[procaare] Re: African AIDS Patients Disprove Racist Views on Treatment (1)

[Jonathan Cohn <procaare@healthnet.org>]

Re: African AIDS Patients Disprove Racist Views on Treatment (1)
- Jonathan Cohn, USA
************************

It is certainly unfair to say that ARVs should not be available in Africa because African
patients are presumed to be less adherent with medication.  At the same time, there is a
significant danger of inducing drug resistance when patients are not consistent at taking
medications, which will lead to poor long term treatment of patients (with only a brief
benefit of therapy) and transmission of drug resistant virus limiting treatment options
for newly infected persons.  If, in the US, we treated only 10% of eligible patients,
selecting those who were expected to be most adherent (as DWB in Kayelisha did), our
adherence rates would also be quite high.

The point is, this article is encouraging, and indicates that ARV therapy can be very
successful in Africa.  It does not limit the urgency of providing very strong adherence
support programs to patients who are offered ARV therapy in Africa, and everywhere else
ARV treatment is made available.  Programatic measures to maximize patient adherence must
be a part of scaling up ARVs if this effort is meant to provide long term benefits.

Jonathan Allen Cohn
Associate Professor of Medicine
Wayne State Univesity School of Medicine
Email: jcohn@intmed.wayne.edu

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