This article has been penned by Dr. Abigail Zuger who is an associate professor of Clinical Medicine at Columbia University College of Physicians and Surgeons (JournalWatch® Specialties, 2010).
She is also the Senior Attending Physician at St. Luke’s-Roosevelt Hospital Center (JournalWatch® Specialties, 2010). Dr. Abigail Zuger has exhibited expertise and special interest in the infectious diseases and specifically HIV infection as can be evidenced by her role as HIV specialist and a board certified internist in infectious disease and specifically HIV.
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In this particular peer-reviewed article, “Can Counseling Change Heterosexual HIV Transmission Rates,” Abigail bases her argument on a program conducted specifically on African-American heterosexual couples to assess the impact, if any, of the counseling on heterosexual transmission (Zuger, 2010).
It is from the findings of this study that she came up with her conclusion that there is negligible, if any, impact of counseling on heterosexual HIV transmission within a number of communities, this therefore exonerates her from blame or accusation of bias in coming up with such an argument especially bearing the fact that counseling has been enlisted by majority of countries as a tool of reducing HIV prevalence rates within their population.
Introduction For almost twenty years now most people have come to know of their HIV status through the Voluntary Counseling and Testing (VCT), a client-initiated AIDS testing and counseling. Because of its effectiveness in creating HIV awareness almost all governments have employed it in one way or the other in their effort at decelerating the rate of this killer disease (Buckley, 2002).
One thing that this article notes that most of the us might not be familiar with is that counseling has not been able to directly reduce the HIV rates; instead it has created awareness about this disease thereby making knowledge of HIV status more prevalent and enabling people living with HIV to join care and treatment initiative of HIV while enabling those living without it to avoid HIV exposure and remain negative (World Health Organization, 2010).
Therefore Abigail argument can be interpreted to mean that HIV rates are only indirectly influenced by counseling services but not directly as some people might think, therefore there are other factors that have to be present for counseling to be effective in reducing the rates of HIV prevalence and incidence. The reason why the program that Dr. Abigail bases her opinion on was carried out on African-American community is due to the fact that HIV incidence and prevalence has been disproportionately high within this community and especially heterosexual transmission (Zuger, 2010).
The article’s content This article is all about the effectiveness of counseling has a tool of reducing the incidence and prevalence of HIV, in exploring the effectiveness of this method the author analysis a program undertaken on 535 HIV serodiscordant couples to check on whether their sexual behaviors before the counseling sessions are influenced in any way by the counseling itself (Zuger, 2010).
It is disappointing to note that they seem to put into effect the sexual-risk reduction measures that they are taught for only a short period (12 months) and then revert back to business has usually which explain why HIV prevalence and incidence rates are high within this community more than any other in the United States. There is little evidence that members of this community avoid high-risk sexual behaviors after a counseling session providing them with sexual-risk reduction strategies. Article’s Claims
Even though the author makes the humble submission that there is little that counseling can do to reduced the incident and prevalence of heterosexual HIV transmission within the African American community she which she bases from a didactic program, she is quick to note that further research, most probably not based on education program, should be conducted to reinforce the findings of this one that she bases her argument, this is captured in the comment section of this article where she declares her reservations when it come to data taken just after a didactic program just like this one (Zuger, 2010).
Article’s claims HIV treatment The article might be silent on the probable treatment of this infection but the author offers advice on the best course of action in reducing HIV infection. This is best captured when he suggest that “similar counseling tools could be streamline into a long-term effort that would have more palpable success. (Zuger, 2010)” One thing about the finding of this article that a keen observer would note is that they might not apply in all circumstances, however the Multipronged approach that the author advocates for can and should be applied in all places because of its universality.
It is evident that there are some communities where members have adopted sexual-risk reduction practices permanent after attending sexual-risk reduction counseling session. I also agree with the author that didactic programs are not always the best to draw a general conclusion on matter as sensitive as a HIV transmission. This therefore denies this article a national or even a global application. The inapplicability of the finding of this article in the national or global stage is further reinforced by the lack of the any scientific evidence to support the claims that this article makes. Conclusion
This article opens a case for further investigation, based on the findings of that programs that the authors bases her arguments it is likely that HIV incidences and prevalence are not sensitive to counseling in certain setting, it might also be possible that in other settings, like Brazil for instance where counseling has positively been credited with the reduction of incidence and prevalence of HIV (AVERTing, HIV and AIDS, 2010), the prevalence and incidence of HIV have responded to counseling and testing thereby making it an important procedure not just in enabling people to know their HIV status but also in empowering those not found living with HIV with information and techniques, like sexual-risk reduction practices, that will prevent them from contacting HIV and thereby reducing its prevalence and incidence among this population. One of the reasons which cast doubt on the finding of this program that the author bases her arguments is the fact that counseling and testing have been employed in almost all places and communities where HIV prevalence and incidence have been high thereby giving it a thumb-up (literary) when it comes to reducing HIV prevalence and incidence. That is the reason why counseling has been noted to be more helpful to people who have HIV because it has taught them on how to reduce HIV exposure and remain negative majority of whom have obeyed that call and backed it with actions. References
Zuger, Abigail, Can Counseling Change Heterosexual HIV Transmission Rates, Journal watch HIV/AIDS Clinical Care 26 July 2010 World Health Organization, (2010). HIV Testing and Counseling. Retrieved 9 August 2010 from http://www. who. int/hiv/topics/vct/en/index. html JournalWatch® Specialties, (2010). About The Journal Watch HIV/AIDS Clinical Care Editorial Board. Retrieved 9 August 2010 from http://aids-clinical-care. jwatch. org/misc/board_about. dtl#aZuger AVERTing, HIV and AIDS, (2010). HIV and AIDS in Brazil. Retrieved 9 August 2010 from http://www. avert. org/aids-brazil. htm Buckley, R. Michael, (2002). HIV Infection in Primary Care. Amsterdam: Elsevier Health Sciences
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