Confronting AIDS Directions for Public Health, Health Care, and Research (1986) / Chapter Skim
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7. International Aspects of AIDS and HIV Infection
7. International Aspects of AIDS and HIV Infection
Pages 261-278
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From page 261... ...
The second category comprises developing countries where AIDS and HIV infection seem to occur among sexually active men and women in approximately equal proportions and in their offspring, and therefore where heterosexual spread is presumed to be the predominant mode of transmission. Such countries include, but may not be limited to, those of central Africa and certain countries in the Caribbean, including Haiti.
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From page 262... ...
These proportions, if valid for other areas in central Africa, would suggest that if seropositive pregnant women deliver, possibly tens to hundreds of thousands of infants in Africa will die of AIDS in the next decade. The adoption of birth control measures in Africa has not been great for instance, Kenya has the world's highest fertility rate; hence the prospects for education and prevention in this matter seem bleak.
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From page 263... ...
The European Economic Community, in addition to the research and prevention efforts in various individual countries of Western Europe, has established an advisory group of scientists drawn from its 12 member
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From page 264... ...
technical development assistance efforts may be jeopardized if HIV infection and AIDS are allowed to spread unchecked. If the United States and other developed countries fail to vigorously support and, where appropriate, to become involved in efforts to control AIDS and HIV infection at all levels internationally, millions more than those now infected in poorer countries may die of this infection over the next decade or so, because the resources of developing countries to control this and other health problems are grossly inadequate.
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From page 265... ...
Data from central African countries suggest that many infants are acquiring HIV infection perinatally (Mann, 19861. When administered to infants infected with HIV, vaccines, particularly live replicating ones, may precipitate rapid progression to AIDS.
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From page 266... ...
The spread of penicillin-resistant gonococci from Southeast Asia to the United States and elsewhere is a recent example of the global spread of sexually transmitted diseases. The mobile nature of today's society has also undoubtedly contributed to the spread of HIV.
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From page 267... ...
government have special international responsibilities or may be able to make contributions to the global effort to control the epidemic. The Agency for International Development sponsors technical assistance programs in a number of countries, including many health improvement programs in areas such as immunization.
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From page 268... ...
It may also result in other countries establishing restrictions on travel from the United States. INFECTION RISKS OUTSIDE THE UNITED STATES Sexual Exposure Sexual relations probably account for the largest amount of transmission of the virus both inside and outside of the United States.
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From page 269... ...
Exposure Through Blood Transfusion Contamination of blood transfusions with HIV poses a decided risk of infection in many parts of the world, the exceptions being the countries (such as those of Western Europe) that have taken precautions with blood donations and have applied the serologic test to blood banking.
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From page 270... ...
But the application of currently available serologic tests will be possible only in some situations, since it is expensive for developing countries and requires highly trained personnel to apply and confirm. Simpler serologic tests, giving sensitive and specific results rapidly and reliably, are essential before widespread efforts to control HIV transmission via the blood supply in developing countries will be practicable.
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From page 271... ...
Notwithstanding a report that regions in DNA of various insects from central Africa are homologous with HIV proviral DNA (Becker et al., 1986) , other sources of data suggest that vectorborne or casual contact transmission is unlikely.
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From page 272... ...
American foreign travelers or residents abroad should be apprised of the risk they face. INTERNATIONAL RESEARCH OPPORTUNITIES The differences in epidemiologic patterns of HIV infection among countries offers a remarkable opportunity to define modes of spread and the effectiveness of alternative control strategies by concentrating resources where they could be most effectively used.
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From page 273... ...
The heavy burden of parasitic and other infectious agents borne by many African populations generally and the distinctive infectious disease patterns seen in African AIDS patients suggest the importance of examining in far greater detail the interaction of HIV with a variety of infectious agents. It seems clear that the immunodeficiency characteristic of AIDS results in the presentation of AIDS patients with disseminated infections with agents common there, such as Mycobacterium tuberculosis.
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From page 274... ...
Hence, investigators supported by the Centers for Disease Control, the National Institutes of Health, and the Department of Defense have been involved in collaborative epidemiologic, serologic, and virologic studies of AIDS and HIV infection at various sites around the world, particularly in sub-Saharan Africa but also in Europe and Southeast Asia. Until the fall of 1985 the Agency for International Development of the Department of State the only federal agency with a direct mandate to be involved in international health activities had no specific policy with regard to support of activities related to AIDS or HIV infection.
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From page 275... ...
There will be opportunities for productive freestanding research projects or research projects that could usefully be coupled to prevention and control efforts but that do not fall within the scope of the WHO program. These could be pursued bilaterally, with funding from agencies such as the National Institutes of Health, the Centers for Disease Control, and the Department of Defense, as well as the Agency for International Development.
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From page 276... ...
, and support of bilateral technical assistance agreements. Given the magnitude of the problem, particularly in central Africa and increasingly in Latin America, and the variety of reasons warranting U.S.
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From page 277... ...
1986. Infection of insect cell lines by HIV, agent of AIDS, and evidence for HIV proviral DNA in insects from central Africa.
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From page 278... ...
1986a. Surveillance for AIDS in a central African city: Kinshasa, Zaire.
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