By:
Alex Kopel
October 17th, 2016
_____________________________________________________________________________________
Although HIV is not a waterborne disease, the issues between clean water and HIV are much more closely linked than one might think. Many of the opportunistic infections that kill people living with HIV/AIDS are transmitted through contaminated water and unsanitary living conditions. Worldwide, more than 34 million people are living with HIV and AIDS and many of them live in regions where they lack access to adequate water, sanitation and hygiene (also known as WASH).
Many studies, including a study
published in February, concluded that access to safe drinking water can
decrease adverse health outcomes and improve the quality of life for
HIV-affected individuals.
WASH is linked to some of the leading causes of morbidity and mortality among people living with HIV (PLHIV). In North America, 50 percent of PLHIV, and up to 100 percent of PLHIV in some regions of the developing world, suffer from diarrheal disease, often caused by poor sanitation. Not only are PLHIV at greater risk for diarrheal disease but are more likely to have severe episodes, and are more likely to die from it. A study in the Democratic Republic of Congo found that HIV-positive infants are 11 times more likely to die of diarrheal disease than uninfected infants.
A 2015 study concluded that contaminated water, lack of sanitation and poor hygienic practices in homes of PLHIV increase the risk of diarrhea, which can result in increased viral load, decreased CD4 counts, and reduced absorption of nutrients and antiretroviral medication.
Diarrheal disease is particularly dangerous for PLHIV because it can lead to an increased viral load, which can then increase disease progression. In addition, PLHIV in unhygienic conditions can suffer from a condition called enteropathy, which hinders proper absorption of antiretroviral medicines and makes them less effective, in some cases leading to drug resistance. Antiretroviral drugs rely on adequate food and at least 1.5 liters of safe drinking water a day to be effective.
PLHIV need more than average amounts of clean water for day-to-day living. A study in Ngamiland, Botswana found that caregivers with HIV patients suffering from diarrheal disease needed an average of 20 liters more water per day to wash soiled clothes and sheets as well as sterilize contaminated areas.
Due to lack of access to safe water for preparing infant formula, many HIV-positive women are forced to breastfeed even though this exposes their babies to HIV. The spread of HIV could therefore be prevented if mothers had a reliable source of safe water and infant formula for their children.
Many groups have realized the importance of providing access to a safe, reliable and sufficient water supply and basic sanitation to PLHIV and their caretakers. Studies have shown that by putting water and sanitation services located in close proximity to HIV-affected households can reduce the burden of caregiving and allow more time for caregivers to take on other activities, including school and work.
Many advocates believe that there is still a lack of research on the role that the water sector plays for people living with HIV/AIDS. Since HIV is generally treated as an epidemic, and not considered a chronic disease or socio-economic problem, the emphasis in research is placed on treatment and prevention.
“Neither international organizations nor country governments have looked closely at the implications and potential contributions of the water sector in combating the disease, and a remarkably small amount of academic research has been done on the subject,” according to Dr. Kate Tulenko, a public health specialist of the Water and Sanitation Program.
“It is necessary for the global HIV/AIDS community to work with the global water community to develop a consensus list of prioritized research needed on water and sanitation and HIV/AIDS,” said Tulenko. “With combined efforts of the AIDS and water communities, WASH services can be offered to people living with HIV/AIDS to improve their health, relieve the care giving burden, preserve human dignity, and fulfill the call for every sector to participate in the fight against HIV/AIDS.”
Yet many WASH and HIV organizations have already joined forces. The non profit WaterAid in America has started projects in Tanzania, Nepal, India and Ethiopia that highlight the way that WASH and HIV programs can be coordinated to have positive impacts.
“We have running water here at the clinic – since late last year,” said Suzete De Graca, who is part of a WaterAid project in Mozambique. “There are both toilets and latrines. Clean water is important for personal hygiene and to clean the house and the whole environment. People living with HIV are more fragile than others – so they need this more than others.”
WASH and HIV organizations and government programs can work together to provide accurate information for PLHIV, helping reduce stigma by dispelling misinformation, such as the belief that HIV can be spread by sharing a toilet.
WASH is linked to some of the leading causes of morbidity and mortality among people living with HIV (PLHIV). In North America, 50 percent of PLHIV, and up to 100 percent of PLHIV in some regions of the developing world, suffer from diarrheal disease, often caused by poor sanitation. Not only are PLHIV at greater risk for diarrheal disease but are more likely to have severe episodes, and are more likely to die from it. A study in the Democratic Republic of Congo found that HIV-positive infants are 11 times more likely to die of diarrheal disease than uninfected infants.
A 2015 study concluded that contaminated water, lack of sanitation and poor hygienic practices in homes of PLHIV increase the risk of diarrhea, which can result in increased viral load, decreased CD4 counts, and reduced absorption of nutrients and antiretroviral medication.
Diarrheal disease is particularly dangerous for PLHIV because it can lead to an increased viral load, which can then increase disease progression. In addition, PLHIV in unhygienic conditions can suffer from a condition called enteropathy, which hinders proper absorption of antiretroviral medicines and makes them less effective, in some cases leading to drug resistance. Antiretroviral drugs rely on adequate food and at least 1.5 liters of safe drinking water a day to be effective.
PLHIV need more than average amounts of clean water for day-to-day living. A study in Ngamiland, Botswana found that caregivers with HIV patients suffering from diarrheal disease needed an average of 20 liters more water per day to wash soiled clothes and sheets as well as sterilize contaminated areas.
Due to lack of access to safe water for preparing infant formula, many HIV-positive women are forced to breastfeed even though this exposes their babies to HIV. The spread of HIV could therefore be prevented if mothers had a reliable source of safe water and infant formula for their children.
Many groups have realized the importance of providing access to a safe, reliable and sufficient water supply and basic sanitation to PLHIV and their caretakers. Studies have shown that by putting water and sanitation services located in close proximity to HIV-affected households can reduce the burden of caregiving and allow more time for caregivers to take on other activities, including school and work.
Many advocates believe that there is still a lack of research on the role that the water sector plays for people living with HIV/AIDS. Since HIV is generally treated as an epidemic, and not considered a chronic disease or socio-economic problem, the emphasis in research is placed on treatment and prevention.
“Neither international organizations nor country governments have looked closely at the implications and potential contributions of the water sector in combating the disease, and a remarkably small amount of academic research has been done on the subject,” according to Dr. Kate Tulenko, a public health specialist of the Water and Sanitation Program.
“It is necessary for the global HIV/AIDS community to work with the global water community to develop a consensus list of prioritized research needed on water and sanitation and HIV/AIDS,” said Tulenko. “With combined efforts of the AIDS and water communities, WASH services can be offered to people living with HIV/AIDS to improve their health, relieve the care giving burden, preserve human dignity, and fulfill the call for every sector to participate in the fight against HIV/AIDS.”
Yet many WASH and HIV organizations have already joined forces. The non profit WaterAid in America has started projects in Tanzania, Nepal, India and Ethiopia that highlight the way that WASH and HIV programs can be coordinated to have positive impacts.
“We have running water here at the clinic – since late last year,” said Suzete De Graca, who is part of a WaterAid project in Mozambique. “There are both toilets and latrines. Clean water is important for personal hygiene and to clean the house and the whole environment. People living with HIV are more fragile than others – so they need this more than others.”
WASH and HIV organizations and government programs can work together to provide accurate information for PLHIV, helping reduce stigma by dispelling misinformation, such as the belief that HIV can be spread by sharing a toilet.
Read more articles from HIV EQUAL, here.
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