AIDS Care Watch

Thursday, May 15, 2008

HIV/AIDS Remains Unprecedented Challenge for Sub-Saharan Africa

By, Joe DeCapua, VOA News, May 14, 2008

The World Bank says HIV/AIDS will remain an unprecedented economic, social and human challenge in sub-Saharan Africa for years to come. A new report by the bank calls on African nations to increase efforts at slowing or preventing HIV infection. It estimates there are 22-and-a-half-million people on the continent living with HIV/AIDS, and it says the disease is the leading cause of premature death.

Elizabeth Lule is manager of the World Bank’s AIDS campaign team for Africa. In Washington, she spoke to VOA English to Africa Service reporter Joe De Capua.

“We see, I think, some progress, definitely some positive results with HIV prevalence declining in a number of countries, like Kenya, Zimbabwe, Cote d’Ivoire, Mali and Burkina Faso. But we also see a very diverse picture with a hyper-epidemic in southern Africa and very high prevalence rates in South Africa, Swaziland, Lesotho and Botswana and the burden of disease increasing in those countries,” she says.

With the HIV/AIDS epidemic more than a quarter of a century old, will it continue indefinitely? Lule says, “Definitely for another generation I would say and depending on whether we make the right investments in the right interventions and address the drivers of the epidemic, which are specific to each country. But we have a large pool of survivors from HIV/AIDS and as you know there is no cure…. With anti-retrovirals we have more people surviving, but who are living with HIV/AIDS. And the new infections, although they have stabilized, the absolute numbers actually continue to grow of people living with HIV/AIDS partly because of population growth in African countries.”

The World Bank report says businesses have been hit hard by the disease, claiming the lives of many young, productive workers. It says, “Some private firms in Southern Africa recruit two workers for every job in anticipation of losing staff to the disease.” This continues despite anti-retrovirals being able to make HIV/AIDS more of a chronic disease than a death sentence.

Lule says, “It’s happening because the coverage of people on anti-retrovirals remains dismally low. Only 30 percent of people who need treatment are actually getting it, partly because of very weak health systems. The fact is that human resources in Africa remain a big problem because of the brain drain, but also HIV/AIDS kills off health workers.”

The bank report says that “more than 60 percent of the people living with HIV/AIDS in Africa are women; and that young women are six times more likely to be HIV positive than are young men. As a result of the epidemic, an estimated 11.4 million children under age 18 have lost at least one parent.”

Lule says that interventions are needed to protect young women, who are often vulnerable to infection from older men, who may have multiple partners. Poverty also plays a role, often causing many women and girls to become prostitutes to raise money to feed themselves and their families.

The World Bank’s “Agenda for Action through 2011” includes: advising countries on the complexities of AIDS fund that’s available from such sources as the Global Fund and PEPFAR and building stronger health and financial systems.


Tuesday, May 13, 2008

HIV/AIDS Cases Increasing Among Commercial Sex Workers in Uganda

By, Kaiser Network, May 12, 2008

HIV/AIDS cases are increasing among women and girls involved in commercial sex work in Kampala, Uganda, HIV/AIDS advocates said recently, Uganda's Monitor reports.

Robert Kanwagi -- coordinator of the Breaking the Ice Project, which is being implemented by the group Reproductive Health Uganda in Kampala -- said a recent survey found that HIV prevalence among the sex workers in the city was as high as 47.2%, compared with the national prevalence of 6.7%. The survey also found that HIV prevalence is as high as 60% among sex workers ages 25 to 29 and that 59.6% of sex workers were found to have other sexually transmitted infections, such as syphilis and gonorrhea.

Kanwagi, who was speaking at a training workshop on HIV and gender issues, said poverty is the primary reason that women become commercial sex workers. He also said that sex workers lack the authority to negotiate safer sex and that those who offer unprotected sex are paid more money than those who use condoms. The Breaking the Ice Project was launched in July 2007 to expand access to HIV/AIDS services among sex workers in Kampala.

RHU National Program Manager Peter Ibembe said HIV/AIDS is spreading among women and girls because of social, economic and cultural factors that deny them access to HIV prevention and treatment services. "A poor woman or girl may not be able to deny a man sex because she needs money," he said, adding, "Because of their lack of decision-making power in matters of sex, as well as other factors like poverty, they become more exposed to the risk of becoming infected than men" (Nafula, Monitor, 5/9).

Friday, May 09, 2008

Mother To Child HIV Transmission Can Be Prevented

By,, May 2008

Pregnant women with HIV who are diagnosed early and properly treated can deliver healthy children.

A study by University College London examined 5151 HIV positive pregnancies between 2000 and 2006. Women who got proper treatment during pregnancy delivered only 1.2% HIV positive infants. This is a significant improvement, compared to 1990s when mother to child HIV transmission rates were 20%.

The study found that the key to success is the combination of antiretroviral therapy (ART) and antenatal testing for HIV.

Antenatal testing diagnoses HIV in very early stages before the disease seriously affects health. In 2000 HIV early diagnosis rates were 70%, compared to 95% in 2005. The testing method is very successful in early detection, giving more survival chances to patients.

Antiretroviral therapy is very successful when given during at least the last 14 days of pregnancy. ART cuts the risk of mother to child HIV transmission to 0.8%. It is known that C-section delivery cuts the risk for HIV infant delivery, but the study suggests that a proper treatment can allow natural delivery of healthy children.

The study is very promising, but it also mentions that the combined treatment is very expensive even for those living in developed countries. Only 10% of women in these countries can afford such treatment. This is why about 1800 HIV infected infants are born each day.

The study urges the need that the treatment must be affordable for all women. This combined treatment can significantly reduce mother to child HIV transmission rates and ensure delivery of healthy infants. This means that the treatment is extremely important to have a healthy population. -- HULIQ


Thursday, May 08, 2008

U.N. Launches Workplace HIV Program

By, Kaiser Networks, May 7, 2008

United Nations Secretary-General Ban Ki-moon on Tuesday launched U.N. Cares, a new workplace HIV program that will provide such services as training, counseling and testing for U.N. staff and their families, Xinhua/China View reports. The program aims to meet 10 minimum standards -- such as insurance coverage and condom access -- by the end of 2011 by making staff, time and resources more available. U.N. Cares will work in conjunction with the organization's advocacy and support network for HIV-positive employees, as well as address workplace stigma and discrimination. Fifteen U.N. bodies to date have pledged about $1.3 million to U.N. Cares, and Ban on Tuesday said that the U.N. Secretariat will provide about $350,000 as part of an initial contribution.

"Since the early 1990s, the impact of the virus on our work and on the communities we serve has been historic in magnitude," Ban said, adding, "At the same time, our workplace, our staff and our families are profoundly affected." According to Ban, the launch of U.N. Cares represents a "milestone in the U.N. response to HIV." Ban also pledged to make the United Nations a model workplace in its response to HIV/AIDS, adding that the organization's "performance will be only as good as the commitment and contribution of every one of us." In addition, Ban called on U.N. staff to learn essential information about HIV, take measures to protect themselves from contracting the virus and participate in U.N. Cares programs (Xinhua/China View, 5/6).

Wednesday, May 07, 2008

Why some carriers don't get sick

By, Charlie Fidelman, Montreal Gazette, May 5, 2008

Despite the odds, a tiny group of people infected with the human immunodeficiency virus manage to stay healthy, never showing symptoms of illness.

So what is shielding this special group of HIV-infected people, dubbed "elite controllers," whose bodies control HIV so well the virus remains virtually undetectable? A team of Canadian and U.S. scientists believes it has solved part of the mystery.

Led by Rafick-Pierre Sékaly of the Centre Hospitalier de Université de Montréal, the team has discovered a "memory T cell" mechanism that protects these rare patients from viral diseases.

Published in the advance online edition of the journal Nature Medicine, the researchers explain how a protein in some people's DNA shields against life-threatening immune illnesses.

Moreover, when injected into sick tissue, this key protein - once modified - was able to reverse cell death in defective HIV cells.

The discovery means researchers might have a reliable target for an HIV vaccine, experts said.

It also opens the door to finding new therapies for other killer immune diseases.

"We're also focusing on cancer, another problem for which you need memory T cells," said Elias Haddad, adjunct professor in microbiology and immunology at U de M and McGill University.

Here's how it works: First, it's important to know that HIV infection is characterized by the slow death of memory T cells, which are vital in the defence against immune diseases, Haddad said.

The study compared three groups: an HIV-negative sample, an HIV-positive group whose infection was under control with medication, and a third group (the elite controllers) whose HIV showed no symptoms.

"They were better than healthy," Haddad said of the elites.

The secret of the elite controllers lies in a key protein called FOX03a. This protein induces "bad genes" to kill T cells, Haddad said. But in the elite group, which can fend off HIV infection without medication, the immune system remained resilient "keeping an anti-viral memory," Haddad explained.

That's because the FOX03a protein failed to get into the cell nucleus. Instead, the protein was targeted for destruction, he said.

It also worked in reverse to rescue cells.

"You can induce a long-term survival of memory cells in patients whose cells would otherwise die faster, and improve their quality of life," he said.

The immunological factor discovered by Sékaly's team could turn out to be helpful against other viral infections, said renowned AIDS researcher Mark Wainberg, head of the McGill AIDS Centre.

"It's an excellent study and an important discovery in terms of potential for long term solutions."

An estimated one out of 300 people infected with HIV are considered elite controllers, but they're largely invisible to AIDS researchers because they do not get sick.

Sékaly's team is recruiting elite controllers to take part in the next study. It can be reached at


HIV infections on the rise in Germany

By, M&C News, May 6, 2008

Berlin - Some 2,752 new cases of HIV were reported in Germany in 2007, a 4-per-cent increase over the previous year, the federal institute responsible for disease control and prevention said Tuesday.

The biggest increase in HIV infections - 12 per cent - was reported in homosexual men, the Robert Koch Institute said. Infections among heterosexuals were down by 7.5 per cent.

There was also a drop in infections among drug addicts and immigrants from countries with a high incidence of AIDS, the institute said.

Around 59,000 people are infected with the virus that leads to AIDS in Germany, Europe's most populous country.

The Robert Koch Institute said most of the new infections occurred in large cities, led by Cologne, Dusseldorf and Berlin.