Km. Decock et al., CLINICAL RESEARCH, PROPHYLAXIS, THERAPY, AND CARE FOR HIV DISEASE IN AFRICA, American journal of public health, 83(10), 1993, pp. 1385-1389
By the end of the century, citizens of resource-poor countries will co
nstitute 90% of the world's human immunodeficiency virus (HIV)-infecte
d people. Clinical management of such persons in developing countries
has been neglected; most AIDS research has concentrated on epidemiolog
y, and donor agencies have generally invested in the prevention of HIV
infection. The heavy burden of HIV disease in Africa requires that ca
re for AIDS be addressed, and prevention and care should be seen as in
terrelated. Prevention and treatment of tuberculosis, the commonest se
vere infection in persons with AIDS in Africa, illustrate this interre
lationship. We outline priorities for applied research on the manageme
nt of HIV disease in a resource-poor environment, and discuss prophyla
xis, therapy for opportunistic diseases, terminal care, and use of ant
iretroviral therapy. Research should define the standard of care that
can realistically be demanded for HIV disease in a source-poor environ
ment. Research and public health progams for AIDs in developing countr
ies must address AIDS care and attempt to reduce the widening gap betw
een interventions available for HIV-infected persons in different part
s of the world.