AIDS Care Watch

Wednesday, November 29, 2006

Aids hurting Botswana’s budget

By, Sunday Times, November 27, 2006

Botswana is currently spending 6% of its national budget to fight HIV/Aids and international donors contribute the equivalent of a further one%.

"Actual spending over 2005 was 1.14 billion pula (185.4 million dollars) of which 900 million pula (79% - 146.4 million dollars) came from the Botswana government.

International donors contributed 228 million (20% - 37.1 mln dollars), the private sector 11 million (one% - 1.8 mln dollars)," a week-end statement from the Office of President Festus Mogae said. The 2005/06 national budget was 15.8 billion pula (2.6 billion dollars).

These are the first detailed figures of the financial cost to Botswana of the epidemic. They were the findings of a National AIDS Spending Assessment and had been released at a meeting during the week of the National Aids Council, chaired by Mogae.

Botswana has one of the world’s highest rates of HIV infection.

The preliminary findings of the Botswana Aids Impact Survey indicated a 17.7% overall infection rate of the 1.7 million population, including 34.4% of the high economically active group of 25 to 49 year olds.

Citizens are entitled to free anti-retroviral (ARV) drugs; pregnant women who test positive also get drugs to prevent them passing the infection to their unborn children. The overall fight against HIV-Aids also includes free testing, counselling, and extensive education programmes.

Other health spending, of which a significant part is inevitably related to illness incurred or exacerbated as a result of HIV infection, accounts for approximately 8.8% of the annual national budget.

The assessment found that approximately 60% of Government spending on HIV/Aids went towards treatment and care, 20 percent towards assisting orphans and vulnerable groups.

Spending by international donors was focused on human resource and programme development, and prevention programmes.

Along with 14 other countries, Botswana benefits from the five-year (from 2004) 15 billion dollar US Presidential Emergency Plan For Aids Relief (Pepfar) and during 2004 was allocated 18 million dollars, in 2005 43 million dollars and in 2006 54 million dollars.

The Global Fund to fight Aids, malaria and tuberculosis (part funded by Pepfar) has started implementation of a 18.6 million dollar (100 million pula) programme in Botswana, Achap (the African Comprehensive HIV-Aids Partnership between drug companies Merck, Bristol-Myers Squibb, and the Bill and Melinda Gates Foundation) is providing additional funding and Merck is donating quantities of ARV drugs.



Uganda: HIV/Aids Prevalence Higher in Rural Areas

By, Kakaire A. Kirunda, The Monitor, November 24, 2006

A 2006 Unaids report that was released on Tuesday presents mixed fortunes for Uganda in her fight against the HIV/Aids pandemic.

The report, which was jointly produced with the World Health Organisation, shows fear of a possible erosion of the gains the country has so far made against the killer disease.

Urban rural gap

As one of the setbacks, the report shows that the HIV prevalence has risen in rural areas compared to urban centres where the predominance of the pandemic has reduced.

It is noted that HIV prevalence has fallen sharply among pregnant women in Kampala from the early 1990s to the early 2000s due to significant behaviour change and increased mortality.

"However, in some rural areas, there is new evidence of an increase in HIV infection. Prevalence rose from 5.6 per cent in men and 6.9 per cent in women in 2000 to 6.5 per cent in men and 8.8 per cent in women in 2004 according to data gathered in a study done in 25 villages," says the report.

It further notes that a similar trend dating to 2002, was found among pregnant women in half of the antenatal surveillance sites included in the study.

The rural study, as highlighted in the report, says HIV incidence in older men and women aged between 40 to 49 years has increased since 2000 as seen in the 2004-2005 national HIV household survey, which showed high infection levels among middle-aged Ugandans.

ARVs treatment value

The report cites recent study findings from rural Tororo, which show that people receiving antiretroviral (ARV) treatment have significantly less risk of transmitting HIV after two years of treatment.

This was found to be partly due to a strong reduction in viral load and less frequent unprotected sex.

According to Unaids, national adult HIV prevalence was 6.7 percent (5.7-7.6 per cent) in 2005.

The disease was found to be significantly higher among women (nearly 8 per cent) compared to men at 5 per cent.

The report estimates that between 850,000 and 1.2 million Ugandans were living with HIV/Aids by the end of 2005.

And at regional level, according to the Ministry of Health, prevalence was lowest in the West Nile (2 per cent) and northeast with ( 4 per cent) and highest in Kampala's central and north-central regions (over 8 per cent).

Unaids says further research is needed to validate these trends but the current findings do hint at the possible erosion of the gains Uganda made against HIV/Aids in the 1990s.


Tuesday, November 28, 2006

South Africa: Hospitals Are Overwhelmed By Dying Aids Patients, As People Delay Getting Help for HIV

By, Anso Thom, Kerry Cullinan & Khopotso Bodibe, Health-e, November 27, 2006

The elderly woman, her thinning grey hair swept into a tiny ponytail, kicks her feet under the blue hospital blanket and lets out a long moan. She rocks her head from side to side and wails quietly, before turning onto her side.

The nurses stoically continue the morning briefing, a ritual that happens just after 7am every day at the medical ward of GJ Jooste Hospital in Cape Town.

Shortly after 7.30am, two nursing assistants are no longer able to ignore the woman's distress and wander over and start straightening the bed linen.

"Move your body up," a large nurse with flashy gold spectacles orders.

Just before eight, the patient keels over the side of the bed and crumples to the floor, her arms outstretched. A young woman in an adjoining bed shrieks and places her hand over her mouth.

Within seconds, two doctors rush over and pick her up by her arms and legs. A nurse rips the pink curtains shut around the bed. A few nursing assistants peer through a gap as three doctors try to resuscitate the woman.

"No, she's dead," a staff nurse tells her colleague and wanders off.

One of the doctors runs to an adjoining ward to fetch a defibrillator machine. The bed springs squeak as a tall doctor rocks up and down, applying pressure to the woman's lifeless chest. Another doctor pumps a bag attached to the patient's mouth.

A professional nurse, a few steps away hardly glances at the commotion, stoically chewing gum while restocking the drug trolley.

At 8.05am the commotion comes to an abrupt end and the patient in bed 23 is declared dead, another addition to South Africa's Aids statistics.

By 8.30am her body is washed, taped up in plastic and taken to the morgue. The only remaining sign that she was ever there is a see-through plastic bag containing a box of Corn Flakes, a pair of dainty black moccasins and a brown blanket.

Despite government's introduction of antiretroviral drugs in 2004 to contain HIV in those already infected, thousands of people are still dying of AIDS-related illnesses, and hospitals from Cape Town to Mussina are struggling to deal with the increased load.

Last year, an estimated 320 000 people died of AIDS-related illnesses in South Africa.

Half-a-million people are estimated to be sick enough to need antiretroviral (ARV) drugs but slightly less than half this number is getting ARVs.

The impact of AIDS can be seen on the country's mortality figures, with a 79% increase in all deaths over the past seven years (1997 to 2004) and a 161% increase in people aged 20 to 49, according to Statistics SA. More people aged between 30 and 34 are dying than in any other age group (58 000 in 2004, in comparison to almost 19 000 seven years before).

"The antiretroviral rollout is not yet at a level where it has significantly altered HIV-related admissions and fatalities at hospitals,"says Professor Helen Schneider of Wits University's Centre for Health Policy.

In addition, say hospital doctors, people with HIV are only seeking help when they are already very sick and it is difficult to treat them.

"We are overwhelmed by medical patients. We used to admit between 10 and 15 medical patients on a daily basis. Now that number has gone up to 40 to 50 patients per day. And most of these patients have HIV-related complications," says Dr George Abraham, acting senior clinical manager of Natalspruit Hospital.

The day before Health-e visited Natalspruit, seven people had died in the 734-bed hospital of AIDS-related illnesses.

Up to 60% of all patients in paediatric and adult medical wards countrywide have HIV-related conditions, according to researchers.

But hospitals in areas with high HIV rates are taking even more strain:

90% of children and 80% of adult medical patients at Stanger Hospital on KwaZulu-Natal's north coast are HIV positive, and 30% of male medical patients die.

Three-quarters of the male patients and 70% of female patients who died in the medical ward of Mseleni Hospital in far northern KZN over the past three months suffered from AIDS-related illnesses.

About three-quarters of the patients in the 135 medical beds at Durban's Addington Hospital have HIV-related illnesses.


Uganda: HIV/Aids Prevalence Higher in Rural Areas

By, Kakaire A. Kirunda, The Monitor (Kampala), November 24, 2006

A 2006 Unaids report that was released on Tuesday presents mixed fortunes for Uganda in her fight against the HIV/Aids pandemic.

The report, which was jointly produced with the World Health Organisation, shows fear of a possible erosion of the gains the country has so far made against the killer disease.

Urban rural gap

As one of the setbacks, the report shows that the HIV prevalence has risen in rural areas compared to urban centres where the predominance of the pandemic has reduced.

It is noted that HIV prevalence has fallen sharply among pregnant women in Kampala from the early 1990s to the early 2000s due to significant behaviour change and increased mortality.

"However, in some rural areas, there is new evidence of an increase in HIV infection. Prevalence rose from 5.6 per cent in men and 6.9 per cent in women in 2000 to 6.5 per cent in men and 8.8 per cent in women in 2004 according to data gathered in a study done in 25 villages," says the report.

It further notes that a similar trend dating to 2002, was found among pregnant women in half of the antenatal surveillance sites included in the study.

The rural study, as highlighted in the report, says HIV incidence in older men and women aged between 40 to 49 years has increased since 2000 as seen in the 2004-2005 national HIV household survey, which showed high infection levels among middle-aged Ugandans.

ARVs treatment value

The report cites recent study findings from rural Tororo, which show that people receiving antiretroviral (ARV) treatment have significantly less risk of transmitting HIV after two years of treatment.

This was found to be partly due to a strong reduction in viral load and less frequent unprotected sex.

According to Unaids, national adult HIV prevalence was 6.7 percent (5.7-7.6 per cent) in 2005.

The disease was found to be significantly higher among women (nearly 8 per cent) compared to men at 5 per cent.

The report estimates that between 850,000 and 1.2 million Ugandans were living with HIV/Aids by the end of 2005.

And at regional level, according to the Ministry of Health, prevalence was lowest in the West Nile (2 per cent) and northeast with ( 4 per cent) and highest in Kampala's central and north-central regions (over 8 per cent).

Unaids says further research is needed to validate these trends but the current findings do hint at the possible erosion of the gains Uganda made against HIV/Aids in the 1990s.


Monday, November 27, 2006

Gauteng is doing well – but HIV infections continue to grow

By, Kerry Cullinan & Khopotso Bodibe,, November 26, 2006

Gauteng has the most extensive provincial HIV/AIDS programme in the country, and has more than tripled the number of people on antiretroviral drugs in the past year alone.

“Over 350 000 people in Gauteng have been tested for HIV. And out of those we have close to 60 000 now who are on treatment,” says Health MEC Brian Hlongwa.

“We can’t expand much faster than we are. We have a very intensive programme and face limitations of staff and space,” adds Dr Liz Floyd, head of the provincial multi-sectoral AIDS unit.

Two and a half years ago, the province only had 2 400 patients on ARVs – and the massive expansion in numbers has put strain on the health system.

Patient numbers are gathered by data capturers working on records at each treatment site, checked against pharmacy registers and sent via the districts to the province, says Dr Madi Moloi, director of the HIV/AIDS, STI and TB programme.

Despite the fact that Gauteng is one of the best resourced province, it has one of the lowest nurse-patient ratios in the country and its health facilities are overburdened with patients.

“Antiretroviral treatment is very labour-intensive and patients need a lot of support, especially in the first three months,” says Floyd. “Too many people are only seeking treatment when they are very sick. We have to stabilise their medical condition before starting them on ARVs.”

In many ways, Gauteng is a text-book example of best practice in a country where such examples are scarce in the government sector. It has strong leadership, extensive partnerships and plenty of resources.

Gauteng was the first ANC province to provide nevirapine for all pregnant HIV positive mothers in 2002, something that earned Premier Mbhazima Shilowa a public tongue-lashing from the health minister.

But Shilowa stood firm and has continued to speak out about HIV/AIDS and push the province’s HIV/AIDS programme.

Hlongwa, appointed six months ago, has also energized the HIV/AIDS programme, declaring the disease “the biggest health challenge the world has ever faced”.

In the past year, the provincial HIV/AIDS budget has increased by 48% to R514-million.

“We are happy as a province that we think we are leading in the country in terms of planning and preparing personnel to deal with the burden of disease,” says Hlongwa.

The province’s biggest breakthrough in the past year is to get that all faith-based organisations – from Apostolics to Zionists – involved in a partnership against HIV.

In addition, the department funds some 250 organisations to reach people the officials cannot – ranging from the home-based carers working for hospices to those working with prisoners.

From tomorrow (27 Nov) until AIDS Day on Friday, the province has organized 12 000 volunteers – many from religious organizations – to go door-to-door to speak to people about HIV.

“One thing that organisations working in HIV have learnt is that face-to-face communication works best. It gives people a chance to ask questions,” says Floyd.

“As a country we have about 12 million people who are functionally illiterate. So, it’s not just a question of producing pamphlets. If people can’t read, they won’t get the message. The spoken word is a very powerful way,” adds Hlongwa.

Treatment Action Campaign secretary Sipho Mthati says her organisation has found those in charge of implementing Gauteng’s HIV/AIDS programme to be “highly motivated and ready to engage”.

“They are quite different from many other provinces,” she added. “They have always co-operated with us. They have decentralised the ARV rollout and have strong political support and leadership.”

But despite the province’s huge output, its impact on bringing down new HIV infections is still disappointing.

Young men under the age of 24, who report high condom use, are the only group to show any significant decrease in HIV infection.

Getting people to change their sexual behaviour is a complicated process.

“Unfortunately, the HIV epidemic shows little signs of abating and it is not clear that the large investments in prevention to date are achieving more than marginal changes in behaviour,” say researchers Professor Helen Schneider, Dr Peter Barron and Professor Sharon Fonn.

Communication alone does not prevent HIV, agrees Floyd and says Gauteng has invested heavily in educational interventions including life skills training at schools and peer educators in prisons and hostels.

“We are also trying to address the social factors that drive AIDS,” says Floyd. “Up to 30% of people don’t control the conditions under which they have sex. We have to address factors of economic inequality, gender inequality, alcohol and drug abuse and sexual violence.”

But Hlongwa emphasizes that ordinary people also need to stand up and take responsibility for themselves.

“We need to get individuals to be empowered and educated to take responsibility for their health and to promote healthy lifestyles. This idea that the Department of Health can look after you and give you a [hospital] bed is a fallacy. It doesn’t exist anywhere in the world,” he stresses.


Friday, November 24, 2006

Uganda: HIV Infection Rate Shoots Up, Says WHO

By, New Vision, November 22, 2006

HIV/AIDS infection rates are rising again in Uganda, the World health organisation (WHO) has said, reports Anne Mugisa.

In a just-released report, WHO said infection rates, which had been brought down to 5.6% in men and 6.9% in women by 2000, had now gone up to 6.5% in men and 8.8% in women.

Uganda has been showcased as a success story of HIV/AIDS prevention through campaigns, education and widespread condom use. Some commentators are blaming the increase on what they say is excessive promotion of abstinence.

But WHO said there is evidence of erratic condom use and more men having unprotected sex with multiple partners.

The state minister for primary healthcare, Dr. Emmanuel Otaala, said there has been despondency and complacency.

He said the recent national survey discovered that the overall prevalence had risen from 6.2% to 6.4%.

He said the Government had as a result repackaged the campaign to penetrate even the smallest units like families.

"We must repackage the sensitisation of the messages in a format that can be understood by the people," Otaala said, adding, "We have started voluntary HIV/AIDS counselling right from the village level. In some districts, we have scaled up counselling up to the home as the entry point into the healthcare. We want to carry out home-based counselling, treatment and preventive care"

Thursday, November 23, 2006

Male circumcision 'lowers risk of HIV infection by 60%'

By, Jeremy Laurance, The Independent, August 9, 2006

It used to be called the unkindest cut. But now the head of the one of the world's largest Aids charities believes we are on the brink of a revolution in attitudes to circumcision.

Richard Feachem, executive director of the Global Fund to Fight Aids, Tuberculosis and Malaria, said research revealing the protective effect of circumcision against HIV was set to change parental expectations and medical practice across the world. Instead of viewing the operation as an assault on the male sex, it was increasingly being seen as a lifesaving procedure which every parent would want for their sons.

Removing the foreskin is thought to harden the glans (head) of the penis, making it less permeable to viruses. Research conducted in 2005 showed the transmission of HIV from women to men during sex was reduced by 60 per cent if the men were circumcised.

A study published last month calculated that if all men in sub-Saharan Africa were circumcised, it would prevent almost six million new cases of HIV infection and save three million lives over the next 20 years.

Dr Feachem said the finding was one of the most significant in the battle against Aids and offered real hope of slowing the spread of the virus. The issue is to be debated at the World Aids Congress, which opens in Toronto next week.

Dr Feachem said: "We know the factors that cause HIV to spread rapidly in a country - the number of concurrent sexual partners, the use of condoms, the presence of other sexually transmitted diseases and male circumcision. Other things being equal, in a circumcised population you have a low and slowly developing epidemic and in an uncircumcised population you have a high and fast developing epidemic."

He added: "Circumcision is growing strongly in popularity in South Africa and in North America. We see males seeking circumcision very commonly in South Africa. The news of its protective effect caused a substantial increase in demand for adult male circumcision.
"Circumcision fell out of favour in North America and the UK as an unnecessary operation. Following this research, I think it extremely probable that parental demand for infant male circumcision will grow as a consequence."

More than one in three boys were estimated to be circumcised in the 1930s, but it fell out of favour from the 1940s onwards. By 1998, it was estimated that 12,000 circumcisions were being performed each year in Britain, suggesting fewer than one in 25 boys was having the surgery. There are big differences between racial and religious groups.

The rate of HIV infection in west Africa is less than 10 per cent, compared with more than 20 per cent in South Africa, which has mystified researchers.

Catherine Hankins, chief scientific adviser to UNAids, and a co-author of the study of the impact of circumcision on Aids in sub-Saharan Africa, published in the online journal PloS Medicine, said: "In west and central Africa there are high circumcision rates and lower HIV rates. Southern and eastern Africa have lower circumcision rates and higher HIV rates."

Deborah Jack, chief executive of the UK-based National Aids Trust, said the research findings were encouraging.

"It is clear the promotion of voluntary circumcision can play an important role in reducing the risk of HIV transmission," she said. But she warned: "People who are circumcised can still be infected with HIV and any awareness campaign would have to be extremely careful not to suggest that it protects against HIV or is an alternative to using condoms."

Aids discoverer finds new hope of cure after trials of vaccine

By, Jeremy Laurance and Paul Vallely, The independent, September 22, 2006

The scientist who discovered the Aids virus more than 20 years ago said he has developed a potential vaccine against the disease that has killed 25 million people around the globe.

Professor Robert Gallo, in 1984, along with the French scientist, Luc Montagnier, the first to identify that HIV caused Aids, said the latest discovery had made him more optimistic that the disease could be beaten than he had felt for a decade.

Almost 40 million people are living with HIV, most in sub-Saharan Africa, and four million more are infected each year. A vaccine that would halt its spread is the holy grail for researchers, but despite 20 years of effort and the expenditure of millions of dollars, all attempts to do so have so far failed.

Professor Gallo, director of the Institute for Human Virology at the University of Maryland, said his team had created antibodies that worked against different HIV strains, essential if a vaccine is to provide effective protection but which has defied previous attempts. The candidate vaccine had been tested successfully in four monkeys, selected because of their similarity to man, and tests are now being done on a further 12 monkeys. If those are successful, the next stage would be to test the vaccine in humans, he said.

"Yes, we are at a preliminary stage, but if 10 years ago I had known I could make antibodies that would neutralise a wide range of variants of HIV, I would have been celebratory. People thought this was pretty much impossible. It's a serious clinical advance; we have been quietly doing it. I do not know what the outcome of the latest trial [on the 12 monkeys] will be but my guess is we will move to phase 1 clinical trials [in humans] in a year's time."

He added: "Before there was no pathway. Now there is some light."
Developing a vaccine against Aids is regarded as one the most difficult challenges facing medicine and some scientists believe it is impossible. The virus mutates rapidly, it integrates itself into the patient's genetic material and it infects the very cells used by the immune system to defend the body against attack.

Professor Gallo said the approach taken by his team was to modify the protective envelope that surrounds the virus, opening a site and making antibodies to it that prevented entry of the virus into the body's cells. But the first challenge the researchers face is that the antibodies do not last longer than three months, meaning a booster dose of vaccine would be needed three to four times a year. "If we can [overcome this] we will be happy bordering on excited," he said.

There are 15 major strains of HIV, but mixing and re-combining has produced a total of about 20. The strain that dominates in Africa is A and in the US and Europe it is B. But among five people infected with the B strain of the virus only one would be protected by a B vaccine, because of variants in the strains.

Professor Gallo said: "I feel personally more optimistic but I don't want to look Pollyanna-ish. HIV has always dealt surprises. I see an avenue. But I don't know if there is a bend ahead and a truck round the corner blocking the way."

Thomas Hanke, a specialist on HIV vaccines at the human immunology unit of Oxford University, said: "There have been lots of claims for vaccines that can neutralise different strains but a vaccine that would be useful hasn't been constructed yet. Professor Gallo's success is a good reason to be positive, but it is also a good reason not to be over-excited."

SOMALIA: HIV/AIDS services struggling to get off the ground

By, IRIN PlusNews, November 22, 2006

NAIROBI - In the two years since the first voluntary counselling and testing (VCT) centre opened up in Somalia, HIV treatment, care and support has come a long way, but renewed violence threatens those gains.

"The whole of south-central Somalia, the area most in need, is a no-go area. This means that they are missing out on half-a-million US dollars [Global Fund financing]," said Malweyi Inwani, health director for the medical charity, Merlin. "Training and supervision cannot take place, as no UN and most NGO expatriates and experts cannot enter."

After 15 years without a functioning government, a transitional authority was set up in 2004 to restore law and order. But its legitimacy has been challenged by a new group, the Union of Islamic Courts, which took control of the capital, Mogadishu, in June, and has continued to extend its authority over much of southern and central Somalia.

Even before the resurgent fighting conditions were difficult for AIDS service providers. "There are not enough trained personnel in Somalia; this causes delays in programmes. We have to train lab staff, clinical staff and counsellors," Inwani said. "Setting up training courses is difficult, as we have to bring in external consultants."

Non-existent road networks and insecurity also required the air freighting of equipment, an expensive undertaking. That has now been made all the harder by a ban on flights to Somalia by neighbouring Kenya, the regional hub for humanitarian organisations.

Nevertheless there have been notable achievements in Somalia in the last few years. Financing from the Global Fund to Fight AIDS, Tuberculosis and Malaria has allowed the expansion of HIV services; people are being trained as VCT counsellors, blood is now checked before transfusion and life-prolonging antiretrovirals are being given to 80 patients in Hargeisa, the capital of Somaliland.

A VCT centre managed by Merlin in Bosasso, capital of the northeastern self-declared autonomous region of Puntland, has been running for the past six weeks. So far, only 24 people have walked through the door - five of whom were found to be HIV-positive - but in highly conservative Somalia, that could be considered a success.

"People are reluctant to come ... there is quite a lot of stigma. Only one year ago did someone say publicly that they were HIV-positive, and they were like a hero to us," said Inwani.

The most recent survey by the United Nations World Health Organization in 2004, estimated a national HIV prevalence rate of 0.9 percent, with variations between south-central Somalia at 0.6 percent, Puntland at 0.9 percent and the self-declared republic of Somaliland, in the northwest, at 1.4 percent.

"HIV prevalence is low compared to surrounding countries, but being an Islamic country there is lots of denial. We are working to ensure that the rate stays low," Inwani said.

Dr Fernando Morales, HIV/AIDS technical advisor for the UN Children's Fund (UNICEF) Somalia office, suggests protective factors have been at work. The country's unrest since 1991 reduced mobility to high prevalence areas such as Kenya, with a 5.9 percent infection rate, while a combination of religious and cultural conservatism has also had an impact.

However, Morales said there were several risk factors, such as widespread ignorance around issues of HIV/AIDS, and gender inequality. The latest fighting has also sent nervous refugees spilling across the country's borders where, uprooted and vulnerable, they face increased risk of HIV exposure.


AFRICA: New figures show AIDS epidemic spreading

By, IRIN PlusNews, November 21, 2006

JOHANNESBURG - The global HIV/AIDS epidemic is expanding, according to new figures released on Tuesday by UNAIDS and the World Health Organisation (WHO), with sub-Saharan Africa still carrying the heaviest burden. Of the estimated 4.3 million new infections in 2006, 65 percent occurred in the region.

Despite a major scale-up in antiretroviral treatment, which reached more than one million people in sub-Saharan Africa by June 2006, the area accounted for almost three-quarters of AIDS-related deaths. Overall, the region is now home to an estimated 24.7 million HIV-infected people, up from 22.6 million two years ago.

The '2006 AIDS Epidemic Update', compiled from the most recent worldwide HIV/AIDS surveillance, records alarming evidence of a resurgence of HIV infection in countries that previously had some success in stabilising or reducing prevalence.

"This is worrying, as we know increased HIV prevention programmes in these countries have shown progress in the past, Uganda being a prime example. This means that countries are not moving at the same speed as their epidemics," commented UNAIDS Executive Director Dr Peter Piot.

A study of some rural areas in Uganda found a rise in prevalence from a low of 5.6 percent in men and 6.9 percent in women in 2000, to 6.5 percent in men and 8.8 percent in women in 2004. The increase appears to correspond with studies suggesting that older men in those areas are engaging in more casual sex.

With a few exceptions, including Mali and Burundi, most countries in East and West Africa are experiencing stabilising or declining HIV prevalence rates.

Southern Africa is still hardest hit. In this region, Zimbabwe is the only country where HIV data from antenatal clinics indicate a decline in adult HIV prevalence from around 30 percent in the early 2000s to 24 percent in 2004. The report says that while behaviour change resulting from increased AIDS awareness probably accounts for some of the decrease, "inconsistencies and biases in some of the data mean that the extent of the decline in HIV prevalence might not be as substantial as indicated by the antenatal clinic data."

In other countries, such as Lesotho and Malawi, UNAIDS points out that sharply rising mortality rates could be masking the impact of new infections, rather than the success of HIV prevention efforts creating an apparently stable level of HIV infection.

In countries where the epidemic emerged a little later, such as Mozambique, Swaziland and South Africa, HIV levels are rising. Among pregnant women attending antenatal clinics in South Africa, HIV prevalence rose from 22.4 percent in 1999 to 30.2 percent in 2005. According to the report, young women in South Africa are four times more likely to be HIV-infected than young men. In the region as a whole, there are around 14 women living with HIV for every 10 men.

Worldwide, 40 percent of new HIV infections were among people aged 15 to 24, but new data suggests that focused HIV prevention programmes can have a positive impact on young people's sexual behaviour. In several African countries young people reported using condoms more frequently, having fewer sexual partners and even delaying their first experience of sex. Countries recording falling HIV prevalence among young people in the last five years include Botswana, Kenya, Rwanda and Zimbabwe. In many other coutries, however, the report notes a lack of sufficient data to measure either behavioural trends or HIV prevalence in young people.

According to UNAIDS, HIV prevention programmes in some countries are failing to reach people most at risk of infection. In Kenya, for example, 53 percent of injecting drug users in a study in the capital, Nairobi, were found to be HIV positive, while a Senegalese study of men who have sex with men found that 22 percent of them had HIV, while the national adult prevalence is just under 1 percent.

"Knowing your epidemic and understanding the drivers of the epidemic, such as inequality between men and women and homophobia, is absolutely fundamental to the long-term response to AIDS," said Piot.



Wednesday, November 22, 2006

SA women in frontline of world Aids

By,, November 21, 2006

Sub-Saharan Africa, accounting for almost two-thirds of all people infected with HIV and 72 percent of global Aids deaths, remains the world's hardest hit region, according to the 2006 UNAids epidemic update released on Tuesday.

With 24.7 million people living with HIV/ Aids, sub-Saharan Africa has 63 percent of the adults and children living with the virus worldwide, the UN agency said.

A huge and disproportionate 59 percent of sub-Saharans Africans with HIV are women, the report added.

In 2006, 2.8 million Africans became infected, and despite substantial progress in providing life-enhancing antiretroviral drugs, 2.1 million people died — 72 percent of the 2.9 million people reckoned to have died worldwide as a consequence of the virus.

Significant increase in ARV treatment

By June this year, around one million people on the continent were receiving antiretrovirals, a tenfold increase since December 2003.

But "the sheer scale of need in this region means that a little less than one quarter (23 percent) of the estimated 4.6 million people in need of antiretroviral therapy in this region are receiving it," UNAids said.

Worst-hit across the region remains southern Africa, accounting for 32 percent of people infected and 34 percent of Aids deaths.

In SA, it's the women…

In South Africa, as in the rest of sub-Saharan Africa, the epidemic disproportionately affects women, the report said.

"Young women (15-24 years) are four times more likely to be HIV-infected than are young men: in 2005, prevalence among young women was 17 percent compared to 4.4 percent among young men."

In slightly older women, aged between 30 and 34, one in three was living with HIV in 2005 compared with one in four men aged between 30 and 39.

In all, one out of nine South Africans — 5.5 million of the more than 47 million population — were living with HIV in 2005, 240 000 of them aged under 15.

"Having emerged a little later than most other HIV epidemics in the sub-region, South Africa's epidemic has now reached the stage where increasing numbers of people are dying of Aids," UNAids said, adding that total deaths from all causes shot up 79 percent from 1997 to 2004, though the exact proportion attributable to Aids was unknown.

South Africans not feeling at risk

Despite the high HIV death toll, a large number of South Africans did not feel at risk, the agency said. During a national household survey in 2005, half the respondents found to be infected had reported previously that they felt at no risk of acquiring HIV.

"Approximately two million South Africans living with HIV do not know they are infected," UNAids added.

In Zimbabwe, on the other hand, HIV prevalence has fallen, with infection levels in pregnant women dropping from 30-32 percent in the early 2000s to 24 percent in 2004. Nevertheless around one in five Zimbabwean adults is living with HIV, one of the worst HIV epidemics in the world.

World's highest prevalence

The world's highest prevalence was reported in Swaziland, where one out of three (33.4 percent) adults is affected.

In East Africa — where prevalence rates are lower — Uganda is stabilising, while Kenya, Tanzania and, to a lesser extent, Rwanda are continuing to register a decline.

Burundi, where a sentinel survey showed a sharp rise among young pregnant women, was one exception.

West and Central African nations, including Africa's most populous nation Nigeria, continue in general to have far lower prevalence rates, under two percent in Benin, Guinea and Senegal, and at around four percent or less in Ivory Coast, Ghana, Mali, Nigeria and Togo.



Tuesday, November 21, 2006

SOUTH AFRICA: Life, love and HIV

By, IRIN PlusNews, November 18, 2006

JOHANNESBURG - "And life goes on ..." concludes the preface to 'Conversations, HIV and the Family', a publication that aims to place HIV/AIDS where it belongs - in the midst of real life itself, with all its nuances and grit.

By documenting the personal accounts of families intimately affected by HIV/AIDS, Conversations, a project of South Africa's Centre for AIDS Development, Research and Evaluation (CADRE), cuts through the layers of science, politics and ideology that effectively distance the epidemic from real people and inadvertently perpetuate stigma.

Some of the 12 families featured took part in a lively launch of the project at the Perinatal HIV Research Unit at Chris Hani Baragwanath Hospital, Soweto, recently. Although still faced with daunting challenges, a couple of those profiled spoke of how their lives had been paradoxically enriched by their journeys with HIV and AIDS.

Valencia Mofokeng, who together with her large blended family runs an AIDS organisation in Orange Farm, said the project had given her a much-needed platform to communicate with others in similar situations: "We people with HIV/AIDS don't have a place to express our feelings. We can talk to our counselors but we need to share our feelings with others too."

"I'm a mother of orphans," said Seipati Mtsi, also featured in Conversations. "I'm their mother and they trust me. They put their life in me. Now I know a lot about HIV/AIDS. I was scared to touch someone. Now I can kiss, share a plate, live with people with HIV/AIDS. Thank God for giving me that strength."

The family portraits, by photographer Giséle Wulfsohn, who has documented HIV/AIDS in South Africa for almost 20 years, show the intimacy of every day family life. These are accompanied by personal testimonies of individuals and family members who describe how their lives have been stretched and altered by HIV and AIDS.

The families are typical in their many variations - nuclear, single parent, extended, homosexual; and their stories document the gamut of human experience. Selinah Mashinini, a single HIV-positive mother who lives with her sister and children in Alexandra township; Christo Greyling, an HIV-positive Dutch Reformed minister who left the church to form an AIDS ministry and went on to marry and have two children after discovering his status; Naboe Abrahams, pregnant and widowed at the age of 15, who has since married again and had more children with a man who still refuses to test.

Sadly, one of those featured in the project, Peter Busse, who chose close friends and his goddaughter for his "family portrait", died earlier this year. Busse, a well-know and well-loved gay activist, threw a huge party last year to celebrate living with HIV for 20 years.

"Living with HIV/AIDS is glossed over in statistics, reports and statements. Seldom do we hear, see, or understand AIDS in the words of those whom it touches most intimately," reads the Conversations preface.

Funded by the US President's Emergency Plan for AIDS Relief (PEPFAR) and supported by the Johns Hopkins Bloomberg School of Public Health, the Conversations project has other components: a mobile photographic display, featuring portraits of the families with quotations from their testimonies, and workshops for organisations, churches and other groups that use social therapy as a creative vehicle to start dialogue and facilitate understanding on how living with HIV impacts on both the family and the workplace.

Betsi Pendry, social therapist and project member commented: "After 25 years into the epidemic there has not been much progress regarding exploratory as opposed to didactic conversations about how HIV/AIDS is lived and experienced by those most affected by it.

"We need to have conversations which explore and allow for the complexity, the contradictions and the confrontations; to have conversations which move beyond a one dimensional characterisation of HIV/AIDS as only a tragedy; to move beyond talking to people about the ABCs; and to move beyond having conversations which are fraught with ideological and moral agendas. We need to be able to have conversations about the range of other issues that come up as we live with HIV and AIDS as a daily part of our collective lives."

The project attempts to do just this by showing that "people continue to grow, be intimate, love and fall in love, have sex and enjoy sex, experience loss and death, sadness and experience hope and renewal", said Pendry. "They show that people create new families, plan for the future and the future of their children and that they are ordinary people."

For more information contact Helen Hajiyiannis, +2711 339-2611


Monday, November 20, 2006

MALAWI: Health worker shortage a challenge to AIDS treatment

By, Reuters Foundation, November 17, 2006

NKHATA BAY - Sarah Nafere has just finished a long night shift as the only nurse tending to 80 patients spread across two wards at Nkhata Bay Hospital in northern Malawi.

She is one of just 18 nurses, five clinical officers and one doctor that staff this district hospital, where the ARV clinic alone provides treatment to 926 patients.

"Each ward is supposed to have three or four nurses, and one nurse is supposed to attend to 10 to 12 patients a day," said Nafere. "But here one nurse is attending to more than 100 patients a day. Do you think she can provide good services?"

The shortage of healthcare workers is a global crisis, but developed countries can afford to throw money at the problem, attracting nurses and doctors from developing countries with vastly better salaries and working conditions.

While the HIV/AIDS epidemic has multiplied the need for doctors and nurses in southern Africa, the pool of workers has shrunk. Those remaining in their countries face a daily, demoralising struggle to manage impossibly heavy patient loads with scare resources. Many take their skills to the private or NGO sectors or flee the profession altogether. An unknown number of others have succumbed to the disease (see sidebar).

In Malawi, the fourth poorest country in the world, where UNAIDS has put HIV prevalence at 14 percent, the health worker shortage is so acute that the ministry of health and international donors are now treating it as an emergency.

"There is a profound human resources crisis in this country," said Dr Michael O'Carroll, a technical advisor the government has appointed to oversee a six-year US$275 million plan to address the problem. "The World Health Organisation says no developing nation can expect to go anywhere without a ratio of one physician to 5,000 of the population. We have one doctor per 60,000, which puts us in one of the worst situations in the world."

Sixty-four percent of nursing posts in Malawi are unfilled and there are 100 doctors working in public hospitals serving a population of 12 million. Anyone requiring the attention of a neurologist, dermatologist or a number of other specialists must travel outside the country.

District hospitals like Nkhata Bay, with an average of 250 beds, should have 175 nurses, said O'Carroll. None has more than 40. "That leads to some very serious issues from a patient point of view, but also for the health workers themselves. You have large numbers of people crying for services and you have nurses that are on their feet 18 hours a day. It's a situation that creates an enormous amount of tension," he said.

Given the scale of the problem, it is something of a miracle that Malawi has managed to keep its ambitious anti-AIDS treatment plan on target. As of the end of September, 70,000 Malawians were accessing antiretroviral (ARV) treatment, about 62,000 of them at public health services. According to the five-year plan, an additional 40,000 patients will begin receiving treatment in 2007 and another 45,000 in each of the following three years.

Dr Bizwick Mwale, director of Malawi's National AIDS Commission, admitted that human resources would be the biggest challenge.

In 2005, with funding from Britain's international development agency (DFID), pubic healthcare workers received a 52 percent wage top-up and a campaign was mounted to lure nurses back from the private sector. Money from the Global Fund to Fight AIDS, Tuberculosis and Malaria is being used to expand the capacity of Malawi's training institutions and provide extra incentives for health workers in remote, rural areas.

Until these efforts yield results, some of the countries that have lured health workers from Malawi are loaning their doctors to fill the gap. About 25 percent to 30 percent of Malawi's doctors are sourced from overseas: some are United Nations volunteers; others come with Britain's Voluntary Services International or through agreements with European governments.

None of these measures is enough to keep pace with the additional 90,000 HIV-infected Malawians who need ARV treatment every year. As ARV clinics at district hospitals rapidly reach their limit, the treatment programme will need to roll out to smaller health centres, where qualified health workers are even scarcer. The only way to move forward, said Mwale, was "to simplify the delivery of ARV treatment".

By developed world standards, Malawi's approach is fairly basic: clinics mainly use diagnostic assessments rather than laboratory tests to determine when patients are ready to begin treatment, and nearly 95 percent of patients are prescribed the same combination of three drugs. After the first six months on treatment, patients are only required to return to clinics once every two or three months.

The next step is to train less qualified health workers to administer the drugs. Rural health centres are usually staffed by one or two nurses and medical assistants, and several health surveillance assistants (HSAs). HSAs are Malawi's least qualified health workers.

Recruited locally, they receive just 10 weeks of training but are an invaluable resource because of their close links with the community. There are 5,200 of them, but the government plans to double that number and train about 1,000 of the new recruits to work exclusively in HIV/AIDS. The eventual goal, explained Mwale, is for HSAs to assist patients who merely need to receive their new drug supplies.

Not everyone is comfortable with cutting corners when it comes to ARV treatment, but no one can deny that the situation demands extreme measures.

"I'm quite worried about further and more rapid scale-up, given the human resources restrictions we're facing," said O'Carroll, "but we have life-saving drugs and we're going to give them to as many people as we can, now."

Sarah Nafere has no plans to leave Malawi for greener pastures, but so far she has seen little evidence of the government's efforts to retain its health workers: "Salaries for we Malawians are not adequate, but I can't leave my relatives suffering here because of money," she said. "If the government can motivate us, if they can renovate our buildings and give us enough money, I think we can improve, we can work happily."


Wednesday, November 15, 2006

Women lead HIV fight in Lesotho

By, British Red Cross Society, November 14, 2006

The HIV pandemic affects more women than men worldwide – a fact dramatically illustrated in Lesotho, in southern Africa, where two in five young women have the virus.

As many as 40 per cent of women aged 20 to 39 have HIV in Lesotho which has a population of just 2.2 million. The number of Lesotho men infected is also high but at 23 per cent is half the prevalence rate of women in the country.As the number of AIDS-related deaths continues to rise, the British Red Cross has been supporting the Lesotho Red Cross in its fight against the disease.

The Lesotho Red Cross runs the largest and most monitored home-based care programme in the country. This operates through a network of trained care facilitators who provide long-term support for people with HIV in their homes.

Women are not only the majority of clients, but also the majority of carers.

Mother-of-three Matlape Sethathi from Lesotho in southern Africa has been helped by the Red Cross after testing positive for HIV.


The 44-year-old had been feeling unwell but until she met Red Cross volunteer Bless Mahlampo, she did not know how to find out about her symptoms or get treatment.

Bless arranged for Matlape to get tested and since then has been providing her with basic medical supplies to ease her symptoms. Matlape has also joined a support group for people on the Lesotho Red Cross home-based care programme.

"The care facilitators are often women," explained British Red Cross delegate Nicola Stevenson, who worked in Lesotho for 18 months. "Girls often have to come out of school to care for their families."

However, the British Red Cross is helping young carers to carry on at school by helping to fund bags, books, shoes and school uniforms.

Another British Red Cross initiative is providing cash for people to travel to clinics.

"We found that transport costs to clinics were frequently a barrier to people getting healthcare," Nicola said.


One HIV client praised the support she receives from a Red Cross facilitator called Mapotso.

"Mapotso gives me information on what to eat and how to look after myself, this sort of support is not available from anywhere else," she said.

"I know to ask Mapotso for information and supplies and when she cannot assist she sends me to the health clinic to see the nurse."

Nicola believes that the programme's greatest impact has been tackling the stigma of AIDS.

"Stigma is huge in Lesotho. There is a lot of misunderstanding about the virus and many people don't even realise they are discriminating against those with HIV," she said.

One way of tackling stigma is through 'Ambassadors of Hope', people living with HIV, who work with Red Cross volunteers and the community to break down stigma by open discussion.
By, British Red Cross Society, November 14, 2006

"People are becoming more open about their HIV status because of the programme's support network," she said. "The support groups enable people to talk about their problems in a structured way. For the first time someone sat down with me and said 'I am HIV positive' and talked quite openly about it and being on the programme."

The support groups also give people the opportunity to participate in livelihood projects. For example, basket making, poultry rearing, horticulture, sewing and candle making.

"Some of these are income-generating but above all they are therapeutic and often raise people's self-esteem," Nicola said.

By regaining self-esteem, people can learn to help themselves, which is key to living positively with HIV.

Tuesday, November 14, 2006

Uganda: Hope for HIV Positive Children

By, Anne M. Mpaulo, The Monitor, November 14, 2006

No amount of strength will prepare you for the mixed emotions that you feel when you walk into Jajas' Home and meet the children who are brought there everyday.

Jajjas' Home, located in Lweza on Naziba Hill along Entebbe Road, was started in 2000 to rehabilitate children living with HIV/Aids through the provision of quality care.

Ruth Sims, the Director, remembers the day that they started. "Mothers who were HIV positive would come to MildMay Centre alone. It was so heart-breaking because they left their children behind. They would only live for two years and then die. One morning I talked to my colleagues and we decided to start up a centre to help these unfortunate children but we had only 50 pounds in the bank."|

Within the second week, Ruth realised that she could not handle the growing number of children with the little space that she had. Well-wishers, sponsors and the government chipped in and they managed to get the piece of land that they have now. Kwagala (love) was the first house to be opened and it caters for children up to five years of age. Mirembe (peace) for six to 13 year olds was opened followed by Suubi (hope), which caters for 13 to 18 year olds.

A day in the day care section at Jajas' Home begins at 7 a.m. when four Range Rovers leave to go and collect the children who live near the home. By 9.30 a.m. all the children are settled in the home ready for the day to begin.

Each child is given special care in accordance with his or her needs. Those who have to get treatment are referred to the doctor while the ones on ARV's are given their medication. There is a full time physiotherapist and masseur to help the sick ones recuperate. At midday, the children are fed individually as advised by a qualified nutritional expert. Each child is given a minimum of two meals and drinks after which they are put to bed. When they wake up, they play together and take their medicine again.

2.30 p.m. is prayer and song time after which they are bathed and if there is a birthday, they celebrate it.

If on that day there is no birthday, they have their tea and board the Range Rovers back home. 5 p.m. finds all the children at their homes.

For the critically ill, there is Kidukirro (a place of refuge), where they are at admitted if a doctor refers them there.

All the services provided at Jajjas' Home are free. Irene Karamagi, the Public Relations Officer says effectively communicating with the children about their condition is their greatest challenge.

"We prefer the children's guardians to tell them because the children trust them more. However, if for any reason they cannot, we sit them with the child and talk to them. Some of the older children already know that they are not fine since they keep falling sick. At Jajja's Home, we empower them with confidence and lots of love.

HOPE: Children at an SOS village in Kakiri. File photo

We remind them that they can still succeed through university and have a job even though they are HIV positive.

We try not to make them cautious of their condition and teach them to hold their heads up high because they are not different from any other children.

Some children get traumatised when they get to a certain age and ask a lot of questions especially when one of their friends die. When the children turn 18, we send them back to MildMay Centre. Some of them become so attached and don't want to leave but we only have enough space for the younger children," says Karamaji.

The day I visited the centre, children were being immunised against measles.

Karamaji explained that there was an outbreak in the area and they were taking precautions. "These children are very delicate and the smallest infection can put them down." The children were happy as they waited in turn to get their injection and made fun of each other especially those that afraid of the jab.

I talked a shy cute girl called Sanyu who is 12 years although she looked six.

When I asked her how she liked the home, she answered in fluent English, "I like Jajas' Home and Kwagala house. I play with my friends and we eat chicken and ice cream," she giggled mischievously and run off to board the car.

Standing by the car door, I turned to see a girl of 14 years holding a baby of seven months in her arms.

Karamaji explained that the child was also picked from her parents' home daily and brought to the centre for day care. I thought it was not right for a baby to come to the centre unaccompanied and she explained that its parents had probably died.

" If we do not bring these children here, they will not be taken care of and will die within a few months."

As I left the centre, I felt sad when I remembered the stars that I had seen pinned up on the roof. Every house had stars with names, which were put up for every child that died from that age group.

Whether these die young or old, at least someone has given them a chance at a life.


Monday, November 13, 2006

Zimbabwe: The Benefits of Involving Men in HIV Programmes

By, IRIN PlusNews, November 10, 2006

Prevention of mother-to-child transmission (PMTCT) programmes need to involve men in care and support services, says a Zimbabwean HIV/AIDS organisation.

Zvitambo, a research project that aims to improve HIV prevention and care services in Zimbabwe, warned that PMTCT efforts would be futile without fully involving men.

Peter Iliff, medical director of Zvitambo, said his organisation had stepped up efforts to draw men into PMTCT programmes after recognising the benefits of having them on board. When men do play a role, both parties benefit: HIV-positive women are more likely to receive anti-AIDS medication during follow-up visits, avoid breastfeeding their infants, and use condoms; men are more likely to access antiretroviral treatment sooner.

"Since the beginning we have been involving men but they were at the periphery. This time we now see them as equally important," said Iliff.

Over 1,000 public health facilities in Zimbabwe are offering PMTCT services, but the government-sponsored initiative mainly targets women. A single dose of the antiretroviral (ARV) drug, Nevirapine, given to an HIV-positive pregnant woman just before labour, and a few drops administered to the newborn in the first 72 hours, halves the risk of HIV transmission.

Formula feeding reduces the risk of transmission via breast milk by one-third, and women enrolling in the programme are advised to bottle-feed. According to Gladys Chiwome, youth manager for Zimbabwe's Women and AIDS Support Network (WASN), family pressure to breastfeed is strong, and mothers who formula-feed are viewed with suspicion. Involving their partners and husbands in the PMTCT programme could change this. "It does not advance the cause to exclude men from [the] PMTCT programme because women end up isolated, without both the husband and family support," said Chiwome.

Most women choose to keep their HIV positive status a secret from men because they fear being kicked out of home or blamed for passing the virus to their babies. "We have had several cases of women who go to antenatal clinics and get tested, but when they revealed their HIV positive status they were severely assaulted - a thing that would not have happened had the husband been included in the programme in the first place," Chiwome pointed out.

But things are slowly changing for the better. "Our records show a great improvement; many men are now accompanying their wives to antenatal and postnatal clinics, where they get information about ways of preventing infection to their children," said Eddington Mhonda, advocacy officer for the Padare/Men's Forum.

Padare, a local nongovernmental organisation working to change gender stereotypes by reaching boys and men in schools, pubs, sports clubs and churches, has been involved in programmes for the prevention of parent-to-child transmission of HIV since 2004.

Tinashe Muboko (39), who was diagnosed HIV positive five years ago, heard about the risks of transmitting the virus from mother to child during a Padare event. When his wife became pregnant about four years ago, he decided to accompany her to her doctor's appointments, where "the doctors advised me and my wife to give birth by caesarian operation and not to breastfeed him."

Padare also uses social soccer league matches to educate men about PMTCT programmes. Mhonda estimated that since 2004 their PMTCT campaign had reached over 8,000 men, apart from its member base of 5,000 men throughout the country.



Friday, November 10, 2006

Liberia: 3 Out of Every 100 Liberians Are Infected With HIV/Aids

By, The Inquirer (Monrovia), November 9, 2006

In the face of the rapid spread of the HIV/AIDS pandemic on an alarming rate in Sub-Saharan Africa, Liberia's Vice President, Joseph Nyumah Boakai, has revealed that nearly three out of every 100 Liberians are infected with the HIV/AIDS virus describing same as very serious.

Veep Boakai noted that an estimate speaks of a 10 to 12 percent prevalence rate in Liberia. The Liberian Vice President then, described such a revelation on the rapid spread of the HIV/AIDS virus in war-affected Liberia as very alarming.

Veep Boakai said HIV/AIDS has become a major obstacle in Sub-Saharan Africa, undermining decades of development efforts saying that this is a problem that threatens to take away the hopes for the future of all generations. He stated that for countries of Sub-Saharan Africa, HIV/AIDS is a development problem per se, and not merely health issue.

The Liberian Vice President made the assertion recently when he served as the keynote speaker at a program marking the official launching of the World AIDS Day organized by the National AIDS Control Program (NACP) held at the Centennial Memorial Pavilion on Ashmun Street, Monrovia.

Veep Boakai said it is necessary for the international community to deal with this problem as a top priority. He said the problem is compounded by the high rate of poverty and conflict saying,

"These twin evils are impending efforts to fight HIV/AIDS. Veep Boakai maintained that a multi-faceted specific action is needed especially to in the light of poverty reduction and conflict prevention. "Based upon this understanding, the government of Liberia, with its international partners will have to strengthen its policies to fight HIV/AIDS," he added.

Veep Boakai said the region continues to lose its sons and daughters who are in the productive age group. He noted that no specific sector has been spared and the disease remains the leading cause of morbidity and mortality in the history of mankind.

Vice President Boakai noted that while some countries in Sub-Saharan Africa have recorded a decline in the prevalence rate, the AIDS pandemic continues to reach alarming levels in Liberia, but he was quick to say that Liberia must also institute strategies to combat this scourge.

Among other things, Veep Boakai said the Liberian government has committed itself fully to fight against this epidemic. He said HIV/AIDS was declared a national disaster so as to give priority to the disease and its impact.

In her welcome statement, the Acting Program Manager of the NACP, Madam Lwopu Bruce said that the month of November has been set aside for the awareness and the sensitization campaign by the NACP in every part of the country.

Madam Bruce said the month of November would be used to intensify campaign against the killer disease as posters; T-shirts and other materials with anti-AIDS messages will be distributed in Monrovia and parts of rural Liberia. Liberia is expected to join other nations the world over in the observance of this year's World AIDS Day slated for December first. The day was set aside by the United Nations to highlight the danger HIV/AIDS poses to human lives.

SOUTH AFRICA: Radio, TV and print have positive impact on AIDS - study

By, IRIN PlusNews, November 8, 2006

JOHANNESBURG - A new survey in South Africa has proved the positive effect of media campaigns in raising HIV/AIDS awareness.

The study by four organisations, including the Johns Hopkins Bloomberg School of Public Health's Centre for Communication Programmes, covered more than 8,000 people across the country and examined how exposure to more than 20 media initiatives had shaped their behaviour.

"It [the survey] shows for the first time that interventions through radio, TV and print have had a profound effect on increased condom use and HIV testing," Dr Warren Parker, executive director of the youth drama series Tsha Tsha, told IRIN/PlusNews.

Parker was confident that at least half the people tested nationwide for HIV over the past year had been influenced by the campaigns.

According to the findings of the survey, Tsha Tsha - with an audience of 14 million - has shown a significant impact on condom use and HIV discussion and testing, while another popular youth programme, Soul City, which reaches 70 percent of the nation's 45 million people, has had a marked influence on stigma reduction.

However, Parker warned that gaps remained in terms of the lack of a common message shared by both the government and civil society organisations in the fight against the pandemic.

Although the government has consistently drawn international criticism for its lukewarm commitment to orthodox AIDS interventions, a recent two-day AIDS congress signalled a new spirit of cooperation with non-governmental organisations in combating the pandemic.

In addition to being poised to present its new anti-AIDS action plan over the coming months, the government has announced a tender for the implementation of its troubled communication programme, Khomanani ('come together').

Khomanani had also been acknowledged as one of the AIDS awareness campaigns that have had an effect in modifying sexual behaviour.

Parker and his survey partners are taking their findings on the road to encourage the implementation of multiple media communication campaigns in current national policies on AIDS.



SOUTHERN AFRICA: HIV/AIDS threatening life expectancy - UN report

By, IRIN PlusNews, November 10, 2006

JOHANNESBURG - Falling life expectancy is one of the most visible effects of HIV/AIDS in many nations and has reversed human development across a large part of Southern Africa, according to a new UN report.

In sub-Saharan Africa, life expectancy today is lower than it was three decades ago. "Several countries in Southern Africa have suffered catastrophic reversals: 20 years in Botswana, 16 in Swaziland and 13 in Lesotho and Zambia," the report said.

The annual Human Development Report 2006 noted that while most people in Southern African countries with relatively stable economies were not expected to reach the age of 50, the situation was even more worrying in Zimbabwe, where the economy was shrinking rapidly.

Zimbabwean women now have an average lifespan of 34 years, the lowest in the world, while men lived for an average 37 years.

Patrick Couteau, regional health and care advisor on HIV/AIDS for the International Federation of Red Cross and Red Crescent Societies, told IRIN/PlusNews that the discrepancy in the lifespan between the sexes could be attributed to feminisation of the pandemic, as well as gender and economic inequalities.

"With women by far outpacing men in HIV prevalence rates, and with their limited access to life-prolonging care and treatment, it is no wonder that women are also more likely to die from AIDS-related illnesses before their the male counterparts do," he said.

Couteau estimated that women aged 15 and over constituted 89,000 (69.4 percent) of the 1.5 million people living with the HI virus in Zimbabwe, and said this was a direct result of unequal power relationships, which left women and young girls at a great disadvantage when trying to access prevention, treatment and care services.

"This is because they are able to exercise less control over decision-making, especially in fragile economies like this [Zimbabwe's]. Whatever limited resources there are will almost always be allocated to men first, leaving women and young girls to scramble for treatment that is already too costly," said Couteau.

According to the report, 57 percent of HIV-infected people in Sub-Saharan Africa were women, and young African women (aged 15-24) were now three times more likely to become infected than men of the same age.

With over 39 million people living with HIV globally, and 3 million people having died of AIDS-related illnesses in 2005, Couteau recommended that new and more realistic approaches be considered to combat the pandemic.

"In our efforts to mitigate the impact of this disease we need to consider striking at both a national and community level. National policy is welcome, but rarely influences the individual," he said. "Communities must be mobilised; reshaped as support structures for the empowerment of women and children."

Access the complete UN report:

Thursday, November 09, 2006

Efforts To Curb Spread Of HIV In Asia-Pacific

By, United Nations, Scoop Independent News, November 9, 2006

With an estimated 930,000 new HIV infections in Asia and the Pacific last year, United Nations agencies have called for urgent efforts to prevent the escalating spread of the virus and reduce mortality by better integrating HIV prevention, treatment and care into maternal and newborn health services.

“Linking HIV-prevention efforts with reproductive health care can strengthen and improve access to both,” the HIV/AIDS Adviser for the UN Population Fund (UNFPA), Chaiyos Kunanusont, told the first Asia-Pacific Joint Forum currently underway in Subang, Malaysia.

“Millions of women who don’t know their HIV status have an unmet need for effective contraception. Integrated services would enable them to protect themselves and also reduce HIV transmission to their children.”

The Forum brings together health professionals, government officials, people living with HIV, and civil society groups from 22 countries.

With 60 per cent of the world’s population living in the region, many in countries with a high proportion of people between the ages of 15 and 25, there is an urgent need to scale up HIV prevention, treatment and care efforts and provide better reproductive health services. Due to inadequate maternal and child health services, many countries also report high ῭aternal and infant mortality, especially during newborns™ first month of life.

The UN World Health Organization (WHO) noted that although efforts in many countries to scale up prevention of parent-to-child transmission and roll out access to HIV treatment are underway, they can only succeed if primary health care systems are strengthened, especially by improving outreach and referral services to those most in need.

“Many countries in Asia and the Pacific already have national guidelines in place for the prevention of parent-to-child transmission. Many countries have trained health workers and are introducing treatment,” UN Children’s Fund (UNICEF) Deputy Regional Director Richard Bridle said. “The challenge remains Ῠow we better link these efforts to prevent disease and improve nutrition to provide a holistic package of services for mothers and their children.

At the conference, which was jointly organized by WHO, UNICEF, UNFPA and the Joint United Nations Programme on HIV/AIDS (UNAIDS), delegates are also promoting a four-pronged strategy for the prevention of primary HIV infection in mothers and young children, including providing medicines to lower the risk that HIV will pass to the baby.

Wednesday, November 08, 2006

Botswana: Campaign Demands HIV Employment Law Now

By, The Voice (Francistown), November 7, 2006

A large coalition of organizations and individuals have launched a campaign urging Botswana government and policy makers to put in place a law to protect HIV related rights in the work place.

Since 2002, Botswana Network on Ethics, Law and HIV/AIDS (BONELA) and the Botswana Federation of Trade Unions, two organizations spear heading the campaign have been working hard to have such a law created and passed in order to guard against rampant violations of HIV related rights in the workplace.

However the government's delay in enacting a law has prompted the coalition to adopt a new approach through the campaign, which boasts the slogan, "HIV Employment Law Now!

So far the campaign, which is fast growing both in support and momentum, has distributed a petition nationally and internationally collecting over 1000 signatures in the first three weeks of its launch both on paper and on line at BONELA's website in a move believed to be the first of its kind in Botswana.

The collected petitions will eventually be presented to parliament after a peaceful march on the 11th of November in Gaborone when supporters will rally the cause from outside the national stadium to the main mall.

"Botswana has waited long enough, says BFTU spokesperson, Patrick Chengeta, "Now we should move. The courts have announced that without a policy workers are vulnerable. The government has a social responsibility."

In a landmark 2003 case involving the firing of an HIV positive employee by the Botswana Building Society, a judge ruled that while the National AIDS Policy had strong persuasive moral authority in the court, it was not a binding law that could be applied to protect workers rights therefore leaving the responsibility to parliament to turn the policy into law.

It this kind of violations of HIV- related human rights and others such as HIV positive people being forced to undergo an HIV test before employment that have prompted BONELA, its partners and supporters into action.


Uganda: Funding Shortfall to Affect Health Programmes

By, UN Integrated Regional Information Networks, November 7, 2006

Health programmes in Uganda could be disrupted following a decision by the Global Fund to exclude the country from its list of beneficiaries, a senior government official said on Tuesday

The decision by the Global Fund to fight Aids, Tuberculosis and Malaria would exclude Uganda from the list of countries due to receive part of its sixth round of grants.

"We had presented a funding request for three years totalling US $111 million of which we expected at least $35 million. But it was not approved," Kihumuro Appuli, the head of the Uganda Aids Commission (UAC), said. "This will cause some inconveniences, but we are going to assess what impact it will cause and find out how we can bridge the gaps that might have been left."

According to the final list of approved proposals on the Fund's website, Uganda has missed out on funds to fight HIV/AIDS and malaria. However, it received a two-year grant of $10.7 million, which would bring to $26 million the total funds the country has received to fight tuberculosis (TB).

Kihumuro said despite missing out, Uganda was getting funding from other sources, mainly from the US President George Bush Initiative on AIDS, of which the country is the biggest recipient. It expects to receive up to $170 million in 2006.

He said Uganda was to establish the reasons why its proposal was rejected and that it was awaiting more details.

Last week, the Fund's board approved the sixth round of 85 new grants, totalling $847 million. These new commitments expand its portfolio to $6.6 billion through more than 460 grants in 136 countries. Some 63 countries are beneficiaries of the newly-approved funding; four are receiving financing for the first time.

Over a five-year period, the new grants will support the provision of life-enhancing antiretroviral (ARV) treatment to 200,000 people living with AIDS, the treatment of nearly 400,000 people infected with TB and the distribution of 11.5 million insecticide-treated bed nets to prevent malaria, among other interventions.

The Fund said in a statement that nearly half of the new funding is committed to Africa, with the remainder to be distributed among other regions experiencing large or rapidly growing burdens of the diseases: Asia, Eastern Europe, and Latin American and the Caribbean.

Just over half of the grants will go to combat HIV/AIDS, while the other half is evenly divided between TB and malaria. The majority of funds, or 60 percent, will flow to low-income nations.

The Fund suspended its grants to Uganda in 2005 when it discovered misuse of the funds, but reinstated them when the government appointed a commission to investigate the funds' management.

The probe into the mismanagement of the Fund, headed by a High Court judge, Justice James Ogoola, found gross mismanagement by the project implementation team.

Health ministers Jim Muhwezi, Mike Mukula and Alex Kamugisha were implicated and later dropped as ministers.


Tuesday, November 07, 2006

Until Death Us Do Part - Love, Marriage And the Virus

By, UN Integrated Regional Information Networks, November 6, 2006

When Nomvula Mnkandlha, 29, met Skhumbuzo Muvhinjeva, 39, at a support group meeting for HIV positive people, in Zimbabwe's second city, Bulawayo, she was not looking for a romantic relationship.

The soft-spoken, recently divorced young woman was still coming to grips with her ex-husband's rejection after she had told him she was living with the virus. Their two-year-old little girl had fallen ill and her mother had decided they should both be tested, but it took her another month to come to terms with her infection and find the courage to tell her husband.

He accepted her status on condition that she would not ask him to go for an HIV test, but a month later he sent her and her daughter back to her parents' home and began divorce proceedings, claiming that his wife would also bewitch and infect him. "I felt angry and betrayed," she recalled.

Nomvula then began attending the support group to which Skhumbuzo belonged. When the two met in 2003, his CD4 count (immune cell count) was dropping drastically and Nomvula offered him support while he slowly rebuilt his strength. "He treated me like a younger sister ... and we enjoyed each other's company," she said.

In a low gentle voice, Skhumbuzo admitted to having had multiple sexual partners during his marriage, but it had taken the death of his wife for him to realise the effect of his behaviour. Two years earlier, after three positive HIV tests, he was still living in denial and only started mentally preparing for what he believed was his imminent death, and what life would be like for his three orphaned children, after the fourth positive test.

Skhumbuzo, a security company banking and wage packager, joined a support group, where "I realised I was not alone ... I could live positively."

Despite Nomvula's initial reluctance their friendship strengthened and developed into a deeper relationship. "He said he needed a mother for his children and a partner for life," she told IRIN/PlusNews with a shy smile. In June 2005, she and her daughter moved in with Skhumbuzo and his children.

Their home is a neat yellow and chocolate-coloured house in Nkulumane, a high-density suburb of Bulawayo, where large AIDS awareness posters hang on the walls of the small sitting room. Skhumbuzo revealed his HIV status to his managers and sometimes teaches colleagues about HIV/AIDS. The lovers are living openly with their status. "This is not a secret, Nomvula said. "Why should we hide what we are?"

But the couple still battle with stigma and discriminatory attitudes. According to Skhumbuzo, his family is waiting for him to die. "They are counting the months and days." Nomvula's family still doesn't believe she has the virus, as she has yet to show a single symptom of illness.

"People still don't understand this disease," said Duduzile Moyo, a National AIDS Council (NAC) ward secretary. "They think it's a death sentence, but there is still so much hope."

Skhumbuzo began receiving free antiretroviral (ARV) drugs at a state hospital in October 2004, and Nomvula became his treatment supporter. "This is important, because I can forget to take my pills and she monitors and reminds me," he said, patting her hand affectionately.

Nomvula is not taking ARVs yet, since her CD4 count is 450 - ARV treatment is recommended for patients with a CD4 count of 200 or less - but she takes a daily dose of cotrimoxazole, an antibiotic drug that helps keep opportunistic infections at bay. The couple also practice safe sex, which remains an important precaution when both partners are HIV positive to avoid potential infection with an ARV-resistant strain of the virus.

They will be travelling to each other's rural homes to finalise the traditional marriage procedures with their families later this year.


Monday, November 06, 2006

Cameroon: New Strategy to Fight HIV/AIDS

By, Elizabeth Mosima, Cameroon Tribune, November 3, 2006

The Scout Association of the University of Yaounde 1 has installed an automatic condom distributor in the campus.

The fight against the spread of HIV/AIDS in the campus of the University of Yaounde I has been a major preoccupation of the authorities of the institution and the student population as well in the last decade. In order to keep the lethal disease at bay, the Scout Association of the University of Yaounde 1, has installed an automatic machine, "Presso Express", for the distribution of condoms at the main entrance of the students' residential quarters. The machine which is a free gift from a humanitarian NGO known as UNFPA is part of the association's programme for the fight against HIV/AIDS in the university campus. The machine is placed on a wall of the university quite close to the campus police post. It is small in size and easy to manipulate. The automatic distributor can contain 36 packets of condoms at a time and each packet contains four condoms.

According to the instructions pasted on the wall, the customer inserts a CFA 100 coin in the machine and then pulls a small handle gently to retrieve a packet of condoms. Only one packet of condoms can be bought at a time. According to Andi Mboutou Paulin Alain, one of the campus police guards, they also take charge of the security of the machine as well as the campus. He said since the installation of the automatic distributor last Wednesday, November 1, customers have been flooding the place but most people prefer to buy them at night. According to him, not only students purchase condoms from the machine as it is not exposed to the public. "Many people, even non students buy their condoms from here. Some people find it difficult to go and buy condoms from stores around. So buying them here is an easy task for them," he said.

According to the director of students' activities at the University of Yaounde 1, Professor Nola Bienvenu, the installation of the automatic distributor was approved by the Rector of the University. He said the machine has come at the right time following the wide spread of HIV/AIDS in the various institutions. "I think for a humanitarian NGO to provide students with a machine for the distribution of condoms which is within the reach of the students and the fact that AIDS is very common in the students' milieu, is a laudable gesture," he said. The automatic distributor operates 24 hours per day and it is managed by the students themselves. The campus police ensure the safety of the machine to prevent acts of vandalism. It is the wish of many students that more of such machines be introduced on campus.

Friday, November 03, 2006

Male genital hygiene affects risk of HIV infection

By, Reuters health, September 22, 2006

NEW YORK (Reuters Health) - Washing the penis regularly lowers the risk of HIV infection in circumcised and uncircumcised men, according to two papers in the Journal of Acquired Immune Deficiency Syndromes for September.

Male circumcision is associated with a reduced prevalence of HIV, according to Dr. Nigel O'Farrell, from Ealing Hospital in London, and colleagues. They now suggest that interventions to improve genital hygiene may also be effective in reducing HIV infection risk.

Specifically, they theorized that the presence of subpreputial penile wetness would increase risk, and that washing to keep the area under the foreskin dry would reduce risk. They define penile wetness as "the observation of a diffuse homogenous film of moisture on the surface of the glans and coronal sulcus."

Their study included 386 uncircumcised men residing in or near Durban, South Africa, who were free of genital ulceration or urethral discharge. Clinicians who examined the men observed that half had some degree of wetness around the glans and coronal sulcus. Approximately 80% were judged to be slightly wet, 19% as wet, and 2% as very wet.

In contrast, only one of 36 circumcised men they examined had wetness.

Factors associated with penile wetness were younger age, low level of attained education, low income, higher lifetime numbers of sexual partners and not washing after sex.

The prevalence of HIV infection was 66.3% among men with penile wetness, versus 45.9% in those with no wetness. After adjusting for HIV predictors and confounders, the adjusted odds ratio (OR) for HIV infection was 2.27 when comparing men with wetness versus those who were dry. The degree of wetness did not affect the risk.

The authors note that the HIV prevalence among uncircumcised men without penile wetness was close to that of circumcised men (42.9%).

Although many of the factors associated with penile wetness were poverty-related, Dr. O'Farrell's group suggests that "information, education, and communication programs at a number of levels would be needed: for instance, encouraging washing related to sexual activity -- precoital or postcoital or as an everyday life skill."

In the second Journal report, Dr. King K. Holmes, from Harborview Medical Center in Seattle, and associates interviewed 150 men living in Kenya regarding socioeconomic status and hygiene practices; 15% were HIV positive, and 97% were circumcised.

Components of hygiene associated with risk included amount of time spent in a bath (more than 10 minutes) and bathing immediately after sex.

Multivariate analysis revealed three independent risk factors for HIV infection: previous treatment for a serious illness (OR = 5.1, p = 0.02), circumcision (OR = 0.12, p = 0.04) and genital hygiene (OR = 0.41, p = 0.03).


Ten Ways to Take Care of Yourself When You Have HIV Disease

By, Adam Fredericks/ Gay Men’s Health Crisis (GMHC)

Take Responsibility For Your Health and Your Life

When it comes down to it, no one cares about you more than you do. While there are services and people you need in your corner, it is you that must run the show. Balance is the key to living a life that is quality and dignified.

Get A Support Network To Be With You In Good and Bad Times

As Bette Midler sang “You Gotta Have Friends” …or at least a support group!

Sometimes it is hard to find support. You may live far from family or be out of contact with them. Old friends may have died or moved and it may feel difficult to make new ones. You might be anxious about anyone finding out you are HIV positive. Here are some ideas:

• Join a support group (if that sounds too intense, try a short term group)
• Get a therapist
• Have a meal with other people
• Attend workshops or other events
• Connect with a spiritual community
• Join an HIV-positive chat room (be careful not to let it become your main contact with other people, since that can isolate you)

Find A Health Provider With Whom You Can Build A Relationship

• Studies show that people with HIV that have a partnership-type of relationship with their provider live longer and have a better quality of life. When choosing a provider, think of the kind of patient you are. Do you want to be actively involved in all health decisions or would you prefer to let your provider make most decisions without you? How much information do you want? Are office hours important to you? Does it matter what hospital your provider can admit you to?
Ask peers, friends and family what they like and dislike about their health provider.

Compare the names in your health insurance provider directory against those you find during your research.

Remember if the fit isn’t right, keep looking. Nothing feels worse than a health provider that doesn’t fit.

Take HIV Medications When You Need Them

There may come a time when you need to consider taking HIV meds. In the U.S., most doctors use the U.S. Public Health Service guidelines for when to begin treatment.

According to the USPHS Guidelines:

Starting HIV meds is strongly recommended regardless of your T-cell count and viral load

• If you have any AIDS related symptoms like fever or weight loss
• If you have any AIDS related infections like thrush
Starting HIV meds is strongly recommended
• If you have a T-cell count less than 350 regardless of your viral load
Starting HIV meds is strongly recommended
• If you have a viral load count greater than 30,000 by branched-DNA viral load test
• If you have a viral load count greater than 55,000 by PCR viral load test
Chart is courtesy of

Simplify Your Regimen

Remember, though, there is more to consider than just your T-cell count and viral load. Ask yourself if you are ready and able right now to take medicine for your HIV. Do you have support? Are issues like food and housing under control?

An HIV treatment education and adherence program can help you learn about meds and their side effects. These programs can also help to take your meds properly.

Work with your health provider to make sure that when you do decide to take meds, your drug schedule will fit into your life. This way you will have a better chance of success with much less stress. It used to be that people had to take meds at different times during the day, which could get very confusing.

Now, it is possible to set up a much easier schedule, taking meds only once or twice a day. Research has shown that people are better able to stick to their meds schedules when they are simplified. Your medication schedule should be discussed and agreed upon by you and your health provider.

Some resources for HIV treatment information include:

Maintain Good Nutrition

Visit an HIV nutritionist to get the most out of your food. Food provides you with many of the nutrients you need to maintain a healthy body and support your immune system. Today’s nutritionists can help you make good food choices using the foods that you know or have heard of and by advising you about food safety. An HIV nutritionist can help you:

• Prevent or treat wasting
• Monitor your lean muscle mass
• Manage cholesterol and triglycerides, blood sugar or liver enzymes
• Manage side effects
• Recommend vitamins and other supplements
• Clarify information and advise on herbal and alternative therapies
• And much, much more…

A lot of community-based organizations now offer HIV nutrition services. For a list of HIV-experienced nutritionists in your area, call your local HIV/AIDS Hotline or check Also try your health insurance provider directory.

Get Up and Do Some Exercise

Exercise is very important when you have HIV. Studies show that exercising increases white blood cells. It can also make you feel better by reducing stress. The three parts to fitness are:

• Flexibility
• Strength
• Cardiovascular conditioning
Of the three, strength training may be the most valuable for someone with HIV. It can:
• Improve the immune system
• Increase appetite
• Increase metabolism
• Increase bone density

Allow you to perform tasks with greater ease

Get A Life Outside HIV

You had a life before HIV disease. You Are NOT Your Disease. Being diagnosed HIV positive has its challenges. After you adjust (however long that takes you), try some of the following suggestions or come up with your own. The thing is to have something in your life that is not HIV-related.

• Consider getting clean and sober
• Start or finish school
• Get a job or change the job you have
• Volunteer
• Start a hobby
• Listen to music in the park
• Get a new apartment
• Travel and explore
• Start a business
• Get a pet
• Fall in love
• Get married
• Have children
• Learn to drive

Stop Stressing…So Much

Okay, so you can’t wipe stress completely out of your life. But you can try to keep your stress levels down. Stress weakens the immune system. Research shows that stress helps HIV to spread more quickly in the blood and prevents HIV meds from completely doing their job. Some people might turn to drugs (street, club or prescription) in order to find some relief from the stress of HIV. This can further damage the immune system. The following are some healthier suggestions for getting rid of stress:

• Change your scenery (go outside if you are inside, come in if you are out)
• Get some form of exercise each day (like going for a walk)
• Take bubble baths
• Get acupuncture, a massage or reiki
• Talk to somebody, don’t just stuff it inside
• Take yoga or tai-chi
• Stand under a train overpass and scream out your frustrations when the train is passing
• Drink hot herbal tea
• Keep a journal (if you don’t want to write it, tape it or draw it)

Ask For Help When You Need It

Living with HIV can be overwhelming and you don’t have to do everything on your own. That is what AIDS service organizations (ASOs) are for. Search around for one that meets your needs and suits your temperament.

You can find lists of ASOs in publications like:

• Being Alive
• HIV+ Magazine
• Positively Aware

And websites like:
• (click on links for “national and int’l resources”)
•; 1-800-AIDS-NYC
• (national and int’l resources)

ABOVE ALL, Maintain Your Sense Of Humor Because Sometimes All You Can Do Is Laugh

Exclusive school for HIV/AIDS children in India

By, MediaCorp press, September 21, 2006

A non-profit organisation has set up a school in India for children infected with HIV/AIDS and barred from other institutions, an official said.
"All the seven orphans and children who have only one parent were turned down by other schools," said Jyotish Joseph, director of Karunalayam, the organisation which started the school in Andhra Pradesh state.
"We teach them local and English alphabets, mathematics and also take care of their medical needs," Joseph told AFP. "The idea is to give them a lively and happy atmosphere."
The school in southern Warrangal district, which started operations last week, is being staffed by a HIV/AIDS counsellor, a teacher and a nurse.
Before the school was launched, the children had been accommodated with adults at the 40-bed center run by the organisation with the help of government funds.
"The decision to start a school was taken as we felt that if we put children along with adults there were more chances of abuse. Also it demoralises them," Joseph said. "But the main purpose is to give them education."
"Here the concept is of exclusive care. In some schools HIV-positive kids are pushed around by other children and looked down upon. Others deny them admission. They face no such problems in our school," he said.
Two years ago parents of more than 400 children in India's most literate state of Kerala threatened to pull their children out of classes if two HIV-positive kids were admitted to a government-funded school.
"In India there is a lack of awareness about HIV/AIDS among teachers and parents. There needs to be more education," Joseph said. "We plan to take in more children maybe 25 initially and open more such schools in other regions."
India outstripped South Africa as the country with the largest number of HIV/AIDS infections last year. India has 5.7 million people living with AIDS against South Africa's 5.5 million. — AFP