The treatment of HIV infection as a chronic manageable disease, instead of a fatal one, has become a reality thanks to Antiretroviral (ARV) treatment.

Does ARV/ART treatment save HIV-positive people?

According to AllLife’s medical experts, while HIV remains a global health issue, South Africa has experienced an impressive reduction in mortality since the introduction of more generally available Antiretroviral (ARV) treatment. As a result, the concept of treating HIV infection as a chronic manageable disease has come closer to reality.

“The introduction of ARVs to people living with HIV in South Africa has significantly modified the course of the disease into a chronic manageable one, with longer survival and improved quality of life,” said Dr Avron Urison, Medical Director at AllLife.

He pointed out that research from the Actuarial Society of South Africa (ASSA) highlighted the dramatic changes in mortality:

“Life expectancy at birth showed a sharp decline from 1994 to 2006 as a result of the AIDS epidemic. Total population life expectancy had fallen to 54 years by 2003 (from 62 years in 1994) and remained there until 2005.13 Since then, life expectancy at birth has improved meaningfully with the help of the aggressive roll-out of ARVs. According to ASSA2008, which was published in 2011, life expectancy would have improved to 58 years by 2014. However, using more up-to-date data from the RMS report of 2014 (Dorrington et al., 2014), the increase is even more pronounced with total population life expectancy in 2014 estimated at 62.9 years. While advances in medical technology and greater access to medical facilities, in general, would have contributed to this improvement, we believe that accelerated ARV roll-out is a significant driver. The indications are that life expectancy has improved even further since 2014, especially in the light of the Department of Health’s (DoH) change in CD4 count threshold in 2011 to 350 cells/μl, and could increase even further following the change in the CD4 count threshold to 500 cells/μl (effective January 2015). Emerging threats to these mortality improvements include increasing drug resistance, rising frequencies of drug stock-outs and patients not adhering to prescribed treatment programmes.”

Urison held that the increased longevity of people living with HIV is owed not only to the large ARV treatment coverage in South Africa, but also in the range of management programmes that help people remain adherent to proper therapy and empower people, through the provision of key health information, to take care of themselves.

AllLife, providers of comprehensive life cover to people living with HIV, links its insurance products to their own, free, in-house, adherence management programme, that ensures their clients can manage their health appropriately, empowering them to take action and maintain their own wellbeing.

Urison added, however, that pre-test (in addition to post-test) counselling also plays a significant role in the process.

“The purpose of pre-test counselling is to provide one with information on the strict phases of testing and the possible medical, social and psychological implications should one be diagnosed as HIV-positive,” Urison pointed out. “This paves way for people living with HIV to acquire all the information necessary to benefit from increased access to antiretroviral treatment provided.”

He said that people living with HIV need to acquire more information from their insurers, doctors and community health centres on the medication they take, as well as on the disease in general.

“That way, the fear that people living with HIV have of their health deteriorating after commencing treatment, will cease,” Urison said.

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