ACW: General Information

HIV/AIDS Remains Unprecedented Challenge for Sub-Saharan Africa

2008-05-15T09:20:00.001+07:00

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.

Source: http://www.voanews.com/english/Africa/2008-05-14-voa30.cfm

HIV/AIDS Cases Increasing Among Commercial Sex Workers in Uganda

2008-05-13T14:26:00.000+07:00

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).

Mother To Child HIV Transmission Can Be Prevented

2008-05-09T16:38:00.001+07:00

By, Huliq.com, 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

Source: http://www.huliq.com/58970/mother-child-hiv-transmission-can-be-prevented

U.N. Launches Workplace HIV Program

2008-05-08T09:30:00.001+07:00

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).

Why some carriers don't get sick

2008-05-07T16:21:00.002+07:00

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_controllers@umontreal.ca

Source: http://www.canada.com/montrealgazette/story.html?id=c4e75d52-213f-474b-94ed-62ee99aa39fe

HIV infections on the rise in Germany

2008-05-07T16:03:00.001+07:00

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.

Source: http://www.monstersandcritics.com/news/health/news/article_1403701.php/HIV_infections_on_the_rise_in_Germany

Indians more prone to HIV-AIDS than others

2008-04-28T10:52:00.001+07:00

By, The Times of India, Ashish Sinha,April 26, 2008

The biggest ever gene mapping exercise of the "people of India" has shown that Indians are more vulnerable to HIV-AIDS than many other population groups around the world. This is because a protective gene marker against HIV-1 is virtually absent in India, making the population more at risk.

The study also shows that the risk increases as one moves from north to south India. It also says the Indian gene pool is quite varied and the term or description "Indian" is hardly homogenous. It includes several variations across population groups spread across the country's land mass.

On the vulnerability to HIV-AIDS, the study says, "There is a high-to-low gradient from north to south (India). These results are consistent with the observations by Majumder and Dey in 2001, and the antenatal clinical HIV prevalence survey (2005) that reports a high frequency of HIV in south Indian populations."

The study, released by science and technology minister Kapil Sibal on Friday, was carried out by more than 150 scientists and researchers from six CSIR laboratories. A part of the genetic landscaping were the Centre for Genomic Applications (Delhi) and a host of anthropologists.

Gene study largest since Green Revolution

Perhaps the largest scientific endeavour since ICAR's Green Revolution effort of 1970s, the mapping covered four main linguistic families of Indians — Austro-Asiatic, Tibeto-Burman, Indo-European and Dravidian. It also encompassed the mostly endogamous (marrying within the larger social group) Indian population defined by distinct religious communities, hierarchical castes and subcastes, and isolated tribal groups.

The study, a part of the Indian Genome variation initiative, has generated information on over 4,000 genetic markers from more than 1,000 biomedically important and pharmacogenetically relevant genes in reference groups. The study reveals a high degree of genetic differentiation among Indian ethnic groups and suggests that "pooling" of endogamous populations without regard to "ethno-linguistic factors" will result in false inferences.

"We note that the people of India are referred as 'Indian' in many population genetic studies. The implication of such usage is that the Indian population is genetically homogeneous, which, as the results of our study indicate, is evidently not true. However, we have also shown it is possible to identify large clusters of ethnic groups that have substantial genetic homogeneity," it says.

The mapping is expected to help in constructing "specific drug response/disease predisposition maps" to aid policy decision making for drug dosage interventions and disease risk management, especially for complex and infectious diseases.

Source: http://timesofindia.indiatimes.com/India/Indians_more_prone_to_HIV-AIDS/articleshow/2984007.cms

Thai HIV/AIDS programs overlook children, UNICEF Official Says

2008-04-28T10:33:00.001+07:00

By, IRIN PlusNews, April 23, 2008

Thailand's HIV/AIDS prevention and support programs have overlooked the needs of children living with or affected by the virus, Scott Barber, chief of UNICEF's HIV Section in the country's capital of Bangkok, said recently, IRIN News reports.

According to a recent UNICEF report, it is estimated that about 50,000 children under age 15 in East Asia and the Pacific are affected by HIV/AIDS. About 10,000 HIV-positive children in the region were receiving antiretroviral drugs in 2006, a 40% increase from 2005. "Just providing (antiretroviral drugs) is not enough," Barber said, adding that antiretrovirals are "only effective if children take them, and this depends on social support, and the reduction of stigma and discrimination."

Thailand in 2007 endorsed a call made by the Association of Southeast Asian Nations in 2006 to put children at the center of HIV/AIDS strategies in the region, IRIN News reports. Several countries in the region have since implemented national strategies aimed at reducing mother-to-child HIV transmission and addressing the virus among children.

MTCT in Thailand has decreased in recent years, with 80% of HIV-positive pregnant women in the country receiving antiretrovirals. Fiji and Malaysia also have had success in reducing MTCT, according to UNICEF. However, in some developing countries in the region, only 30% of pregnant HIV-positive women receive treatment, IRIN News reports.

Chutima Salsaengjan -- a social worker with the Thai nongovernmental organization We Understand Group, which organizes art and drama programs for children living with HIV/AIDS -- said it is "important to treat [HIV] but also important to help children cope" with the virus. "For children, small things can make a big difference," she said (IRIN News, 4/23).

Thailand: Helping HIV/AIDS children

2008-04-24T11:06:00.001+07:00

By, IRIN plusNews, April 23, 2008

As a child, Poel wondered why she fell sick so often, why she was always breaking out in lesions, why she constantly felt tired. The answer seems obvious now - her parents died of HIV/AIDS when she was very young. But the aunt who looked after her never sent her for tests and her status was only discovered when she was admitted to hospital with tuberculosis at 11.

"They gave me medicine," Poel, who lives in Khon Kaen Province in northeast Thailand, and is now 18, told IRIN. "But the pills were very big and hard to swallow. They were made for adults. They should think about the children."

Thailand has long been held up as a shining example of how good policies can help stem the spread of HIV. However, it has overlooked the special needs of children such as Poel.

"Just providing ARVs [antiretroviral drugs] is not enough," says Scott Barber, chief of the UN Children's Fund (UNICEF) HIV section in Bangkok. "They are only effective if children take them and this depends on social support and the reduction of stigma and discrimination.”

In a recent report, UNICEF estimates that across East Asia and the Pacific, some 50,000 children under the age of 15 are affected by HIV or AIDS. About 10,000 received ARVs in 2006 - a 40 percent jump on 2005.

In addition, more countries have national programmes to prevent mothers from passing HIV to their babies and more emphasis is being placed on helping infected children.

In Thailand, parent-to-child transmissions have dropped considerably in recent years, with 80 percent of expectant women receiving ARVs. UNICEF said Fiji and Malaysia have reported similar numbers. But in other developing Asia Pacific nations, fewer than 30 percent of expectant mothers are treated.

Thailand's success is attributed to an aggressive top-down approach. The campaign against HIV/AIDS was instituted more than two decades ago and included a massive public information exercise, efforts to enforce the use of condoms in all commercial sex establishments and, in 2003, a commitment by the government to provide universal ARVs. At least 600,000 people are infected with HIV or AIDS and at least one Thai child is born with the virus every day.

In 2007, Thailand joined its ASEAN neighbours in endorsing a call, made at the 2006 Hanoi Regional Consultation on Children and AIDS, to put children at the centre of the fight against HIV.

Small steps

"For children, small things can make a big difference," says Chutima Salsaengjan, a social worker from the We Understand Group, a Thai NGO that runs art and drama projects for children living with HIV. "It's important to treat the illness, but also important to help the children cope."

For Poel, being diagnosed HIV-positive brought shame and loneliness. "When the people in my village found out, they started to ostracise me," she told IRIN.

Poel said she spent most of her early teens locked up in her bedroom, too afraid to face the world. She hated taking her medicine and going for regular blood tests. It was only when she began participating in art and drama workshops organised by the We Understand Group that her life started turning around. She said she was encouraged to express herself, share her fears and seek support from other children affected by HIV.

The experience inspired her to go back to school and more recently she started mentoring younger members of the art and drama workshops and other HIV-infected youth.

"I like to help people,' she says, admitting that in the process she is also helping herself.

Source: http://www.irinnews.org/Report.aspx?ReportId=77880

Fading Smiles: One Third of Thailand’s Gays Threatened by HIV

2008-04-14T11:32:00.001+07:00

By, UK Gay News, April 13, 2008

Kingdom’s HIV infection rate among gay,bi men has risen to 30.7% in 2007

The Thai Ministry of Public Health has released figures detailing the dramatic rise of HIV infection among MSM (men who have sex with men). Estimated at 28% in 2005, that number has increased to just under 31% in 2007.

This continuing spike in infection rates, mentioned only briefly in the Thai Press, has seemingly gone unnoticed; just as Thailand’s sexual minority including gay and MSM communities has languished from seriously low levels of official funding and only limited research into AIDS prevention among them.

With a vibrant GLBT sub-culture, “The Land of Smiles” has annual pride parade celebrations in four major cities; with Phuket Island’s tourist-pleasing festival marking its first decade.

Achieved with minimal official support, these self-produced public events are often focused on AIDS/HIV awareness (Pattaya’s annual parade coincides with World AIDS Day).

Without support from the government, Thai gays have been left to sink or swim on their own; and they’re sinking.

Despite Thailand’s famous reputation for tolerance, its homosexuals and “third genders” are never-the-less subject to public bias and official discrimination: in 2004 a Culture Ministry Deputy declared war on open gays for being abnormal influences in the media; in 2007 a member of the assembly drafting

Thailand’s new constitution objected to including protections for GLBT because such people would “make Thai society weak”.

More damaging, a long term Moral Order campaign, begun under the former Taksin administration, saw officials raiding legal businesses and threatening arrests and closures when condoms were discovered on premises.

Condoms, the most effective weapon that gay venues had in a public health crisis, vanished as they were deemed instant proof of wrongdoing.

Two decades ago, when homosexuals made up only 1% of Thailand’s run-away HIV infections, gays began grass roots education to prevent the kind of scourge that had wracked communities in Europe and the US.

Groups like The White Line Dance Troupe toured straight brothels and schools, in addition to gay bars and dance clubs, to spread the safer sex message to the larger society.

Despite being pioneers in Aids/HIV prevention and continuing to highlight prevention messages in its public events, the gay community received little meaningful assistance or attention in Thailand’s recent prevention efforts.

Since the U.S. Centers for Disease Control and Prevention Collaboration (TUC) showed HIV prevalence of 17.3% among MSM in Bangkok in 2003, that figure has nearly doubled in just four years. Last month the Commission on AIDS in Asia reported that MSM infection rates in Asia as a whole are estimated to more than double in the next decade.

To its credit, the Ministry of Public Health has significantly added its support to developing national strategies, with the community, for dealing with HIV among MSM.

What is missing, at least since the 1997 economic crisis, is the political will at the highest levels of government.

Unless prevention efforts change dramatically – and UNAIDS suggests that 80% of a sub-population at high risk must be reached directly with HIV prevention efforts including condom and lubricant distribution, to achieve at least a 60% change in risk behaviours – HIV disease seems set to consume more smiles in Thailand’s future.

Source: http://www.ukgaynews.org.uk/Archive/08/Apr/1401.htm

More Than 2M Children Worldwide Living With HIV/AIDS, Report Says

2008-04-08T10:08:00.001+07:00

By, Kaiser Network, April 7, 2008

More than two million children worldwide were living with HIV/AIDS in 2007, according to a joint report released Thursday by UNICEF, UNAIDS and the World Health Organization, Reuters reports (Worsnip, Reuters, 4/3).

According to the report -- titled "Children and AIDS" -- most children living with HIV/AIDS acquired the virus through mother-to-child transmission. The report also found that 290,000 children under age 15 died last year of AIDS-related causes and that 12.1 million children in sub-Saharan Africa lost one or both parents to HIV/AIDS (AFP/France 24, 4/3). In addition, the report found that young people ages 15 to 24 account for 40% of new HIV cases among people older than 15 (Deen, IPS/AllAfrica.com, 4/4).

The report highlighted four strategic areas of focus to address HIV/AIDS among children: prevention of MTCT; pediatric treatment of HIV; prevention among adolescents and young people; and protecting and supporting children affected by the virus. According to the report, 21 countries -- including Botswana, Brazil, Rwanda, South Africa and Thailand -- are on track to meet UNICEF's goal of providing MTCT prevention services to 80% of people in need by 2010, up from 11 in 2005. In addition, although the number of HIV-positive pregnant women receiving antiretrovirals to prevent MTCT increased by 60% from 2005 to 2006, only 23% of women in need receive such services. The number of HIV-positive children in low- and middle-income countries with access to antiretrovirals also increased by 70% from 75,000 in 2005 to 127,000 in 2006, the report said (AFP/France 24, 4/3).

However, the report added that "with millions of children and women not being reached, these results are in no way satisfactory." Treatment levels, risk-reduction programs and government services to address HIV/AIDS are insufficient and reach a low percentage of people in need, according to the report (Reuters, 4/3). The reported noted that "steady progress" has been made in addressing the virus in Eastern and Southern Africa but added that the "priority is now to implement new initiatives and scale up those that have already been tested and proven effective." HIV/AIDS has "starkly altered the experience of growing up" for millions of children worldwide, who have experienced "deepening poverty, school dropout and discrimination as a result of the epidemic," the report added.

The report recommended four strategies to fight HIV/AIDS among children:

Strengthening families and communities;

Reinforcing health, education and welfare systems to help support HIV/AIDS-affected children;

Integrating prevention of MTCT programs in maternal, infant and child health programs; and

Consolidating data to keep track of advances and shortfalls (IPS/AllAfrica.com, 4/4).

In addition, the report welcomed an increase in donor funds to fight HIV/AIDS. According to the report, about $10 billion in HIV/AIDS funding was available in 2007, compared with $6.1 billion in 2006 (AFP/France 24, 4/3).
Reaction
"Today's children and young people have never known a world free of AIDS," UNICEF Executive Director Ann Veneman said, adding, "Children must be at the heart of the global AIDS agenda." Peter Piot, executive director of UNAIDS, said "Much more needs to be done to prevent HIV amongst young people and adolescents if we are to make a major change in the direction of the epidemic" (IPS/AllAfrica.com, 4/4). Kevin DeCock, director of HIV/AIDS programs at WHO, added that "health systems and their most precious component, the health care work force, must be strengthened" to address HIV/AIDS in children (AFP/France 24, 4/3).

Source: http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=51371

Ethiopia Launches HIV/AIDS Workplace Policy

2008-04-07T09:52:00.000+07:00

By, Kaiser Networks, April 4, 2008

Ethiopia recently launched a policy that provides a framework for addressing HIV/AIDS in the workplace, the Daily Monitor/AllAfrica.com reports. According to the Monitor/AllAfrica.com, the policy was developed during a three-year project, called "HIV and AIDS Workplace Policy Project for NGOs in Ethiopia," which was hosted by the Jerusalem Children and Community Development under the slogan Stop AIDS Now!, or SAN!

The campaign emphasizes building the capacities of more than 35 local and international nongovernmental organizations in the country to create, implement and manage the impact of HIV/AIDS workplace policies. The campaign also addresses the high rate of new HIV cases projected for 2008, projections that the majority of cases will occur among people ages 15 to 45 and the virus' effect on Ethiopia's working population. Speaking at the launch of the project on Saturday, Dereje Alemayehu, steering committee member of SAN! Ethiopia, said the campaign was designed to address the realization by organizations in the country that a response to HIV/AIDS is needed in the workplace. He added that the project will address some of the major difficulties that organizations in Ethiopia face by providing support to implement the policies. The project also aims to increase awareness and knowledge of how to effectively address the disease in the workplace by using various tools and techniques, Alemayehu said. According to the Monitor/AllAfrica.com, SAN! has implemented similar workplace policies in India and Uganda (Tesfaye, Daily Monitor/AllAfrica.com, 4/2).

Infant HIV infections down 20% since 2001

2008-04-07T09:40:00.001+07:00

By, Bill Varner, Bloomberg News, April 5, 2008

The number of babies born with the virus that causes AIDS or infected by breast milk decreased by 20 percent in six years, according to a United Nations report that credited treatment programs.

New infections dropped to 490,000 in 2007 from about 540,000, the World Health Organization and U.N. Children's Fund said. AIDS deaths among children younger than 15 declined to 290,000 from just more than 300,000, the agencies said.

"Important gains have been made in addressing treatment needs for children and in preventing mother-to-child transmission of HIV," Peter Piot, executive director of UNAIDS, which coordinates relief efforts, said in a statement.

The U.N. agencies said the number of women in African, Asian and Latin American nations receiving antiretroviral drugs has more than doubled, to about 25 percent.

The medicines reduce the mother's risk of transmitting the virus. Gains were reported in Benin, Botswana, Brazil, Namibia, Rwanda, South Africa and Thailand.

Achieving an "AIDS-free generation is possible," the report said, citing the overall increase in funding for AIDS treatment to $10 billion last year from $6.1 billion in 2004.

The U.N. report also said the number of HIV-positive children in low- and middle-income countries receiving antiretrovirals increased 70 percent since 2005, to 127,000 from 75,000.

Source: http://www.chron.com/disp/story.mpl/headline/metro/5676861.html

Thailand joins gay blood ban

2008-04-03T12:00:00.001+07:00

By, Adam Lake, Pink News, April 2, 2008

The Thai Red Cross Society has decided to reject blood donations from homosexual men in a move which has met with strong opposition from human rights organisations.

It said it had large amounts of unused blood that had tested HIV-positive.

Most of the infected blood was reportedly from men who were having unprotected sex with other men, according the director of the National Blood Centre, Soisaang Pikulsod.

Thailand is not the first country to ban gay men from donating blood.

In 1985 the American Red Cross and Food and Drug Administration stopped accepting blood donations from "any male who has had sex with another male since 1977, even once."

Intravenous drug users or recent immigrants from certain nations with high rates of HIV infection are also barred from donating blood.

The continued inclusion of men who have sex with men on the prohibited list has created some degree of controversy.

The United Kingdom Blood and Tissue Transplantation Service states on its website:

"We ask gay men not to give blood because gay men, as a group, are known to be at an increased risk of acquiring HIV and a number of other sexually transmitted infections,many of which are carried in the blood.

"Changing the rule to allow gay men to donate one year after they last had sex with another man would increase the risk by 60%"

Currently in the UK, a man who has ever had oral or anal sex with another man, even with a condom, is barred from donating blood for life because they are deemed to be more at risk of passing on sexually transmitted diseases.

A National Blood Service spokesperson said the ban on gay and bisexual men giving blood is "justified" despite the fact that lifting the order would dramatically increase depleted stocks.

Campaign group BloodBan.co.uk has branded current guidelines "outdated and discriminatory" and called for an overhaul of the policy.

Despite the fact that the National Aids Trust [NAT] state that black Africans are an equally high risk group for blood-borne STDs, they are not subject to a blanket lifetime ban in the way that men who have had gay sex are.

The only other people who are permanently banned from donating blood are individuals who have ever received money or drugs for sex and individuals who have ever injected, or been injected, with drugs.

Guidelines from the UK Blood Safety Leaflet specify that any individual donating:

"must wait twelve months after sex with a partner who has, or you think may have been sexually active in parts of the world where HIV/AIDS is very common, including most countries in Africa."

The twelve-month wait is not an option for gay or bisexual men, even one who has been celibate for most of his life.
Australia formerly had a similar ban, but now only prohibits donating blood within one year after male-male sex (longer than the typical window period for HIV blood screening tests performed on donated blood).

In Finland the parliamentary ombudsman launched an investigation on the possible unconstitutionality of the life-time ban in January 2006.

France, Russia and South Africa have also recently lifted the blanket ban on blood donations from gay and bisexual men.

They have concluded that their blood donor policy should be based on differentiating between risky and non-risky behaviour, regardless of sexual orientation.

Source: http://www.pinknews.co.uk/news/articles/2005-7287.html

Masturbation the solution to HIV crisis

2008-03-24T10:12:00.000+07:00

By, Bridget Tapuwa, Nehanda Radio, March 24, 2008

Are you also shocked by the statistics given about Zimbabwe? Are we not marching right into a wall, with the HIV/AIDS pandemic blighting a country already grappling with many other problems?

In Zimbabwe the pandemic is reported to be causing the deaths of more than 5000 people each week. A significantly large part of the population is infected; reports say 1 in every 5.

The enormity of the pandemic has among many other effects, fuelled a rapid growth in the number of orphans which has swelled to well over 2 million making ours the country with the highest number of orphans per capita in the world.

Since the 1990s, the HIV/AIDS virus has slashed the average life expectancy from 61 to about 28 years. It is reported that only about 40 000 people are on anti-retroviral drugs out of a possible 180 000.

And more than 2 000 people are reported to be getting infected every month. The health delivery system is almost dysfunctional to an extent that most sick people do not seek treatment. The news we then hear of Zimbabwe’s declining HIV prevalence should therefore be met not only with scepticism but also confusion in view of the country’s volatile political and economic climate.

The statistics so presented could be seriously skewed. What do the true statistics reveal about the Zimbabwean scenario? These statistics provide an insight into what is happening in Zimbabwe. Most people are still taking a very casual approach to the HIV/AIDS issue despite the devastating impact it has had on the country. Multiple sexual relationships are still so much in practise, with most using them as a strategy to temporarily evade the stress brought about by the economic and social hardships they are subjected to.

And most people believe that they are just too smart to be at risk. Most marriages in Zimbabwe still come about as a result of pregnancy, thus clearly indicating that premarital unprotected sex is still so much in practise, for most without prior HIV testing, which is in most cases still much resented. In any case the issue of HIV testing looses its intended purpose if partners will still engage in multiple unprotected sexual relationships after the testing. Zimbabwe’s escalating HIV/AIDS statistics only but reveal that a lot is happening behind the scenes, which people deny; a lot of cheating in relations.

For Zimbabweans most of the HIV infections are a result of multiple sexual relationships.
In cases where people are aware that they are HIV positive, most do not disclose to their partners and instead choose to infect them. It then becomes imperative that every one question themselves about the issue of trust; how much trust should we vest in our partners, if any trust at all, or should we not only but trust God? More so given that the HIV virus is notorious for its capability to ‘hide’ in the blood stream for the longest time without having any of its symptoms showing up.

It appears most Zimbabweans so often a time unnecessarily discard their entire thought systems, thought systems on issues which affect them, about one’s tomorrow, about the importance of health and many other pertinent issues; there is inherent in most, an unwillingness to use their powers of observation and reasoning. There is slowness to react to changing situations in one’s environment and there is also some form of passivity; an attitude which also raises its ugly head through the lack of mass public action over the turmoil bedevilling the country, politically, socially and economically.

Where then are we heading as a nation? Are we not facing a bleak future? In 5 to 10 years time, are we not likely to have ¾ of the population infected with HIV or wiped away by AIDS? Unless of cause if people are going to take very urgent drastic shifts in behaviour. What we observe should not however be a source of despair and discouragement. Instead we should exploit these observations to our advantage; use them as a source of encouragement- as a fuel that will drive the engine of change- change in the ways we have been running our lives, change in our focus in life, change in our perception of issues.

Because we are the change agents, we are the ones who can and will make a difference, the ones who can shape our own destiny. We need to have a sense of responsibility through taking ownership of our own destiny. What weapon and shield then can we use for survival as a nation? Does not the solution lie in us rediscovering ourselves, re-identifying ourselves, getting to know ourselves better, revisiting our choices in line with the changing environment that we are surviving in and are exposed to? And it is all about really revisiting our choices when it comes to the subject of sex; each one asking themselves whether there is anything to lose through revisiting their route to sexual appeasement.

Should not then the solution lie in protected sex for all those engaging in sex, married and unmarried; total abstinence for others and/or masturbation? For Zimbabwe at least, it downs to me that we adopt these options. We have certainly reached this last resort. This now stands as our only last option on our set of cards, our one and only hope for survival.
Masturbation remains the only safe and healthy sexual outlet other than abstinence. Furthermore it is argued that the self-stimuli derived from masturbation are equally self- comforting and sexual arousing.

So there is nothing really to lose, should one resort to this option. If anything they have a better guarantee of a long life. In the light of the frightening HIV/AIDS scenario, we are strongly advocating masturbation for Zimbabweans; masturbation, the only clean way to sexual appeasement. Whilst the condom has generally been promoted as clean, there is always room for some exchange of dirt between partners. In any case; there are always some people, Zimbabweans too who need no partners in life, those who are happier alone. And yet they may have never heard about masturbation.

So, with the elections coming up in a couple of days to come; the new Government in waiting should in addition to the female and male condom, also avail affordable or free vibrators and promote masturbation for the Zimbabweans who want to remain clean, and yet also get sexual appeasement. Whilst some may argue that it is not in line with our African culture, yet still, we are here looking at the devastating effects that sex has brought unto the African and how we can deal with it.

In as much as we, Africans do not like talking about such issues as sex, yet still the truth remains, we have it behind the scenes, in hiding, and we are contracting the deadly virus. That reminds me how often some of us in open claim not to be indulging, yet we get the evidence through pregnancy. Should we not revisit and adjust our culture so as to live? The new Zimbabwean Minister had better look into this if she wants us to live longer.
For the married who desire to have children, unprotected sex could only be practised immediately upon undergoing HIV testing.

Why rule out this option, when we are responsible for reducing the matrimonial bed to a mere venue for receiving the HIV virus? In as much as these solutions may sound extreme, we find it imperative to highlight that as a nation, Zimbabwe is now at a Choice Point. We have reached that critical juncture where we now have to make that crucial choice; that choice which will determine one’s span of life.

Desired now are solutions which suit our nation well, a peculiar nation whose statistics have reached extreme levels; a nation worst hit by the HIV/AIDS pandemic, a nation ranking last in almost all developmental issues. So it is up to you, the ball is in your court really to make your choice this very day before it is too late.

The writer is based in Belgium and she can be reached at britavoice@gmail.com
http://britavoice-zim-girl.blogspot.com/

Source: http://www.nehandaradio.com/zimbabwe/health/tapuwabridgethiv240308.html

HIV/Aids cases on rise अगं: Unprotected, casual sex to blame

2008-03-20T09:23:00.002+07:00

By, Apiradee Treerutkuarkul, Bangkok Post, March 20, 2008

Casual and unprotected sex is being blamed for the high number of new HIV/Aids cases _ with at least 40 people a day being infected. The number was released in a survey by the national sub-committee on Aids prevention.

The survey results have prompted health authorities to dust off a campaign to encourage the use of condoms.

Mechai Veravaidya, chairman of the sub-committee on Aids prevention, said new cases were mostly found among teenagers aged between 15 and 19. This group was sexually active and tended not to use condoms while having casual sex with multiple partners.

According to the survey only 13% of students in Mathayom Suksa and university level who had sex used condoms. Moreover, only 9% of office employees used condoms with their partners.

These groups were at high risk of contracting HIV/Aids as they had multiple partners without using protection. A lack of campaigning for condom use had made the HIV/Aids problem become very serious again, Mr Mechai, who was once known as 'Mr Condom' for his relentless condom campaign, said.

Mr Mechai said the country desperately needed to renew the condom campaign in a bid to reduce the number of new infections. Otherwise the disease would affect the national healthcare system.

An estimated 500,000 Thais are living with HIV/Aids. More than 80% of people living with HIV/Aids are in need of antiretroviral drugs.

Meanwhile, the World Health Organisation reported that 700,000 people living with HIV/Aids worldwide had tuberculosis-related problems.

In 2006, around 200,000 HIV-positive people died of TB-associated causes.

At the same time, doctors are studying three professions at risk of TB infection as Thailand ranks 18th out of 22 countries with the highest number of TB cases.

Praparn Youngchaiyud, president of the Thai Chest Association, said a team of researchers was studying TB infections among taxi drivers, food vendors and nurses because their closed working environments could make them more easily susceptible to the disease.

It would take another two years to conclude the study.

However, Dr Praparn believed the TB infection rate among these professions was no higher than others such as labourers.

Paijit Warachit, deputy permanent health secretary, said there were 91,000 new TB cases each year. A high number of TB infections and multiple drug resistance also prompted health authorities to promote screening tests and expand coverage of Directly Observed Treatment, short-course (DOTs), the WHO-recommended strategy for TB control.

Source: http://www.bangkokpost.com/News/20Mar2008_news04.php

HIV epidemic driven by clusters of sex

2008-03-19T12:21:00.001+07:00

By, United Press International, March 19, 2008

The rapid growth of HIV/AIDS cases in London during the late 1990s was driven, in part, by transmission of the deadly virus within clusters of sexual contacts.

Study leader Andrew Leigh Brown and colleagues at the University of Edinburgh and London's Chelsea and Westminster Hospital said people frequently passed the HIV virus to others within months after becoming infected themselves.

The study, published in PLoS Medicine, found the growth of HIV among men who have sex with men in London was not a slow and steady process, but episodic. With multiple clusters of transmission occurring within a few years during the late 1990s, the number of HIV infections in this population doubled.

Genetic data on HIV is routinely obtained to best determine HIV medications, therefore Leigh Brown and colleagues were able to compare the sequences of HIV genes from more than 2,000 patients, mainly who attended a large London HIV clinic from 1997 to 2003.

Of the sequences analyzed, 402 closely matched at least one other viral sequence. Further analysis showed the patients whose viruses showed matches with others formed six clusters of 10 or more, as well as many smaller clusters.

Source: http://www.upi.com/NewsTrack/Health/2008/03/19/hiv_epidemic_driven_by_clusters_of_sex/7139/

Talking Sex: Keeping it safe in the era of HIV

2008-03-10T09:43:00.002+07:00

By, Dr Alverston Bailey, The Jamaica Gleaner, March 8, 2008

Safe sex (also called safer sex or protected sex) is a set of practices that are designed to reduce the risk of infection during sexual intercourse to avoid developing sexually transmitted diseases (STDs). On the other hand, unsafe sex refers to engaging in sexual intercourse without the use of any barrier contraception or other preventive measures against STDs.

Safe sex practices became a buzz word in the late 1980s as a result of the AIDS epidemic. Promoting safe sex is now a critical component of sex education. Safe sex should be regarded as a harm reduction strategy. Please note that safe sex is about risk reduction, not risk elimination.

Sexual contact is the most common route of HIV transmission. By December 2001, 51 per cent of all HIV infections among adolescents and adults reported to the U.S. Centers for Disease Control and Prevention (CDC) were sexually transmitted. Worldwide and in Jamaica, heterosexual transmission is the most common route of HIV infection.

Researchers consistently detect HIV in blood, semen and cervical secretions of infected persons. Infectious HIV exists in saliva, tears and urine. However, it has only been recovered from these fluids at extremely low titers, therefore, saliva, tears, and urine are unlikely sources of HIV transmission.

Infectious HIV has also been isolated in breast milk, and transmission from HIV-infected mothers to nursing infants is well documented. Breast milk is not commonly encountered during sexual intercourse. However, should you accidentally or intentionally come in contact with HIV-infected breast milk during sex, care should be taken to avoid contact with your eyes and mouth.

Let us now describe various sexual practices and the associated risks of HIV infection:

No-risk practices. These sexual activities cannot transmit HIV:

Masturbation

Touching, massaging, hugging, caressing

Social (dry) kissing

Any type of sexual intercourse between partners who are certain that they are uninfected.

Extremely low-risk practices. These activities carry a small (based on case reports) or theoretical risk of HIV transmission between partners of unlike or unknown HIV serostatus:

French (wet) kissing

Mutual masturbation (if no cuts on hands, and no ulcers or lesions on genitals of either partner)

Vaginal sex with a male or female condom (with proper use, including putting latex or polyurethane condom in place before any penetration)

Fellatio with condom (with latex condom placed on penis before oral contact)

Cunnilingus with dental dam (with latex dam placed over vaginal area before oral contact)

Contact with urine (only with intact skin, avoiding contact with mouth)

Using one's own sex toys (without sharing of any toys that contact body fluids)

Low-risk practices. Epidemiological studies have found these sexual activities to have a low probability of HIV transmission between partners of unlike or unknown HIV serostatus:

Fellatio without condom (Risk of HIV infection to insertive partner is extremely low, risk to receptive partner is increased if ejaculation occurs in mouth.)

High-risk practices

These sexual activities carry the highest risk, based on epidemiological studies of transmitting HIV between partners of unlike or unknown HIV serostatus:

Vaginal intercourse without a male or female condom

Anal intercourse

Anal penetration with the hand (fisting) or other rectal trauma

To minimise the risk of STDs and HIV, I will now describe a variety of safe sex techniques:

Abstinence

The only effective way to avoid the risks associated with sexual contact is to abstain from sexual activity entirely; this will eliminate the chances of contracting STDs and HIV.

Monogamy

Monogamy practice faithfully is very safe (as far as STDs and HIV are concerned) when your partner is uninfected.

Sex by yourself

Known as autoeroticism, solitary sexual activity (including 'phone sex' - mutual masturbation at a distance with the aid of technology and 'cybersex') is relatively safe. However, some practices, such as self-bondage and autoerotic asphyxia, are made considerably more dangerous by the absence of people who can intervene if something goes wrong. Masturbation is safe, so long as contact is not made with other people's discharged body fluids.

Non-penetrative Sex

A range of sex acts, sometimes called outercourse can be enjoyed by lovers with significantly reduced risks of infection and no risk of pregnancy. Non-penetrative sex (also known as outercourse) is sexual activity without vaginal and possibly oral penetration, as opposed to intercourse. No bodily fluids should be exchanged,

There are many options for non- penetrative sex as outlined below:

Axillary intercourse: where a man rubs his penis in his partner's armpit, also known as bagpiping.

Frottage: any form of consensual sexual rubbing, whether naked or clothed

Handsex: stimulating genitals with the hand

Foot sex: stimulating genitals with the feet

Limiting fluid exchange

Various devices are used to avoid contact with blood, vaginal fluid, and semen during sexual activity:

Male condoms: Condoms cover the penis during sexual activity. They are most frequently made of latex, but can also be made out of polyurethane. Polyurethane is thought to be a safe material for use in condoms, since it is nonporous and viruses cannot pass through it.

Female condoms: are inserted into the vagina prior to intercourse

Dental dam: (originally used in dentistry) is a sheet of latex used for protection when engaging in oral sex. It is typically used as a barrier between the mouth and the vulva during cunnilingus.

Medical gloves: may be used as a dental dam during oral sex, or to protect the hands during mutual masturbation. Hands may have invisible cuts on them that may admit pathogens that are found in the semen or the vaginal fluids of STD infectees.

In the absence of a vaccine, practising safe sex is the only effective means we have at our disposal to halt the spread of HIV and STDs. The options I have described are many and varied; discuss them with your partner and have a safe and satisfying sex life.

Dr Alverston Bailey is a medical doctor and is also the immediate past president of the Medical Association of Jamaica. Send comments to editorial@gleanerjm.com or Fax: 922-6223.

Source: http://www.jamaica-gleaner.com/gleaner/20080308/features/features4.html

Americans and the Caribbean HIV explosion

2008-03-05T13:17:00.002+07:00

By, Masimba Biriwasha, RH Reality Check, March 3, 2008

For both self-protection and for humanitarian reasons, Americans should be seriously concerned about the explosion of HIV/AIDS in the Caribbean.

The Caribbean region is the second worst HIV/AIDS affected regions in the world, after sub Saharan Africa. Poverty, gender inequalities and a high degree of HIV-related stigma have caused a festering of the epidemic in the region.

Human mobility throughout the Caribbean, between the region and other geographic areas including migration and tourism which brings more than 20 million visitors each year has also been singled out as a major driver of the epidemic.

According to UNAIDS, AIDS remains one of the leading causes of death among people aged 25 to 44 years in the region, and the adult HIV prevalence is estimated at 2.3%.

The main mode of HIV transmission in this region is unprotected heterosexual intercourse; unprotected sex between sex workers and clients is a key factor in the spread of HIV, reports UNAIDS.

UNAIDS estimates that 330,000 HIV-positive people live in the Caribbean, about 22,000 of whom are children, with 51 percent of people living with HIV, the virus that causes AIDS, being women.

Against this background, there is massive human interaction between the US and the Caribbean, with many Americans attracted to visit the idyllic, sandy and sunny spots in the region.

Statistics from the U.S. Department of Commerce show that 14 percent of the 27,351,000 US travelers in 2004 went to the Caribbean.

While bringing much needed revenue to the region, the impact of tourism has seen a rise in sex work, with poor women and men aged between 18 to 44 selling their bodies as a means of survival throughout the Caribbean.

Many American tourists both male and female perceive the Caribbean region as sexually exotic and free-going. So it's common that when Americans visit the Caribbean, many end up engaging in sexual activity, in a high HIV risk environment.

According to Avert, an international AIDS charity, the Caribbean's thriving sex industry, which serves both local clients and many tourists, features prominently in the AIDS epidemics of certain countries, such as the Dominican Republic and Jamaica.

Americans, particularly tourists to the Caribbean region, should therefore be concerned that they can easily contract HIV if they do not utilize protective measures. It is imperative for Americans who engage in sexual unionships in the region to be concerned about the consistent use of protection to avoid HIV and STI infection.

Given the high rates of American visitors to the region, it is conceivable that the epidemic can rebound in the US, if they do not apply protective measures during sexual contact.

More importantly, if the AIDS problem in the Caribbean continues to grow unabated, there is no doubt that it will spiral into the US. The non-availability of AIDS drugs and treatment in the region may force Caribbean people to illegally migrate to the US where the treatment options are many.

In fact, migration between the islands and to the United States is prevalent in the Caribbean region and plays a key factor in the spread of the disease. In that sense, Americans need to be seriously concerned because they are vulnerable to both HIV and secondary diseases such as TB that immigrants may bring with them.

Having said that, the decimation of entire populations within the Caribbean can destabilize many of the countries, thereby posing a security risk right in front of the US's doorstep.

Americans also have a responsibility to ensure that the tools and methodologies that have worked in their country can be exported to the Caribbean region, albeit, in a culturally sensitive manner.

"The epidemic's full extent is obscured by fear, denial, limited treatment and a lack of public health resources," the New York Times reported on the impact of HIV/AIDS in the region, "What is certain, however, is that a social and economic catastrophe is imperiling many countries as infections steadily climb and AIDS spreads in the general population."

For the ordinary American traveler, this could potentially mean that traveling to the sunny and sandy beaches of the Caribbean may be rendered impossible.

It is incumbent upon the Americans to intensify calls for non-judgmental, humanitarian efforts targeted at the region. The Global Gag Rule which restricts funding for family planning reinstated in 2001 by President George Bush has been a major factor blamed for the restriction of women's access to contraceptives in the region.

The U.S. President's Emergency Plan for AIDS Relief, precludes anyone who does not condemn sex work from getting the money, thereby dampening efforts to fight the epidemic among the most affected women and girls of the region. Evidence already shows that restricting access to contraceptives and promoting abstinence only approaches does not work.

Therefore Americans must demand that the US government show leadership through revoking the Global Gag rule which only serves to worsen the situation of already marginalized women in the Caribbean region and other poorer parts of the world.

And, for purely humanitarian reasons, Americans should be concerned about the suffering of fellow human beings infected or affected by HIV/AIDS in the Caribbean region.

US citizens should alleviate the suffering of these people, unconditionally and without any ulterior motive through provision of material support for purchasing medicine and supplies.

Humanitarian aid can go a long way to save lives and support orphaned children in the region, thereby averting full-scale destabilization of the region due to the epidemic.

Source: http://www.rhrealitycheck.org/blog/2008/03/23/americans-and-the-caribbean-hiv-explosion

HIV/AIDS education should be reinforced

2008-01-09T11:28:00.000+07:00

By, Isaac Kyeyune, The New Vision, January 8, 2008

Uganda was praised for its efforts to address the AIDS scourge. This was made possible with high political commitment and massive external support. Uganda is hailed for massive youth sensitisation programmes, the ABC approach, HIV counselling and testing, sex education, family planning, research, and reproductive health services.

But the gains are being lost. HIV/AIDS spread is increasing, and in many places, people walk miles to access an HIV test, which is costly. There is limited funding, little sensitisation and publicity, and educative materials are not enough yet these are the tools that drove AIDS-related activities that helped in bringing down the scourge. It is no surprise that recent studies in Uganda indicate that the youth are in greater danger than before and cross-generational sex is a hot issue in HIV prevention.

This is probably because the young generation missed the educational messages and slogans like AIDS kills, which were intensive in the late 1980s and 1990s when they were too young to understand. There are many pointers that ignorance and complacency is on the increase. Recent press reports indicated that, for example, some fishermen around Lake Victoria admit to fearing water more than HIV. A study also indicated that when having sex, the youth are more worried about pregnancy that contracting HIV.

It is possible that many people are no longer worried about AIDS because it no longer kills in the manner it used to because of ARVs. Lack of sensitisation had led some people to equate ARVs to a cure. The latest UN data indicates that about 760,000 European Union citizens are living with HIV and the number of infections has been increasing since 2002.

In Europe and Central Asia, the number of people with the virus doubled over a six-year period from 1.25 million to 2.4 million.

During 2005, the EU recorded nearly 27,000 new diagnosed cases of HIV, while the recent sero-survey report in Uganda indicated worse trends. AIDS education should be given due attention. The complacency will catch up with those responsible and possibly may be too late to be reversed.

Source: http://www.newvision.co.ug/D/8/459/605657

WHO urges less qualified AIDS workers for poorer countries

2008-01-09T10:16:00.000+07:00

By,AFP, January 9, 2008

Less qualified health workers should be used in HIV/AIDS care in developing countries facing severe shortages of doctors and nurses, the World Health Organisation (WHO) said Tuesday.

To increase access to treatment, the WHO called instead for "task shifting," giving health workers with fewer qualifications greater responsibilities.

"Doctors and nurses are essential but countries cannot afford to wait years while they complete their training," said Anders Nordstrom, WHO's assistant director of health systems.

"Task shifting not only addresses the two interlinked emergencies of the health worker crisis and the HIV/AIDS pandemic, but also offers long-term potential for strengthening health systems in a way that is consistent with the current renaissance in primary health-care services," Nordstrom added.

The WHO said at least 57 countries, mostly in Africa, are facing severe health personnel shortages in their fight against HIV/AIDS. An additional four million health workers are needed globally.

Although sub-Saharan Africa is home to just over ten percent of the world's population, it is the most ravaged by HIV/AIDS with more than 60 percent of all cases, or around 25.8 million people, according to UNAIDS.

Source: http://afp.google.com/article/ALeqM5hjUVJfugOlwwLFG-v5abQbTcdVqA

Western Cape to target HIV hot spots after survey

2007-12-18T15:22:00.000+07:00

By, Tamar Kahn, BusinessDay, December 18, 2007

CAPE TOWN — Western Cape would step up its drive against HIV in hot spots identified by its latest district survey of pregnant women attending public clinics, health MEC Pierre Uys said last week.

The survey has been conducted yearly for seven years, and shows important trends and variations in HIV prevalence among the province’s 25 health districts.

HIV prevalence last year ranged from 3,9% in the Little Karoo to 32,7% in Khayelitsha.

In line with the national ante-natal clinic survey of HIV and syphilis prevalence, Western Cape reported a slight overall decline in HIV between 2005 and last year, and a drop in HIV prevalence among very young pregnant women.

The provincial average fell slightly from 15,7% in 2005 to 15,1% last year, with the figure for women under the age of 24 dropping from 12,8% to 11,9% year on year.

Women aged 25-29 years bore the brunt of HIV infection in Western Cape, and this age group saw the greatest rate of increase over the past decade, rising from 7,9% in 1997 to 21,1% last year.

The national survey found prevalence rates that were almost double that of Western Cape, with HIV prevalence dropping slightly from 30,2% in 2005 to 29,1% last year.

While the overall trend was downward, Western Cape’s district survey highlighted important deviations. It showed an uptick in HIV prevalence in several districts, including Helderberg, which saw a rise from 12,8% in 2005 to 17,3% last year. Similarly, Oostenberg reported a rise over the past three years, from 14,8% in 2004 to 18,8% last year.

“High-prevalence areas require additional energy and resources,” said Uys. “We really want programmes that address local issues. For example, in Khayelitsha we now have programmes targeting older men,” he said.

“We have already targeted schools, and we want to get peer-educator (HIV) programmes into all of them,” he said.

The health department had also developed programmes aimed at sex workers and truck drivers , he said. The province had earmarked R15,1m for local programmes, he told Business Day. The province had budgeted R339m for HIV/AIDS programmes for the current financial year in addition to the services it provided at clinics and hospitals, he said.

“As far as treatment, care and support is concerned, the department will continue to strive towards improving access to care and support which encompasses the full spectrum of basic health services, palliative treatment, home-based care, treatment of opportunistic infections and building on the antiretroviral treatment programme.”

Source: http://www.businessday.co.za/articles/topstories.aspx?ID=BD4A664468

SA on track to halve mother-to-child HIV by 2010

2007-11-26T15:57:00.000+07:00

By, The Times, November 26, 2007

South Africa is on track to meet a United Nations target for reducing mother-to-child HIV transmission (PMTCT) by 2010, the United Nations Children’s Fund (Unicef) said yesterday.

“SA is one of 17 low- and middle- income countries that are set to achieve the ... target of reducing mother-to-child infections by 50percent,” read a recent report by Unicef on PMTCT, paediatric HIV care and treatment in low- and middle-income countries.

In SA the PMTCT programme had been expanded to cover 90percent of public health facilities. More than 32000 children with HIV had started antiretroviral therapy by September this year . The report would be presented in Johannesburg today at a two-day Global Partners Forum on PMTCT, organised jointly by Unicef, the World Health Organisation and 18 other organisations and representatives from regions affected by HIV/Aids, including Asia, the Caribbean, Eastern Europe and Latin America.

Unicef reported that by December last year 127000 children were on ARVs worldwide.

Health department spokesman Sibani Mngadi said: “We want to offer a comprehensive package of care and treatment to those infected and affected. The health of women and children is our priority.”

Source: http://www.thetimes.co.za/News/Article.aspx?id=639487

130,000 Swazi children orphaned and vulnerable: report

2007-11-26T15:21:00.000+07:00

By, AFP, November 24, 2007

Nearly a third of Swaziland's children are considered orphaned and vulnerable as AIDS takes its toll on the country, a study commissioned by the state's emergency response council said Friday.

"There are currently 130,000 OVCs (orphaned and vulnerable children) in the country, which represents 31.1 percent of all children countrywide," the study said.

"However, it is projected that the OVC figure could rise to 200,000 by the year 2010."

It added: "HIV and AIDS is permanently altering the structure of Swazi society. It is expected that by 2025 there will be a thinning of the older age groups and the very young."

Life expectancy in the country dropped from 60 years in 1997 to the world's lowest of 31.3 in 2004, while the mortality rate has sharply increased across the entire population over the past 15 years, the report added.

According to UNICEF's website, HIV prevalence among 20 to 30-year-olds is nearing 50 percent, higher than the national adult average.

In Swaziland, close to 40 percent of adults are living with HIV and AIDS, the highest infection rate anywhere in the world, UNICEF said.

Source: http://afp.google.com/article/ALeqM5iB5uTBbnYyWjr-2JLGxHoc27oZHQ

Mozambuque: Rains, pregnancy and AIDS - a recipe for malaria

2007-11-26T09:56:00.000+07:00

By, IRIN Plusnews, November 23, 2007

On a cloudy Monday morning in Maputo, capital of Mozambique, Cremilda Bulha, 28, dressed in a white T-shirt and traditional capulana cloth skirt, waits in the outpatient line at Maputo Central Hospital.

With the same certainty as she comments "there's going to be more rain today," to the patient next to her, she tells IRIN/PlusNews: "I've got malaria."

The viral disease is spread the Anopheles mosquito and causes headaches, fatigue, high fever, nausea and, in some cases, death. The number of malaria cases goes up during the rainy season, because mosquitoes breed in stagnant water.

Besides having to deal with these symptoms, Bulha is pregnant with her second child and is also HIV-positive, which increases her likelihood of catching malaria.

Susana Nery, a public health specialist from the Malaria Consortium organisation, explains that in countries like Mozambique, where the disease is endemic, people are bitten various times and gradually build up resistance.

This protective shield weakens in pregnant women, HIV-positive people and children, making them more susceptible. "These people's immunological system falls and their natural resistance diminishes," Nery stresses.

In the first six months of 2007, 2.5 million cases of malaria were recorded after floods hit the country, and 1,518 patients died, according to the Ministry of Health's 19th Epidemiological Bulletin.

Only half right

After two hours the nurse calls Bulha's name and the rain starts again. Her first forecast was right, but second was wrong: her malaria test came back negative.

She is three months pregnant and began antiretroviral (ARV) treatment two months ago, but it is her pregnancy, more than the HIV, that makes her more vulnerable to the malaria virus.

"The weak immunological system takes longer to react against malaria," says Maputo Central Hospital physician Rui Bastos. He explains that HIV-positive individuals are more likely to get malaria only when their immunological system is debilitated - in other words, when HIV infection has progressed to AIDS, which is not the case with Bulha.

Her defence cell (CD4) count is high, and she is only taking ARVs to prevent transmission of the HIV virus to her unborn child. In the AIDS phase it is important for HIV patients to take special care with regard to malaria, says Eduardo Mondlane Medical School professor Armindo Tiago Junior.

A person with malaria may be hospitalised for an average of three days; for an AIDS patient this increases to a week. "The weak immunological system takes longer to react against malaria," the physician explains.

Aware of this problem, the Red Cross of Mozambique has prepared its eleven health technicians throughout the country to take extra-special care with cases of malaria in HIV patients.

"HIV-positive individuals are more likely to catch illnesses such as malaria," says Frieda Draisma, the Red Cross of Mozambique's community work coordinator. Mozambique has a seroprevalence of 16.2 percent in a population of 19.8 million.

Nets and medication

The prevalence of malaria among pregnant Mozambican women is approximately 20 percent, according to data from the National Malaria Control Programme.

In 2004, Health Alliance International, a US-based global healthcare organisation, analysed 5,528 pregnant women in the provinces of Sofala and Manica, and in all instances found more cases of malaria among HIV-positive women than among HIV-negative ones.

As a Health Ministry policy, from the 20th week of pregnancy all expecting mothers must undergo intermittent presumptive treatment (IPT), in which they take a series of prophylactic pills that reduce the probability of contracting malaria. If they are undergoing ARV treatment, care needs to be doubled, said Tiago Junior.

When taken together, the ARV, nevirapine, and the anti-malarial medication, sulfadoxine-pyrimethamine, provoke vomiting and abdominal pain as well as reactions in the skin, such as blemishes, and in the mucous membranes, so the two drugs are never prescribed simultaneously.

The doctor makes a choice according to what he concludes is more important to the patient. If necessary, a different medication is used in place of the anti-malarial or the ARV.

The distribution of mosquito nets, especially to pregnant women, is one of Mozambique's main strategies to combat the disease. In the past three years, the Malaria Consortium and the Red Cross of Mozambique have distributed more than 700,000 nets in the northern provinces of Cabo Delgado and Nampula, the central provinces of Manica and Sofala, and Inhambane Province in the south.

The provinces included in the programme were chosen by the Ministry of Health due to the incidence of the disease and the shortage of health assistance.

While she waits for the rain to let up, Bulha comments: "This is just the kind of weather malaria likes." Although she is taking ARVs and undergoing anti-malaria treatment, Bulha covers her bed every night with the mosquito net she got at the beginning of the year. "That's what's going to protect me. Since I got it I haven't had malaria again."

[ENDS]

HIV-infected woman gives birth

2007-11-22T16:37:00.000+07:00

By, Statesman News Service, November 21, 2007

An HIV-infected woman who had initially refused to terminate pregnancy gave birth to a healthy boy yesterday at the government-run hospital here, with health personnel lending a helping hand in realising her dream of ‘motherhood’.

In a related development, the district wing of the state health department ordered that inpatients delivering babies in government-run hospitals would have to undergo an HIV-detection diagnostic test. It has now been made mandatory as a safety concern, official sources said.

There was fears of inmates and attendants getting panicky. Even medical staff were scared as never before had any HIV-infected person been operated upon at a local hospital.

An effort, however, was made to help the woman in distress. “The steely resolve and indomitable spirit of the expectant mother overwhelmed us,” said Mr Manoj Kumar Behera, additional district medical officer of the district hospital. Both the infected mother and the newborn are safe, hospital sources said.

Medical attention is being paid to the mother and the child. Medical expenses for the child birth and post-maternal care are being born by the Zilla Swasthya Samity, Dr Behera said.

“We took precautionary measures while delivering the child. A special kit provided by the AIDS control society-run Voluntary Counselling and Confidential Treatment Centre came in handy,” said Dr Akhyaya Kumar Taria, who conducted the child birth.

“My world has fallen apart. Everything is finished. I can seek solace in my child. He is God's Gift to a cursed woman like me. God will act as his saviour,” said Sabitri (not the real name) with tears welling in her eyes.

Source: http://www.thestatesman.net/page.news.php?clid=9&theme=&usrsess=1&id=177374

AIDS label hurts kids

2007-11-21T14:20:00.001+07:00

By, Patricia Watson, The Jamaica Gleaner, November 19, 2007

There are hundreds of children in Jamaica living with or affected by HIV. In January 2007, 5,125 children under the age of 15 were estimated to have been orphaned by AIDS. In 2006, 73 children aged zero to nine years old were diagnosed with HIV. Many of these children live and play in your neighbourhood, go to your church and attend your school. They are, however, forced to be silent about the disease they live with out of fear related to how persons will react. They also fear the discrimination they and their families would face if they revealed their status.

HIV/AIDS has a deep impact on every aspect of their lives - emotional, social, spiritual, physical and economic. Children infected or affected by HIV are rarely heard but, despite the silence, they have much to say about childhood, children's rights, parenting, family life, sexual and reproductive health issues, the Church and AIDS, and employment for people living with HIV.

Children and HIV/AIDS

Children living with HIV/AIDS in Jamaica have, in general, been silent about issues affecting them. Their opinions are rarely sought in the development of policies and programmes which have an impact on their lives. Even when they take part in consultations, they feel this participation is merely tokenistic. Up to 20,000 children in Jamaica are estimated to have been made vulnerable by HIV. Overall, five to seven per cent of all orphans in Jamaica are orphaned by HIV/AIDS, according to the Ministry of Health.

The Rapid Assessment of the Situation of Orphans and Other Children living in Households Affected by HIV/AIDS in Jamaica (2002) highlights the many economic, social and emotional problems faced by these children, including increased vulnerability of those whose parents are ill or have died; lack of psychosocial support to help them cope with their parents' illness or death, or their own HIV-positive status; stigmatisation in schools, churches, children's homes and the wider community; and the challenges facing HIV-positive children who are in institutional care.

Recent focus group discussions by the Panos Caribbean Institute revealed some concerns facing children infected with or affected by HIV. Younger participants identified the following as adults' actions which make them unhappy: "They call us names", "They scorn us", "They call us AIDS victim", "They make us feel that we are not important", "They chase us out of the community".

Discrimination

Older participants said adults' actions which make them unhappy include discrimination from persons who should know better; violence, insults and threats; stress; lack of access to services and medicines; shame and guilt, and lack of family and community support.

The Special Delivery initiative was born out of the issues which these children identified and their desire to highlight these issues to the wider society. Children understand childhood best - they live it. Children infected and affected by HIV/AIDS know their situation best and can guide others to respond to their greatest needs. People will listen when children speak. Children can bring much more than emotion to the issue of HIV/AIDS - they can bring information and solutions. Providing them with the information and skills required to speak for themselves is an important component of the advocacy process.

Over the coming weeks, children living with HIV, supported by Panos Caribbean and The Gleaner Company, will be delivering letters advocating for positive change on the issues they have identified to influential movers and shakers in Jamaica. Letters will be delivered to the Prime Minister and other government leaders, heads of development agencies and the media.

Source: http://www.jamaica-gleaner.com/gleaner/20071119/lead/lead5.html

U.N. estimates 33 million infected with HIV

2007-11-21T14:02:00.000+07:00

By, Reuters, November 20, 2007

More than 33 million people are infected with the AIDS virus -- far fewer than original estimates of close to 40 million, the United Nations said in its latest report.

Here are some facts about AIDS, according to UNAIDS:

-- An estimated 33.2 million people were infected with the human immunodeficiency virus in 2007. This included 30.8 million adults and 2.5 million children under the age of 15. Women made up half of those infected.

-- 2.1 million people died of AIDS in 2007, including 1.7 million adults and 330,000 children.

-- 2.5 million people were newly infected with AIDS in 2007, including 2.1 million adults and 420,000 children.

-- Every day more than 6,800 people become infected with HIV and more than 5,700 die from it.

-- There is no cure for HIV, which gradually destroys the immune system. Drug cocktails called highly active antiretroviral therapy or HAART can control infection and keep patients healthy.

-- HIV is now commonly passed through sexual contact between a man and a woman. It can also be passed from man to man, by infected needles, and from a mother to a baby. (Reporting by Maggie Fox)

Source: http://africa.reuters.com/wire/news/usnN19535413.html

Children who care for the sick

2007-11-21T13:51:00.000+07:00

By, Gloria Ganyani(Zimbabwe), HDN Key Correspondent Team, November 8, 2007

Four-year-old Mavis Phiri* looks after her sick mother. She knows where her mother’s tablets are kept and she knows when to give them to her.

Every morning she cleans the house using oil to make the floor shiny. If she goes out to play with friends in the neighbourhood, she rushes back home whenever people come to their house. She knows she has a responsibility to attend to visitors who come to see her mother.

Mavis is one in a growing number of children who are affected by HIV and are being forced by circumstance to care for a sick parent.

"We are realizing that there is an increasing number of children who are caring for a sick parent" said Mrs Veronica Nhemachena, Programmes Manager for the Midlands AIDS Service Organisation (MASO), in Zimbabwe.

"In most cases, there is no other person who can be a caregiver in that household. Sometimes one parent will have passed on. The extended family structures no longer exist and people are now separated from relatives. This leaves the children with little, if any, choice but just to look after the sick parent."

According to a report, Africa’s Orphaned and Vulnerable Generations: Children Affected by AIDS, published by the United Nations Children’s Fund (UNICEF), 12 million children aged between 0–17 years in sub-Saharan Africa have lost one or both parents to AIDS.

"Children are experiencing the greatest parental loss in southern Africa, where HIV prevalence rates are highest," says the report.

Zimbabwe has not been spared and as a result there now exist many child-headed families and child caregivers in the country.

In Gweru, as in many other places in the country, some children are actually given time off from school to go back home to nurse a sick parent. The authorities now accept the responsibilities that such children have, which impact negatively on the child’s social, emotional and economic development. If a child such as Mavis fails to complete her education, chances of advancement are slim.

Besides the numerous challenges of keeping up at school, these children also suffer the consequences of stigma and discrimination because of their association with a person living with HIV.

One child who is taking care of her ailing mother said it was not uncommon for children in school to chase her away from their circles saying: "My mother says we must not play with you because your home is full of AIDS."

Questions arise as to whether having children look after relatives at home is not tantamount to child abuse? Should the children not be the ones to be looked after?

According to the Convention on the Rights of the Child, children are entitled to a standard of living adequate for their physical, mental, spiritual, moral and social development. The convention also states, however, that the parent(s) or others responsible for the child have the primary responsibility to secure, within their abilities and financial capacities, the conditions of living necessary for the child's development.

"It may not be ethical for children to be caregivers but that is the reality on the ground," said Mrs Nhemachena.

She suggests that children should be trained in home-based care and given universal prevention skills so that they know how to look after their parents as well as how to protect themselves from infection.

Most of all, there is need to ensure that children such as Mavis are given adequate psychological support so that they can manage the pressures of looking after a chronically ill relative or cope with the loss of a parent.

* Not her real name.

Health & Development Networks (HDN) 2007

Global Fund Approves $1B in New Grants

2007-11-15T13:34:00.000+07:00

By, Kaisernetwork, November 14, 2007

The board of the Global Fund To Fight AIDS, Tuberculosis and Malaria on Monday announced that it has approved 73 new grants worth $1.1 billion over the next two years, the AFP/Yahoo! Health reports. The Global Fund approved the grants during its 16th board meeting in Kunming, China, a statement said. Forty-eight percent of the total funding goes to HIV/AIDS activities, 42% for malaria and 10% for TB, the fund said. The statement also said that 66% of the projects are in Africa, 13% in Asia, 13% in the Middle East and 5% in Latin America (AFP/Yahoo! Health, 11/12). More than 80% of the grants will go to low-income countries.

The Global Fund Board also approved $130 million for renewal of five grants that are nearing their five-year expiration dates. According to the fund, the seventh round of grants brings the fund's portfolio to $10 billion in 136 countries. About 50% of the proposals submitted for round seven were approved, up from an average of 40% during the previous six rounds. The West Bank and Gaza won approval for their first grant to support an HIV prevention program (Global Fund release, 11/12).

The new grants increased the fund's grant allocation 32% higher than the $846 million initially planned for 2007. The fund has said it needs between $12 billion and $18 billion to pay for existing programs and to launch new ones between 2008 and 2010 (AFP/Yahoo! Health, 11/12).

"Global Fund-supported programs are already making an impact against AIDS, tuberculosis and malaria in many countries around the world," Rajat Gupta, chair of the Global Fund Board, said, adding, "This is the largest funding round in the Global Fund's history. The board is pleased with the strength and high level of ambition of the new grants and is looking forward to scaling up in the fight against the three diseases." Michel Kazatchkine, executive-director of the Global Fund, said, "These new grants show that need is increasingly turned into high-quality demand for resources," adding, "This is a trend we must develop further" (Global Fund release, 11/12).

Source: http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=48846

THAILAND: Migrant workers unprotected and uninformed

2007-11-14T12:57:00.000+07:00

By, IRIN Plusnews, November 12, 2007

Mae Sot - Seven years ago, in her small Myanmar hometown, Tha Zin, 30, a garment factory worker, watched as one of her closest friends - a girl just a few years younger - sickened and finally died of an AIDS-related illness.

As her condition worsened, most people in the community stayed away but Tha Zin, much to the chagrin of her parents, continued to visit her dying friend, comforting her as best she could, despite her own uncertainty over whether she could be at risk.

Tha Zin, then 22, didn't really know what caused the condition, though the rumours in the neighbourhood were that it had to do with her friend's relationship with a certain 'sugar daddy'. "At that time, I didn't know much about this disease and how it could be transmitted, but I thought that I had a pure heart so I should be okay."

Today, she has a far better grasp of HIV transmission. In the Thai border town of Mae Sot, where she arrived 3 years ago in search of work, she has attended several AIDS awareness sessions organised by the charity, World Vision, as part of a US$12 million, 5-year project to help foreign migrant workers in Thailand reduce their risk of contracting the virus.

Tha Zin is now an informal peer educator in the factory where she works, sharing her newly acquired knowledge with other workers, mainly younger Burmese women who have come to Thailand alone.

Talking about HIV to these young women is a tough task. "It's very difficult to share awareness and knowledge," she told IRIN/PlusNews. "When I explain, some people look down on me. They think, 'she knows everything about this disease, so she must have been a prostitute'. In their experience, they think the disease is only from sex workers and drugs. They don't know you can get it from needles and bleeding."

Low levels of knowledge and awareness

Thailand is thought to have nearly 2 million foreign migrant workers, mainly toiling in low-paying jobs in factories, on farms, construction sites, and fishing boats - the so-called "three Ds", for "dirty, dangerous or degrading" - jobs many Thai's are unwilling to do.

Most foreign workers live in highly concentrated areas like Mae Sot, a town on the Burmese border that has become a centre of the Thai garment industry, and Samut Sakhon, 28km southwest of Bangkok and a hub of the labour-intensive seafood processing industry.

While precise figures on the number of migrant workers in Thailand are not available, the overwhelming majority - an estimated 90 percent - are from neighbouring Myanmar. In Myanmar, the highly conservative military junta publicly recognised HIV/AIDS as a threat to its population only about six years ago, after years of insisting that the country had no such problem.

The regime still tightly controls efforts to raise awareness about the disease: non-governmental organisations (NGOs) have complained of limits on the number of people who can attend HIV workshops, and prohibitions on their operating in many parts of the country, particularly sensitive ethnic minority areas.

This means most Burmese workers arrive in Thailand with little understanding of HIV/AIDS or how to protect themselves when they move away from their families and find themselves at greater risk of HIV. Similarly, migrants from Cambodia and Laos, coming from the poorest regions of their countries, often also have a poor understanding of the virus.

HIV prevalence statistics for migrant workers are not available, as the Thai government does not survey migrants separately, but sample reports, primarily among foreign fishermen and sex workers in border towns, showed high but fluctuating prevalence rates between 2002 and 2004, according to the Prevention of HIV/AIDS Among Migrant Workers Project (PHAMIT) in 20 of Thailand's provinces.

For example, in 2004, HIV prevalence among fishermen, who are mainly Burmese, was 9.6 percent in Chumpon Province, and 5.6 percent in Phuket Province;
among the mainly Burmese sex workers in Ranong, a major port in Ranong Province, which borders Burma, HIV infection rates stood at 28 percent; and among the mainly Cambodian sex workers in the province of Trad, bordering Cambodia, it reached 38 percent, the health ministry said.

PHAMIT, funded by the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria, consists of NGOs and works with the Ministry of Health to increase foreign labourers' knowledge about HIV/AIDS.

As part of the project, the Global Fund has financed the development of information, education and behaviour-change communication material in Burmese, Cambodian and several ethnic minority Burmese languages to help migrants understand issues like HIV, reproductive health and family planning, and how to access Thai health care.

Reaching out to migrants

Yet, even with the support of the Thai health ministry, efforts to reach out to foreign workers have been beset with difficulties, mostly stemming from their precarious position, given their illegal status, constant risk of deportation and often gruelling work schedule.

Although Thailand depends heavily on foreign workers, around half of them are unregistered and, technically, illegal, leaving them vulnerable to police harassment as well as serious exploitation by their employers, according to labour rights organisations.

In Mae Sot, where World Vision and other humanitarian groups have sought to train women in every garment factory to serve as informal peer counsellors, many of the women, who are in Thailand illegally, are forced to work six days a week and late into each night, with some getting only a single day off each month, which gives them little or no free time to attend training sessions on health or other issues.

To conduct all-day in-depth trainings, charities have to appeal directly to factory owners to release some of their workers for a day. Many are reluctant to do so, or agree, only to change their minds on the day of the planned training.

"It's up to the employer," said Mie Mie, a Burmese HIV/AIDS coordinator with World Vision. "Sometimes they say, 'Yes, you can come and do counselling,' but on the day we come, they say, 'we have so many orders'." The charities also have to pay the women for the wages lost during training time.

Dr Ei Ei Khin, a Burmese physician and technical advisor to World Vision's migrant worker projects in Thailand, said even when workers understood how to protect themselves from HIV, their more immediate fear was the risk that they would be arrested and held in immigration detention centres before being either freed or deported, thus losing many days of work and wages.

This often deters garment workers in Mae Sot from leaving their factory compounds, where they normally live, and restricts access to condoms unless charitable groups supply them to directly to the workers quarters in the compound. "If there is no NGO working for that factory, it's very difficult for the workers to get access to condoms," Khin said.

In recent years, the authorities' attitudes towards the migrants, especially in some provinces, have been hardening, with new restrictions being introduced to curtail the mobility of migrant workers. In several provinces, local authorities have prohibited migrants from using mobile phones, riding motorbikes, being out after 8 p.m., or gathering in groups of more than five.

Despite these hurdles, Khin believes the message is slowly reaching Thailand's foreign labourers. "Behaviour is changing," she said. "It's not enough, but it's changing."

ak/kn/he
[ENDS]

Zimbabwe: HIV rate falls again

2007-11-06T11:34:00.000+07:00

By, IRIN PlusNews, November 4, 2007

When Zimbabwe registered a decline in HIV prevalence rates in 2004, and again in 2006, the news was met with scepticism, but new official figures released on Wednesday indicate the downward trend has continued, with rates falling by 10 percent over the past 5 years.

The Zimbabwe Ministry of Health and Child Welfare, assisted by a group of international experts, based the new seroprevalence rate on HIV infection in pregnant women attending antenatal clinics, and estimate the level among the adult population at 15.6 percent, according to a UN statement.

"Zimbabwe's HIV rate has been falling since the late 1990s. This is a continuing fall," Roeland Monasch, Deputy Representative of the UN Children's Fund (UNICEF), told IRIN/PlusNews. The rate has steadily decreased from 25.7 percent in 2002 to 21.3 percent in 2004, dropping to 17.7 in 2006. Zimbabwe's population is around 11.6 million.

"The biggest falls among pregnant women were recorded among the 15-24 year age group, showing a drop in HIV from 20.8 percent to 13.1 percent in just four years (2002 to 2006)," the statement said.

But Monasch warned that "15.6 percent remains high, and this is not the moment for complacency. Rather, we must take advantage of this positive action by youth and put even greater energy and resources into Zimbabwe's fight against HIV and AIDS."

Sound statistics

Despite some disbelief in previous years, most observers now acknowledge that Zimbabwe's HIV prevalence rate is in fact dropping. "There is not another country in Southern Africa that has this much detailed, scrutinised data, and it shows progressive falls in the HIV rate," Monasch commented.

Representatives from the US Centres for Disease Control and Prevention, the Imperial College, London, the UN Population Fund (UNFPA), UNAIDS, the World Health Organisation and UNICEF were involved in the latest review.

"The drop over the years is statistically significant - pregnant women are a proxy for the overall sexually active population. This information is used as input in the HIV/AIDS epidemiological models to estimate overall prevalence for men and women in reproductive age ... these models are continuously reviewed by independent experts to ensure the most accurate estimates are derived," UNICEF spokesman James Elder explained.

Awareness changes behaviour

The dramatic plunge in prevalence rates has been attributed to the success to programmes aimed at soliciting behavioural change among the country's youth. Survey data showed that the adoption of protective behavioural measures had improved, especially in reducing number of sexual partners and increasing condom use.

Zimbabwe was one of the first countries to develop a comprehensive epidemiological review, which resulted in an evidence-based, behaviour-change strategy with the promotion of partner reduction and consistent condom use at its core. According to Bruce Campbell, the UNFPA representative in Zimbabwe, "young people are having fewer partners and using more condoms. They have heard the messages, taken action, and are being safer."

Given the severe economic and food security difficulties faced by Zimbabweans, some suggest the falling prevalence rates might point to factors other than behaviour, such as mortality, which could mean that the number of people dying from AIDS were outnumbering those newly infected with HIV.

According to 'Evidence for HIV decline in Zimbabwe', a review of the epidemiological data by UNAIDS in late 2005, "the decline in national HIV prevalence between 2000 and 2004 resulted from a combination of declining HIV incidence and rising adult mortality," but also that "sexual behaviour change has contributed to the declines in HIV prevalence and HIV incidence in Zimbabwe."

Monasch said, "Additional research is still [being] done to assess how big each factor is contributing to the decline. This is not an easy or quick exercise, but we remain confident that combined Government and UN behaviour-change strategies throughout the 1990s were absorbed and applied by Zimbabwe's educated populace ... the evidence clearly indicates that mortality alone is not responsible for the drop."

The migration of Zimbabweans to other countries "was not found to be a significant factor," Elder said. The UNAIDS review agreed: "International migration is believed to have been extensive, and the possibility that it contributed in a small way to the decline in HIV prevalence cannot be ruled out ...

"Nonetheless, the evidence available does not support the view that the overall level of migration, and (particularly) the degree of over-representation of symptomatic and asymptomatic HIV-positive individuals amongst migrants needed to cause a decline in national HIV prevalence."

Monasch was confident the positive trend could hold. "It's sustainable, but it requires funds to keep the programmes running. We know what works in Zimbabwe, and it's now been proved that, given the right behaviour change programmes, Zimbabwe's educated youth will absorb the messages and act accordingly," he said.

"Young people are having fewer partners and using more condoms; Zimbabwe has one of the highest rates of condom use in Southern Africa." Nonetheless, he warned that there was room for improvement.

"We must continue our combined efforts to ensure national HIV-prevention programmes are maintained and enlarged. HIV-positive children in need of treatment are still inadequately reached with treatment, and less likely to receive treatment compared to adults."

Mary Sandasi, Executive Director of the Women's AIDS Support Network, told IRIN, "There is a lot of education going out to people and that could assist the fall of HIV infection, but I also look at the deaths that are still happening and there is a lot that can still be done."

tdm/he[ENDS]

HIV Prevalence in Zimbabwe Decreases to 15.6%, Health Official Says

2007-11-05T10:23:00.000+07:00

By, Kaisernetwork, November 2, 2007

HIV prevalence in Zimbabwe during the past four years has decreased from 18.1% to 15.6%, Owen Mugurungi, head of the AIDS and TB unit at the Ministry of Health and Child Welfare, said on Wednesday when announcing national HIV/AIDS estimates for 2007, the Herald/AllAfrica.com reports (Chipunza, Herald/AllAfrica.com, 11/1).

According to Zimbabwe Health and Child Welfare Minister David Parirenyatwa, the decrease in HIV prevalence was seen among people ages 15 to 49. Weekly AIDS-related deaths also declined from 3,000 to 2,300, Parirenyatwa said. He added that the decline in HIV prevalence is a "significant drop, but the figures are still very high, and more should be done to further lower the numbers."

About 1.3 million people in Zimbabwe are expected to be living with HIV/AIDS by the end of the year, Xinhua News Agency reports. However, the number could increase if people do not change their behaviors and attitudes toward the disease, Parirenyatwa said (Xinhua News Agency, 11/1). In addition, the number of HIV cases among children younger than age 15 has increased from 125,161 cases in 2003 to 132,938 currently. Mugurungi attributed the increase to the extended survival of children receiving antiretroviral drugs and the low-cost antibiotic cotrimoxazole. According to the Herald/AllAfrica.com, about 18,000 of the 194,000 children in need of cotrimoxazole have access to it, and of the approximately 24,000 children in need of antiretrovirals, about 7,000 have access to them. "We take cognizance of our efforts attained in the antiretroviral rollout program for the decline in the prevalence rate," Mugurungi said, adding, "If we take out the impact of antiretrovirals, the prevalence rate could have been 15.3%."

The 2007 estimates were compiled using data from prenatal clinics at 19 sites in the country, the Zimbabwe Demographic Health Survey 2005-2006, the national census, testing and counseling data, and the Prevention of Mother-to-Child Transmission Program, the Herald/AllAfrica.com reports (Herald/AllAfrica.com, 11/1).

According to the AP/International Herald Tribune, some analysts were "skeptical" of the figures because of the "lack of medical care" in the country. In addition, although Zimbabwe said its estimates were verified by the United Nations, UNAIDS disagreed. "It looks like they've used the methodology that we recommended," UNAIDS spokesperson Sophie Barton-Knott said, adding that "however, as we haven't received this data officially, we cannot validate it."

UNICEF said the decline in prevalence is "one of the most significant and rapid declines of any country in the world." The organization added that "mortality also played a hand in the drop." Other analysts said that they doubt the estimates because of the problems with Zimbabwe's economy and infrastructure, lack of access to health care and the difficulty of using statistics when as much as one-third of the population has left the country. "I think with the current state of affairs in Zimbabwe, one would be kind of skeptical about statistics, which could also be caused by an undercount, by mass migration," David Bourne of the University of Cape Town said (AP/International Herald Tribune, 11/1).

HIV Arrived in U.S. From Haiti 10 Years Earlier Than Previously Believed, Study Says

2007-11-01T14:12:00.000+07:00

By, Kaisernetwork, October 31, 2007

The most widespread HIV subtype outside Africa likely emerged in Haiti in the 1960s and arrived in the U.S. a few years later -- about 10 years earlier than previously believed -- according to a study published Tuesday in the Proceedings of the National Academy of Sciences, the Los Angeles Times reports.

For the study, Michael Worobey, an evolutionary biologist at the University of Arizona, and colleagues analyzed five blood samples collected in 1982 and 1983 from Haitian HIV/AIDS patients in Miami that had been frozen and stored by CDC (Chong, Los Angeles Times, 10/30). In addition, the researches examined genetic data from 117 early HIV/AIDS patients worldwide (Dunham, Reuters, 10/29). The researchers examined two viral genes and compared their sequences with viruses found worldwide, using HIV samples from Central Africa considered to be some of the earliest forms of HIV as a baseline.

The researchers then constructed a timeline of HIV development by measuring how much the genes in recent blood samples differed from early samples. According to the study, samples from Haitians were genetically the most similar to the African virus, indicating the Haitian viruses were among the earliest to branch off. The researchers found a 99.7% certainty that HIV subtype B originated in Haiti, Worobey said.

Worobey concluded that the virus was brought to Haiti by Haitians who traveled to the Democratic Republic of Congo after it became independent in 1960. He added that the virus was then carried to the U.S. by Haitian immigrants between 1966 and 1972 (Los Angeles Times, 10/30). The researchers believe an unknown Haitian immigrant likely arrived in a large U.S. city, such as New York or Miami, and the virus circulated in the U.S. population and then to other nations before it was discovered. The mutation timeline of the virus presented in the study places the virus in the U.S. about 12 years before the disease was recognized by scientists in 1981, Reuters reports (Reuters, 10/29).

The study's findings confirm many scientists' suspicions that the virus was imported to the U.S. from Haiti and subsequently spread to Australia, Canada, Europe and Japan, AFP/Yahoo! News reports. HIV/AIDS prevalence among Haitians living in the U.S. was 27 times higher than in the broader U.S. population in the early days of the U.S. epidemic, according to AFP/Yahoo! News. In addition, the researchers concluded that HIV spread from Haiti to Trinidad and Tobago, fueling the Caribbean epidemic (AFP/Yahoo! News, 10/29).

Reaction

"Once the virus got to the U.S., then it just moved explosively around the world," Worobey said (AFP/Yahoo! News, 10/29). Worobey added that there likely were "hundreds of thousands of infections" before HIV was discovered. Arthur Pitchenik, a study co-author from the University of Miami, said the study "gives [scientists] more clear insight into the history of" the HIV/AIDS pandemic and "what path the virus took" (Reuters, 10/29).

Worobey added that the study did a "good job of settling the debate" over whether the virus arrived in the U.S. from Africa or Haiti. "This shows quite clearly that the data is really only consistent with a Haiti-first origin," Worobey said. Beatrice Hahn, a virologist at the University of Alabama-Birmingham who was not involved with the study, said the study's "calculations are as good as the currently available methods allow." Hahn cautioned against blaming the spread of HIV/AIDS on Haitians or Central Africans. "These viruses are fairly clever, and they have to survive. They will find niches. ... You realize chance events play a very important role," Hahn said (Los Angeles Times, 10/30).

The Miami Herald on Wednesday examined how the study's findings have "stoked controversy among researchers and Haitians" by "reopening deep wounds over the medical community's role in perpetuating a stigma against people from the island" (Tasker/Charles, Miami Herald, 10/31).

SOUTH AFRICA: Microbicide trials - what's in it for participants?

2007-10-29T14:58:00.000+07:00

Why would a woman volunteer to use a product that may or may not protect her from HIV infection, undergo a lengthy screening process and then commit to regular clinic visits for up to two years?

South African women make up a significant number of the thousands in the African continent who have volunteered to participate in clinical trials for microbicides - a range of female-controlled products in the form of gels, creams, sponges and vaginal rings, which scientists are hopeful will prove effective at protecting women from HIV and other sexually transmitted infections (STIs).

A number of microbicide products have proven safe and effective in laboratory tests, but before being approved for use by the general public they must be tested on women in areas of the world where HIV prevalence is high enough to yield incontrovertible results.

The challenge for scientists is to design trials that have sufficiently attractive benefits to recruit and retain participants, without offering what ethics committees would deem incentives or inducements.

Benefits

South Africa's Medicines Control Council mandates that trial participants receive a R150 (US$21) "reimbursement" to cover transport costs each time they visit a trial site. The money is usually more than enough, and undoubtedly provides at least some motivation for unemployed women surviving on small incomes.

"I heard from a friend about the free check-ups and the money," admitted Bathabile*, 34, from Soshanguve, a township north of Pretoria. She had hoped to participate in a trial of a microbicide gel, Carraguard, run by the Population Council, an international nonprofit organisation, but was excluded when she tested HIV positive.

Zanele, 27, also from Soshanguve, qualified to participate in the Carraguard trial and stayed with it for two years until it ended in March 2007. She spent her leftover reimbursement money on clothing, but said it was not her main reason for taking part.

"I wanted to know my [HIV] status and get STI treatment and pap smears," she told IRIN/PlusNews. "And I wanted to help other women, because I know women who've been affected by HIV."

According to Dr Claire Von Mollendorf, of the Reproductive Health and HIV Research Unit (RHRU) at the University of Witwatersrand, in Johannesburg, who has been involved in several microbicide trials, many women volunteered for altruistic reasons: "They want to help because they've all had family members that have died from HIV."
By, IRIN PlusNews, October 29, 2007

Most of the participants IRIN/PlusNews interviewed at Setshaba Research Centre in Soshanguve, one of three sites in South Africa where the Carraguard trial was conducted, cited the health benefits as their main reason for taking part: regular HIV tests, treatment for STIs, annual Pap smears, free condoms, and counselling on how to reduce their HIV risk.

"I miss the health services we got here," said Zanele. "Last week I went for an HIV test at the [public] clinic, and the nurses were rude and the queue was long, unlike here, where I would just come in and be attended to just like that."

Rivonia, 22, qualified for the trial and used the gel for three months before testing positive and having to drop out of the trial. Despite the initial shock of discovering her status, she had no regrets about her involvement. "I wouldn't have tested if it hadn't been for the trial," she told IRIN/PlusNews. "Even now, I wouldn't have known that I'm HIV positive."

Rivonia and Bathabile were among about 30 women - all of whom tested positive during the initial screening or became positive over the course of the three-year trial - who then joined a support group started by the trial staff. The group met weekly and attended cookery classes by a nutritionist, received health advice and referrals from a doctor, and support from each other.

Staying the course

Scientists need at least 80 percent of microbicide trial participants to use the product for periods of up to two years to obtain reliable results. In the case of Carraguard, which comes in the form of a gel, many women said they enjoyed using it because the gel acted as a lubricant, increasing sexual pleasure for themselves and their partners. Similarly positive feedback has come from other microbicide trials.

Jonathan Stadler, a social scientist with the RHRU who has interviewed women about their experiences during microbicide trials, said many reported liking the fact they could be using a product that might protect them against HIV and STIs.

"In a world of HIV and AIDS, where all we've managed to give people so far is the condom, and suddenly you get something which is so much nicer to use, the fact that this might actually be effective is a very attractive idea for most people," he said.

There is evidence that women who do not tell their male partners about their trial participation are more likely to drop out. Dr Khatija Ahmed of the University of Limpopo, principal investigator of the trial, said only about half the 2,400 women in the Carraguard trial in Soshanguve told their partners, and a small percentage of those dropped out when the partners discovered they were using the gel.

"It helps if the partner is involved, especially in terms of adherence, and also for the treatment of STIs, because we did offer treatment to partners as well," said Ahmed. "But this is a woman-based clinical trial. We advise participants to tell their partners, but it's really their choice, because different people have different relationships."

Zanele was six months into the trial before she told her boyfriend. "I was nervous because he takes long to understand these issues," she said. "Finally, he heard from other people that there's this gel and women are getting paid to use it, and then I told him. In the beginning, he didn't want to use it but after he heard what its purpose was, he said, 'let's use it'."

Some of the women in the Carraguard trial also attracted unflattering neighbourhood gossip, much of it related to their reimbursements. "People would say, 'Why should we get paid? It means the gel will infect us'," said Rivonia.

Von Mollendorf commented that "study fatigue" tended to set in after the first few months of a microbicide trial. "It becomes tedious for the women, and that's why, in the middle of your study, you try to have retention parties or events to encourage them to stay in the trial. You give them more information and updates from other microbicide trials."

Outcomes

The Carraguard trial, the results of which are expected by the end of the year, is the first microbicide trial to complete the final human effectiveness phase of testing. "The entire microbicide world and all the communities where the research was conducted are waiting for those results," said Ahmed.

Participants and the wider community will be informed about the results of the trial, and Ahmed is hopeful that if the product proves effective they wwill also be given priority in having access to it.

"The Population Council is already negotiating with various pharmaceutical companies with regard to manufacturing the product at a cost that is affordable to the people who need it," she said.

For her part, Zanele is looking forward to other studies coming to Soshanguve. "I would like to be in another trial," she said.

Source: http://www.plusnews.org/InDepthMain.aspx?InDepthId=64&ReportId=74136

Catholic Church's Opposition to Condom Use Contributes to Spread of HIV in Latin America, UNAIDS Official Says

2007-10-25T14:41:00.000+07:00

By, Kaisernetwork, October 24, 2007

The Roman Catholic Church's opposition to condom use is contributing to the spread of HIV in Latin America, Alberto Stella -- UNAIDS coordinator for Honduras, Nicaragua and Costa Rica -- said on Monday, Reuters reports.

"In Latin America, the use of condoms has been demonized, but if they were used in every relation, I guarantee the epidemic would be resolved in the region," Stella said. He added that youth "start to be sexually active between 15 and 19 without sex education" -- a factor that contributes to the spread of HIV. In addition, evidence indicates that promoting abstinence is "not working," according to Stella.

About half of the 1.1 billion Catholics worldwide live in Latin America, and the Roman Catholic Church "holds sway" in the region, Reuters reports. About 1.7 million people in Latin America are living with HIV/AIDS. The number of new HIV cases in the region increased to 410,000 in 2006 from 320,000 in 2004, according to UNAIDS (Reuters, 10/23).

Israeli Doctors Providing Male Circumcision in Swaziland in Effort To Prevent Spread of HIV

2007-10-24T10:45:00.000+07:00

By, Kaisernetwork, October 22, 2007

Teams of Israeli surgeons have begun providing male circumcision in Swaziland in an effort to prevent the spread of HIV, the Washington Post reports. Health officials in Swaziland, which has fewer than 100 doctors and the world's highest HIV prevalence, say that over the next five years, they hope to offer the procedure to 200,000 sexually active men at a rate of roughly 200 daily -- 20 times faster than the current pace. According to the Post, six Israeli doctors are scheduled to work for two weeks in Swaziland this year under a program organized by the Jerusalem AIDS Project and underwritten by the U.S.-based Jewish organization Hadassah and other donors.

The Israeli doctors primarily are expected to train Swazi doctors on how to perform circumcision among adult men. However, many Swazi doctors already know how to perform the surgery. According to some Swazi doctors, what they primarily need from the Israeli doctors are "extra hands to help get enough done to impact the epidemic," the Post reports. The demand for circumcision -- especially surgeries that are no cost or subsidized -- appears to "far outstrip supply in Swaziland," according to the Post. The health system "routinely runs low" on basic medical supplies -- such as sutures, gloves, dressings and surgical tools -- the Post reports. In addition, there is a "major constraint" on surgeons and doctors, Dudu Simelane -- executive director of the Family Life Association of Swaziland, a nongovernmental group hosting the Israeli doctors -- said.

Some Swazi surgeons have shown that they can each perform 10 circumcision procedures -- which take about 25 minutes -- daily during the country's occasional series of "Circumcision Saturday" events, the Post reports. According to medical experts, it would take four doctors at each of five separate facilities to perform 1,000 circumcisions weekly if Swazi doctors can maintain that speed every weekday (Timberg, Washington Post, 10/21).

In South Africa, AIDS takes toll on older women

2007-10-24T10:35:00.000+07:00

By, Khadijah Rentas, Columbia Missourian, October 21, 2007

The image of rural older women surrounded by young orphans has become a symbol of the effects of HIV/AIDS on sub-Saharan Africa. With more and more working-age people dying of the disease, poverty can strike households quickly and without mercy.

Charities, international organizations and governments have united to combat HIV/AIDS in Africa, pouring millions of dollars into education, prevention and treatment efforts. This year, the South African government appropriated more than $539 million to improve health care facilities.

The effects of the disease are devastating, especially to South African women, who are infected at a much higher rate than South African men, according to statistics compiled by the United Nations. AIDS-related deaths in 20- to 39-year-old women tripled between 1997 and 2004, and 1.2 million South African children have been orphaned by the disease.

As a result, in a country where one in four is unemployed and half the population lives in poverty, many rural households are being held together by older women who rely on government pensions to feed, clothe and shelter large extended families. Designed to provide financial support for one person, the pensions are often the only source of income for rural families spanning several generations — children, grandchildren and even great-grandchildren, according to research conducted in Agincourt, South Africa, by an MU professor and colleagues from the University of Colorado and the University of Witwatersrand in Johannesburg.

Enid Schatz, director of social science research at MU’s School of Health Professions, and her fellow researchers set out to determine whether an older woman who had had an AIDS death in her household suffered greater economic stress than those who did not. The results, published in August, showed that the burden of caring for adult children and grandchildren in rural South Africa is falling on many older women, not just those whose families have experienced a death from AIDS.

“We expected to find very different situations, but we found more commonality,” Schatz said. “You don’t have to have an AIDS death in your household to be affected.”

In addition to daily living expenses, older South African women often must help other families with funeral expenses or help take in children whose parents have died. In many cases, the older women must also support unemployed adult children.

Schatz interviewed 60 older women between the ages of 60 and 75 years old in 60 households. Of those, 38 women received a government pension, which at the time was equal to about $100 a month. Out of 30 older women, 28 received pensions and only a third lived in a household where an adult had died in the last two years from AIDS-related causes. Most of the women were caring for children who had lost a parent to AIDS or who had a single parent who had migrated to another part of the country to find work and had to leave children behind.

“There’s been a long history in southern Africa of fostering children,” Schatz said. “But I think the magnitude of it and the burden of it is increased because the parents aren’t coming home.”

South Africa offers grant money for social programs aimed at children, but Schatz and her colleagues found that women had trouble accessing the funds because they lacked knowledge about the programs or did not have the necessary documents for eligibility, such as birth certificates.

Although the government aid helped, the research found that it was not enough to support an extended family. The study reported that most of the women said their pensions ran out before the next check arrived, sometimes as much as two weeks before.

“I think AIDS is to some degree another crisis,” Schatz said. “And there are other crises, like, ‘How am I going to pay school fees for children who are left behind?’ ”

The United States Agency for International Development, a government-sponsored relief program, allocated $252 million in aid for South Africa. That aid, which has increased more than $100 million since 2006, funds programs that focus on economic growth, peace, security and the HIV/AIDS pandemic. President Bush’s Emergency Plan for AIDS Relief allocated more than $363 million in 2007 to the prevention, care and treatment of HIV/AIDS, an increase of about $168 million since 2006.

According to the PEPFAR Web site, only 20 percent of the money has been allocated for prevention, one-third of which is for abstinence-only education, eclipsing spending on condom distribution and on education aimed at reducing the chance of mother-to-child transmission of the virus.

Although she has not compiled research on policy, Schatz said aid money typically does not trickle down to the people she works with. Older women interviewed by the researchers said the best thing the South African government could do to ease their burden would be to increase their monthly pensions. Since the research’s publication in August, the pension has been increased by $25 a month.

According to the Global HIV Prevention Working Group, which is supported by the Kaiser Family and the Bill and Melinda Gates foundations, new HIV infections in sub-Saharan Africa will increase by 36 million by 2015.

Yusuf Kalyango, a native of Uganda who teaches international reporting at MU, said poverty, coupled with a lack of education, has fostered the spread of the disease, making it more difficult to control in the future. As Schatz’s research suggests, the burden will fall heavily on South Africa’s older women.

“Illiteracy, poverty and general ignorance will contribute to the spread of HIV,” Kalyango said. “Two things have to happen simultaneously, and that is economic empowerment and education. If citizens are not educated, they cannot be empowered.”

Source: http://www.columbiamissourian.com/stories/2007/10/21/south-africa-aids-takes-toll-older-women/

HIV/AIDS Prevention Among MSM in China Remains a Challenge, Health Official Says

2007-10-22T10:41:00.000+07:00

By, Kaisernetwork, October 19, 2007

Preventing the spread of HIV among men who have sex with men remains a challenge for the Chinese government, Wang Yu, chief of the Chinese Center for Disease Control and Prevention, said on Wednesday, China Daily reports. The United Nations and the Asian Development Bank in a recent report said the number of HIV cases in China is rising faster than the average number in most Asia-Pacific countries despite efforts by the government.

According to Wang, more than half of the new HIV cases reported in the country this year as of June were among MSM and commercial sex workers. He did not disclose how many cases had been reported so far this year but said that there are 60,000 to 70,000 new cases reported annually in the country.

MSM are "one of the high-risk groups vulnerable" to HIV transmission and account for nearly 25% of new cases, Wang said, adding that China's "prevention efforts among them have done nearly nothing to stem the rate" of transmission. He said it is difficult to reach MSM because of stigma. According to Wang, preventing the spread of HIV among MSM is crucial because it is "very common for them to spread [HIV] to their families." Wang said that health officials still are working on a package of measures aimed at MSM. He added that officials are training volunteers and "sending them out to spread" awareness in the MSM community (Fu, China Daily, 10/18).

Vietnam Should Improve Efficiency of HIV/AIDS Control Programs To Reduce Impact, Spread of the Disease, Deputy PM Says

2007-10-16T10:17:00.000+07:00

By, Kaisernetwork, October 15, 2007

Vietnam needs to improve the efficiency of its HIV/AIDS control programs to reduce the impact and spread of the disease in the country, Deputy Prime Minister Truong Vinh Trong said on Friday at the end of a two-day conference on HIV/AIDS prevention in Hanoi, Vietnam, the Vietnam News Brief Service reports. "Localities nationwide have made efforts in implementing HIV/AIDS prevention activities; however, the efficiency is not high," Trong said, adding that 18 of the country's 60 cities and provinces have faced challenges in implementation.

According to Trong, Vietnam's relevant ministries and agencies should promote increased cooperation with international organizations and implement interventions to reduce the spread of the disease from high-risk groups to the general population. Trong asked the relevant ministries to issue practical plans and measures to help accomplish the national strategy on HIV/AIDS prevention, which aims to keep Vietnam's HIV/AIDS prevalence at less than 0.3%. As of Aug. 30, the country recorded 128,367 people living with HIV, 25,119 of whom had developed AIDS. The country also recorded 14,042 AIDS-related deaths, the Vietnam News Brief Service reports. It is estimated that Vietnam will have about 351,000 people living with HIV, including 157,000 people living with AIDS, by 2010 (Vietnam News Brief Service, 10/12).

In related news, Vietnam recently announced it plans to invest 1,352 billion Vietnamese dong, or about $84.5 million, in HIV/AIDS prevention activities between 2007 and 2010, Xinhua/People's Daily reports. Most of the funds will be used to prevent new HIV cases among high-risk groups and the general population. Some of the funds also will be used to intensify training for health professionals, Xinhua/People's Daily reports (Xinhua/People's Daily, 10/12).

New HIV Cases Among Married Couples in Thailand Increasing, Survey Says

2007-10-16T09:20:00.000+07:00

By, Kaisernetwork, October 15, 2007

The percentage of new HIV cases recorded among married couples in Thailand has increased from 38.7% of new diagnoses in 2005 to 40% of new diagnoses in 2006, according to a recent survey by Thailand's Department of Disease Control, Thailand's Nation reports.

According to the survey, between 44% and 52% of married couples in the country engage in unprotected sex. The survey also found that 22% of new HIV diagnoses were among men who have sex with men. In addition, 11% of men who are newly diagnosed contracted the virus from commercial sex workers, and 10% contracted the virus from their partners, the survey found.

Thawat Suntrajarn, chief of DDC, said the agency has a plan in place to prevent the spread of the virus, particularly among married couples. The DDC and Ministry of Public Health plan to provide 20 million condoms in hospitals to couples living with HIV/AIDS to combat the spread of the virus. In addition, the health ministry will provide HIV-positive people with 10 condoms monthly and antiretroviral drugs at no cost. DDC also will provide 10 condoms monthly to HIV-positive people who do not show symptoms and will encourage their partners to receive HIV tests.

South Africa: When microbicide trials go wrong - Part 2

2007-10-15T10:55:00.000+07:00

By, IRIN PlusNews, October 12, 2007

It's an overcast Thursday morning in the port city of Durban, on South Africa's east coast, and some of the former participants in a microbicide trial, discontinued earlier this year, have gathered at the now deserted research site behind a busy downtown taxi rank, to be interviewed by IRIN/PlusNews.

The trials of a microbicide candidate containing cellulose sulphate were stopped after preliminary results showed it could increase the risk of HIV infection.

CONRAD, a reproductive health research organisation, was carrying out the trials in Benin (West Africa), India, South Africa and Uganda, and is conducting more tests to find an adequate scientific explanation for the higher number of seroconversions (HIV infection) in the cellulose sulphate arm of the study.

In South Africa, public outrage over the results was heightened by sensational media coverage depicting the participants in microbicide trials as 'human guinea pigs', and alleging that the women were encouraged to visit bars and other similar places of entertainment, and to engage in unprotected sex.

Street smart, articulate and well informed about their rights, the six participants PlusNews spoke to are no 'guinea pigs'; they all emphasise the benefits of the gel, and how they were not "forced" to join the study. But they're also not really clear about why the trial was stopped, and all they want to know is, "When will the gel become available again?"

At the time the trial ended, Nokuthula Lefora, 37, was one month away from completing her 12 months of using the gel and really enjoyed using it, as it enhanced her sex life. "When you use it, you become aroused and moist and you feel good." Participants on the trial were required to insert the gel in the vagina an hour before sex, using an applicator, and to use it with a condom.

The married mother of four first heard the rumours in her informal settlement that a group of women were claiming to have been infected after using the potential prophylaxis. She subsequently received a telephone call from researchers at the Medical Research Council, alerting her to the premature end of the trial and telling her to stop using the gel and return it to the research site.

Then the news broke in the media. "When I heard about this on TV and radio, about women who were told to go to shebeens and have sex with a lot of men, I was confused; I thought, 'They can't be talking about my trial, because it didn't sound like the one I was on.'"

A presentation in July by the local researchers on why the microbicide trial had been discontinued doesn't seem to have convinced Lefora though, as she maintained that the women who seroconverted were "troublemakers" who became HIV-positive because they did not use the gel properly. She has recently been for an HIV test and is negative, and told IRIN/PlusNews that she would use the gel again - despite the fact that "it didn't pass".

What happened to the women?

When Nomusa (last name withheld) heard that the trial had been stopped, her initial reactions were fear and panic. Now, almost a year later, HIV negative Nomusa misses the regular health screening she received at the research centre, as well as the friends she made. The last time she had a PAP smear test was in 2006 during the trial, and she doubts she'll be able to have the test at her local clinic.

"Forget about the R150 they used to give us; it helped so many people to be on this thing. We got tested, and I know some of the women I came with found out they were HIV here. They are now getting help ... before we came here, some people didn't even know that condoms expire," she commented.

At the offices of the Medical Research Council's (MRC) HIV Prevention Unit, which is responsible for several microbicide trials being carried out in South Africa, Dr Roshini Govinden, the principal investigator of the Durban cellulose sulphate trial, told IRIN/PlusNews that the participants were "disappointed" when the trial was halted.

"We started calling them immediately, and told them to stop using the gel and come to the clinic to bring [it] back ... and we even offered to send someone to pick it up," she said. "A lot of them did come back and we got all the product back ... except for one woman who was a little bit annoyed and accused us of trying to give her HIV. She never came back."

The partner of one participant burnt her gel supplies, while the male partners of women in other microbicide trials run by the MRC raised concerns that using "gel" increased HIV risk, and did not want them to participate in the trials.

Former participant Nelisiwe (not her real name), who had recruited other women to enrol in the study, found out the trial had stopped via phone calls and text messages from women she had encouraged to join. "They were asking me, 'Have you heard about your gel? They say it has HIV'".

Nelisiwe and her 22-year-old daughter, who also participated in the trial, had already finished their 12-month trial period by this time, and both are still negative. The six women interviewed by PlusNews were all HIV negative, and those who had seroconverted during the trial have been reluctant to speak to the media.

The standard of care for women who become HIV positive during microbicide trials is a hotly debated issue: should researchers be obliged to offer the best possible care, the standard of care in the host country, or something between?

According to Govinden, all the women who seroconverted during the trial have been referred to healthcare facilities, and HIV-positive participants can access free CD4 count and viral load tests, as well as treatment for opportunistic infections, at a nearby HIV/AIDS clinic supported by the US President's Emergency Plan for AIDS Relief (PEPFAR). She said the women also received intense counselling.

Ntokozo Madlala, advocacy officer for the Gender AIDS Forum, told IRIN/PlusNews that access to care for women who had seroconverted during trials was still a patchy issue, as there was "no uniform standard of care" and some research organisations offered better HIV care services than others. "It depends on who is funding it and sponsoring the trials," she said.

The Global Campaign for Microbicides has called on all trial sponsors to set up mechanisms to ensure that participants have access to HIV care before trials begin. Care is usually arranged in partnership with local facilities, or the creation of a reserve fund to pay for treatment.

Many trials also try to facilitate access to care for women who test HIV positive at screening, by providing CD4 tests and other tests that can help them qualify for local treatment programmes.

Keeping the momentum going

That there will be more trial failures cannot be ruled out. But it doesn't help that the country's AIDS activists have been slow to become involved with microbicides, and there are no "strong and visible" advocates and watchdogs for the potential prevention tool.

Madlala admitted that many NGOs have been "too relaxed" about closely following the microbicide research process, choosing instead to pursue "sexier and more urgent" issues, like treatment.

"I don't think you can be an activist and shut out issues looking into prevention for women," she said. "It's a pity, because the research field is moving at a very fast pace. South Africa is becoming the place for microbicide trials, but we as advocates need to get our act together, because some of us still don't know what a microbicide is, or how clinical trials work."

kn/he

Malawi starts distributing ARVs to those in need

2007-09-24T10:10:00.000+07:00

By, SABC News, September 23, 2007

Malawi has begun the distribution of anti-retroviral (ARV) drugs to about 100 000 adults and 20 000 children living with HIV. Figures from the National Aids Commission show two million out Malawi's 12 million population are HIV positive.

President Bingu wa Mutharika's secretary for Nutrition and HIV/Aids, Mary Shawa, says that almost 90 000 children across Malawi have HIV. She says most of the children contracted the virus through mother to child transmission.

Shawa says the government has now established 144 delivery and service centres, up from 36 in 2004, to deal with mother to child transmission. Currently 100 000 HIV positive people in Malawi are already on AZT, paid for by the Global Fund initiative against Aids, malaria and TB.

An estimated 14% of Malawi's 12 million people are infected with HIV/Aids, with about 240 people dying of the disease each day. More than one million children have been orphaned by the epidemic.

Source: http://www.sabcnews.com/africa/southern_africa/0,2172,156304,00.html

Partnership is the key to success in tackling HIV and STIs in PNG

2007-09-24T10:04:00.000+07:00

By, Scoop World Independent News, September 21, 2007

This week in Port Moresby, a landmark partnership, the PNG-Australia Sexual Health Improvement Program (PASHIP), has been formalised to tackle the spread and treatment of Sexually Transmitted Infections, particularly HIV.

The PNG Government, the Australian Government and local and Australian NGOs have joined together in a 50 million Kina ($20 million AUD) program to take a proactive approach in tackling the scourge of HIV that is estimated to affect up to 2.5% - or 150,000 people in Papua New Guinea.

Caritas Australia, is in charge of rolling out the new partnership in the Southern Highlands, Simbu and the National Capital District of PNG, whilst four other NGOs and health providers will be involved in a total of eight provinces.

Caritas Australia CEO Jack de Groot said "This unique partnership to tackle Sexual Transmitted Infections, particularly HIV in PNG is indicative of the role and responsibilities that church agencies like Caritas Australia has in our neighbouring countries.

"Currently the Catholic health system delivers around 25% of PNGs total health services and this partnership is also recognition of the important role that the Catholic Church and other Churches play in delivering basic services to many in the Pacific. The PASHIP initiative has at its core the building of capacity for local organisations to tackle STI and HIV problems".

"Working at the grassroots level is crucial to effectively tackling STIs in PNG. Our work focuses on education, prevention and treatment and reflects our philosophy of promoting the dignity of people. We are able to carry out this work in a culturally appropriate manner as our partners are part of local communities. This is crucial in challenging the stigma that is still associated with STIs and HIV in many parts of PNG", said Mr de Groot.

"PASHIP is innovative in that it recognises that PNG has many issues it must face. HIV is a crucial one but we must not be neglectful of the many other issues that affect people's health in PNG. The flexibility of this new initiative is based on supporting local organisations to strengthen their abilities to deal with the key health problems facing PNG. In this way we are offering not a band aid but a long term solution built on the skills and capacity of local people: said Mr de Groot.
In launching the partnership Australian High Commissioner to PNG, Mr Chris Moraitis, said by funding PASHIP, the Australian Government recognises PNG is facing serious issues in the area of sexual health. "Many provinces in PNG report alarmingly high death rates due to problems of untreated STIs, and of course, STI infection is strongly linked to HIV infection," he said.

Dr Timothy Pyakalia, Deputy Secretary, National Department of Health. emphasised that PASHIP is a partnership between Australia and PNG, NGOs and government departments. He also emphasised the need to build capacity, which is a key element of this program.

Dr Pyakalia said that "the current arrangement with the Churches - who deliver the bulk of health services in remote and rural areas - was made in the 1980s. Back then HIV wasn't a problem. Then, PNG had a population of 3 million; now it has over 6 million. Then, 250,000 people had malaria, now over 2 million suffer from it. The Churches are being asked to take on more. This program is important in helping to building capacity."

Source: http://www.scoop.co.nz/stories/WO0709/S00538.htm

Nigeria: Country Ranks Third in HIV Infection - NACA

2007-09-21T11:38:00.000+07:00

By, Patrick Ugeh, This Day (Lagos), September 20, 2007

Nigeria ranks third among most infected countries with the Human Immuno deficiency Virus (HIV), coming after South Africa and India in that order.

This was disclosed yesterday in Abuja, by Ekeoma Uwaoma, Relationship Manager, National Agency for the Control of Aids (NACA), at a one-day capacity workshop organised by the Federal Ministry of Energy in collaboration with NACA.

Uwaoma, in a paper titled, Basic Facts on HIV/Aids, alerted the nation that there were increasing cases of Nigerian ladies who, in their desperate desire to get back at the society, especially because of the stigmatisation which is still very prevalent, dress up provocatively and seek for lift from men, only to end up raping them and gleefully taunt their victims: "Welcome to the club, you are now HIV-positive."

She also said the population of Nigerians living with the disease is more than the entire population of Liberia. Giving a hint of the near-crisis situation of the pandemic in the country, she narrated an incident in which a patient with the disease who was referred for admission could not be taken by two hospitals in the Federal Capital Territory, Wuse and Asokoro general hospitals, on account of shortage of beds.

She said the patient eventually ended up at the National Hospital.

Noting that the prevalence of HIV in Nigeria wasadversely affecting the attainment of the MillenniumDevelopment Goals, Uwaoma called on the government to issue a circular to make budgetary provisions for the Energy and parastatals under it to take care of HIV-ralated issues, lamenting that enough attention had not been given to the handling of the disease. She cited lack of transparency on the part of government officials as a major stumbling block.In his address, the Permanent Secretary, Ministry of Energy (Power), Engr. Sadiq Mahmood, who was represented by Engr. Mohammed Amate, Director of Planning, Research and Statistics, announced that theministry would soon set up HIV centres in the various departments and urged the participants to spread the knowledge they would acquire from the workshop to their colleagues.

Source: http://allafrica.com/stories/200709200302.html

Kenya: Muslim opposition to condoms limits distribution

2007-09-18T09:34:00.000+07:00

By, IRIN PlusNews, September 17, 2007

The strong anti-condom stance of religious leaders in northern Kenya means few people there are using them and traders are refusing to stock them, which AIDS activists warn is jeopardising the fight against the pandemic.

"I will never sell condoms in my shop; it is like promoting adultery and operating a brothel," Sharrif Mohamed, who owns a shop in Isiolo, Eastern Province, told IRIN/PlusNews.

Most traders in the mainly Muslim northeastern part of the country have refused to stock condoms, which are usually only available at government health centres.

Zamzam, a single mother of three in Garissa, a town North Eastern Province, dismissed condoms as "a thing for the prostitutes", saying, "I use my brain and intelligence when I want to sleep with a man, and can tell who is sick [with HIV/AIDS]; I am not a prostitute to use it." This level of ignorance is common across the region, where literacy levels are the lowest in the country.

"The HIV/AIDS pandemic is a curse and punishment because people have engaged in immoral acts and offended Allah [God]," Maalim Hussein Mohamud, a teacher at a 'madrassa', or Islamic school, in Mandera, near the Somali border, told IRIN/PlusNews. "They have to repent, observe religious teaching and not use condoms."

Mohamud said the only way to prevent the viral infection was to observe religious teachings, abstain from 'illegal' sexual acts and avoid the use of condoms.

"Our position is very clear: we shall never support the use of condoms; Muslims must shun acts that will endanger their lives. To be safe [from HIV], youths must pray five times daily, fast, and refrain from looking at women; extramarital affairs must be avoided and women must dress decently," he insisted.

Noor sheikh, who works at the government's HIV/AIDS and sexually transmitted infection control programme in North Eastern Province, said stiff opposition to the use of condoms was proving to be a hindrance to HIV prevention. "Our region has the lowest use of condoms in the country," he said. "Of course it is a factor responsible for many cases of infections."

Some activists have complained that the government has not done enough to educate the local population about condom use, particularly in rural areas, and it was also often very difficult to obtain condoms.

"Many youths are informed about the use of condoms, but have said they are not available in remote parts of the region," said Margaret Leshore, of the Samburu Women's Empowerment Programme, a non-governmental organisation advocating women's rights.

The condom is one of the main HIV prevention strategies employed by the government, and free condoms are available at most health centres around the country.

Although northern Kenya has some of the country's lowest prevalence rates, concerns have been raised about low awareness of the pandemic and the region's continued resistance to condom use.

na/kr/he[ENDS]

Pregnancy May Help Cut Risks For HIV Infected Women

2007-09-17T10:33:00.000+07:00

By, Medical News Today, September 15, 2007

Women with HIV infection who become pregnant have a lower risk of progression to AIDS and death, researchers at Vanderbilt University Medical Center report.

Their findings, posted last week on the online edition of the Journal of Infectious Diseases, suggest that "the complex set of immunologic changes" that occur during pregnancy may be interacting in a beneficial way with combination drug therapy.

Some previous studies in the developing world had reported higher levels of complications and deaths from AIDS among pregnant women. But those studies were conducted before the advent of highly active anti-retroviral therapy (HAART), drug "cocktails" that over the past decade have dramatically reduced death and complication rates among people infected with the AIDS-causing human immunodeficiency virus (HIV).

The Vanderbilt study included 759 women treated between 1997 and 2004 at Nashville's Comprehensive Care Center, one of the nation's largest outpatient AIDS treatment programs. More than 500 of these women received HAART, including 119 of the 139 women who had at least one pregnancy during the study period.

After using statistical modeling methods to adjust for differences between women, including their age, health and response to therapy, the researchers found that "pregnant women did better," said Timothy Sterling, M.D., the study's senior author and associate professor of Medicine.

In addition, women who became pregnant more than once during the study tended to have a lower risk of disease progression than did women who became pregnant only once. That also supports the conclusion that something about pregnancy is beneficial, he added.

However, more study is needed, Sterling cautioned. Pregnant women were healthier than the women who did not become pregnant, and they may have been more likely to adhere to their therapy out of concern for the fetus.

They also received "intensive care" frequent visits with their physician, case managers and nutritional counselors. "Perhaps efforts should be made to do that for everyone, pregnant or not, female or male," he said.

The study was begun four years ago by first-year medical student Mercy Udoji as part of what is now Vanderbilt Medical School's Emphasis Program, which provides a variety of research and scholarly activities for students during their pre-clinical years.

Jennifer Tai, M.D., made major contributions to the study while participating in the Vanderbilt Medical Scholars Program.

Tai, currently a resident in pediatrics at the University of Colorado, and Udoji, a resident in anesthesiology at Duke, are listed as first authors on the paper and previously have presented data from the study at scientific conferences.

"They both did a fantastic job," said Sterling, who directs the Epidemiology/Outcomes Unit of the Vanderbilt-Meharry Center for AIDS Research. "Neither one had formal training in statistical methods or analysis, but they learned the necessary skills through the conduct of this study."

"Seeing this project from start to finish has made me recognize the rising importance of clinical research and its role in patient care," said Udoji, a Nashville native and former Tennessee State University track star. "I look forward to participating in more projects in the future."

The study was supported by the National Institutes of Health. Co-authors were Gema Barkanic, Daniel Byrne, Peter Rebeiro, Beverly Byram, Asghar Kheshti, Justine Carter, Cornelia Graves, M.D., and Stephen Raffanti, M.D.

Source: http://www.medicalnewstoday.com/articles/82489.php

KENYA: What about the female condom?

2007-09-17T10:21:00.000+07:00

By, IRIN PlusNews, September 14, 2007

Unpopular and misunderstood, the female condom has failed to take off in Kenya, depriving women of one of the few means over which they have control of protecting themselves against HIV infection in male-dominated societies.

"The introduction of the female condom in Kenya has failed to slow down HIV in women," Dr Enoch Kibunguchy, assistant minister for health, told IRIN/PlusNews. An estimated 740,000 women are infected with the virus, and carry the burden of HIV in the country.

"The female condom was introduced in Kenya in a wrong manner. Manufacturers dumped the condoms in the country and did not bother to provide accurate information on its use," he said. "A belated attempt by the government raise its profile came in too late, as attitude against it had already become ingrained."

Over 200,000 of the condoms were supplied in 2007 but consumption was a paltry 10,000, while an estimated 12 million male condoms were used every month, according the director of the National Aids Control Council, Prof Alloys Orago.

"While consumption of the male condom has been rising because of its low cost, the cost of the female condom is outrageously high," he added. The female condom retails for as much as US$3, which is beyond the means of most women.

Cultural barriers also often made it difficult for women to negotiate safer sex. "Although the [female] condoms are dispensed at government facilities for free, few women go for them," said Kibunguchy.

"Women give the condom a wide berth because it is cumbersome to wear, while others find it embarrassing. Even among the highly educated and professional class of women, the female condom is not a popular contraceptive." However, he said the government would keep promoting the use of the female condom.

Reversing the unpopularity of the female condom would require "a change in attitude", Kibunguchy commented. "Even economic empowerment, although critical, may not raise female condom uptake if supply and information are not well matched."

AIDS activists agreed, with many blaming the poor uptake of the female condom on insufficient effort by government to popularise it.

Too early to give up

Allan Ragi, executive director of the Kenya AIDS NGOs Consortium (KANCO), an umbrella organisation for HIV/AIDS civil society, called on the government to refocus its energies on making the female condom more widely available.

"For poor, rural women, the female condom is a lifeline; if a woman's husband shows up drunk at midnight, wanting to have sex, if she's already ... [got] the condom then she ... [can be] protected," he said. "But accessibility has been a problem since the beginning - where is this woman supposed to get the condom?"

Better marketing and more information were necessary to ensure that all women in Kenya had the condom as an option for protection against sexually transmitted infections and pregnancy, Ragi said. "Family planning and antenatal clinics would be a good starting point to empower women with the knowledge and the condoms."

jlk/kr/kn/he[ENDS]

Africa: 'Marriage Not a Barrier to Catching HIV/Aids'

2007-09-12T14:29:00.000+07:00

By, Kakaire A. Kirunda, The Monitor (Kampala), September 10, 2007

While marriage has highly been thought to greatly reduce the risk of catching HIV/Aids, it is increasingly emerging that this notion is proving otherwise.

This emerged at the just concluded 1st regional forum on best health care practices. The forum, was organised by the East Central and Southern Africa Health Community in Arusha, Tanzania.

Debate ensured amongst delegates following a presentation by Dr Isaiah Tanui of the Global Aids Programme of the Centres for Disease Control in Kenya in which he cited Uganda as one of the countries in the region with a high incidence of HIV in married couples.

Dr Tanui's argument was based on Uganda's recent national HIV/Aids survey that appeared to indicate that over the last decade marriage did not protect couples from catching the deadly disease. The survey indicated that married couples accounted for the largest proportion of new HIV infections in the country. "Sixty five per cent occurred among married people, 26 percent among divorced or widowed women, and nine percent among never married," said Dr Tanui.

But last December, the press quoted the Director General of the Uganda Aids Commission as saying that research conducted from 1996 through 2005, showed that 42 per cent of the 130,000 new HIV infections in the country occurred within marriage. It emerged from the discussions that ensured after Dr Tanui's presentation that the problem was not only for Uganda but an emerging one for the entire region in all the 10 active East, Central and South African -Health Community countries.

Some delegates called for compulsory HIV testing for all couples intending to marry.

Another group led by a Seychelles delegation called for an aggressive voluntary counseling and testing (VCT) for intending marriage partners. The called on religious organisations to join the campaign.

However, Dr Peter Toroitich of Kenya's National Aids Control Project cautioned the forum that compulsory testing would raise human rights questions. "What we need is to revisit our VCT policies and advise pre-tests every time there are new relationships," he added.

Source: http://allafrica.com/stories/200709100704.html

Kenya: Risk HIV or remain childless, the dilemma of discordance

2007-09-10T11:31:00.000+07:00

By, IRIN PlusNews, September 6, 2007

HIV-discordant couples in their child-bearing years face a life-changing decision: to remain childless or risk the HIV-negative partner contracting the virus for the sake of having a child.

"People get married to procreate, so when couples find out that they are discordant, the biggest challenge is what to do about having children," said Churchill Kamau*, of Discordant Couples of Kenya (DISCOK), a non-governmental organisation (NGO) that supports people in such relationships.

"We are finding, at least in our organisation, that the couples are willing to risk infection for the sake of a child." Kamau is HIV-negative, but discovered his wife was HIV-positive when she fell pregnant in 2005.

Their child is HIV-negative, thanks to a prevention of mother-to-child transmission (PMTCT) programme provided by the antenatal clinic, but he is not certain they would try to have another baby. "At the moment I would say no, but I can't rule it out in the long term," Kamau told IRIN/PlusNews.

Alternative reproduction options that could protect the HIV-negative partner exist: sperm washing when the man is HIV-positive, or artificial insemination when the woman is HIV-positive, but most Kenyan couples are too poor to afford these methods, and instead opt for unprotected intercourse.

According to the Carol Ngare, manager of Voluntary Counselling and Testing (VCT) for the National AIDS and Sexually Transmitted Infections Control Programme (NASCOP), about 13 percent of married couples who attended VCT services in Kenya were HIV discordant.

"Because of easily accessible PMTCT, most couples now know that even if one passes the virus on to the other, they are unlikely to pass it on to their child," Kamau said. "They are also aware of free ARVs [antiretroviral drugs], so they are more confident of being around to see the child grow up, even if they do contract the virus."

He stressed the need for couples to be aware of their options, and said the government should work with groups like DISCOK to reach discordant couples, who were often secretive because they were afraid of being stigmatised.

"For instance, I have never told my family that my wife is HIV-positive - they would pressure me to leave her," Kamau said. "For many couples, it is the same; they do not access information because they are afraid of disclosing their discordance to the wider community."

According to NASCOP, couples are encouraged to go for testing together, so they can know each other's status and decide how to proceed if they discover they are discordant.

"The counselling messages aim at giving them the disadvantages and benefits of getting pregnant, and ensuring that whatever choice they make is through informed consent," Carol Ngare, voluntary counselling and testing manager at NASCOP, told IRIN/PlusNews. "Whatever choice they make, they will be supported in counselling and treatment, where required, through PMTCT."

However, the proportion of people who visit these centres with their partners is below 10 percent, and DISCOK's Kamau said the government should run a campaign specifically encouraging couples to do so.

Source: http://www.plusnews.org/Report.aspx?ReportId=74154

South Africa: Microbicide trials - what's in it for participants?

2007-09-10T11:20:00.000+07:00

By, IRIN PlusNews, September 5, 2007

Why would a woman volunteer to use a product that may or may not protect her from HIV infection, undergo a lengthy screening process and then commit to regular clinic visits for up to two years?

South African women make up a significant number of the thousands in the African continent who have volunteered to participate in clinical trials for microbicides - a range of female-controlled products in the form of gels, creams, sponges and vaginal rings, which scientists are hopeful will prove effective at protecting women from HIV and other sexually transmitted infections (STIs).

A number of microbicide products have proven safe and effective in laboratory tests, but before being approved for use by the general public they must be tested on women in areas of the world where HIV prevalence is high enough to yield incontrovertible results.

The challenge for scientists is to design trials that have sufficiently attractive benefits to recruit and retain participants, without offering what ethics committees would deem incentives or inducements.

Benefits

South Africa's Medicines Control Council mandates that trial participants receive a R150 (US$21) "reimbursement" to cover transport costs each time they visit a trial site. The money is usually more than enough, and undoubtedly provides at least some motivation for unemployed women surviving on small incomes.

"I heard from a friend about the free check-ups and the money," admitted Bathabile*, 34, from Soshanguve, a township north of Pretoria. She had hoped to participate in a trial of a microbicide gel, Carraguard, run by the Population Council, an international nonprofit organisation, but was excluded when she tested HIV positive.

Zanele, 27, also from Soshanguve, qualified to participate in the Carraguard trial and stayed with it for two years until it ended in March 2007. She spent her leftover reimbursement money on clothing, but said it was not her main reason for taking part.

"I wanted to know my [HIV] status and get STI treatment and pap smears," she told IRIN/PlusNews. "And I wanted to help other women, because I know women who've been affected by HIV."

According to Dr Claire Von Mollendorf, of the Reproductive Health and HIV Research Unit (RHRU) at the University of Witwatersrand, in Johannesburg, who has been involved in several microbicide trials, many women volunteered for altruistic reasons: "They want to help because they've all had family members that have died from HIV."

Most of the participants IRIN/PlusNews interviewed at Setshaba Research Centre in Soshanguve, one of three sites in South Africa where the Carraguard trial was conducted, cited the health benefits as their main reason for taking part: regular HIV tests, treatment for STIs, annual Pap smears, free condoms, and counselling on how to reduce their HIV risk.

"I miss the health services we got here," said Zanele. "Last week I went for an HIV test at the [public] clinic, and the nurses were rude and the queue was long, unlike here, where I would just come in and be attended to just like that."

Rivonia, 22, qualified for the trial and used the gel for three months before testing positive and having to drop out of the trial. Despite the initial shock of discovering her status, she had no regrets about her involvement. "I wouldn't have tested if it hadn't been for the trial," she told IRIN/PlusNews. "Even now, I wouldn't have known that I'm HIV positive."

I wouldn't have tested if it hadn't been for the trial. Even now, I wouldn't have known that I'm HIV positive.
Rivonia and Bathabile were among about 30 women - all of whom tested positive during the initial screening or became positive over the course of the three-year trial - who then joined a support group started by the trial staff. The group met weekly and attended cookery classes by a nutritionist, received health advice and referrals from a doctor, and support from each other.

Staying the course

Scientists need at least 80 percent of microbicide trial participants to use the product for periods of up to two years to obtain reliable results. In the case of Carraguard, which comes in the form of a gel, many women said they enjoyed using it because the gel acted as a lubricant, increasing sexual pleasure for themselves and their partners. Similarly positive feedback has come from other microbicide trials.

Jonathan Stadler, a social scientist with the RHRU who has interviewed women about their experiences during microbicide trials, said many reported liking the fact they could be using a product that might protect them against HIV and STIs.

"In a world of HIV and AIDS, where all we've managed to give people so far is the condom, and suddenly you get something which is so much nicer to use, the fact that this might actually be effective is a very attractive idea for most people," he said.

There is evidence that women who do not tell their male partners about their trial participation are more likely to drop out. Dr Khatija Ahmed of the University of Limpopo, principal investigator of the trial, said only about half the 2,400 women in the Carraguard trial in Soshanguve told their partners, and a small percentage of those dropped out when the partners discovered they were using the gel.

"It helps if the partner is involved, especially in terms of adherence, and also for the treatment of STIs, because we did offer treatment to partners as well," said Ahmed. "But this is a woman-based clinical trial. We advise participants to tell their partners, but it's really their choice, because different people have different relationships."

Zanele was six months into the trial before she told her boyfriend. "I was nervous because he takes long to understand these issues," she said. "Finally, he heard from other people that there's this gel and women are getting paid to use it, and then I told him. In the beginning, he didn't want to use it but after he heard what its purpose was, he said, 'let's use it'."

Some of the women in the Carraguard trial also attracted unflattering neighbourhood gossip, much of it related to their reimbursements. "People would say, 'Why should we get paid? It means the gel will infect us'," said Rivonia.

Von Mollendorf commented that "study fatigue" tended to set in after the first few months of a microbicide trial. "It becomes tedious for the women, and that's why, in the middle of your study, you try to have retention parties or events to encourage them to stay in the trial. You give them more information and updates from other microbicide trials."

Outcomes

The Carraguard trial, the results of which are expected by the end of the year, is the first microbicide trial to complete the final human effectiveness phase of testing. "The entire microbicide world and all the communities where the research was conducted are waiting for those results," said Ahmed.

Participants and the wider community will be informed about the results of the trial, and Ahmed is hopeful that if the product proves effective they wwill also be given priority in having access to it.

"The Population Council is already negotiating with various pharmaceutical companies with regard to manufacturing the product at a cost that is affordable to the people who need it," she said.

For her part, Zanele is looking forward to other studies coming to Soshanguve. "I would like to be in another trial," she said.

Source: http://www.plusnews.org/Report.aspx?ReportId=74136

China's blood still unsafe, needs help

2007-09-07T16:38:00.000+07:00

By, Ben Blanchard, Reuters, September 6, 2007

BEIJING (Reuters) - China's blood supply is still not being properly monitored for HIV/AIDS a decade after a blood-selling scandal, and it needs international help to tackle the problem, a report said on Thursday.

The government has tried to clean up the sector after hundreds of thousands of farmers in central Henan province were infected in the 1990s through schemes in which people sold blood to unsanitary, often state-run health clinics.

Then-Health Minister Gao Qiang admitted in a speech earlier this summer that China's blood donation system was far from perfect and safety worries remained.

"The demand for blood and blood products is growing in China, and supply is short," said Sara Davis, co-author of the report and director of Asia Catalyst, a New York-based group that helps non-government organisations in Asia.

"This creates an economic incentive for hospitals to rely on illegal, untested blood donations, and that fuels the spread of AIDS," she added in a separate statement.

In June, the food and drug regulator said it had discovered fake plasma being used in at least 18 hospitals in northeastern China.

"China is not alone," Davis said. "Most developed countries have dealt with similar AIDS blood scandals, and they should step forward to offer assistance to China."

An estimated 650,000 people are living with HIV/AIDS in China, and health experts say the disease is moving into the general population with most new infections now spread sexually, although drug-users follow closely behind.

While other countries such as Japan and France, which have also had problems with infections through blood transfusions, have taken effective measures to ensure no repeat of past scandals, that is not the case in China.

"Today, China's blood supply remains dangerously unsafe. Around the country, patients who check into hospitals for routine surgery may check out with HIV/AIDS as a result of hospital blood transfusions," the report said.

"In China, where the AIDS blood transmission outbreak in some provinces dwarfs those of Japan and France ..., health officials who acted negligently or criminally while directly profitting from the causes of the blood scandal have rarely been held personally accountable," it added.

The government should set up a compensation fund for those infected by transfusions and order courts to accept all lawsuits from these victims, the report recommended.

"Haemophiliacs and other patients infected with HIV through blood and blood products provided by hospitals have suffered physical and emotional pain and suffering caused directly by those hospitals and clinics," it said.

"They are entitled to reparations for these violations of their rights."

Source: http://in.reuters.com/article/worldNews/idINIndia-29366220070906?pageNumber=2

Increasing Number of AIDS Cases Despite Decrease in India's National Estimate

2007-09-06T13:18:00.000+07:00

By, Kaiser Network, September 5, 2007

Although India recently reduced its HIV/AIDS caseload estimate, the number of AIDS cases in New Delhi has been increasing since 2000, according to a recent Ministry of Health and Family Welfare report, the IANS/Economic Times reports (IANS/Economic Times, 9/2). Indian Health Minister Anbumani Ramadoss in July announced that the number of people estimated to be living with HIV/AIDS in the country is about 2.47 million, or half of previous estimates, according to United Nations-backed government estimates. The new estimate decreases India's HIV prevalence from 0.9% to 0.36%, Ramadoss said. The new estimate was calculated with the assistance of international agencies, such as the United Nations and USAID. The earlier estimate was based on blood samples taken from pregnant women and high-risk groups, such as injection drug users and commercial sex workers. The new estimate was based on a population-based survey that took blood samples from 102,000 people to determine HIV prevalence among the general population (Kaiser Daily HIV/AIDS Report, 7/6).

According to the report, the number of recorded AIDS cases in New Delhi has increased from 498 in 2000 to 5,082 in 2007. In addition, the city recorded 743 new AIDS cases and 97 AIDS-related deaths between January and June, the report said. According to a health ministry official, there are two potential reasons for the increasing number of AIDS cases in New Delhi: the city's mobile population and its antiretroviral treatment program. In addition, the large number of vulnerable groups in the city is contributing to the situation, according to Mahesh Ganesan, a doctor who works with the AIDS Healthcare Foundation. "It's a myth that a large population in Delhi is aware of AIDS," Ganesan said, adding, "Industrial workers and youth remain the main vulnerable sections. Higher prevalence of premarital sex, sometimes in adolescence, also contributes to the numbers."

The national ministry of health recently launched the third phase of India's National AIDS Control Program, which aims to stop and reverse the spread of HIV during the next five years. In reaction to the NACP launch, New Delhi's AIDS Control Society has designed a program to increase HIV/AIDS awareness, according to a state health ministry official. The official added that railway stations, public transportation terminals and shopping areas will be the focus of the program, which involves radio and print advertisements, posters, banners and panel meetings (IANS/Economic Times, 9/2).

Source: http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=47285

Papua New Guinea AIDS Crisis May Mirror Africa's, UN Says

2007-08-31T10:58:00.000+07:00

By, Emma O'Brien, bloomberg.com, August 31, 2007

Papua New Guinea's AIDS epidemic may mirror the crisis in Africa as infections surge with more than 75 percent of sufferers unable to access drugs to manage the disease, the United Nations said.

``It could very much become an Africa-type situation if the required services are not in place,'' Tim Rwabuhemba, Papua New Guinea coordinator for the United Nations AIDS agency, said in an interview from the capital, Port Moresby. ``There is an urgent need for more HIV services across the board here.''

The nation of 6 million people now accounts for 90 percent of the Pacific region's HIV cases and is one of only four Asia- Pacific countries experiencing an epidemic, according to the UN. Sub-Saharan Africa is home to 60 percent of all people living with the HIV virus, a total of more than 25 million people.

HIV, the virus that causes AIDS, appeared in Papua New Guinea in the early 1990s and has spread to the remote highlands, a region where villagers didn't come into contact with Europeans until the 1930s.

More than half a million Papua New Guineans will be infected with the virus by 2025, resulting in a 13 percent drop in the available workforce and a 1.3 percent decline in the $15 billion economy, AusAID, Australia's development agency, said.

In 20 years, 117,000 children will have lost their mothers to AIDS and 70 percent of the country's hospital beds will be needed for patients, it estimates.

Poverty Line

Although rich in natural resources such as copper, timber and gas, about 37 percent of Papua New Guinea's population lives below the poverty line and 80 percent of people in urban areas are unemployed.

The inaccessibility of regions in Papua New Guinea and a shortage of diagnosis and anti-retroviral medication helped the virus infect almost 2 percent of the population, with new infections increasing mostly in the countryside, Rwabuhemba said.

``Stigma and discrimination is an issue as education programs, particularly in the highlands, haven't made the impact we would desire,'' Rwabuhemba said. ``People have not come to terms with this situation and there is an irrational fear.''

Allegations emerged this week that AIDS sufferers in the Southern Highlands province were buried alive by their families because they became too sick to be cared for.

``That was a very big slap for us when we saw it on the front page of the newspaper, a great shock,'' Rwabuhemba said. ``We cannot substantiate it.''

Health worker Margaret Marabe said she saw five people buried in the Tari district of the province, where she conducts AIDS awareness campaigns, local newspaper the Post Courier said Aug. 27. They cried out for help as they were covered with soil, Marabe is reported to have said.

Tribal Tensions

Police are investigating the claim and the National AIDS Council has been instructed to conduct an awareness campaign in the region, Health Minister Michael Ogio said in a faxed statement.

Tensions between tribes and a lack of infrastructure in the Southern Highlands has hampered services to the region, according to the government.

``Without knowledge of what HIV is and the impact of it, people in the area certainly would show strong fear,'' Ogio said. ``The stigma and discrimination which may result in families neglecting people living with HIV/AIDS in the area still has to be addressed more aggressively.''

Cases Increase

HIV cases in Papua New Guinea have been growing at a rate of 30 percent a year since 1997, according to the UN. Heterosexual sex is the most common means of infection, Rwabuhemba said.

Infection often develops around mining and logging sites and along transport routes such as the Highlands Highway, which runs through the middle of the country, said Paul Barker, director of the Institute of National Affairs in Port Moresby.

``People have multiple wives, particularly in the highlands. I knew of one man in a very remote location with 60, so that contributes,'' he said. ``There's a strong social stigma and while people's attitudes have started to change, it's been slow, especially in rural areas.''

When AIDS was first discovered highlanders blamed the boils, night sweats and weight loss on sorcery and retribution was common, Barker said. While awareness has grown in the past decade, sufferers are still routinely dumped at hospitals and medical centers and not visited by their family.

``Sometimes all their relatives may have died as well so the hospitals often shoulder the burden of burials and care,'' he said.

Papua New Guinea shares the island of New Guinea with Indonesia and was an Australian colony until 1975.

To contact the reporter on this story: Emma O'Brien in Wellington on eobrien6@bloomberg.net

Source: http://www.bloomberg.com/apps/news?pid=20601081&sid=ag58R85zpjE0&refer=australia

MALAWI: Fish farming eases living with HIV/AIDS

2007-08-28T14:41:00.000+07:00

By, IRIN PlusNews, August 27, 2007

Widowed Esnat Singano, 54, did not know her husband was HIV positive until almost two years after his death in 2000, when she also tested positive for the virus.

After one of her four children also died as a result of the disease, she was left to care for two of her grandchildren and struggled to find the money to send them to primary school. "They needed clothes and food and many other things to be in class; these are the things I could not afford," she told IRIN/PlusNews.

Life has become a little easier for Singano since World Vision, an international relief organisation operating in Malawi, introduced a food security programme in her village in the southeastern district of Zomba two years ago.

"I have been able to grow maize twice a year," she said. "But, more importantly, the introduction of a fish-farming project has changed my life."

The programme funded by the World Bank, which aims to increase the income and nutritional status of households affected by HIV/AIDS, helped Singano to build two fish ponds last year.

"I jumped on the idea when it was told to us by World Vision," she said. "Clubs were formed and many people joined. It is now a year since I started farming fish and so far I have harvested three times; from it I have made 1,200 Malawian kwacha (US$850)."

Besides the income Singano earns from selling her fish, they are also an important source of food for her and her grandchildren.

Timamu Muhajiri, 77, is another beneficiary of the project. After 30 years working a mine in Zimbabwe, in 1991 he returned home with his wife, 10 children and five grandchildren. He said the pension he received from his former employer was a fraction of what he earned from his two fish ponds, which yielded a "harvest" worth about US$550 every three months.

"I think I have been wasting a lot of time and money looking for employment outside the country," Muhajiri said. "What I needed was only the technology to improve my farming."

Over 1,000 households headed by orphans and widows have benefited from the World Vision project, which receives technical support from the WorldFish Centre, a non-profit, international research organisation.

Families with small plots of land were helped to dig small, rain-fed ponds, where they raise tilapia, a common local fish species. There are five species of tilapiine cichlids recorded from Lake Malawi, and other species of the fish occur worldwide.

Although the project implementers pulled out in July 2006, families in the Zomba area, where over 60 percent of the population live in poverty, are now earning an income from their fishponds.

The WorldFish Centre developed the project with mainly the children and elderly in mind, because the ponds require little heavy labour and the fish can be fed with farm and kitchen waste.

"The basic principle of integrated agriculture-aquaculture is to grow fish in water bodies that are closely integrated into a household farm, and intentionally make use of the resource flows of all the diverse activities on a farm, such as livestock, vegetables and crops," said Daniel Jamu, the WorldFish Centre's regional director.

He said fish could provide essential nutrients to the 14 percent of Malawi's population estimated to be living with HIV. The ponds yield about 1,500kg of fish per hectare per year, which often leaves some excess that can be sold to pay for medical care and household needs.

Malawi's expanding population has led to a growing demand for fish, but over-fishing of Lake Malawi and the Shire River has caused a decline in fish stocks and reduced annual per capita fish consumption from 14kg in the 1970s to 4.2kg in 2005.

According to Jamu, the success of the fish-farming project in Zomba has enabled his centre and its partners to expand the initiative to include 26,000 farming households in Malawi and neighbouring Mozambique and Zambia.

rw/ks/he
[ENDS]

It Takes a Village to Save a Child: An innovative constructed village offers hope for Thai HIV and AIDS orphans

2007-08-27T11:12:00.000+07:00

By, Tania Campbell, Ohmy News, August 7, 2007

What do celebrated classical musician Bruce Gaston, the princess of Thailand, BMW and a German documentary film crew all have in common? They all support Baan Gerda, an innovative orphanage in Thailand for children who are HIV positive. However, don't dare let Karl Morsbach, the founder of this novel enterprise, hear the word "orphanage." His vision instead dictates that it is a constructed community or organization more like a village, where the children live in a loving family environment. Named after Morsbach's deceased mother, the village lies two hours north of Bangkok in the verdant, snake-riddled Lopburi province. Among leafy trees, child-sized plastic dinosaurs and ponds with floating purple lotus flowers are 13 stilt houses where these foster families -- two adults and up to nine children -- live. Painted bright colors and full of ebullient, laughing children, it is a far cry from the notorious state-run orphanages for children with HIV and AIDS.

Altogether, there are 71 children. The adults who take on the parenting role are either HIV positive or AIDS widows. Selecting such caregivers was a conscious decision -- providing much needed employment for extremely stigmatized adults who are more likely to have a better understanding of the needs of HIV children. Together, the children and adults create their own family unit, which is glued together not by blood but by love. "We raise the children in a loving environment, in the hope that they will take the love they receive through life," states the Baan Gerda handbook, a bible for anyone wishing to create the same model.

While creating such a village is no mean feat, Morsbach and his Thai wife Tassanee were able to raise the capital to establish their vision, and then attracted generous donations from corporations, well-heeled acquaintances and a godparent-style sponsorship program that ensures the successful continuation of Baan Gerda. Initially, their vision was to build somewhere to care for the children in their final stages and let them die in peace and comfort -- an alternative to the abhorrent and notorious 'Death Hospices' that are the fate of too many Thai orphans suffering from the virus. "When we built it seven years ago, we thought they would die," Morsbach muses. Now, thanks to the cheap availability of antiretroviral (ARV) drugs, a healthy lifestyle and a loving family-oriented environment, they haven't lost a child in three years.

Morsbach's story is somewhat unusual in terms of how he became "Pa" to 71 children. He went from high-flying corporate executive at a German company stationed in Bangkok to children's rights activist after realizing that "I wasn't put on this earth to make other people rich." Along with his wife, he set up five schools on the Thai-Burmese border to give rural children access to an education. Then, after seeing a particularly poignant photo and article in a Bangkok newspaper of a child about to die from HIV, they switched their focus to combating Thailand's HIV epidemic. After two years saving euros in Germany to fund their vision, the couple returned to Thailand and created what has now evolved into a thriving and unique organization that has become a model for the likes of UNESCO.

On closer inspection, Morsbach's background as a corporate executive and his current position as the founder of Baan Gerda may not be as different as chalk and cheese after all. He set up a points system to reward the efforts of the parents, based on the kind of system he used with his employees: they get points based on love, cleanliness, how much TV the children watch, etc. Those who score a certain number of points are rewarded with a year-end cash bonus. "Happy children need happy parents," he says. The parents must also be vigilant in monitoring the children's health and ensuring their medication is administered at 7 a.m. and 7 p.m. daily, no excuses and no exceptions.

In addition to the medicine, a volunteer doctor visits the children regularly for checkups as part of their health routine. She has established a close bond with the children and does it for love, not money. An Australian dentist has donated equipment so that they can set up a dental clinic in their on-site medical center. Morsbach became interested in the mysteries of the ancient Japanese healing art of Reiki and now all of the children receive free Reiki from practitioners in Germany -- healing from thousands of kilometers away. Sounds a bit odd for a straight-laced German but Morsbach asserts that he's "far from believing it doesn't work." In fact, he cites several examples of children whose health improved markedly overnight after a Reiki session. He even practices it himself on the children.

With his big vision and entrepreneurial streak, Morsbach has steamrolled ahead and started something of a cottage industry in the village. He used his contacts in Vienna's fashion world to have the women of Baan Gerda trained by professional tailors to make environmentally and socially conscious fair trade clothes and accessories to be exported to Austria. This gives them an opportunity to learn new skills while making money. The men are taught carpentry and with their skills make things for the village. With most of the children away at school during the day, many of them welcome this training as a way of breaking up their routine, and the vocational training will be an invaluable asset if they ever decide to leave Baan Gerda.

The children are surprisingly well adjusted considering the trauma most of them have endured such as watching their parents die and being ousted from their communities. The children first came to them from a temple hospice, but now many come through word of mouth. They found one girl digging through trash at a market. She, like many of the children, had literally been left for dead. On occasion, the adults turn up with only a suitcase in hand after being ostracized from their communities.

Morsbach believes the children at Baan Gerda shouldn't be defined by the fact that they have HIV. A jolly, optimistic man, his glass is half-full: "It's important to see the positive side -- the children are happy." Now that they are all, for the most part, in glowing good health, Morsbach has focused on their intellectual, social and emotional development. For the past few months, the children have been receiving weekend music lessons from the famous American musician, Bruce Gaston, who resides in Thailand. He fell in love with the kids, as everybody does, after visiting the house and now makes the two-hour trip from Bangkok every Saturday to teach them for several hours before rushing back to Bangkok to perform in his band's regular Saturday night concert. He has made them his project, a kind of Thai Partridge Family, and recently they performed an invitation-only concert in Bangkok. The fact that the children have HIV was a minor detail on the invitation. Now there is talk of making an opera with the children, reflecting their own, and humanity's struggle for survival.

Ever the pragmatic German, Morsbach, when not begging for money from corporations, spends a lot of time thinking about the future and how the children will integrate into the "real world." With donations from various companies, they have built a library, computer room and a music room. "Some people criticize us for using the money to buy things like a piano when we could help save another child with medicine." Still, he emphasizes, the children must not only be physically healthy but also mentally well-adjusted, as one day, they will complete high school and move onto university or vocational training and inevitably have to leave the village.

Every year, the children are treated to a special outing. On one occasion, they went to a large amusement park in Bangkok. However, upon learning about the children's HIV status, officials banned them from entering the park. One volunteer with the group posted this refusal on a Web site and soon enough a hoard of university students arrived and took all the children, one-by-one, into the park undetected. This event was recaptured in a recent documentary about the village entitled "Heaven's Meadow: The Small Wonders of Baan Gerda" by a German documentary filmmaker. In addition to these outings, they celebrate Christmas, go to the beach once a year and have sports' days. Often, inspired visitors drop by, such as artists, dance therapists and English teachers.

Morsbach encourages visitors to come, especially university students. He believes that it will reduce the stigma surrounding HIV in Thailand, because, as he puts it "many people are scared to breathe the same air as a child with HIV." The downside to this is that the place becomes something of a zoo, especially on weekends, with visitors roaming around taking pictures of the children. Still, it's a small price to pay considering that if it wasn't for the village in the first place, the children and many of the adults would most likely be dead. Although things are slowly changing, he acknowledges that "our biggest enemy is stigma." He cites the example of one girl who, before she came to the village, was forced to take her lessons from outside the classroom, peering in through the door to see the board. And that was only after the school was forced to reinstate her having earlier expelled her.

Slowly, around 3:15 p.m., the place comes to life as 60-odd children wander home from their nearby schools built by the king of Thailand. Most of them stop by the playground to coddle the smallest child -- a one-year-old boy who will not be able to walk due to leg deformation. The love is evident as they shower kisses upon him and push him around on his little plastic tricycle. Another young child has a compromised lung and the parents are not sure how much longer he'll live. Still, he trots about with a spring in his step and a huge, gaping grin. He knows that he may not be around forever, so he makes the most of each day and is a lesson for how to appreciate every waking moment, just as Baan Gerda is a lesson and model in how to effectively and lovingly treat orphans with HIV and AIDS.

Source: http://english.ohmynews.com/articleview/article_view.asp?no=375905&rel_no=1

HIV+ and orphaned: Children no one wants

2007-08-27T10:40:00.000+07:00

By, S. Shanthi, The Times of India, August 27, 2007

New Delhi: It's a ray of hope in an area of gloom. Recently, a 15-day-old baby, Chhoti, was found abandoned. Though rumoured to be HIV positive, many couples on hearing about her through the media, volunteered to adopt her.

However, not many are as lucky as her. Most people don't come forward to adopt HIV positive children. Recently, an HIV positive woman in Chhattisgarh, driven by poverty, offered her newborn daughter for sale. But no one wanted the baby as she too was infected. Later, the local administration, which got to know about the issue, stopped her from selling the baby and made arrangements for her treatment.

Says Sonia Kohli, who runs Sahyog, an NGO, and in whose custody Chhoti was, "Since the news was out in the media, people initially came forward to adopt Chhoti. When the hype died, people backed off. Even some doctors advised me against keeping the child. I have now given the child to a family, but I am sure that if Chhoti was HIV positive, nobody would have legally adopted her."

Arun Dave, president, AIDS prevention club, Rajkot, corroborates, "Ever since we started working for the cause of AIDS, 18 years back, not even one family has volunteered to adopt an HIV positive child."

In many cases, even when the child turns out to be negative later, people are scared to adopt. HIV positive children turn negative only until they are one-and-a-half years old. After that, it's believed their status doesn't change. But medical miracles do happen. Anyhow, adoption agencies have a definite role to play here — in convincing the families and educating them about the issue. "If we have a child who is HIV positive-turned-negative, we tell the family about the child. After counselling and making them understand the medical aspects, if they are still willing, they accept the child. However, this happens only once in a blue moon," says Madhavi Hegde Karandikar, adoption practitioner, Bal Asha, Mumbai.

Such children are mostly adopted, either by rich parents and those settled abroad or foreigners. "Adopting an HIV positive child requires a lot of willpower. Moreover, social acceptance of such children is less in our country. Outside India, people are more educated about HIV," says Nilima Mehta, chairperson, Child Welfare Committee, Mumbai.

"There is a social stigma attached to it. Even today, there is not much awareness about HIV. Not many even know the difference between HIV positive and AIDS. They are ignorant about how HIV is passed and so don't want their families and friends to know that the child was born with the virus," says Dave.

Outside India, there are many organisations which have been successful in placing HIV positive children in permanent and foster homes. One such project is Children With AIDS Project of America, which seeks out adoptive parents for HIV infants and children. Its database has over 1,000 waiting families.

Experts say there are no legal restrictions for adoption of HIV positive children. "We can give such children in adoption, provided there are families willing to take them and all documents are in place," says Wendy Andrews, adoption officer, Hope Foundation, New Delhi. Despite various measures taken by the government, people suffering from the disease still face stigma and isolation. A UNAIDS report claimed in 2006 that India had the largest number of people living with HIV/AIDS, an estimated 5.7 million.

"Adopting a child involves knowledge within oneself that all children are equal, be they healthy or with special needs and therefore equally deserve security within a family. One should be better informed about the subject and make a choice knowing and understanding all these aspects," says Aloma Lobo, chairperson, IYC Community Centre, Bangalore.

shanthi.selvarajan@timesgroup.com

Source: http://timesofindia.indiatimes.com/India/HIV_and_orphaned_Children_no_one_wants/articleshow/2313020.cms

Human trafficking helps spread HIV/AIDS in Asia-UN

2007-08-24T10:57:00.000+07:00

By, Ranga Sirilal, Reuters, August 22, 2007

Colombo - About 300,000 women and children are trafficked across Asia each year, acclerating the spread of HIV/AIDS, the United Nations said on Wednesday.

"Trafficking ... contributes to the spread of HIV by significantly increasing the vulnerability of trafficked persons to infection," said Caitlin Wiesen-Antin, HIV/AIDS regional coordinator, Asia and Pacific, for the United Nations Development Programme (UNDP).

"Both human trafficking and HIV greatly threaten human development and security."

Major human trafficking routes run between Nepal and India and between Thailand and neighbours like Laos, Cambodia and Myanmar. Many of the victims are young teenage girls who end up in prostitution.

"The link between human trafficking and HIV/AIDS has only been identified fairly recently," Wiesen-Antin told the International Congress on AIDS in Asia and the Pacific.

"Neither HIV/AIDS nor human trafficking have been integrated or mainstreamed adequately, either at policy or programmatic level."

UNAIDS estimates 5.4 million people were living with HIV in the Asia Pacific region in 2006, with anywhere between 140,000 and 610,000 people dying from AIDS-related illnesses.

That makes it the world's second largest number of people living with HIV after sub-Saharan Africa, where 25.8 million people are infected with the virus.

Conference host Sri Lanka has one of the lowest rates of HIV in Asia, with an estimated 5,000 infected people out of a population of around 20 million.

Neighbouring India, by comparison, has the world's third highest HIV caseload after South Africa and Nigeria, with around 2.5 million people living with the virus.

Source: http://www.alertnet.org/thenews/newsdesk/COL138701.htm

Children worst affected by HIV and AIDS, says World Vision

2007-08-22T11:11:00.000+07:00

By, Reuters Alertnet, August 21, 2007

In Mumbai, India, a woman widowed by AIDS lives with her ten-year-old son on the doorstep of the house she should have inherited, barred entry by her in-laws.

In a village in Nepal, a former migrant worker mourns his wife as he cares for his four children, two of whom are HIV positive.

In Cambodia, an orphaned nine-year-old boy and his little brother travel alone across the country in search of relatives who will offer them a home.

Across Asia and the Pacific there are countless stories like this with one common theme; they involve children.

Orphaned, stigmatized, driven to work and exploitation, sometimes contracting the virus from their mothers at birth, children feel the effects of HIV and AIDS more than any other sector of society.

The theme of next week's 8th International Congress on AIDS in Asia and the Pacific (ICAAP) in Colombo is 'Waves of Change, Waves of Hope.' Alongside UN agencies, NGOs and government representatives discussing a diverse range of HIV-related issues, international NGO World Vision will be highlighting the plight of children.

"Without adults to care for them, children orphaned by HIV and AIDS are vulnerable to many forms of hardship and discrimination, from missing out on school or being underpaid in child labour, through to sexual abuse or trafficking," said World Vision regional advocacy director Laurence Gray.

"Governments, local authorities and community members need to open their eyes to the vulnerabilities of the children in their care and take urgent steps to protect them from the effects of HIV and AIDS."

World Vision will produce and circulate a summary of each day's proceedings at the ICAAP meeting, commencing Monday 20 August, with a special emphasis on the issues and solutions that concern children.

This summary will be available online at http://www.wvasiapacific.org/content/view/232/1/ and will be emailed daily to partners and media expressing interest.

Source: http://www.alertnet.org/thenews/fromthefield/217167/118752348749.htm

Married monogamous women silent sufferers of AIDS

2007-08-22T10:58:00.000+07:00

By, Daily News, August 21, 2007

Colombo: Married monogamous women are the most silent sufferers of HIV/AIDS. They are estimated to constitute nearly 25-49 per cent of the total number of people infected, yet they are faceless, Prasad Rao, Director, Regional Support Team, Joint United Nations Programme on HIV/AIDS, UNAIDS said.

He said that according to one UNDP studying South Asia, 40 per cent of women leave their in-laws' house after their husband's death due to AIDS, and 80 per cent of these women mostly infected by their husbands are denied of property rights.

Answering some questions posed by journalists during a press briefing held at the BMICH, Colombo yesterday in connection with Eighth International Congress on AIDS in Asia and the Pacific (ICAAP) going on till August 23, Mr. Rao said that political commitment can be measured by the national policy on HIV/AIDS, openly talking about the subject and making available adequate resources.

Ms. Annmaree O'Keeffe, AusAID said that when it comes to the Asian region more attention should be paid on the social stigma and related issues of the epidemic. Doctors are not the best communicators and therefore professional health communicators are needed to educate the people on the issue, she added.

Prof. Samuel of the IAS said that social science and medical science should be combined and come together to combat HIV/AIDS. Ms. Anandi Yuvaraj of PATH also spoke. Dr. Nafis Sadik chaired the press briefing.

Source: http://www.dailynews.lk/2007/08/21/news16.asp

India: Nearly 70,000 children living with HIV virus

2007-08-21T13:59:00.000+07:00

By, Hindustan Times, August 21, 2007

An estimated 70,000 children are HIV positive in the country, while nearly 21,000 others get the infection every year, the Rajya Sabha was informed on Friday.

Union Minister of State for Health and Family Welfare Panabaka Lakshmi said paediatric antiretroviral ARV drugs are available at 127 centres across the country.

She said as per the revised estimates, there are 70,000 HIV infected children in the country and nearly 21,000 new infections occur in children every year.

"Following the launch of paediatric ART initiative in November 2006, more than 18,000 infected children have been identified and currently nearly 6,500 eligible children are receiving ARV paediatric drugs," she said.

Denying that there was any shortage of ARV drugs, she said about 17,000 children are availing them.

The minister said the estimates for the year 2006 recently released by the National AIDS Control Organisation (NACO), supported by UNAIDS and WHO, indicated that there are around 2 million to 3.1 million people living with HIV in the country.

Noting that the epidemic has stabilised at 0.36 per cent prevalence level during the last four years, she said in 2006 and 2005, the HIV figure in the country stood at 2.47 million.

By using the new method of estimation, she said the number of HIV infected persons in 2004 was found to be at 2.44 million.

Andhra Pradesh, which has a prevalence rate of 1.6 per cent, has around 4,79,866 people infected with the virus, while in Manipur, having a prevalence rate of 1.68 per cent, the figure stands at 22,010.

In Nagaland with a prevalence rate is 1.27 per cent, around 15,277 people have been infected with the virus.

Source: http://www.hindustantimes.com/storypage/storypage.aspx?id=0756ba75-9829-4ca0-a819-0e7c8bded1c2&&Headline=Nearly+70%2c000+children+living+with+HIV+virus

Kenya: Young Women Weep in Anguish As HIV Infection Rates Increase

2007-08-20T09:32:00.000+07:00

By, Arthur Okwemba, The Nation (Nairobi), August 18, 2007

As anti-Aids campaigners smiled and gave each other a pat on the back for the drop of HIV prevalence rates from 5.9 per cent to 5.1 per cent, young women wept in anguish.

Information released by National Aids Control Council this week shows that being a girl aged between 15 and 24 years is no fun at all, as one is at a high risk of HIV infection compared to female adults.

For every one young man in the age bracket who is infected with HIV, there are four young women. HIV and Aids prevalence among males was 3.5 per cent and 6.7 per cent among females.

"There is great concern with a ratio that is too high as this one. We want to bring it to every one man infected there are two women infected or an infection ratio of one man to one woman," says council chairperson Miriam Were.

"But we have to address some of the most difficult issues if this is to happen."

Aids experts and anthropologists say a significant proportion of the women cannot negotiate for safer sex through use of protection. A case in point is the female condom.

Although introduced in the country a few years ago, it is yet to reach those who need it most. With the cheapest of the few outlets selling it asking for Sh80 a piece, most women find the price prohibitive.

Its manufacturers argue that the material used is very expensive, hence the pricing.

On the other hand, the male condoms retail at Sh10 or are given out at no cost.

But men either refuse to use them or if they do, it is not always correctly.

It is against this backdrop that the Government has started distributing the female condoms free of charge.

For the past three years, the National Aids and STDs Control Council (Nascop) has distributed over a million female condoms.

Family panning

Beneficiaries have been commercial sex workers and couples, who obtain them in bars, restaurants, family panning clinics, or women and youth groups.

Despite the effort, few young people have benefited.

The institutions used were cited as "hostile" or "not favourable" for youngsters.

Arguments are now being advanced for introduction of sexual and reproductive health service centres that are friendly to young people through which the condoms can be distributed.

International Planned Parenthood Federation-Africa Region which offers reproductive health services to youths in 44 African countries, says opening up of the youth-friendly centres will enable young people access the condoms. Dr Josephine Kibaru, head of Division of Reproductive Health revealed that the Government will set up youth friendly services centres in every district hospital.

But accessibility and cost are the only challenges on the use of the female condom as some women are still likely to shun it.

The majority of the women who have used the gadget say it was difficult to insert, cumbersome, and troublesome to remove.

And their male partners asked them to remove it.

"I tried it with my boyfriend, but I had to remove it before finishing the act due to the noise it was making," says 22-year-old Lydia Nyambura, a city resident.

With all these problems, the focus seems to have remained largely on male condoms.

Male condom

While statistics show use of male condom to have increased from two million per month in 2000, to more than 10 million monthly today, this increase seems not to benefit women, particularly young girls. Yet, the assumption has been increase in condom use would see a significant drop in the number of women infected with HIV. This is not, however, the case.

It is reckoned that the men either use the condoms incorrectly, inconsistently, or not at all during sexual intercourse.

The 2003 Kenya Demographic and Health Survey findings show that of those aged between 15 and 24 years, only 12 per cent of the young women and 14 per cent males used condoms during their first sexual intercourse.

Another study by University of Nairobi social scientists in 2002 indicated that condom use decreased as relationships matured.

Prof Omu Anzala of Kenya Aids Vaccine Initiative says a woman's biological make-up makes them more susceptible to HIV infection than men.

"A man is at risk of HIV infection during the sex act, but the woman is exposed during and long after the act," he says. When the semen carrying the virus gets into the woman's vaginal track, it can stay there for more than two days, giving the virus enough time to infect her.

Poverty has also fuelled the spread of the virus.

A World Bank study whose findings were released this week, says poor women exchange sexual favours for food.

Women from Bungoma and Kiambu interviewed during the study said they resorted to extra-marital sex to meet household needs.

1st Asia Pacific Court of Women on HIV to be held in Colombo

2007-08-20T09:23:00.000+07:00

By, People's Daily Online, August 17, 2007

Twenty HIV positive women will tell their stories of being denied of inheritance and property rights in Sri Lankan capital Colombo as part of the 8th International Congress on Aids in Asia and the Pacific (ICAAP), a senior UN official said Thursday.

Caitlin Wiesen, Regional HIV/AIDS Team Leader of the UNDP Regional Center in Colombo, told reporters that the "Asia Pacific Court of Women on HIV, Inheritance and Property Rights" will be the first regional summit on this compelling issue.

Wiesen said, "When women are denied their rights to inheritance and property, they are robbed of the social and economic empowerment needed to help prevent HIV infection and cope with its impact on families and communities."

She said the feminization of epidemic in the region are daunting, with about 30 percent of the new infections in the region being among women.

"With little or no control over their sexual lives and burdened by abuse, exploitation and violence, women in the region are extremely vulnerable to HIV," Wiesen said.

About 30 testifiers and expert witnesses from Sri Lanka, Nepal, Bangladesh, Pakistan, India, Cambodia, Vietnam, Papua New Guinea, Thailand, Malaysia and other countries will present testimonies to the Eminent Jury in the Court.

Wiesen said the Court, aiming at bringing to public focus the challenges faced by women in the context of HIV and AIDS, is scheduled to be held on Saturday.

Organizers said over 2,000 delegates from 40 countries will attend the 8th ICAAP from Aug. 19 to Aug. 24.

Source: Xinhua

CHAD: AIDS funding flows again

2007-08-17T09:58:00.000+07:00

By, IRIN PlusNews, August 16, 2007

Almost a year after suspending a grant of over US$20 million for Chad's AIDS and tuberculosis response, the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria announced this week that it had lifted the sanctions, which had severely disrupted efforts to curb the spread of the HIV epidemic, health officials said.

In November 2006, The Global Fund froze funding for the impoverished West African country worth more than US$ 20 million over five years, following concerns over the misuse of funds and the ability of the recipients to manage the money.

According to UNAIDS country coordinator Claire Mulanga, the money had not been effectively absorbed by organisations, resulting in too few activities being implemented to address the country's pandemic.

"Because we didn't have in-country presence, it is very important that the principal recipients have adequate capacity. This was not the case with Chad," Nicholas Demey, Global Fund communication officer, told IRIN/PlusNews. In addition, "there was some minor misuse of funds", which prompted the Global Fund to take action.

Since then, UN agencies, the government and other development partners have been working to put measures in place "to make sure this doesn't happen in future," he added.

Stricter conditions have been laid down: technical partners will become more involved in the process; the Global Fund Secretariat will be monitoring the principal recipient more closely; and there will also be regular audits and tighter control of expenditure.

"The money that was stolen is now being reimbursed, and the people responsible have been suspended from their functions. Now we need to have the human capacity in place, in order to fulfil the projects," Mulanga added.

Dr Barou Djouater, coordinator of the National AIDS Programme, welcomed the move: "We worked hard to make sure we met all the conditions of the Global Fund; a lot of people have suffered; now the hard work begins."

Chad, which has a HIV-prevalence rate of 4.8 percent, relied heavily on the Fund's resources. "This is a very poor country, and very few donors are willing to invest here, so it was a big, big loss for the country when the grant was stopped. There was no other way to get money for AIDS," Mulanga told IRIN/PlusNews.

Although the Global Fund continued to support the provision of life-prolonging antiretroviral treatment during the suspension, other initiatives, such as the prevention of mother-to-child transmission of HIV, mass awareness campaigns and orphan support projects, ground to a virtual halt.

The war in neighbouring Sudan's western Darfur region has brought growing instability to eastern Chad. Attacks on civilians in the Central African Republic (CAR), to the south, have sent waves of refugees into Chad, threatening security in the region.

Mulanga noted that the conflict and instability in the country had also weakened the government's ability to respond effectively to the epidemic. "AIDS is not at the top of the agenda ... the government is more focused on managing the conflict."

kn/he
[ENDS]

KENYA: Lower infection rates creates new challenges

2007-08-16T09:26:00.000+07:00

By, IRIN PlusNews, August 15, 2007

New statistics showing a decline in Kenya's HIV prevalence demonstrate that the government's fight against the pandemic is having an impact, but they also present fresh challenges, health officials said this week.

Prof Alloys Orago, director of the National AIDS Control Council (NACC), noted that the rollout of the antiretroviral (ARV) treatment programme, with over 105,000 participants, had significantly "averted deaths", making it more difficult to measure the impact of the pandemic.

"Kenya will have to shift from prevalence measurement to incidence [new infections] monitoring mechanisms to determine the impact of HIV/AIDS if the dramatic decline in prevalence witnessed over the past three years is sustained," he told IRIN/PlusNews after opening a two-day HIV/AIDS Programme Review conference in Nairobi on 14 August.

On 13 August, NACC reported that national prevalence had dropped from 5.9 percent in 2006 to 5.1 percent in 2007, with the possibility of reaching less than 5 percent in 2008.

The statistics, compiled by the National AIDS and Sexually Transmitted Infections Control Programme, showed that HIV/AIDS-related deaths, which stood at 116,000 in 2001, had dropped to below 83,000 in 2006.

"The success in scaling down infection rates is creating another challenge: that of the growing population of HIV patients who need care and support," Orago said.

Another worrisome issue was the continued feminisation of Kenya's HIV/AIDS pandemic: in the 15 to 24 age group there are four infected women to each infected man.

"Men still dominate the instruments of power, while women are still left out of major decision-making," Orago said. "Even decisions about sex are still made by men, in spite of the high level of HIV awareness."

However, the decreased prevalence showed that the government's aggressive Total War against AIDS campaign was changing behaviour. "After the government declared HIV/AIDS a national disaster in 2003, HIV/AIDS ceased to be just a health issue," he said. "All sectors were co-opted into the campaign."

Good progress made

Encouragingly, the new report points out that HIV prevalence was significantly lower in people aged 15 to 24: in 2003 it fell from 1.2 percent to 0.8 percent among males, while among females it dropped from 5.8 percent to 4.4 percent.

Orago attributed this decline to a behavioural shift by teens delaying their first sexual experience, as well as the increased distribution of male condoms.

Another effective strategy in the government's anti-AIDS campaign was "the use of infected patients ... to bring about behavioural change", he said, and the "visual evidence" of 'live witnesses', or infected people, to drive home anti-HIV messages had "contributed to the drop in the number of sexual partners".

Orago noted that more funding was needed if the pandemic were to be effectively controlled.

jk/kr/he
[ENDS]

BENIN: Internet new frontline in AIDS awareness

2007-08-14T11:28:00.001+07:00

By, IRIN PlusNews, August 10, 2007

Dieudonné Sourou never leaves the cybercafé in Cotonou, Benin’s commercial capital, where he comes every week to check his personal emails, without sending what this 25-year-old calls "useful messages" raising HIV awareness.

In this little cybercafe in the northern outskirts of Cotonou, Sourou focuses on typing his note, a process he repeats week after week. A long list of addresses awaits him in the corner of his screen.

"Last week, I sent a message to this list of people about the new report by the World Health Organization on the preventative role of circumcision in the fight against transmission of HIV," he told IRIN/PlusNews.

Like Sourou, several young Beninese have decided, of their own accord, to involve themselves in the fight against the virus.

"It's our way of having an impact, so that the community really becomes aware of the disease," explained Alain Doumin, a student in his final year of high school in Cotonou, who came to the cybercafe with a series of documents on HIV/AIDS.

"We don't have the money for big measures to raise awareness on the public stage. This avenue doesn't require much money and allows us to get involved in the fight," he added, before diving into his work once more.

These youth send the messages to recipients they've never met - friends comprise "at most 10 percent of the recipients", Doumin said - with the goal of reaching as large an audience as possible.

"The impact is far-reaching. We send messages outside of Benin. We gather addresses from listings of the main internet providers without knowing exactly who we're sending to in most cases," Sourou explained.

Real-life experiences at the heart of it

Most of the youth said it was often a personal experience that convinced them to get involved in the fight against HIV and AIDS.

"I started [sending messages] after watching a young man die of AIDS in my neighbourhood," said Gabin Ogbonikan, another youth who said he has sent more than 50 messages in two years. "That really affected me, and I told myself the response to a tragedy cannot be indifference."

Claude Dossa, a young manager of a cybercafe in Porto Novo, the Beninese capital, decided to use his keyboard to influence behaviour when he noticed that many young people of his generation were associating with sex workers, and probably not using condoms.

"I figured naivety and the lack of information constituted the fundamental problem at the sources of this risky behaviour," he said. "Every person, within the framework of his own life and profession, has to try to contribute to fill the gaps on this issue. As a cybercafe manager, this is the best way I can contribute."
Not everyone is in the position to go and find the information. So we have to do the work in their place

Saturnin Afolabi, a second-year linguistics student at the Abomey Calavi University in the north of Cotonou said he sends "at least two messages every week about what is at stake in terms of preventing the disease" and tries "to inform people about new strategies emerging at the national or international level".

"Nobody asked us to write these messages. We just became aware of a situation," he said.

UN figures from 2005 show that about 1.8 percent of Benin's population is HIV-positive, a decrease from 2003.

However, "that shouldn't mean the end of mobilisation", said Afolabi, who, like Ogbonikan, has been tested for HIV. "For example, in the big towns, there is considerable work to do, and that's not yet sufficiently understood by the majority of people."

Well-received messages

The recipients of the messages appreciate the initiative and regularly send encouraging responses, Afolabi said.

"It's very encouraging and it permits us to meaningfully evaluate the impact our work is having. If they respond and encourage the initiative, we've already won half the battle."

These spontaneous initiatives are encouraged by more orthodox advocacy groups.

"I know that some young people are doing excellent work in dispersing information, discretely, without asking for any financial or material support," said Daniel Gbaguidi, a community leader in the fight against AIDS. "Many people who receive the messages in turn forward them to others, which simply reinforces the action. We can't ask for more."

While the internet is still far from being used by the majority of Beninois, its use is on the rise.

Honore Chintan, computer specialist and owner of a cybercafe in a slum neighbourhood of Cotonou, acknowledged there was "work to be done to democratise the internet", but predicted it could become "a useful tool in the fight against AIDS" in Benin.

Source: http://www.plusnews.org/Report.aspx?ReportId=73670

Women step up to raise HIV/AIDS awareness

2007-08-14T11:15:00.000+07:00

By, The Desert Times, August 10, 2007

AIDS is a disease with the ability to affect many people - including women and children.

The 100 Women group at Desert AIDS Project knows that and is trying to spread awareness.

"My initial motivation was that if we could get 100 women to step up and become major donors, it could (help) our female clients," said founder Susan Unger.

The group, now almost two years old, is made up of female donors who support the Desert AIDS Project. In the last two years, they have raised about $150,000. All of that money is earmarked for programs that benefit women and children.

"They don't want to just write a check," Unger said. "They want to volunteer and make a difference."

The group was founded to aid the growing number of women who are infected with HIV or AIDS in the valley.

"Many see it mainly as gay men (who have the disease)," 100 Women member Joy White said. "The female population is growing."

Desert AIDS Project Executive Director David Brinkman said the gay male community has been impacted for years by educational programs, but women and children have not received the individualized care.

The group hopes to increase outreach and education. For example, they are helping the Desert AIDS Project fund a women's health fair.

"When you feel like you are the only one, you're isolated, it's very rewarding to see these leaders stepping up and lending a hand," Brinkman said.

The group hosts quarterly events that feature a guest speaker, sometimes a client of the Desert AIDS Project. New and current members can attend the events to learn more about how AIDS affects women and children.

Source: http://www.mydesert.com/apps/pbcs.dll/article?AID=/20070810/NEWS01/708100301

Even older women at high risk have little interest in being tested for HIV

2007-08-10T14:18:00.000+07:00

By, News-Medical.net, August 8, 2007

Few older women were interested in being tested for the virus that causes AIDS despite having significant risk factors for lifetime exposure, according to a study published in the July/August edition of the Journal of Women's Health.
The risk is especially great among African-American women, who represent 73 percent of new HIV cases in women over age 50.

"Older people largely have been overlooked in HIV prevention and testing programs, and consistently have lower HIV testing rates as compared with younger adults," said Aletha Akers, M.D., M.P.H., assistant professor of obstetrics, gynecology and reproductive sciences at the University of Pittsburgh School of Medicine and the study's lead author. "Those who are tested tend to do so late in their disease, when they are more likely to have overt symptoms such as opportunistic infections. Often, they progress more rapidly to AIDS and die within a year of HIV diagnosis, which leaves little opportunity for treatment or secondary prevention for their partners."

For this investigation, Dr. Akers and her colleagues analyzed data collected from 514 women ranging in age from 50 to 95. The women visited a general internal medicine clinic at a large, inner-city hospital in Atlanta over a period of 11 months in 2001 and 2002. To evaluate attitudes concerning lifetime HIV infection risk and interest in HIV testing, trained research assistants administered a 68-item questionnaire in a private room over the course of a single, face-to-face interview with study participants, most of whom said they were not currently sexually active.

More than 60 percent of the participants had never been tested for HIV, although more than half of them could be described as moderate- to high-risk for lifetime exposure to the virus based on sexual history and other factors. Only 115, or 22 percent of participants, said they would be interested in HIV testing. Their most often cited reasons were curiosity and concern about a current or past sexual partner's behaviors. About a third of women had already been tested. Previously tested women were more likely to be younger, sexually active, better educated about HIV and tested at the suggestion of a health care provider.

Most women, however, felt little need for testing. "Those who lacked interest were more likely to be older, African-American and not sexually active," said Dr. Akers, who also is an assistant investigator at the university-affiliated Magee-Womens Research Institute. "These women had a low perceived risk, which was not always accurate based on their histories. A third of all the women who were not interested in HIV testing reported lifetime risk factors for the disease, but we found that they tended to point to ,those people, when talking about the danger of HIV rather than at themselves or their partners."

In short, women with little HIV knowledge and low perceived personal risk were less interested in HIV testing, a finding that is consistent with attitudes in much younger, high-risk adults, the study found. Fewer than 25 percent of the participants could recall ever receiving counsel to get a test for HIV from a provider, despite their risk factors.

"Yet, in part because of a lack of education and prevention efforts targeted at older populations, older women appear to be less capable of accurately assessing their lifetime risk of HIV even when they have significant risk factors and live in communities with high rates of infection," Dr. Akers said. "We need to design prevention strategies and AIDS education for this vulnerable population and help providers to incorporate HIV risk screening into the services offered to older women from high-prevalence communities."

http://www.upmc.com/communications/newsbureau

Source: http://www.news-medical.net/?id=28572

Namibia: Woman Most Affected By HIV-Aids - ICW

2007-08-10T14:13:00.000+07:00

By, Kakunawe Shinana, The Namibian (Windhoek), August 9, 2007

Many more women than men in Namibia are living with HIV-Aids, Caroline Thomas of the International Community of Women living with HIV-Aids (ICW) said at the Sister Namibia press briefing on Monday.

Sister Namibia in collaboration with the Women's Leadership Centre organised a briefing on the impact of HIV-Aids on women and girls.

Thomas said this impact has resulted in women and girls being burdened with caring for the sick and the dying with little support, while providing for a rapidly growing number of orphans.

"Young women are particularly at risk of new infections, because of the many cultural practices that involve sexual and other violation of their bodies," she said, adding; "Girls and young women in poverty are also exposed to HIV infection through 'sugar daddy' relationships with older men."

UNAIDS estimates that 62 per cent of people living with HIV are women, compared to 38 per cent men.

Despite prevention campaigns over the years, the infection rate has not decreased.

The Namibian Ministry of Health and Social Services conducted a national survey among pregnant women which shows a national average of 19,9 per cent of those tested in 2006 were HIV positive compared to 19,7 per cent in 2004.

Figures vary greatly among the regions of Namibia, with the highest rate in the Caprivi Region amongst the age group 25 to 49.

Almost 50 per cent of pregnant women tested in 2006 in Katima Mulilo were HIV positive.

Thomas said poverty drives many women and girls into prostitution, or they are trapped in unhealthy and often violent relationships as a means of survival.

Gender inequality is in many ways sanctioned by cultural practices.

Culture teaches boys to become men to rule over women and control their bodies, while girls are taught to be submissive and to be dependent on men, instead of promoting women's right to body integrity and choice.

Source: http://allafrica.com/stories/200708090241.html

30 percent of pregnant women HIV positive — SA report

2007-08-08T10:46:00.000+07:00

By, The Harald, July 22, 2007

Just over 30 percent of pregnant women in South Africa are infected with the HIV/Aidsvirus, according to a government report released yesterday which estimated that 5,5 million South Africans are living with HIV/Aids.

The survey, conducted in October 2005 and released yesterday by the Department of Health, said the figures showed little increase over 2004. It said this was a sign that the level of new infections was levelling out.

"This is encouraging to note, but a great deal of work still needs to be done to ensure that new infections no longer take place at all in South Africa," said Health Minister Manto Tshabalala-Msimang in the foreword to the report.

South Africa has the highest number of people living with the virus in the world, accounting for more than one eighth of the estimated 40,3 million cases.

The government has often been accused of doing too little to prevent and treat the disease, even though it has done much to step up its care and treatment program, which recently became the largest in the world.

President Thabo Mbeki used to question the link between HIV and Aids and the health minister, in particular, has attracted the wrath of health activists for preaching the benefits of garlic and beetroot rather than antiretroviral medicines.

But the survey said there were finally grounds for hope that new infections had peaked.

It said that HIV prevalence among teenagers was an estimated 15,9 percent in 2005, down from 16,1 percent the previous year. — AFP.

Source: http://www.herald.co.zw/inside.aspx?sectid=6464&cat=2&livedate=7/22/2006

Aids rate in young women drops

2007-08-08T10:43:00.000+07:00

South Africa has recorded the first significant drop in the HIV and Aids rate since 1990, with women younger than 20 showing a 2,2 percent decrease in prevalence.

But although Health Minister Manto Tshabalala-Msimang said the encouraging results of the 2006 Annual Antenatal Survey were a cause for celebration, the department has acknowledged that the decrease is inconclusive.

Dr Lindiwe Makubalo, chief director for monitoring and evaluation, said other empirical studies would need to be conducted to verify whether the decrease was a real one.

The survey showed the overall HIV and Aids prevalence among pregnant women using public antenatal clinics to be 29,1 percent in 2006, against 30,2 percent in 2005.

However, the infection rate for women in the 30-34, 35-39 and 40-plus age groups showed respective increases of 0,6 percent, 1,3 percent and 1,5 percent.

The decreases in the younger-age categories dovetail with predictions by UNAids that HIV and Aids incidence in South Africa would plateau out and decline in the next few years.

Makubalo said the trend would therefore need to be observed carefully for confirmation in the next three years. The government, therefore, could not afford to be complacent.

Makubalo noted, however, that the decrease in the under-24 categories was significant because a decline in prevalence in young women was suggestive of a decline in new HIV infections.

In addition, the modelling used to collate the survey data adjusted the figures to take death rates into consideration, so the decreases could not be attributed to higher fatalities among young women.

From the study, the department deduced that the number of people estimated to be living with HIV in South Africa is about 5,41 million, down slightly from the previous estimate of 5,54 million.

Overall, HIV prevalence among adults between 15 and 49 was estimated at 18,34 percent.

The minister said a big thank-you to the youth of the country for "taking prevention messages seriously".

The overall picture suggested that HIV prevalence "may be at the point where we should begin to witness a downward trend", she said.

She added that she did not want to give the impression that the department intended "throwing a party" because of the results.

"HIV and Aids is still a public health problem and we need to redouble our efforts in this regard," she said.

Makubalo said the prevalence increases for women older than 30 were likely due to women in stable relationships finding it increasingly difficult to get their partners to use condoms or to follow any of the other prevention messages encouraged by the department.

There was also the possibility that increases were due to infected women merely moving age categories - what she described as the cohort factor.

A total of 33 034 pregnant women attending public antenatal clinics participated in the study at 1 415 facilities - double the number of participants in the 2005 study.

Provincially, prevalence has progressed at different paces. In Gauteng, prevalence has decreased from 32,4 percent in 2005 to 30,8 percent in 2006.

The Free State was the only province to show an increase (0,8 percent), while the other seven provinces recorded decreases in prevalence of between 0,6 and 3,1 percent. KwaZulu-Natal's rate remained the same.

The highest prevalence rate in the country is found in KwaZulu-Natal (39,1 percent) and the lowest in the Western Cape (15,1 percent).

For the first time, the survey included prevalence data for each district, with rates varying greatly between areas within districts in some instances.

The district with the highest prevalence was Amajuba (KwaZulu-Natal) with 46 percent, with the Northern Cape's Namakwe district showing the lowest prevalence, 5,3 percent.

Source: http://www.iol.co.za/index.php?from=rss_South%20Africa&set_id=1&click_id=13&art_id=vn20070803003838686C316416

AFRICA: Falling HIV rates tell complex story

2007-08-06T15:50:00.000+07:00

By, IRIN PlusNews, August 2, 2007

When it comes to sub-Saharan Africa's devastating AIDS crisis, there is an understandable tendency to latch onto any scrap of good news.

Figures suggesting the epidemic is waning in some countries are being trumpeted by governments and international donor agencies as evidence that their prevention efforts are succeeding.

Kenya's National AIDS Control Council recently ascribed a small drop in the country's HIV infection rate to people absorbing the messages in awareness campaigns and changing their behaviour accordingly.

South Africa's health minister, Manto Tshabalala-Msimang, claimed that the first evidence of declining HIV prevalence in pregnant women - from 30.2 percent in 2005 to 29.1 percent in the latest survey - was mainly due to "our continued focus on prevention as the mainstay of our response to combat HIV".

But the real story behind increases and decreases in HIV prevalence is far less clear. "There's an awful lot of vested interests, but it's sufficiently murky that no one really knows what's going on," Prof John Hargrove, director of the Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA) at the University of Stellenbosch, South Africa, told IRIN/PlusNews.

Twenty-five years is not long to get to grips with an epidemic that has evolved very differently in different parts of the world: in Europe, North America and Asia it has largely been confined to high-risk groups like injecting drug users, sex workers and men who have sex with men; in southern Africa it has spread rapidly via heterosexual networks.

Although theories abound, "nobody really knows why southern Africa is worst affected", said Dr Brian Williams, another epidemiologist at SACEMA. "And if we don't know that, it's very difficult to explain why prevalence is going up or down."

Lack of reliable data

Part of the problem was having adequate, reliable surveillance figures. In general, said Hargrove, the data had been "bitty" and mostly derived from urban populations.

The first generation of HIV-prevalence figures were obtained by testing pregnant women at antenatal clinics, but the age groups of the women, and the fact they were clearly having unprotected sex, meant the numbers tended to overestimate HIV infections in the general population.

Where possible, antenatal surveys are now combined with more representative data gathered in household surveys, but UNAIDS noted in its 2005 epidemic update that the high numbers of people who refused to be tested in household surveys, or were absent from home, could lead to underestimations of HIV prevalence.

While prevalence only tells us how many people are living with HIV and AIDS, incidence measures the number of new HIV infections occurring during a specific period. Incidence provides the most up-to-date and revealing snapshot of an epidemic, but the technology for determining recent infections is still quite new and prohibitively expensive for most African countries.

In the absence of such surveys, HIV prevalence in people aged 15 to 20 is often used as a proxy, because it is probable that most infections in this age group are recent.

The variety and unreliability of most surveillance methods causes epidemiologists like Hargrove and Williams to take any news of apparent declines in HIV prevalence with a large pinch of salt.

For years, Uganda has been held up as the poster child of successful prevention policies: from a peak adult HIV-infection rate of about 15 percent in the early 1990s, UNAIDS now estimates Uganda's prevalence at 6.7 percent.

President Yoweri Museveni swiftly responded to the emerging crisis as early as the late 1980s, and grassroots campaigns communicated basic prevention messages, such as abstinence from sex before marriage, being faithful to one's partner and the use of condoms. The ABC approach, as it has now been dubbed, combined with Museveni's leadership, have been widely credited with reducing risky sexual behaviour and lowering the prevalence rate.

But Williams pointed out that the evidence for Uganda's falling infection rate was "not really clear", and was based on a handful of antenatal surveys in the capital, Kampala. "We're desperate for a success story, so Uganda will be a success story regardless of the lack of evidence," he said.

Justin Parkhurst, of the London School of Hygiene and Tropical Medicine, also questioned the "so-called proof" of Uganda's success in reducing HIV infections in the British medical journal, The Lancet. He pointed out that the evidence supporting prevalence declines had been based on "selective pieces of information, which have been falsely presented as representative of the nation as a whole."

Parkhurst suggested that governments in low- and middle-income countries were under pressure to respond to donor fatigue by exaggerating the success of their AIDS programmes. "The standard of proof for policy recommendations seems to have been lowered, to provide the international community with the African success story it wants, or even needs," he concluded.

If Uganda's prevalence had indeed declined, there was still no sure way of determining why. Parkhurst cautioned against attributing the decline to "a few specific interventions introduced by the Ugandan government": not only were there numerous players in the AIDS fight besides the government, but "individuals can change their behaviour for reasons unrelated to intervention programmes".

Williams believed that while real behaviour changes, such as having fewer partners and higher condom use, might have taken place, they had less to do with the government's efforts and more with the widespread experience of watching friends and relatives die from AIDS-related illnesses.

Natural history of an epidemic

The dynamics of an epidemic can also bring about changes in HIV prevalence: in the early phases, HIV infections have tended to rise steeply and then level off as they reached a "saturation" point in the population; at a later stage, HIV prevalence might start declining, not necessarily because of widespread behaviour change, but because the number of people dying from AIDS-related illnesses has outpaced the number of new infections.

When the mortality rate of those infected reaches a balance with the incidence of new infections, prevalence will plateau - the stage South Africa is currently experiencing.

Paradoxically, the impact of a national antiretroviral (ARV) programme that keeps large numbers of HIV-infected people alive for longer might actually increase prevalence, or offset a lower rate of new infections.

This could explain why a country with a large ARV programme, like Botswana, has not seen significant declines in HIV prevalence, while Zimbabwe, with it's relatively small programme, has. But the real story is probably far more complex, and impossible to decipher at present, due to the lack of investment in research, monitoring and tracking national AIDS epidemics.

"Billions have been spent on virology, but we just haven't done enough basic public health research," said Williams. "Very few studies have been done trying to understand what's actually going on."

Ideally, such a study would need to monitor several thousand people over a period of at least five years, testing them regularly for HIV. According to Williams, such studies have not been done, and even in-depth evaluations of the impact of specific prevention programmes have been few and far between.

The case of Zimbabwe

When news broke in 2006 that Zimbabwe's HIV prevalence had fallen from a peak of around 36 percent in 1996 to 21 percent by 2004, it was greeted in many sectors with puzzlement and even disbelief, in light of the country's social and economic collapse in recent years.

Prof Alan Whiteside, director of the Health Economics and HIV/AIDS Research Division (HEARD) of the University of KwaZulu-Natal, in South Africa, said government prevention campaigns in the mid-1990s had probably contributed to Zimbabwe's falling HIV infection rates, but the country's economic collapse could have played an even bigger role. With less disposable income and mobility, people were perhaps less likely to maintain multiple sexual partners.

Michael Chome, country director for Population Services International (PSI), an international NGO that partners the Zimbabwean government in prevention programmes, was ambivalent for nearly a year about the real causes of Zimbabwe's decline in prevalence.

Eventually he was swayed by PSI's own data, showing large increases in condom sales - a figure considered more telling than a greater distribution of free condoms - as well as significant increases in reported condom use and decreases in non-regular sexual partners.

He attributed these changes to a "very open-minded ministry of health and a very literate population", as well as the concentrated efforts of donors, which had created "a needle-like focus".

Zimbabwe's pariah-like status has tended to scare away donors but, according to Chome, news of the country's declining HIV prevalence was helping to attract more funding for AIDS programmes.

Social indicators

On the thorny question of whether prevention programmes have had a direct impact on HIV prevalence, Whiteside was as reluctant to give a definitive answer as the epidemiologists: "We can't say for sure, but equally we can't say they haven't," he said.

"There is a natural history [of an epidemic], and perhaps we've underestimated it ... The trouble is, we're looking at things that are going to take years to develop, and our monitoring and evaluation tends to be short-term."

In the absence of reliable long-term data, Whiteside believed the key to interpreting HIV/AIDS figures was "to understand what is going on in our societies more broadly".

He suggested that looking at social indicators such as the rates of rape and teenage pregnancies, or the numbers of children completing school, could provide indirect evidence of behaviour change, or lack of it.

ks/he/kn
[ENDS]

Botswana: HIV Prevalence Reduces, But Still High

2007-08-02T10:53:00.000+07:00

By, Monkagedi Gaotlhobogwe, Mmegi/The Reporter (Gaborone), July 31, 2007

The HIV/AIDS surveillance report for 2006 says HIV prevalence among pregnant women between the ages of 15 and 49 years in Botswana continues to slide downward, but the prevalence rate continues to be one of the highest in the world.

This year's sentinel surveillance survey also said it recorded the highest sample size ever used and the lowest exclusion rate in surveys done in Botswana.

However, the report, sponsored by the Ministry of Health, National Aids Coordinating Agency (NACA), World Health Organisation, UNAIDS, BOTUSA, ACHAP and the Botswana-Harvard School of Public Health AIDS Initiative, also warns that HIV prevalence among pregnant women in Botswana remains one of the highest in the world at 32.4%.

The report says a close look at statistical trends shows that the decline of HIV prevalence among pregnant women has been constant since 2001 except in 2003 when it took a sharp increase.

According to the report, the overall percentage decline in HIV prevalence from 2001 to 2006 is estimated at 10.5 per cent. "This decline was greatest among young people aged 20-24 (23.8 percent) followed by those aged 15-19 years (23.2 percent).

The report attributes the downward trend in HIV prevalence to the sharp increase in condom use among the youth aged between 15 and 24 years.

It says in general, males report a higher condom use than females and condom use remains generally stagnant across age groups between 2002 and 2005.

The adjusted HIV prevalence in Botswana among women (pregnant or not pregnant) continues to be high at 32.4 per cent for women between 15-49 years, according to the report.

Chobe District has the highest HIV prevalence of 42 per cent, and Selebi-Phikwe has HIV prevalence of 41.1 per cent.

In general, the report noted that HIV prevalence remains highest in the northern part of the country.

The report blames resistance to behavioural change as a contributing factor to high prevalence rates. "There doesn't seem to be much change in the trends of reported multiple partners for males and females," it says.

It says the percentage of sexually active young people increased from 2001 to 2003 and remained high since then.

" Sexual behaviour dynamics observed over the last five years based on data from surveys were not encouraging as far as their contributions to reducing HIV incidence," the report says.

It further added that apart from condom use with non-marital, non-cohabiting sex partners which was high among the 15-24 year olds, all other sexual behavior indicators included in the analysis have remained stagnant.

The report also observes that being single and living in cohabitation have been strongly associated with very high risk of HIV infection compared to living in marital union.

It was also discovered that educated women rarely fall pregnant, while domestic workers and women with primary education consistently recorded high HIV prevalence.

" The two variables are closely related to the impact of poverty on HIV transmission", says the report.

Source: http://allafrica.com/stories/200707310966.html

High Rates of HIV Infection Documented Among Young Nepalese Girls Sex-Trafficked to India

2007-08-01T09:28:00.000+07:00

By, Newswise, July 31, 2007

A study by Harvard School of Public Health (HSPH) researchers of girls and women who were sex-trafficked from Nepal to India and then repatriated has found that 38 percent were HIV positive. The infection rate exceeded 60 percent among girls forced into prostitution prior to age 15 years. One in seven of the study’s participants had been trafficked into sexual servitude prior to this young age.

Approximately 600,000 to 800,000 people are trafficked across the globe every year, and 80 percent of these individuals are estimated to be women and girls, according to the U.S. Department of State. The State Department further reports that the majority of transnational victims are females trafficked into commercial sexual exploitation. An estimated 150,000 women and girls are trafficked annually within and across South Asia, with the majority destined for major Indian cities, according to a report by the Congressional Research Service.

“The high rates of HIV we have documented support concerns that sex trafficking may be a significant factor in both maintaining the HIV epidemic in India and in the expansion of this epidemic to its lower-prevalence neighbors,” said Jay Silverman, Associate Professor of Society, Human Development, and Health at HSPH.

India has the third largest HIV/AIDS population in the world, with approximately 2.5 million infected individuals, according to the country’s National AIDS Control Organization, supported by UNAIDS and the World Health Organization. Neighboring Nepal has far lower but increasing numbers of HIV/AIDS cases. Trafficking of Nepalese women and girls to India has been cited by the World Bank as a risk factor for HIV transmission in the region.

Silverman is the lead author of the study published in the August 1, 2007, issue of the Journal of the American Medical Association (JAMA). He led a research team in reviewing the medical documentation and case records of 287 girls and women who had been sex-trafficked from Nepal to India between the years 1997 and 2005. All had been repatriated back to Nepal and had received rehabilitative services from Maiti Nepal, a non-governmental organization that works to assist trafficking victims. The word “Maiti” means “mother’s home” in Nepali.

The researchers found that among the 287 girls and women, 38 percent tested positive for HIV. Among those with complete documentation of trafficking experiences (225 girls and women), the median age at time of trafficking was 17 years, with 33 girls (14.7 percent) trafficked prior to age 15 years. Compared to those trafficked at 18 years or older, girls trafficked prior to age 15 years had an increased risk for HIV, with 60.6 percent infected among this youngest age group. Risk was also associated with being trafficked specifically to Mumbai, India, and with longer durations in brothels.

“HIV infection has been seen as perhaps the most critical health consequence of sex trafficking, but sex-trafficked girls and women are rarely studied — leaving the prevalence of HIV and other health issues among this highly vulnerable population little understood,” said Silverman. “This study sheds new light on infection rates among a sex-trafficked population and exposes both the tragic existence of the youngest victims and the dire health consequences of this crime.”

Silverman and his team suggest several likely explanations for the observed high risk for HIV infection among the youngest trafficked girls. Previous research on male brothel clients in India suggests that these men prefer very young girls, often presented as virgins, due to fear of HIV and other infection, as well as to the widespread myth that sex with a virgin will cure such illnesses. As a result of client demand and of the relatively high profits earned from prostituting these very young girls, brothel owners take steps to keep them in captivity for longer periods of time. The HSPH team found that girls trafficked under age 15 were more likely than older girls to be held in brothels for a year or longer, and that the risk of HIV infection increased by two percent for every additional month of brothel detention.

“Historically, there has been little recognition of these young girls in brothels because they are typically hidden from both legal authorities and those working to help and study prostituted women,” said co-author and former HSPH doctoral student Jhumka Gupta.

Added co-author and HSPH doctoral student Michele Decker, “Now, we are learning that these youngest girls not only exist, but are actually the most vulnerable to HIV, highlighting the need for improved prevention of trafficking and greater efforts to identify and rescue sex-trafficked girls.”

Silverman and his team suggest that the prevention of sex trafficking and the intervention into the practice should be seen as a critical aspect of preventing both the spread of HIV/AIDS and reducing a widespread and violent human rights violation.

The authors assert that few resources have been devoted to the prevention of sex trafficking, particularly in relation to the large estimated numbers of affected individuals and to the public health consequences. In particular, the authors specify that approaches oriented to male clientele that reduce the demand for sex from young prostituted girls must be emphasized.

“Just as in other areas of HIV prevention, we can no longer afford to ignore the behavior of men and boys,” said Silverman. “Addressing the widely accepted male demand for commercial sex is critical to ending this modern day form of female slavery.”

The study was supported by grants to J. Silverman and B. Willis from the Office of Trafficking in Persons, U.S. Department of State; J. Silverman and A. Raj from the Harvard University Center for AIDS Research; A. Raj from the Center for International Health at the Boston University School of Public Health; and J. Silverman and J. Gupta from the Harvard University South Asia Initiative.

“HIV Prevalence and Predictors of Infection in Sex-Trafficked Nepalese Girls and Women,” Jay G. Silverman, PhD, Michele R. Decker, MPH, Jhumka Gupta, ScD, MPH, Ayonija Maheshwari, MD, MPH, Brian M. Willis, JD, MPH, Anita Raj, PhD, JAMA, August 1, 2007, vol. 298, no. 5.

Harvard School of Public Health is dedicated to advancing the public's health through learning, discovery, and communication. More than 300 faculty members are engaged in teaching and training the 900-plus student body in a broad spectrum of disciplines crucial to the health and well being of individuals and populations around the world. Programs and projects range from the molecular biology of AIDS vaccines to the epidemiology of cancer; from risk analysis to violence prevention; from maternal and children's health to quality of care measurement; from health care management to international health and human rights. For more information on the school visit: http://www.hsph.harvard.edu

Source: http://www.newswise.com/articles/view/531912/?sc=rsmn

Sixty per cent of HIV-infected living in rural India: WHO

2007-08-01T09:02:00.000+07:00

By, Hindustan Times, August 1, 2007

Sixty per cent of the estimated 5.2 million HIV-infected adults in India are living in rural areas, according to a WHO report.

Though commercial sex is the major reason behind the prevalence of the pandemic in most parts of the country, injecting drug use (IDUs), especially in north-eastern states, Delhi, Mumbai and Chennai, is fast emerging as a major source of transmission.

"Analysis of surveillance data by place of residence indicates that HIV has been spreading to the rural areas," the report said.

"Of the estimated 5.2 million HIV-infected adults in India, 3.05 million or nearly 60 per cent were residing in rural areas. Of the reported AIDS cases, sexual transmission accounts for 86 per cent in India," the report said.

Apart from several states recording a higher HIV prevalence among rural sentinel surveillance sites than urban sites, the dreaded disease has now started penetrating the low-risk general population, the report pointed out.

"The HIV epidemic of Manipur that was once a concentrated epidemic among IDUs, is now considered a generalised epidemic," the report said.

In 2005, seven of the 10 ante-natal clinic sentinel surveillance sites in Manipur recorded an HIV prevalence of one per cent or above indicating the spread of infection from high-risk to low-risk populations, the report said.

The report said HIV among IDUs increased markedly from seven per cent in 2002 to 23 per cent in 2005.

Increasingly, HIV infection rates are being observed among IDUs in not only the northeastern states, but other urban areas like Delhi, Mumbai and Chennai, it said.

Source: http://www.hindustantimes.com/storypage/storypage.aspx?id=c3303c9e-ba90-4cc3-9eae-21b7258f8220&ParentID=d475feaa-5917-4269-865e-44eaa5ff93e5&&Headline=60%25+of+HIVcases+in+rural+India%3a+WHO

South Africa: Still No Verdict On Anti-HIV Gel

2007-07-27T13:11:00.000+07:00

By, Tamar Kahn, Business Day (Johannesburg), July 26, 2007

Researchers are still unsure whether the Ushershell microbicide used in the aborted international study involving South African women was harmful, but it clearly did not protect women against HIV, the 4th International AIDS Conference heard yesterday.

"We don't think it's effective, and there may be an indication of increased risk (of contracting HIV)," said Lut van Damme, international clinical research manager with the US-based health research group Conrad.

The group stopped clinical trials of Ushershell in January, after interim analysis of trial data from about 1400 women in SA, Benin, Uganda and India showed the gel might do more harm than good. Half the women used the gel, which contained a cotton-based compound called cellulose sulphate, and the rest used a dummy version.

Ten earlier studies and two contraceptive trials had shown the gel to be safe.

Van Damme told delegates that final data analysis showed 25 women who used the Ushercell gel got HIV, compared to 16 women who had used the dummy. "It was a shock to all of us," she said.

Van Damme said there were several possible reasons why the gel might have failed to protect women from HIV, such as causing inflammation, or disturbing the natural vaginal flora. She said a new Ushershell safety study was planned, which would involve 60 women in the US.

"It would be unethical not to try and understand what's going on," she said.

SA is at the forefront of international research into anti-HIV microbicides as it has good research infrastructure and an HIV-positive population of more than 5,5-million.

Scientists hope microbicides will offer women a discreet way to reduce their risk of contracting HIV from an infected partner, particularly where men are reluctant to use condoms. The South African arm of the Ushershell research was headed by the Medical Research Council's Prof Gita Ramjee, and funded by the US Agency for International Development and the Bill and Melinda Gates Foundation.

A week after the trial was stopped, Health Minister Manto Tshabalala-Msimang ordered the National Health Research Ethics Council to investigate all anti-HIV vaginal gel trials in SA. It has yet to report its findings.

A second Ushercell study in Nigeria was also stopped as a precaution when the Conrad trial was halted.

A nalysis of the data from the Nigerian sites found no apparent increase in HIV risk among the women who used the cellulose sulphate microbicide, Willard Cates from Family Health International told the conference.

Source: http://allafrica.com/stories/200707260086.html

Early treatment for babies with HIV shows higher survival rate

2007-07-26T09:49:00.000+07:00

By, The Associated Press, July 25, 2007

New data showing that HIV-infected babies treated in the first weeks of life are four times more likely to survive than those left untreated highlights the importance of early diagnosis, a leading World Health Organization official said Wednesday.

Early results of a new study found that antiretroviral drug therapy given to infected South African infants not yet showing any HIV symptoms within the first three months of life helped those babies live longer than infants who started therapy after showing signs of the disease.

Current World Health Organization guidelines call for drugs to be administered only after signs of a weakening immune system are observed.

The early results of the South African study were so promising that the findings were set to be released to the WHO and other health officials for evaluation to consider changing the WHO guidelines.

"These are new and exciting and potentially very important data," the director of the WHO's AIDS program, Kevin De Cock, said on the sidelines of an International AIDS Society Conference in Sydney.

"It's obviously immensely important in its insight into pediatric treatment strategies," he added. "But the data will need to be looked at more before we really say what the implications are for treatment policy."

Every year, about half a million babies are born infected with HIV worldwide.

De Cock said the South African study, which was funded by the U.S. National Institute of Allergy and Infectious Diseases, highlighted the need for early HIV diagnosis in infants and children.

"You can't scale up therapy or provide appropriate treatment to people if they don't know their HIV status," he said. "There's a need across the board to scale up HIV testing."

The trials, involving 377 babies between 6 and 12 weeks old, were started in July 2005 in Soweto and Cape Town, South Africa. Of those given the drugs early despite no sign of illness, only 4 percent died, compared with 16 percent in the group where treatment was delayed until the babies showed signs of disease.

Last month, an independent safety and monitoring board in London concluded that the results were so overwhelming, the study should be altered to allow all of the infants to begin treatment and the early findings should be released to the scientific community.

"We're hoping that these results will have an implication in formulating guidelines all over the world," the lead co-author, Dr. Avy Violari of the University of the Witwatersrand in Johannesburg, said Tuesday. Violari presented the research to the Fourth International AIDS Society Conference on Wednesday, its final day.

At the AIDS conference on Tuesday:

Robert Bailey, a professor of epidemiology at the University of Illinois, said studies in Africa showed that uncircumcised men were 2½ times more likely to contract HIV from infected female partners. Only 30 percent of men worldwide have had the procedure, mostly in countries where it is common for religious or health reasons.

The American Foundation for AIDS Research said HIV infection rates among men who have sex with men were rising in Africa, Asia and Latin America, citing figures from Unaids. Studies also show that less than 5 percent of that group have access to HIV-related health care, the research group said.

Source: http://www.iht.com/articles/2007/07/25/news/aids.php

Male circumcision called key to slowing AIDS

2007-07-26T09:38:00.000+07:00

By, Meraiah Foley, Associated Press, July 24, 2007

SYDNEY, Australia — A U.S. health expert urged governments worldwide Tuesday to endorse circumcision to slow the spread of HIV, saying men without the procedure have a greater risk of contracting the virus from infected female partners.

Experts at an AIDS conference in Sydney also warned that HIV infection rates were rising among men who have sex with men in developing countries because of discrimination and lack of access to health services.

The World Health Organization says male circumcision reduces the risk of female-to-male transmission of the disease by about 60 per cent. But only 30 per cent of men worldwide have had the procedure, mostly in countries where it is common for religious or health reasons.

Robert Bailey, a professor of epidemiology at the University of Illinois, said studies in Africa showed that uncircumcised men were 2½ times more likely to contract HIV from infected female partners, although many health officials were still unclear about its benefits.

“If we had a vaccine that was 60-per-cent protective, we would be very happy and we would be rolling it out as fast as we can,” Mr. Bailey told reporters at an International AIDS Society Conference in Sydney.

“The next step is to get the leaders of countries to actually come up with policy statements endorsing the practice,” said Mr. Bailey, who has conducted circumcision-related studies in Africa and the United States.

Without local support, international agencies would be unlikely to encourage the procedure to avoid being seen as imposing foreign cultures or values, he said.

Circumcision – the removal of the foreskin from the penis – has long been suspected of reducing men's susceptibility to HIV infection because the skin cells in the foreskin are especially vulnerable to the virus.

In March, the WHO urged heterosexual men to undergo the procedure because of compelling evidence that it reduces their risk of getting the disease. It cautioned, however, that male circumcision is not a complete protection against HIV, and said men should still use condoms and take other precautions such as abstinence, delaying the start of sexual activity and reducing the number of sexual partners.

“Circumcision could drive the epidemic to a declining state toward extinction,” Mr. Bailey said. “We must make safe, affordable, voluntary circumcision available now.”

He also called on international agencies to ramp up funding for circumcision in countries hardest-hit by the epidemic.

Michel Kazatchkine, the executive director of the Global fund, a leading international health agency, also called for increased funding.

“I believe that the evidence is overwhelming for the efficacy of circumcision,” Mr. Kazatchkine told the Associated Press on the sidelines of the meeting. “And if countries come to us ... I see no reason at all why we wouldn't fund that.”

Mr. Kazatchkine said his organization had not received any requests for funding for circumcision, since the WHO advice on the topic was only released in March.

Also at the conference, a leading American AIDS research group said HIV infection rates among men who have sex with men were rising in Africa, Asia and Latin America, citing figures from UNAIDS.

Studies also show that fewer than 5 per cent of that group have access to HIV-related health care, the American Foundation for AIDS Research (amfAR) said.

“This is a massive failure of the HIV/AIDS response globally and I think one that needs to be addressed,” said Kevin Frost, amFAR's chief executive officer.

In Kenya, about 40 per cent of homosexual men are estimated to be HIV positive, compared with a 6-per-cent rate in the country's overall population, amFAR said. In Senegal, nearly 22 per cent are believed to be infected, compared with fewer than 1 per cent of the general population.

In Uruguay and Mexico, 21 per cent and 15 per cent are estimated to have the disease.

Under an initiative launched at the AIDS Society Conference, amFAR will seek to raise $3-million over the next three years to provide grants for AIDS education and research among men who have homosexual sex in developing countries.

Source: http://www.theglobeandmail.com/servlet/story/RTGAM.20070724.waidscirc0724/BNStory/specialScienceandHealth/?page=rss&id=RTGAM.20070724.waidscirc0724

GLOBAL: AIDS community moving too slowly on male circumcision

2007-07-25T10:30:00.000+07:00

By, PlusNews, July 24, 2007

Sydney - Six years, over US$20 million, and probably one million new preventable infections; that's how much it took for AIDS researchers to be convinced that male circumcision should be considered as a prevention strategy.

Delegates attending the fourth International AIDS Society Conference on HIV Pathogenesis and Treatment this week, in Sydney, heard on Tuesday that studies showing the reduced risk of HIV infection were available as far back as 2001.

But it took three randomised, controlled trials in South Africa, Kenya and Uganda before the international health community could be persuaded to act on the evidence, said Prof Robert Bailey, principal investigator of the male circumcision trials in Kenya.

"I'm not sure what could have been done differently, but it does raise the question of whether we have raised the bar too high for converting evidence into action in the face of a crippling pandemic. Perhaps for the next intervention, the threshold of proof will not be quite so high and we can start acting sooner," he said.

Dr Thomas Coates, associate director of the AIDS Institute at the University of California, Los Angeles, is also puzzled by the lack of enthusiasm for male circumcision in the scientific AIDS community - particularly among social scientists, such as Prof Peter Aggleton, a researcher at the University of London, who has warned that introducing the procedure as a prevention strategy could create "new physical and social differences, around which division can solidify".

Coates accused social scientists of creating these divisions themselves. "If social scientists want to be taken seriously, they have to stop listing problems and start coming up with solutions," he commented.

"In terms of science ... this is as good as it gets ... this [evidence] is a scientist's dream. The next logical step is to go into the field and implement. Certainly, given the evidence, there's no reason to hesitate."

How to move from evidence to practice, and at what speed, is another matter. Models suggest that the faster male circumcision is scaled up, the more infections can be prevented, with each averted infection costing governments less.

Bailey noted that the cost-effectiveness of male circumcision, even at the most conservative estimates, compared "favourably" with other prevention services such as school-based prevention campaigns and treating sexually transmitted infections.

Although circumcision was another male-controlled prevention method, women could not afford to be ignored in plans to roll out this programme, Bailey warned.

"As sex partners, as sisters and mothers, women are going to be instrumental in assuring broad and rapid uptake of circumcision in these communities," he said.

Many questions still need to be researched. Bailey told IRIN/PlusNews that the protective effect regarding women, and men who have sex with men, remained unclear, and trials to look into these issues were only in the early stages.

While acknowledging the challenges, a frustrated and impatient Bailey called for male circumcision services to be made available "as soon as possible" in regions with high HIV prevalence rates.

"One cannot help but contemplate that if it were a drug or a compound or a shot with a fancy label, international agencies and donors would have been fighting to be the first to make it available many months, even years, ago," he said.

"But no one stands to profit from male circumcision - no one, that is, but the 4,000 men in Africa who will be newly infected tomorrow, their partners and their children. Haven't we delayed long enough?"

kn/he

Nepal Health Official Tells Gay HIV Organization to ‘Find Something Better To Do’

2007-07-23T09:52:00.000+07:00

By, Gaywired.com, July 21, 2007

Nepal’s Blue Diamond Society (BDS) was told Wednesday to stop its ‘Care Support’ sexual health outreach program in Dhangadi and “to look for something better to do”.

This is causing further grave concern over the level of homophobia that exists amongst the Government officials and NGO workers in Nepal, BDS says.

It was two months ago that BDS set up the scheme, funded by the Elton John Aids Foundation and Sidaction in France, because of the increasing number of those living with HIV in the Dhangadi area in the far west of Nepal.

The plan was to coordinate and provide care support to those with HIV and their sexual partners.

Since the scheme started two months ago, more than 15 people living with HIV have been sent to Kathmandu for further support, treatment and hospice facility. The scheme dos not discriminate on grounds of sexuality, working with both the MSM and MSW communities, as well as TG groups.

At a regular monthly meeting organised by the District Public Health Office, BDS outreach educator Ram Awatar said he was astounded at what was said.

Krishna Bhatta, the Public Health Officer said that the “anus doesn’t have any sexual tissues, that’s why there is no chance of HIV/AIDS transmission” and that “there [are] no MSM/MSW/TG in Dhangadi, so I believe this Care and Support program in Dhangadi for MSM/MSW/TG is absolutely unnecessary”.

Then, Ms. Durga Shrestha from BASE, an NGO, told at the meeting: “If we allow this program in Dhangadi, this will promote homosexuality, which will pollute the entire society”.

It didn’t end there.

Santoshi Sharma, from women’s development, told the meeting that “people will copy the homosexual behavior, so there is no possibility for this program to continue in Dhangadi”.

Bhatta then told the meeting that he would find out who was providing the funding. I also need proof whether there are HIV+ people from MSM/MSW communities here,” he added.

Ram Awatar was then told that the donor providing funding for the BDS ‘Care Support’ scheme should come to the next meeting of the District Aids Coordinating Committee (DAAC) “we will discuss whether we should allow any program for MSM/MSW/TG in Dhangadi or not.”

Speaking in Kathmandu, Sunil Pant, the director of the Blue Diamond Society, said: “We are not sure where Elton John is available or not to visit Dhangadi for the next DACC meeting.

“This is another devastating blow against MSM/MSW/TG in a week by government departments,” he continued.

“Last Saturday, five métis (effeminate males) were brutally assaulted by Nepal police for carrying condoms in a Kathmandu park.

“With such attitudes of Government, public health officials and NGOs, sexual health and HIV prevention and care support treatment interventions for MSM/MSW/TG is impossible.”

Source: http://www.gaywired.com/article.cfm?section=123&id=15642

Thailand To Launch Condom Campaign, Implement Legal Protection For Women Whose Partners Refuse To Use Condoms

2007-07-17T15:00:00.000+07:00

By, Medical News Today, July 10, 2007

Thai Public Health Minister Mongkol Na Songkhla recently at Thailand's 11th annual national seminar on HIV/AIDS said he is concerned about the increasing number of HIV cases in the country, especially among married couples, the Bangkok Post reports. According to the Post, about 40% of the 18,000 new HIV cases diagnosed annually in Thailand occur among women who contract the virus from their husbands. About 28% of new cases are among men who have sex with men and 10% are among commercial sex workers, according to the Post.

Mongkol said he is considering launching a "family condom" campaign and encouraging married couples to be monogamous. "Using condoms should be regarded as showing respect to each other so that both husband and wife will be safe from sexually transmitted diseases such as HIV/AIDS," Mongkol said, adding that women also should "stand up for a better deal from their husbands."

The Thai National Committee on AIDS will carry out the condom-promotion program with Mechai Viravaidya, chair of the Population and Community Development Association. Mechai said that as part of the program, the committee will ask hotels to put complimentary condoms in guest rooms (Apiradee, Bangkok Post, 7/5).

In addition, Mongkol at the seminar said that Thailand soon will provide legal protection to women whose partners refuse to wear condoms during sex, the Thai News Service reports. According to an agreement reached at a recent UNAIDS meeting in Geneva, laws on social issues and gender equality should be implemented as primary solutions to curb the spread of HIV, Mongkol said (Thai News Service, 7/5).

Source: http://www.medicalnewstoday.com/articles/76214.php

Aids fatalities on the rise

2007-06-19T10:30:00.000+07:00

By, Robert Laing, The Times, June 18, 2007

HIV/Aids is South Africa’s tenth biggest natural killer.

The number of deaths from Aids-related diseases increased by 3.3percent, which researchers at Statistics South Africa said might partly be attributable to improvements in death registration and population growth.

The report by Stats SA entitled “Mortality and causes of death in South Africa, 2005: Findings from death notification” said that tuberculosis was responsible for most natural deaths (12.5 percent) followed by influenza and pneumonia (7.7 percent) and intestinal infectious diseases (4.8 percent).

The report said: “This release covers mortality and causes of death broadly, and hence does not focus specifically on HIV/Aids. It does, however, provide indirect evidence that HIV may be contributing to the increase in the level of mortality for prime-aged adults, given the increase in the number of deaths due to associated diseases.

“The data captured through this exercise can contribute to detailed studies in which the incidence of deaths due to Aids-related conditions is estimated”.

The data indicated that the death rates of the leading natural killers were generally on the increase, with HIV/Aids deaths increasing by 8.1 percent from 2004 to 2005. Diabetes mellitus was another disease the statistics showed needs to be given priority.

The report is divided into sections with titles like “Death by Sex”, “Death by Age”, and “Death by province”.

The age data shows South Africa’s infant mortality rate is on the rise, listing 1906 babies under the age of 14 months having died of malnutrition in 2005.

The highest number of deaths were children under four (10.4 percent), followed by adults between 30 and 34 (10 percent).

Intestinal infectious diseases were the leading cause of death for those aged one to four years.

Nearly a quarter (23.6 percent) of children aged one to four years died as a result of this disease. The second leading causes were influenza and pneumonia, followed by malnutrition and tuberculosis. HIV ranked sixth.

The report is not entirely depressing in that it showed unnatural deaths decreasing: The data showed that 91 percent of South Africans died from natural causes.

The Western Cape had the highest percentage of deaths associated with non-natural causes, mostly due to assaults.

Source: http://www.suntimes.co.za/News/Article.aspx?id=494822

Women suffer most in AIDS fight; Africa's losing battle takes its heaviest toll on females

2007-06-15T11:51:00.000+07:00

By, Mary Katherine Keown, The Sudbury Star, June 13, 2007

She was 27 years old, a single mother of two young children, and had only days to live. Theresia, a former prostitute, was dying of AIDS.

She was frail, weak and had been sick for a long time. She went to the hospital and was tested for HIV. She tested positive, but was sent away without treatment, or pain medication, because she was not a suitable candidate for anti-retroviral treatment.

"It was disgusting," says Madeline Johnson, a Canadian CUSO co-operant working at Uhai Centre, about her visit to Theresia. "She had skeletal hands, and was a pile of ribs and tiny boobs. We prosecute people for allowing animals to live like that, with those kinds of problems. How is it OK to allow humans to live like that?" Uhai Centre is a frontline, Arusha, Tanzania-based agency that works with HIV-positive people, particularly women, orphans and vulnerable children.

Theresia was confined to a filthy foam mattress. She was unable to wear a skirt or pants because of genital infections, and could not speak because of severe thrush. She was given medications for her opportunistic infections, but died 10 days after the Uhai team visited her.

"When the five-year-old picked up the two-year-old and walked out of the room, I saw their future," Johnson says, close to tears.

"It was awful. I have no idea what's happened to those children or whether they're even eating."

HIV is indiscriminate, but in sub-Saharan Africa, and Tanzania in particular, it is an infection that targets women.

It was not always this way.

As in most other regions of the world, HIV initially infected more men than women, but because of the nature of African society, it has become an overwhelmingly feminized illness.

"From the beginning of the AIDS crisis in sub-Saharan Africa, the epicentre of the epidemic, the number of infected women has been growing more rapidly than that of infected men," writes Michael J. Kelly, a Zambia-based priest, in The Female Face of HIV and AIDS.

The article is used as part of an annual lecture delivered through Trocaire, the official overseas development agency of the Catholic church in Ireland.

"The widening gap between the numbers of infected women and men, especially in recent years, provides a dramatic illustration of the increasingly female face of the epidemic," Kelly says. "By the end of 2006, an estimated 59 per cent of infected adults in the region (sub-Saharan Africa) were women. For every 10 infected adult men, there were more than 14 infected adult women.

"This gender differential has arisen partly because HIV transmission in sub-Saharan Africa occurs mainly as a result of heterosexual activity, and partly because of the extensive gender inequality experienced in the region.

"In other regions of the world, where transmission occurs mainly through homosexual activity, injection drug use or commercial sex work, men are still more likely than women to be infected with HIV." There are several reasons HIV/AIDS has been feminized in sub-Saharan Africa, including the severe economic disparities that exist between the affluent and the poor. Nearly 60 per cent of Tanzanians live on less than US$2 per day, or US$730 annually, according to the 2006 UNAIDS Report on the global AIDS epidemic. This extreme poverty has been a major factor driving the HIV/AIDS epidemic in Tanzania.

The UNAIDS report indicates that, at the end of 2005, Tanzania had an HIV prevalence rate of approximately 6.5 per cent. Of those living with HIV/AIDS, approximately 55 per cent were women aged 15 and above, up from 52 per cent in 2003.

Traditional gender roles have contributed to the spread of HIV among women. AIDS impacts women differently than men, and poverty and violence make women more susceptible to HIV infection.

"Poverty makes women dependent on men," Johnson says. "Because of that, they must endure violence, including sexual violence. The thing is, in marriage, most men don't feel the need to use condoms. They feel entitled to sex.

"For example, Elizabeth, a client at the Uhai Centre, married out of economic necessity.

Her new husband beat her and her three children, who were severely malnourished. Uhai Centre finally intervened and sent the three oldest children to live in an orphanage. When Elizabeth and her youngest child were tested for HIV, they both tested positive."

Julius Sabuni, a lawyer, and the human rights and advocacy officer at the Eastern Africa National Networks of AIDS Service Organization (EANNASO), agrees with Johnson's assertions.

"Generally, women and children - particularly girl children - are most affected by HIV," Sabuni says. "Historically, women have borne the brunt of community social life. The gender inequalities that exist, and have existed for a long time, have made women carry the burden of day-to-day household chores and socio-economic life, in general.

"They are the ones who care for the sick when people fall sick due to HIV infection. Because the medical system cannot cater to HIV/AIDS patients adequately, most patients are cared for in their homes. It is women who care for the sick."

The virus also infects more women than men.

"Socio-economic factors (that contribute to risk of HIV infection) include the power to negotiate sex, which, of course men have and women lack, in our context," Sabuni explains. "It is the men who make the advances and it is the men who decide whether or not to put on a condom. Because of the economic power that men have and women lack, it is always men who decide."

In Tanzania, marriage has emerged over the last decade as a major risk factor for HIV infection.

"HIV is common among sex trade workers, but the prevalence rate has fallen," Sabuni explains. "The prevalence rate among married couples has risen. Ten years ago, sex workers used to die and were affected very much, but nowadays commercial sex workers are not as high-risk as married people."

Sabuni also attributes the high prevalence of HIV infection among women in sub-Saharan Africa, in part, to traditional practices, such as widow inheritance and spear sex.

While little scientific evidence exists to support this thesis, Sabuni points out that numerous studies have indicated these practices, particularly widow inheritance, put women at higher risk for infection.

"There are many cultural practices in Africa that are believed to contribute to HIV infection," Sabuni says. "There is the practice of widow inheritance in some communities in Tanzania, whereby you find a brother of the deceased husband inheriting the widow of his late brother, allegedly to take care of the family. The inheritor takes on all the responsibilities, including having children with the widow."

For many women, particularly low-income, rural-dwelling and/or poorly educated women, being inherited is not a choice; it is the only way they can continue to support their families.

"Women, particularly, have suffered the most when it comes to discrimination and HIV/AIDS," Sabuni asserts. "They have been denied inheritance. This is a violation of human rights - a number one violation of human rights. They have also been denied property after their husband has died."

Spear sex, although less common now than in the past, is still practiced by some tribes in Tanzania and is also believed to put women at elevated risk of HIV infection.

"There is a practice, which the Masai call 'spear sex,' in which women are shared among male members of the community," Sabuni says. "Men will go to a homestead and if the husband is not there, the visitor will stick a spear in the ground at the front of the house. He will go in and have sex with the woman, if they are of the same age group.

"The practice has existed for some time and now we are seeing its negative results."

Sabuni says that, while awareness-raising campaigns have made some progress in eradicating spear sex and widow inheritance, they continue among the Masai (a semi-nomadic tribe present in several eastern African countries) and in some other tribes, and contribute to the growing number of HIV infections in southern and eastern Africa.

Theresia was a former prostitute.

She died of AIDS, alone on a filthy mattress surrounded by the evidence of her impoverished life. The virus, however, did not target her - entirely - because of her lifestyle or her socio-economic class. Theresia's major risk factor was, simply, her gender.

Source: http://www.thesudburystar.com/webapp/sitepages/content.asp?contentid=568167&catname=Local+News&classif=

Uganda: Married Women at Higher Risk of HIV

2007-06-15T10:56:00.000+07:00

By, Joyce Namutebi, New Vision (Kampala), June 13, 2007

While HIV prevalence among young people in Uganda has gone down dramatically, married women remained at high risk of contracting the disease, Mrs. Janet Museveni said yesterday.

Addressing hundreds of delegates at the 8th Commonwealth Women affairs Ministers Meeting, the first lady said advocacy efforts, including multi-media campaigns, had contributed to the sharp decline in prevalence rates among the age group 15 to 25 years.

These campaigns also helped to bring down teenage pregnancy from 43% in 1995 to 34% in 2000 and to reduce casual sex by 60% in the last 20 years.

However, adult women, especially married women, remained at the greatest risk of contracting HIV, Mrs. Museveni noted.

"The most immediate cause of women's HIV vulnerability is their limited power to negotiate safer sex, combined with the lack of female-controlled HIV prevention methods other than the female condom," she observed.

"The female condom has proved to be too costly for many women, is not always available and cannot always be used without the partner's knowledge."

Mrs. Museveni, who has been at the forefront of fighting the pandemic and caring for orphans, called upon the Commonwealth countries to help find an Aids vaccine.

She also asked the heavily affected countries to support vaccine trials, like Uganda has been doing.

"If an Aids vaccine is to become a reality, there is need to significantly expand the level of political support globally. Where there is significant political will, there is usually significant financial support," she stated.

The First Lady appealed to the Commonwealth to assist Uganda in addressing the impact of conflict on women and children, especially in the North.

She called for the training of counsellors to help rehabilitate the victims of rape and mutilation, re-integrate young women in their communities and help settle unwanted babies of rape victims.

Earlier at the conference, Uganda was hailed as a 'success story' and an 'interesting case study' for bringing prevalence in pregnant women down from 18% in the early 1990s to 6% in 2005.

"This has made Uganda a subject of intense scrutiny to discover what lessons learnt can be transferred to other contexts," said Dr. Robert Carr of the University of the West Indies in Jamaica.

He stressed that the context in which Uganda was responding to the HIV scourge was complex, considering that 32% of married women were in polygamous marriages.

Quoting from the Aids Policy Research Centre at the University of California, San Francisco, he confirmed that adult women in Uganda were more vulnerable to HIV because of their low status, lower education levels, higher unemployment and weaker negotiating skills in relationships.

"The Government has implemented a far-reaching affirmative action programme to promote women's political participation. However, many customary and statutory laws discriminate against women in areas of marriage, divorce and inheritance. These customs include property grabbing," he stated.

The vulnerable position of Ugandan women was highlighted by a community-based study in Rakai. "Thirty percent of women had experienced physical threats or abuse from their current partners. 90%of women viewed beating of the wife or female partner as justifiable in some circumstances,"said Dr. Carr.

The Rakai researchers found a link between alcohol consumption and domestic violence. "Women whose partners frequently or always consumed alcohol before sex faced risks of domestic violence almost five times higher than those whose partners never drank before sex."

Dr. Carr pointed at the particular vulnerability of girls orphaned by Aids. "Poverty and being orphaned expose the girl child to a greater risk of HIV infection through early marriage, sexual abuse and prostitution."

Uganda managed to turn the HIV/Aids tide by identifying goals and developing policies that related to addressing gender inequality.

He cited promoting behaviour change among sexually active people, the reduction of mother-to-child transmission by a third by 2005, and protecting the rights of at least 50% of the families most affected by HIV/Aids as some of the goals.

Source: http://allafrica.com/stories/200706140413.html

Ghana: Fighting HIV/Aids Before 2010

2007-06-13T10:04:00.000+07:00

By, Ghanaian Chronicle (Accra), June 11, 2007

WITH LESS than three years for all HIV/AIDS prone countries across the globe to fulfill the pledge to achieve universal access to HIV prevention, treatment and care by 2010, Action Aid International Ghana has expressed fears that Ghana, unlike some other African countries, was in danger of missing the target which was fashioned to give hope to the over 40 million people living with HIV/AIDS worldwide.

According to the Northern Regional Senior Programme Officer of Action Aid Ghana, Mr. Anaba Nabila Kumsonyare, Ghana as a nation had failed to recognise that one of the easiest ways of preventing the virus from spreading was providing drugs to HIV positive pregnant women to curtail mother to child transmission, which is currently one of the leading causes of HIV/AIDS.

Speaking at the Global Week of Action on HIV/AIDS celebration here in Tamale, the Action Aid official passionately called on the ruling government to urgently attach seriousness to the implementation of the pledge to achieve universal access to HIV prevention, treatment and care by 2010. The Programme which was sponsored by Action Aid International Ghana was jointly organised by Northern Sector Action on Awareness Centre (NORSAAC), Social Centre for People's Empowerment (SCOPE), Tamale Metro Assembly (TMA), Ghana HIV/AIDS Network (GHANET), Positive Steps Ghana and PLWHA all in Northern Region.

He revealed that global examples of access to drugs, treatment and care had shown that countries like Swaziland, China and Cambodia have been able improve tremendously by 40%, 27% and 91% respectively.

He therefore expressed the hope that government would ensure that Ghana overtakes all these countries in terms of treatment.

Mr. Anaba maintained that, "unless our leaders back their rhetoric with real action and resources to promote and fulfill women's sexual and reproductive rights, we run the risk of losing the fight against HIV/ AIDS. Women and girls are the fastest growing group of people living with HIV/AIDS and the young women constitute 76% of all new cases in sub-Saharan Africa".

He asserted that there could be no effective treatment, care and support for people living with HIV/AIDS, without well resourced, comprehensive and strengthened primary healthcare services that reached the poor in society.

He therefore reminded African governments of a promise they made in 2001 to invest 15% of their annual expenditure on public health systems, which almost all of them had failed to do, apart from Botswana.

Meanwhile, only one out of every ten HIV/AIDS victims has access to drugs and treatment.

Mr. A. Ibrahim Afa-zie of the Ghana HIV/AIDS Network (GHANET), said the Global Week of Action on HIV/AIDS had been instituted to draw attention of the World to the devastating nature of the AIDS pandemic and to canvass world support in terms of financial and human resources to fight the disease.

He greatly expressed worry about the HIV/AIDS pandemic, which he noted was affecting both social and economic fortunes of Africa.

Mr. Afa-zie was of the view that if care was not taken, Ghana and for that matter Africa would be ruled by HIV/AIDS Presidents, Ministers of States, Members of Parliament, District Chief Executives and Assembly persons.

Source: http://allafrica.com/stories/200706111212.html

Bangladesh: HIV prevalence rises to 4 pc

2007-06-13T10:01:00.000+07:00

By, The New Nation, June 12, 2007

The rate of HIV prevalence increased from 1.4 per cent to 4 per cent in past three years in the country.

Injecting drug users are 20,000 to 40,000, heroine smokers 30,000, female sex workers at street, brothel and hotel are 54,000 to 90,000, male sex workers and males who have sex with males are 40,000 to 150,000 and hijras 10,000 to 15,000 in the country at present.

In injecting drug users, HIV prevalence increased 4 to 7 .1 per cent in last four years.

Due to low condom use and sharing needles, high-risk behaviour people are increasing in the country every day.

This was disclosed at a national workshop on 'Advocacy Experiences and HIV/AIDS Mainstreaming' organised by Padakhep Manabik Unnayan Kendra (PMUK) in support with the National AIDS/STD Programme and Save the Children at Officers' Club in the city yesterday.

Maj Gen (Retd) Dr ASM Matiur Rahman, Adviser to the Ministry of Health and Family Welfare, Water Resources and Religious Affairs, addressed the workshop as chief guest.

Md Abdul Karim, Secretary of the Ministry of Home Affairs, M Ataur Rahman, Secretary of the Ministry of Religious Affairs, M Didarul Anwar, Secretary of the Ministry of Information, Sheikh Md Wahid-uz-Zaman, Secretary of the Ministry of Science and IT, Md Abdus Sabur, Secretary In-charge of the Ministry of Chittagong Hill Tract Affairs, Md Golam Mostafa Talukder, Secretary, In-charge of the Ministry of Youth and Sports, Abdul Awal Majumder, Additional Secretary of the Ministry of Education, Rokeya Sultana, Secretary, In-charge of the Ministry of Women and Children Affairs, Dr Nizam Uddin Ahmed, Director of HIV/AIDS Programme, Iqbal Ahammed, Executive Director of the PMUK, Kelland Stevenson, Country Director of Save the Children USA, Dr Md Hanif Uddin, Programme Manager of the National AIDS/STD Programme, among others, spoke, while Jamil Osman, Additional Secretary of the Ministry of Health and Family Welfare chaired the session.

Health Adviser said the government is going to introduce HIV/AIDS test for the external migrants. Some 14,000 people are infected HIV/AIDS in the world everyday. But in Bangladesh, this rate is too low.

"If everybody of the country follow the rules to prevent the HIV/AIDS and also follow the religious taboos, HIV/AIDS can not be spread in the country," he also said.

The government will take more steps to prevent the HIV/AIDS in the country with including NGOs, representatives of the civil society and media personnel very soon, he added.

© Copyright 2003 by The New Nation

Source: http://nation.ittefaq.com/artman/publish/article_36768.shtml

South Africa: Reduced HIV and Aids Pregnancies - Health Dept

2007-06-12T09:56:00.000+07:00

By, Seshnee Govender, BuaNews (Tshwane), June 8, 2007

Health Minister Manto Tshabalala-Msimang has highlighted South Africa's progress in decreasing the prevalence of HIV amongst pregnant women.

"I am happy to announce that the 2006 antenatal survey results show a statistically significant decrease in the prevalence of HIV amongst pregnant women who use public health facilities.

"This is mainly as a result of our continued focus on prevention as the mainstay of our response to combat HIV and lead to an HIV free society," said Minister Tshabalala-Msimang during her budget vote Thursday.

The department and its partners have also developed the National Strategic Plan for HIV and AIDS for 2007-2011 which builds on the gains of the Strategic Plan for 2000-2005.

It aims to achieve a 50 percent reduction of new infections by 2011 and provide an appropriate package of treatment, care and support services.

The package of care provided for in the plan includes counselling and testing services as an entry point; healthy lifestyle interventions, including nutritional support; treatment of opportunistic infections; anti-retroviral therapy and monitoring and evaluation to assess progress and share research.

The minister said that her department will do everything in their power to contribute to the successful implementation of the National Strategic Plan.

The department has also re-launched the government's HIV and AIDS communication programme, Khomanani which has been allocated R190 million for a two year period.

"We have re-launched the Government HIV and AIDS communication programme, Khomanani which has been allocated R190 million for a two year period.

"This communication programme encourages responsible sexual behaviour and mobilise access to treatment, care and support services for those who are infected and affected," she said.

During the last financial year, more than 439 million male and more than three million female condoms were distributed.

"We supported home and community based programmes in 60 percent of sub-districts and more than 493 000 patients with debilitating conditions received nutritional support.

Since the start of the antiretroviral treatment component of the Comprehensive Plan, more than 282 836 patients have been initiated on ARVs in the 335 accredited facilities by the end of March 2007.

Tuberculosis (TB) control remains a major challenge, the minister said but some advances have been made in this regard.

"Case finding is relatively good, 89 percent of patients diagnosed with Pulmonary TB are started on treatment and large numbers are placed on direct observed treatment," she said.

The department's efforts to control malaria has improved as 4 404 malaria cases were reported between June 2006 and April 2007 as compared to 11 246 cases reported for the June 2005 to April 2006.

During the same reporting period, the number of deaths decreased from 88 to 31.

The main reasons for this decline include indoor residual spraying using Dichloro-Diphenyl-Trichloroethane which has now been accepted by World Health Organisation as the significant tool in malaria control after many years of South Africa's engagement on this issue.

The department has also made significant gains in the hospital revitalization programme.

"We already have state-of-the art tertiary hospitals in the form of Inkosi Albert Luthuli and Pretoria Academic Hospitals and ten other hospitals have been completed in the past three financial years.

"We currently have 46 revitalisation projects with 30 already on site and 16 in the planning stages.

"We hope to complete the following hospitals during this financial year: Mamelodi Hospital in Gauteng; Worcester Hospital in the Western Cape; Rietvlei Hospital in KwaZulu-Natal; and Barkley West in Northern Cape," the minister said.

The department has also highlighted the success of the Emergency Medical Services (EMS).

"We have developed a national EMS Plan for 2010 and we are confident that with the right levels of investment in EMS as well as in hospitals in the host cities, we will be ready for any eventuality that may occur during the 2010 FIFA Soccer World Cup," she said.

Source: http://allafrica.com/stories/200706080980.html

India Downsizes Number With HIV/AIDS

2007-06-12T09:46:00.000+07:00

By, The Associated Press, June 8, 2007

The number of Indians infected with HIV is far smaller than previously believed, according to new data that appears to vindicate critics who said earlier U.N. assessments of the country's epidemic were vastly overestimated.

Experts say the still-unreleased survey is likely to show that India's number of HIV cases, which last year was said to be the highest in the world at 5.7 million, is actually well below that mark.

"The actual number we've come up with in aggregate is likely to be lower, and perhaps substantially lower," said Ashok Alexander, director of the Avahan, the Indian program of the Bill & Melinda Gates Foundation, which helped fund the study.

Alexander declined to estimate what the new number would be, saying the data is still being analyzed and precise numbers would not be released for a few more weeks.

The new estimate comes from combining data collected from prenatal clinics; a survey of high-risk groups, such as sex workers; and from the government's National Family Health Survey - a method Alexander said was more reliable than the previous estimates, which relied largely on extrapolating from the prenatal clinic data.

The health survey - the third conducted since 1992-93 but the first to provide an HIV estimate - is considered the most comprehensive source and carries the most weight in determining the new figures. It covers about 200,000 people between the ages of 15 and 54, more than half of them women, and was conducted through face-to-face interviews all across India between December 2005 and August 2006.

A statement released Friday by the government's HIV control program, UNAIDS and the World Health Organization acknowledged that the new data provided "a more accurate picture of the epidemic because of availability of more information based on population surveys and improved data from high-risk groups."

But in an indication of how sensitive the new data is in India, where billions of dollars have been poured into prevention programs to stop the spread of HIV, the statement made no mention of the lower overall estimate.

Instead, it only pointed out that HIV rates remain high about groups most at risk - sex workers and their clients, especially truckers; men who have sex with men; and intravenous drug users.

Daniel Halperin, an HIV and AIDS expert at the Harvard School of Public Health, said the new data put health officials in a bind.

"On the one hand there's a real HIV epidemic in India and it needs to be addressed, but on the other, there's an understandable concern that people were worried that funding or attention could be diminished if the prevalence numbers come out lower," he said.

While health experts called the new data good news, they cautioned that HIV is still a major problem, particularly in southern Indian states where rates might be as high as 1 percent of the general population.

"This is a bit like declaring victory before even fully fighting the battle," Alexander said.

This is not the first time experts have questioned India's official HIV numbers.

Halperin and colleagues have published several studies in leading medical journals arguing that the number of AIDS victims in India and other parts of the world are actually far lower than the official numbers claim.

In 2006, Indian doctors argued in a published report that the methodology gave a flawed picture because the amount of HIV-positive people reporting to prenatal clinics, sexually transmitted infection clinics and public hospitals was not representative of their true numbers in the population.

The lead investigator behind the report, Dr. Lalit Dandona of the Administrative Staff College of India in the southern city of Hyderabad, estimated the number of infected adults at between 3.2 million and 3.5 million.

In a country with a population of more than 1.1 billion people, that's far fewer than 1 percent.

While Africa has long attracted most of the attention from international HIV experts, some Western AIDS organizations have argued in recent years that the Indian government was underestimating the scale of its HIV problem, Halperin said.

He thought the new data could serve as vindication for Indian officials.

"It turns out that some people in the government years ago were correct in rejecting the notion that the epidemic was spiraling out of control," he said.

Experts found the dramatic revision in line with an improved understanding of AIDS across the globe.

"There are corrections that happen in the data from time to time," said Paul Zeitz, executive director of the Global AIDS Alliance in Washington. "But if India still has millions of infections, there are still risks for increasing those numbers."

Source: http://www.365gay.com/Newscon07/06/060807india.htm

Africa: Thousands of Babies Are Still Being Infected With HIV By Mothers

2007-06-08T10:07:00.000+07:00

By, Kerry Cullinan, Health-e (Cape Town), June 7, 2007

Shocking figures about HIV infection in babies and high AIDS-related child mortality have made the transmission of HIV from mothers to babies a key focus of third South African AIDS conference.

South Africa has had a prevention of mother-to-child HIV transmission (PMTCT) programme since 2003, yet it is only reaching an estimated one-sixth of pregnant, HIV positive women.

This means that thousands of babies are being infected each year as at least one in three pregnant women nationally was HIV positive by 2005 and around a third of HIV positive mothers transmit HIV to their babies.

"South Africa is one of only nine countries in the world where the child mortality rate is increasing instead of decreasing, mainly as a result of HIV-related deaths," revealed Professor Nigel Rollins, head of the Centre for Maternal and child health at the University of KwaZulu-Natal.

"In KwaZulu-Natal alone, 20 000 to 30 000 children are being infected with HIV each year and half of them will need antiretroviral drugs by the age of 12 months.

"There is no way that the health system will be able to meet the treatment and care demand for these children if this infection rate continues," Rollins told a session convened by the United Nations children's organisation, Unicef.

The health system is already failing to treat HIV positive children. By last year, only 21 000 children were getting ARVs out of an estimated 123 000 children who needed the medicine, according to Farai Dube from Enhancing Children's HIV Outcomes.

Over six out of 10 children under the age of five who died in Durban last year showed clinical signs of HIV infection, yet "the vast majority" did not have access to PMTCT or ARV treatment, according to Dr Kimesh Naidoo of King Edward Hospital.

The new National HIV/AIDS Strategic Plan aims to reduce the rate of mother to child transmission to 5% by 2011.

To do so, government needed to prioritise pregnant women with a low CD4 count (measure of immunity in the blood) who were most likely to transmit HIV to their babies, said Rollins.

These women should be treated with at least two antiretroviral drugs to reduce their infectiousness and ensure that they were well enough to look after to look their babies, he added.

At present, the PMTCT programme gives one dose of nevirapine to women when they are in labour and to their babies within 72 hours of birth.

"We will never cut the transmission rate to 5% with one dose of nevirapine. In the US and Europe, mother-to-child transmission has been reduced to around 2% with the use of two to three antiretroviral drugs," said Dr Francois Venter, head of the SA HIV Clinicians' Society.

"If we fix PMTCT, we don't have to expand child HIV treatment."

A wide range of conference delegates pleaded for government to change the way that PMTCT was being implemented to reach more women. Among the proposals put forward were that:

PMTCT should be integrated into antenatal clinics and run by midwives and nurses instead of being a stand-alone programme run mainly by lay counsellors.

All antenatal clinics and hospitals should stock nevirapine.

Clinic staff should be involved in developing locally appropriate messages to encourage women to have HIV tests.

Source: http://allafrica.com/stories/200706070583.html

Women won’t wait

2007-06-07T14:20:00.000+07:00

By, Susana Fried, Open Democracy, June 6, 2007

It is dangerous to separate the fight against HIV/Aids and the struggle for women’s health and rights, Susana Fried warns the G8.

The German presidency of the G8 has made fighting HIV and Aids in Africa a priority for the Summit at Heiligendamm this week. Leaders of the world's wealthiest countries have committed to supporting HIV/Aids prevention, treatment, and care, with the goal of coming "as close as possible" to universal access to treatment by 2010. But these lofty promises have not yet translated into dedicated funding to address a major and prevalent driver of the pandemic - the deadly intersection of HIV/Aids with violence against women and girls.

To state the obvious - violence against women and girls is a big contributor to death and illness among women, as well as to a host of human rights abuses. Moreover, gender-based violence, and particularly intimate partner violence, is a leading factor in the increasing "feminization" of the global Aids pandemic. Simultaneously, HIV/Aids is both a cause and a consequence of the gender-based violence, stigma and discrimination that women and girls face in their families and communities, in peace and in conflict, within and outside of intimate partnerships, and by state and non-state actors.

Yet agencies continue to treat HIV/Aids and violence against women and girls as separate issues - so that not only are efforts to address violence as a cause and consequence of HIV infection under-funded, but also the strategic imperative for integrating these efforts continues to suffer from a dangerous and dysfunctional split. Rather than comprehensively addressing this deadly intersection, national and global Aids responses continually fail to grapple with its implications.

The discrimination and abuse faced by same sex desiring and gender non-conforming individuals is captured by the term "heteronormativity". This term is used to encompass practices used to enforce "normal" (men as 'masculine' – read assertive and in control, and women as feminine – read passive and docile) heterosexuality. Cathy Cohen has defined heteronormativity as the practices and institutions "that legitimize and privilege heterosexuality and heterosexual relationships as fundamental and "natural" within society" (2005: 24). Her work emphasizes the importance of sexuality as implicated in broader structures of power, intersecting with and inseparable from race, gender, and class oppression. See also

The roots of the problem

Women and girls are at persistent risk of attack. According to the recent World Health Organization (WHO) multi-country study on violence against women, in 13 of their 15 study sites, one-third to three-quarters of women had been physically or sexually assaulted by an intimate partner. Violence, or the threat of it, not only causes physical and psychological harm to women and girls, it also limits their access to and participation in society because the fear of violence circumscribes their freedom of movement and of expression as well as their rights to privacy, security and health. Women and girls encounter violence in their homes, communities, schools, workplaces, streets, markets, police stations and hospitals. And women who are HIV-positive face an additional danger: the stigma and threat of violence against people living with HIV and Aids.

Women are two to four times more likely to contract HIV during unprotected sex than are men, because their physiology places them at a higher risk of injuries, because they are less able to control the circumstances and conditions of sexual intercourse, and because they are more likely than men to be at the receiving end of violent or coercive sexual intercourse. Elements of the Aids testing, treatment and prevention machinery may also bring risk, such as the danger of violence connected to disclosure of HIV positive serostatus, coercive testing in the guise of voluntary counseling and testing (VCT), or the insidious treatment of women as vectors of disease, as in the case of prevention of mother-to-child transmission programmes (PMTCT) that fail to treat pregnant HIV positive women as clients with rights, or only as, and nothing more than, child-bearers.

The impacts of both HIV/Aids and violence against women is exacerbated by inadequate services and failure to protect sexual and reproductive health and rights; laws that are weak or discriminatory toward women living with HIV/Aids; social and community standards that validate the subordination of women and all others whose sexuality and gender identity do not conform to social standards of appropriate femininity and masculinity; and the intersecting forms of discrimination faced by women and girls because of their race, language, sexuality, ethnicity, and other similar factors.

This is why national and international commitment to universal access is crucial to reversing the HIV/Aids pandemic. But only in rare instances have states fully committed to grappling with women's human rights in relation to violence or HIV/Aids. Equally rarely have donors and other multilateral agencies created structures of accountability in service of respecting, protecting and fulfilling the human rights of women and girls. The Women Won't Wait campaign's March 2007 report looked at the policy, programming and funding patterns of the five largest public HIV/Aids donors and found that strong statements of policy concern 'evaporate' at the level of implementation. The level of funding for efforts to address gender-based violence remains small and often marginalized, while the integration of violence against women programming in the much larger pot of funding for HIV/Aids is inadequate and hard to trace.

Gender-based violence continues to be treated as an "add-on" rather than as integral to work on HIV/Aids. Meanwhile, levels of funding for women's rights work are 'dismal', according to the Association for Women's Rights in Development. Violence against women and girls is rarely highlighted as a major driver and consequence of the disease, nor measured statistically to contribute to the evidence base. It is nearly impossible to determine the precise amount of money contributed to work at the intersection because none of these donors publicly track their programming for and funding to violence eradication efforts within their HIV/Aids portfolio. All this despite the fact that - as WHO Director-General Margaret Chan has said - "what gets measured gets done".

Show us the money

Real commitments on the issues of gender-based violence against women and girls and the feminization of the AIDS epidemic from member nations of the G8 are long overdue. G8 member nations must now take bold steps to demonstrate their commitment to respect, protect and fulfill women's rights - especially in the context of HIV/Aids - by promoting policies and negotiating positions that ensure adequate health care, education, legal services, and gender-sensitive and rights-based Aids and anti-violence interventions.

Women's movements throughout the world have long fought for concrete action to promote and protect the human rights of all women - including the rights to be free from violence, coercion, stigma and discrimination, and the right to achieve the highest attainable standard of health, including sexual and reproductive health. But this global standard is rarely translated into policy and practice. In the case of HIV/Aids, this results in a deadly failure in policy and an abrogation of governments' and donors' accountability. The waiting must end

Source: http://www.opendemocracy.net/democracy-fifty/women_wait_4680.jsp

HIV And Malaria Combine To Adversely Affect Pregnant Women And Their Infants

2007-06-06T10:29:00.000+07:00

By, Medical News Today, June 4, 2007

University of Toronto researchers have uncovered the basis by which pregnant women protect themselves against malaria and have also discovered how the HIV virus works to counteract this defence. The research could lead to improved vaccines for pregnant women in malaria-ravished regions.

Malaria is a parasitic disease spread by mosquitoes that kills more than one million people every year. While the disease affects mostly children, malaria also severely affects pregnant women, especially during their first pregnancy, accounting for an estimated 400,000 cases of severe anaemia and 200,000 infant deaths each year. With the recent realization that HIV further aggravates pregnancy-associated malaria (PAM) there is an urgent need to understand these diseases during pregnancy and turn this knowledge into effective therapies.

Until now the mechanisms by which pregnant women defend themselves against malaria and how HIV impairs this defence have been unknown, but a paper published in PLoS Medicine (Public Library of Science) pinpoints how the virus targets the immune response in pregnant women. "PAM can be a deadly condition that leaves mothers and their children particularly vulnerable," says Professor Kevin Kain, an infectious disease specialist and lead author of the study. "We set out to understand how women acquire protection against malaria during pregnancy and how HIV infection impairs that protection. By understanding how they lost protection in the face of HIV we learned how they acquired protection against malaria in the first place."

PAM occurs when red blood cells infected with malaria parasites gather in the placenta resulting in damage to both mother and developing infant. First-time mothers are particularly susceptible to PAM whereas women in subsequent pregnancies become protected against PAM. Having HIV results in this loss of protection and makes them as susceptible as first-time mothers.

To uncover how HIV affects PAM, Kain and his team collected samples from women in the first pregnancy as well as from women in their subsequent ones living in the Kenyan region where malaria is common. The researchers demonstrated that protection to PAM is mediated by a special type of antibody that allows women to preferentially clear the parasites in their placentas. They found that HIV-infected women lose these antibodies and again become susceptible to the ravages of PAM.

The findings, according to Kain, may help in the development of PAM vaccines. "This is only the first step in creating therapeutics to treat this devastating disease," he stresses. "We hope to help translate this knowledge into more effective vaccines designed to generate these types of protective antibodies."

###

The study was funded by Canadian Institutes of Health Research (CIHR) Team grant in Malaria, Genome Canada through the Ontario Genome Institute, and the McLaughlin-Rotman Centre/MCMM.

Source: http://www.medicalnewstoday.com/medicalnews.php?newsid=72571&nfid=rssfeeds

One out of 100 adults in India HIV-positive

2007-06-05T11:17:00.000+07:00

By, The Times of India, June 4, 2007

NEW DELHI: India might be a low prevalence country for AIDS with only 0.9% of the adult population estimated to be infected with HIV. But in numbers, the situation looks grave with nearly 1 out of 100 adults in the country being HIV-positive.

In Bihar and Uttar Pradesh, the task of raising awareness about HIV is especially difficult due to the high proportion of rural population and relatively low levels of literacy. In Bihar, nearly 90% of the population lives in villages. In Uttar Pradesh, the figure is 79%. A particular problem is the literacy levels of females in both states. In Bihar, only one-third of females were literate at the time of the 2001 Census, as were 42% in Uttar Pradesh.

Despite such obstacles, awareness of HIV, how it spreads and ways to avoid it have risen in both states, according to bilingual HIV statistical chartbooks on the situation of HIV/AIDS in India, Bihar and Uttar Pradesh brought out by the Population Foundation of India, New Delhi, and Population Reference Bureau (PRB), Washington DC. The books were released at a seminar organised on Saturday. According to the charts, testing for HIV prevalence at sentinel sites in Bihar and UP has shown that HIV infection is spreading in the states, although the overall level of prevalence appears to be low at present.

Women are the most vulnerable to AIDS and yet their knowledge of the deadly disease is abysmally low. India's most scientific survey — the National Family Health Survey III, which for the first time came up with trend data on HIV/AIDS-related behaviour — has made some startling revelations.

Source: http://timesofindia.indiatimes.com/One_out_of_100_Indians_HIV-positive/articleshow/2096115.cms

Directly observed HIV therapy for children is promising

2007-06-05T09:48:00.000+07:00

By, News-medical.net, June 3, 2007

Directly observed antiretroviral therapy is a promising strategy to ensure that HIV-infected children in developing countries take life-saving medications, new research from The Warren Alpert Medical School of Brown University shows.
The study was conducted in collaboration with Maryknoll, the international Catholic charity that runs a program for AIDS orphans in Phnom Penh, Cambodia's capital city. The study is the first to test the benefits of directly observed treatment in children living in developing countries. Findings are published in the June issue of the American Journal of Public Health.

"Results of this study tell us that directly observed treatment for children with HIV is an important strategy to consider in resource-limited settings, said David Pugatch, M.D., director of the pediatric and adolescent HIV program at Hasbro Children's Hospital and an assistant professor of pediatrics at The Alpert Medical School.

"With the cost of AIDS drugs dropping, antiretroviral treatments are increasingly becoming available in Asia, Africa and Latin America," Pugatch said, "yet there is little evidence of what is the best way to deliver these drugs to children living in these countries. We found that directly observed therapy is an effective and economical way to go."

Without antiretroviral treatment, half of all HIV-infected children die by age 2. With therapy, however, many children survive to adulthood. That's why the World Health Organization is calling for worldwide universal access to antiretroviral therapy by 2010.

But what's the best way to deliver these drugs to children in developing countries, places with often limited access to basic tests and trained professionals" Pugatch and his Brown colleagues, who have helped combat AIDS in Cambodia for years, decided to find out.

They evaluated the outcomes of HIV-infected children receiving directly observed therapy, a method that calls for health care workers to either watch patients take every drug dose or deliver those doses themselves. This method, widely used to combat tuberculosis, is aimed at ensuring that people take their medications. That adherence will keep patients healthy and reduce the likelihood of drug resistance.

Researchers evaluated HIV-infected children living in orphanages or with extended family in Phnom Penh. Researchers assessed 117 late-stage HIV-infected children ages 1 to 13.

Because treatment started so late, 22 children died of AIDS within the first six months. The remaining 95 children were treated for at least six months or as many as 18 months. Trained childcare workers administered the generic drugs, in liquid or pill form, twice daily.

The results: The number of immunity-boosting T helper cells in the blood of children more than tripled. Children gained significant amounts of weight. Drug toxicities were uncommon and easily managed. And the price was right: Staff costs for the program were about $5 per child per month, or 15 percent more than the price of the medications. Calculated another way, it cost $400 per child per year to buy the drugs and another $60 to pay the professionals who administered them.

"For just a little extra money, we could be sure that children had 100 percent adherence to their medications," Pugatch said. "We know that a high degree of adherence reduces the chances of drug resistance , which can lead to treatment failure and the need to put kids on more expensive, second-line therapies."

The next steps researchers must take, Pugatch said, are to conduct a randomized, controlled trial to compare directly observed therapy with standard care as well as to conduct a rigorous cost-benefit analysis. "We need to know what works in treating children in resource-poor settings so we know where to put limited HIV treatment dollars," he said.

http://www.brown.edu/

Source: http://www.news-medical.net/?id=25949

Cultural traditions regarding women fueling spread of HIV in Botswana and Swaziland

2007-06-04T11:50:00.000+07:00

By, Medical News Today, June 1, 2007

Cultural traditions that do not value women are fueling the spread of HIV in Botswana and Swaziland, according to a Physicians for Human Rights report released on Monday, AFP/Yahoo! News reports. "The legal systems in both countries grant women lesser status than men, restricting property, inheritance and other rights," the report said. It added, "Neither country has met its obligations under international human rights law," and as a result, women "continue to be disproportionately vulnerable to HIV/AIDS."

According to AFP/Yahoo! News, women do not have control over sexual relationships, including condom use, and they are afraid that testing positive for HIV will jeopardize their relationships or lead to stigma. The report also found that women's HIV status in Botswana, which has not criminalized partner violence or marital rape, affects their ability to provide food for themselves and their children after contracting the virus. The report found that many HIV-positive women in Botswana engaged in risky sex in exchange for food.

The report found that 19% of people who participated in a community survey in Botswana said it is more important for women to respect male partners than for men to respect their female partners. In addition, the report found that 97% of respondents held at least one discriminatory belief toward women. According to AFP/Yahoo! News, Swaziland has an HIV prevalence of about 40%, and men in the country are encouraged to have multiple sexual partners (AFP/Yahoo! News, 5/28).

Source: http://www.medicalnewstoday.com/medicalnews.php?newsid=72633&nfid=rssfeeds

Women's rights key to Africa AIDS crisis

2007-05-28T11:03:00.000+07:00

By, Andrew Quinn, Alernet, May 25, 2007

Improving women's rights could boost the battle against AIDS in southern African countries, where women are often forced into risky sex by male partners or economic desperation, a new report said on Friday.

Physicians for Human Rights said its study of 2,000 women in Botswana and Swaziland showed inequality and gender discrimination were major factors behind a pandemic which has seen the two countries struggle with the worst AIDS crises in the world.

"If we are to reduce the continuing, extraordinary HIV prevalence in Botswana and Swaziland, particularly among women, the countries' leaders need to enforce women's legal rights," study co-author Karen Leiter said in a statement.

"The impact of women's lack of power cannot be underestimated."

Almost 25 million Africans are infected with the HIV virus, giving the continent the worst AIDS burden in the world. Women make up 75 percent of HIV-positive Africans aged between 15-25.

The PHR study concentrated on the two African countries with the highest HIV prevalence rates -- Swaziland, where an estimated 33 percent of adults are infected, and Botswana, where about 24 percent carry the virus.

Researchers conducted random surveys on gender attitudes and sexual behaviour and concluded that greater social and economic inequality between the sexes directly correlated to the HIV risk faced by African women.

"Despite the differences in the two countries, the women in the samples have very similar demographics ... they were poorer, had a greater number of dependents, were less educated and were less food sufficient," Leiter said.

"They are compelled often by their circumstances to engage in sexual behaviour that raises their HIV risk."

Economic dependence on men meant that women often lose control of their sexual choices, including whether or not to use a condom, while social inequality meant that men and women are held to different standards of behaviour when it comes to multiple sexual partners, the report said.

In Botswana, for example, researchers found that survey participants who reported higher levels of discriminatory beliefs about the role of women were almost three times as likely to have had unprotected sex with a non-primary partner on the previous year.

U.S.-based PHR, which was a co-recipient of the 1997 Nobel Peace Prize, said African governments and traditional social leaders were failing to ensure existing legal and constitutional protections for women's rights.

In particular, both Botswana and Swaziland need to work to end discrimination against women in marriage, inheritance, property and employment rights and boost efforts to end domestic and sexual violence against women.

Source: http://www.alertnet.org/thenews/newsdesk/L25415175.htm