Strategies to integrate community-based traditional and complementary healthcare systems into mainstream HIV prevention
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Strategies to integrate community-based traditional and complementary healthcare systems into mainstream HIV prevention programs in resource-limited settings Subash Thapa1*
and Arja R. Aro2
Abstract Background: Global spending for HIV prevention has been decreasing over the years. As a result, several low-income countries, including Nepal, are increasingly facing the challenge to minimize the funding gap to continue providing HIV prevention services to the people. In this paper, we have attempted to clarify why it is important to integrate community-based traditional and complementary healthcare systems and mobilize them into the mainstream HIV programs to ensure access to HIV prevention messages, HIV testing, and treatment in resource-limited settings. Main body: First, we argue that the traditional and complementary healthcare practitioners can be mobilized to routinely provide HIV prevention messages to their clients, and, next, some of them can be trained to build their capacity to work as counselors or educators for HIV prevention in the community. Conclusion: These approaches, if implemented, can help continue HIV prevention initiatives and contain the HIV epidemic at the local level in the rural communities with limited cost and resources. Keywords: Community-based approaches, Complementary medicine, HIV prevention, Nepal, Traditional medicine
Background HIV testing, the disclosure of HIV positive status and antiretroviral treatment (ART) uptake are important strategies for the HIV prevention. However, more than 40% of population at-risk of HIV worldwide do not have an access to HIV testing services and more than 50% of the people living with HIV do not receive ART [1]. Global spending for HIV prevention has been decreasing over the years and several low-income countries are increasingly facing the challenge to minimize the funding gap to continue providing HIV prevention services [2, 3]. Even, to maintain the current progress in HIV, it is estimated that low-income countries need to significantly increase their investment from US$20 billion to more than US$35 billion by 2031 [4].
* Correspondence: [email protected]; [email protected] 1 Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark Full list of author information is available at the end of the article
In Nepal, HIV is a concentrated epidemic among at-risk population groups. The epidemic is mostly driven by heterosexual transmission, which accounts for more than 85% of total new HIV infections [5]. Among the total population infected with HIV, 40% are the general male population and 35% are the general female population. The other population groups include injecting drug users (8%), transgender people (2%), their clients (5%), men having sex with men (9%), and female sex workers (1%) [5]. The Nepal Demographic Health Survey of 2016 has reported that 89% of men and 80% of women have never been tested for HIV. And, only 12% of men and 19% of women have knowledge about
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