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Then, the HIV Prevention Trials Network (HPTN) announced in May 2011 that the 052 clinical trial had demonstrated a 96% reduction in heterosexual HIV transmission 14. HIV/AIDS researchers debated whether ARV treatment that effectively suppresses viral replication might also reduce transmission rates 13. BC’s HIV treatment guidelines recommend beginning antiretroviral (ARV) therapy earlier in the course of infection – at CD4 count of 500 cells/mm 3, sometimes higher 12. People treated early can live long and productive lives, with lifespans approaching that of the general population 11. Highly active antiretroviral therapy (HAART) has changed HIV from death sentence to manageable chronic disease. Rationale for routine HIV testing is summarized here in a few key points:
In BC, about 65% of diagnoses occur after our patients should already be on treatment 9, with up to 17% having advanced disease at the time of diagnosis 10. That translates to about 3,500 people in British Columbia 2,8 who may unknowingly infect others with the virus, and who may benefit from treatment if diagnosed. It’s estimated that 1/4 of Canadians living with HIV are unaware that they are infected 7. Specifics of those recommendations vary, but the goal is the same: to reduce the proportion of individuals with HIV infection who remain undiagnosed or present late for care. The United States 3, United Kingdom 4, France 5 and the World Health Organization 6 are among those preceding Canada with guidelines for expanded HIV testing. Routine HIV testing for all adults is now recommended 1,2 by Vancouver Coastal Health, Providence Health and the BC Centre for Excellence in HIV/AIDS. But I did not routinely offer and recommend an HIV test to all adults, in either of my practices. At the sexual health clinic, I encouraged ‘higher risk’ patients to get tested.
In family practice, I only occasionally recommended an HIV test outside of antenatal care. Marisa Collins ( biography and disclosures) The issues of sexual orientation and sexual behavior (as well as the points they differ and overlap) still require further research and are more complex than most believe.Dr. Politics is all about rights and bills, which genuinely affect people the most. Though, it’s worth mentioning that the recent year saw a rise of several pro-LGBT religious groups, including individual churches, synagogues, and denominations. Religion comes from the perspective of religious fundamentalism. Healthcare is all about biology, particularly neurobiological research, and our psychosexual development studied by Freud. As every field brings its side of sexuality to the front, and none take a comprehensive approach.
And we doubt they’ll achieve a common ground anytime in the future. Is it a choice or a predisposition? The best minds of our world have not come to a unanimous conclusion yet. Numerous scientists, psychologists, healthcare professionals, and even religious activists are debating the nature of homosexuality (as well as other kinds of sexuality). Why am I gay ? That is a question that is even harder to answer.