Cuba first to eliminate mother-to-baby HIV transmission | Hacker News Reader

Cuba first to eliminate mother-to-baby HIV transmission

theguardian.com

148 pointswrongc0ntinent27 comments

Back in the 1980's there was a group of punk rockers in Cuba called "Los Frikis" that Radiolab did an episode about[0]. Back then, it was prevalent amongst this group to inject themselves with HIV virus as a form of protest against Castro's regime. With 30 years between generations, if any of the Los Frikis had families, their grandchildren would be born around now. I wonder if this news and their acts of protest are related.

[0]: http://www.radiolab.org/story/los-frikis/

They injected themselves with HIV to get into the sanatorium where it's a much better life. It was also a message saying they'd rather die than live in the world the government created for them outside. Two of them are still alive, out of around 200, and they're still there, despite the sanatorium being now abandoned.

http://www.browardpalmbeach.com/news/los-frikis-documentary-...

"acts of protest" Yeah... sure...

If this can be replicated elsewher it's huge.

For Zimbabwe, 40% of infant / childhood deaths are from HIV/AIDS. The vast majority of those from mother-to-child transmission. Life expectency in Zimbabwe and numerous other African nations has decreased by about 20 years since the 1980s, falling to levels of the 1940s and 1950s.

http://www.worldlifeexpectancy.com/country-health-profile/zi...

http://www.worldlifeexpectancy.com/life-expectancy-africa

(Poke around that site a bit, but be warned, it's sobering.)

Maybe it's in the article and I'm missing it, but can anyone cite what the WHO considers "eliminate" to mean in this context? All I see is that in 2013 two babies were born with HIV (though seeing as mother-to-baby appears to include from breastfeeding, I'm not sure that number is the full picture). Does eliminate mean there was a single year (2014 I guess) with no mother-to-baby transmission?

The reason I'm curious is because just because this year there are no cases, doesn't mean there won't be next year. So I wonder what the definition they're using is.

You will find more info in the WHO press release here http://who.int/mediacentre/news/releases/2015/mtct-hiv-cuba/... (under "note to editors" some, but there is a separate document mentioned that specifically addresses requirements)

Article says rate down to 2%, which is the lowest achievable when good practice is followed

This is pretty great. Only 2 babies born with HIV in Cuba last year, although the article doesn't say how many were born previous years.

Only data I could find says as of 2011, 6,200 adults had HIV in Cuba.

Seems to check out with the numbers.

6200 HIV adults and a stable population says something like 3100 are female and with 30 child bearing years and two children over that period about 200 of them should give birth each year. A 1% probability of passing along HIV with the retroviral treatment gives 2 HIV babies a year.

(I'm actually a little surprised when a news article's math works.)

I don't know whether the policy has changed since I read of it many years ago, but the Cuban government treated HIV infection pretty much the way the US government once treated leprosy: turn up positive, and you were quarantined.

not entirely accurate, yes you are quarantined, but for 8 weeks of intensive education about your condition and the risks of infecting others. Then you are released and given full access to antiretroviral drugs.

Technically, this does work doesn't it?

I suspect not. It seems likely that such a policy would prevent any at-risk patients voluntarily testing, meaning they remain unaware of their HIV status and continue to spread the virus.

I'm not sure if there's research on this though - it would be interesting to see.

If Cuba is anything like the USSR, preventing voluntary testing does not mean one can remain untested. The government medicine also means you cannot deny medical procedures that the government has prescribed to you.

It works on everybody you find, but that kind of treatment tends to discourage people from coming forward, which can make things worse.

It was a much better environment inside the sanatorium - free good food, medicines, beds, so it isn't too bad of a choice to come forward - some people even injected themselves with HIV to get into the sanatorium.

That seems very short-sighted. With (what appeared at the time as) a looming epidemic, what made them so confident that conditions at the sanatorium would be maintained in the future?

Not in a much more meaningful way than a gunshot to the head works for curing cancer.

For some kinds of cancer a gunshot to the head is the humane choice

So many Cuba posts/articles these days. I'm still cautious about how this will actually turn out for the cubans or if we'll get a rosy view of what it's actually like over there.

Probably a mix of genuine moment-driven features with lobbying efforts.

http://www.paulgraham.com/submarine.html

Fantastic news, let's hope other countries soon follow their example!

Another thread on HN had informative posts describing how diseases have been cured in Cuba by government threatening to kill any doctor who reported an instance of it.

That's a huge claim, and a short Google-voyage did not show any such claim. It is very counter-intuitive given the overall quality of the Cuban medical system. Do you have a source for that/ link to the HN discussion?

How do you know that it is true?

Thats one way to do it...

Displacement.

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Cuba first to ​eliminate mother-to-baby HIV transmission

Cuba first to eliminate mother-to-baby HIV transmission