Posted by: rstewart1 | 03/21/2011

New challenges in treating next generation of AIDS patients

NOTE: This is a guest blog by Dr. Rick A. Martinez of  Johnson & Johnson

I have been traveling to the Caribbean often since 2003. The trips are not for vacation, but to visit local organizations dealing each day with the HIV epidemic and its impact on the community. More to the point, I go to learn how my employer, Johnson & Johnson could assist in the battle stop the disease.

Just eight years ago, very few people received treatment and many died at home in the care of overwhelmed and desperate relatives or friends. Seeing the devastating impact of the epidemic, Jeffrey Sachs commended the private sector for its donations of services and products, and called on governments to step it up and take action to save more lives.

They heard the call and soon after Sachs’ study, governments from several countries pooled their resources into a “global fund” to help poor countries gain access to life saving medicines for their citizens. Since its inception, The Global Fund to Fight AIDS, TB and Malaria has provided an estimated 2.9 million people around the world with anti-retroviral medications.

The result was heartening to witness. The public and private sectors joined forces to provide millions of victims with the ARV treatments critical for improving health and productivity – and offer some relief to the families who felt the burden of caring for sick family members.

But as with every global challenge – address one problem and new ones appear.

During my recent visit to Nassau I met several teenagers living with HIV, who are not taking the medications they need to manage their illness. Why? Sadly, despite the fact that Bahamian government provides young people with HIV medication, the teenagers are rebelling. They are refusing to take their ARVs because of stigma and peer pressure. Like other teens, they are eager to prove that they fit in – and as a result are putting their lives in jeopardy.

The Director of the Bahamas AIDS Foundation, Camille Barnett shared with me that her organization regularly receives calls from doctors desperate to help these young people.  The foundation is also striving to help teens who have lost both parents to AIDS – and are now homeless. Many of these young people have dropped out of school, so the Foundation’s off-site programs offer mentoring, tutoring and meals to these young people.

These kinds of nonmedical, psychosocial services re-connect and acculturate them where caring adults from the community can supervise those that have lost both parents. Otherwise, this new generation of HIV victims would be cut off entirely from the social supports necessary for every teen.  In these cases the Foundation’s services are life-saving to teens with HIV. But for every teen lucky enough to find the Foundation’s help, another is faltering alone without the knowledge or access these teen-focused supports.

In this decade, we can be proud of what has been done to improve access to HIV medicines. But now, we face a new set of challenges that are no less vexing. We must, on one hand, focus on addressing the psychosocial needs of young people facing the very adult task of managing HIV infection – while at the same time helping other teens deal with the loss of parents who have succumbed to the virus.

I am hopeful that the world will apply the same ingenuity we summoned previously to expand access to HIV medications to tackle this new set of challenges. The alternative is unthinkable – we cannot stand by while HIV ravages another generation.

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