accepted is a strong preventive strategy for the spread of HIV. Its control of the spread of the disease can be by:
Structuring a preventive stealth
Numerous efforts to bring the prevalence of HIV under control has been quelled by some unchanging widespread social and behavioral practices that contribute to the spread of HIV. For example, women in many countries and cultures are unable to insist that a sex partner use a condom, which would help protect them from infection. To combat this problem, many public health experts support development of an effective and inexpensive “stealth” method such as a microbicide, an HIV-killing gel or cream that a woman could use with or without a partner's knowledge. By the use of such agents, an infected partner can really delay the time for his or her spouse to get infected.
Prevention of mother to child transmission
Worldwide, the frequency of transmission of HIV from mother to child range from 11% to more than 40% of children born to HIV-infected women, with transmission rates approximately doubled in breast-fed compared to formula-fed children. Cases of mothers refusing to be consensual to antenatal HIV can be reduced to the minimum if a premarital screening test is backed with counseling and further enlightenment of HIV positive couples. A source stated that perinatal antiretroviral treatment with zidovudine can reduce mother-to-child (vertical) transmission of HIV from around 25% to 8%. Also, knowledge of the HIV positive status of a mother can help implement avoidance of breast feeding and other critical obstetric management. An established case of HIV infection in a woman before marriage may improve her responsiveness to routine antenatal checkup - a concept that is all-important in the developing world where antenatal schedules are repeatedly overlooked.
Control of the incidences of opportunistic infections
Prior to the widespread use of potent combination antiretroviral therapy (ART), opportunistic infections (infections taking advantage of the immunosuppression in HIV-infected persons) were the principal cause of morbidity and mortality in this population. In the early 1990s, the use of chemoprophylaxis, immunization, and better strategies for managing acute opportunistic infections contributed to improved quality of life and improved survival. However, the widespread use of potent ART starting in the mid-1990s has had the most profound influence on reducing OI-related mortality in HIV-infected persons in those countries in which these therapies are accessible and affordable.
