Seroconversions

At work today, we had our third seroconversion in two weeks, meaning that, in only fourteen days, three of our study participants who were initially HIV-negative have been infected with the virus. That’s three more individuals added to the forty million already living with HIV/AIDS. Three more who will ultimately die from a disease that has been around for twenty years and yet we still can’t find a way to prevent or cure it. These three individuals weren’t infected because they were part of a classic ‘high risk’ group such as sex workers or injecting drug users. And they weren’t uneducated about HIV; on the contrary, they received counseling and education from the project at least once every three months. Their only downfall was being married to or cohabiting with someone who was HIV-positive. So if these individuals weren’t participating in ‘high risk’ behavior and they weren’t unaware of the disease, how much, then, are our prevention strategies really doing? In the world of HIV, we continue to preach the ABCs, but are those interventions really appropriate for the largest risk group in the world? Abstinence promotion isn’t exactly an appropriate intervention when you’re working with married and cohabiting couples. Being faithful is a suitable message, but it does nothing for discordant couples where one partner is already HIV-positive. Condom use is the only other strategy, and while it has been proven effective, it isn’t always an option. What about those with religious beliefs which prohibit contraceptive use? Or those in relationships with partners who refuse to use them? Or those who want to have children? Maybe the ABCs are the best option we have right now, but if the best we have doesn’t work for the largest risk group in the world, then what do we really have?