[hivaids-twg] Today's News (2009.11.05ex)
Diaz, Clara
diazc at unaids.org
Thu Nov 5 12:45:40 GMT 2009
Please find attached the following AIDS-related articles compiled by UNAIDS
AFRICA AND MIDDLE EAST
1. Times LIVE, SA - SA's 1st HIV convention for people living with HIV/AIDS
2. Business Day, SA - Aids Programme May Be Reducing Deaths
3. IRIN/PlusNews - SWAZILAND: TB-HIV services needed to lower world's highest rates
4. Angola Press - Ouverture des journées scientifiques sur la tuberculose et le VIH/Sida
ASIA AND PACIFIC
1. Xinhua News, China - Nailatikau sworn in as Fiji's new President
2. UN IRIN - HIV-positive cases jump to 556 in Afghanistan
EUROPE
1. BBC News, UK - Vietnam sees the funny side of sex
2. Reuters, UK - Punishing success in tackling AIDS: Funders' retreat could wipe out health gains in HIV affected countries
3. AidsMap News, UK - Circumcision protects gay men who have a 'preference' for insertive sex from HIV
4. AFP - Lutte anti-sida, tuberculose, paludisme: inquiétudes sur le financement
5. AFP - L'Afrique du Sud en quête d'un "nouvel homme" pour lutter contre le sida
LATIN AMERICA AND CARIBBEAN
1. Kaieteur News, Guyana - AIDS Committee supports free movement of people living with disease
2. Jamaica Gleaner - Jamaica AIDS Support applauds Obama - US entry ban on HIV-positive persons nears end
3. Juku'éke, Paraguay - Director de UNFPA en la región participará de estudio abierto de Radio Viva
4. Diario CoLatino, El Salvador - Migración, factor de riesgo en el aumento del VIH
5.
NORTH AMERICA
1. U. of Pittsburgh The Pitt News - Editorial: Overturning HIV immigration ban brings benefits
2. Brookings Institution - Tackling HIV/AIDS in Africa: From Knowledge to Behavior Change
3. New York Times - Beauty at the Ball
4. IPS Terra Viva - Southern Researchers Fill Gap on Neglected Diseases
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AFRICA AND MIDDLE EAST
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SA's 1st HIV convention for people living with HIV/AIDS
Times LIVE, SA
04/11/2009
Claire Keeton
The first ever convention for people living with HIV/AIDS will take place in Midrand on Friday, initiated by the outstanding HIV activist Pholokgolo Ramothwala, who has been living with HIV for the past 11 years.
He says: "Positive Convention is a conference about living with HIV/AIDS for people living with HIV or AIDS. Its theme is based on the premise: 'No one knows and understands the challenges of living with HIV or AIDS than those who are living with the virus'.
"It will address social and workplace issues faced by people living with HIV/AIDS, that is, stigma, discrimination, alcohol abuse, treatment adherence, reproductive rights and legal issues amongst others. The topic 'Young professionals living with HIV/AIDS' will be given a special focus."
Ramothwala is expecting about 300 people to attend the conference, which will also focus on the role that people with HIV can play in prevention efforts and as role models in promoting healthy lifestyles and self confidence.
High profile speakers like the Minister of Health Dr Aaron Motsoaledi, SANAC CEO Dr Nono Simelela, Constitutional Court Judge Edwin Cameron, and Dr Mary Fanning, the US Health Attaché, will speak at the meeting.
Soul City, the Positive Women's Network, PEPFAR agencies, the US Centers for Disease Control and Prevention, USAID and Johns Hopkins Health and Education South Africa are supporting this initiative.
More than five million South Africans are HIV positive, according to the 2008 HSRC national survey.
2
Aids Programme May Be Reducing Deaths
Business Day, SA
05/11/2009
Tamar Kahn
Cape Town - The government's AIDS treatment programme may have begun to put the brakes on SA's rising death rate, a senior official of the Department of Health told Parliament yesterday.
Referring to figures released earlier this week by Statistics SA showing a slight drop in the number of deaths recorded by the Department of Home Affairs in 2006 and 2007, the deputy director-general for strategic health programmes, Yogan Pillay, said: "It might be a data problem or it might be good news. We hope at least in part it's the ARV (antiretroviral) programme."
More research was needed to determine whether the figures were part of a sustained downward trend, Pillay said.
Stats SA's latest findings are important because, while there is plenty of published evidence that ARVs save lives, there has been little South African data showing their effect on the population level.
SA was a late starter with its state- sponsored AIDS treatment programme, largely due to former president Thabo Mbeki 's doubts about the safety and efficacy of ARV medicines. Despite a fast-growing HIV/AIDS epidemic and rising deaths, the government only started providing ARV medicines in 2004. The programme started slowly, but by April this year more than 700000 people had started treatment at state health facilities. More than 900000 are expected to have been enrolled by the end of March.
Stats SA's latest mortality report, released on Monday, shows 601133 deaths were registered by home affairs in 2007, a 1,8% drop on the updated 2006 figure. But it is being cautious in interpreting the data.
3
SWAZILAND: TB-HIV services needed to lower world's highest rates
IRIN/PlusNews
04/11/2009
MBABANE, 4 November 2009 (PlusNews) - Swaziland not only has the world's highest HIV prevalence rate, it now also has the highest tuberculosis (TB) rate, but health officials warn that not enough is being done to integrate TB and HIV services.
Last week the Ministry of Health and Médecins Sans Frontières (MSF), the international medical humanitarian organization, brought together health experts to look at practical solutions for the small landlocked country.
One in four adults is infected with HIV; by the end of 2007 an estimated 170,000 people were living with HIV, and every year an estimated 13,000 people develop TB, the primary opportunistic disease in HIV-positive people.
"When you look at the history of TB in Southern Africa you see that it was considered a very serious disease in the 1950s, but seemed to be under control by the 1980s; but with the arrival of HIV and AIDS, TB rates have really gone out of control," said Prof Alan Whiteside, head of the Health Economics and HIV Research Division (HEARD) at the University of KwaZulu-Natal in South Africa.
Themba Dlamini, manager of Swaziland's National TB Control Programme, said 80 percent of Swaziland's TB cases were also HIV-positive.
But with governments focused on HIV/AIDS, TB has not been getting enough attention.
"Part of the problem is we've been very good at mobilizing for HIV and AIDS, and we sort of forgot about TB as we did that. Unfortunately, I don't think the people mobilizing for TB have been as articulate and as powerful as those mobilizing for HIV and AIDS - we need to put TB higher on the public agenda," Whiteside told IRIN/PlusNews.
Swaziland's Health Minister, Benedict Xaba, reminded delegates that although the country provided free TB medicines, other costs, such as hospital fees and transport, made it difficult for many people to access health services.
"There are several issues that Swaziland needs to face. Access to care is particularly important ... so people who show signs of symptoms can be checked immediately. Free consultation is absolutely imperative - we must think of free care from diagnosis to clinical cure," urged Dr Mario Raviglione, Director of the Stop TB Department of the World Health Organization (WHO).
Raviglione urged the country to step up efforts to integrate TB and HIV services. "It doesn't make any sense for a person taking TB drugs and ARVs [antiretrovirals, to treat HIV] to go to two separate doctors. These must be integrated."
About 58 percent of TB patients completed their six-month course of treatment last year, falling far short of the 85 percent target recommended by WHO. International guidelines also set a 70 percent detection target for TB, but in Swaziland the case detection rate is below 60 percent.
The good news is that, unlike HIV/AIDS, TB is curable. "I know people living with HIV and TB, and their TB has been dealt with," noted Whiteside. "It is a community message we need to get out - that we are capable of eliminating the scourge of TB in your community."
5
Ouverture des journées scientifiques sur la tuberculose et le VIH/Sida
Angola Press
05/11/2009
Luanda - Les premières journées scientifiques sur la tuberculose et le VIH/Sida s'ouvrent jeudi, à Luanda, sous le thème "en regardant vers l'avenir sans tuiberculose et le Sida", a appris l'Angop de source proche de l'organisation.
Selon la source, la rencontre qui regroupera 300 participants, parmi lesquels des médecins, infirmiers, est une organisation de l'hôpital Sanatorium de Luanda, et vise à aborder intégralement les malades y internés, souffrant de la tuberculose et du VIH/Sida.
L'objectif de ces journées est de discuter des thèmes relatifs à la prévention, thérapeutique et au diagnostic des tuberculeux et Sidatiques, fournir des informations plus actualisées pour aider les professionnels dans leur travail.
Parmi ces thèmes figurent "l'hôpital Sanatorium de Luanda, avant et après", "l'Analyse de la situation de cet hôpital", "la Tuberculose extra-pulmonaire, un défi pour le médecin", "Co-infection VIH/Sida-Tuberculose-épidemiologie en Angola et dans le monde" et "la stratégie nationale de contrôle de la Tuberculose à Luanda".
Ces journées seront animées par des médecins angolais et cubains.
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ASIA AND PACIFIC
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Nailatikau sworn in as Fiji's new President
Xinhua News, China
05/11/2009
SUVA, Nov. 5 (Xinhua) -- Fiji's newly appointed President Ratu Epeli Nailatikau was sworn in on Thursday at Government House, Suva by the Chief Justice Anthony Gates.
Nailatikau, former speaker of the House of Representatives, will serve for three years in Fiji's highest office of the land.
He was also a former commander of the Fiji Military Forces where he spent 20 years and former diplomat of 17 years.
On July 30, 2009, he became acting President after the retirement of Ratu Josefa Iloilo aged 88 and his appointment was decided by the interim Cabinet.
After the swearing in, Nailatikau spoke on the need for unity, love and hope.
Nailatikau has been an active advocate on HIV/AIDS after his appointment as UNAIDS Special Representative for the Pacific.
He was chosen because of his political position, respect throughout the Pacific region, and his outspokenness on AIDS-related issues.
He has previously served as a UNAIDS Pacific spokesman, and in 2004 chaired the first conference of Pacific Parliamentarians on the Role of Pacific Parliamentarians in the fight against HIV/AIDS, in Suva.
Nailatikau's outspoken calls to tackle the AIDS crisis have attracted controversy the most as he often called on people to recognize the reality that promiscuity existed, and that safe sex needed to be promoted to combat the associated AIDS risk.
Editor: Deng Shasha
3
HIV-positive cases jump to 556 in Afghanistan
UN IRIN
05/11/2009
KABUL, 5 November 2009 (IRIN) - Over 50 people have been diagnosed as HIV-positive in Afghanistan over the past nine months, bringing the number of registered cases to 556, according to the National HIV/AIDS Control Programme.
"Most of them have got the virus through intravenous drug use," Malika Popal, the Programme's advocacy and communications adviser, told IRIN, adding that three HIV/AIDS patients had died so far this year.
The Health Ministry estimates 2,000-3,000 people are living with HIV/AIDS in Afghanistan. The virus prevalence rate of about 0.5 percent is considered among the lowest in the world.
Armed conflict, lack of awareness of HIV/AIDS, lack of access to basic social services such as education and health, rising intravenous drug addiction, and the poor social status of women are among the factors which, experts say, could lead to a rapid spread of HIV/AIDS.
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EUROPE
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Vietnam sees the funny side of sex
BBC News, UK
04/11/2009
By Ha Mi, BBC Vietnamese service
Vinh, a 24-year-old man, says his parents never talked to him about sex.
"But they would make jokes about it so that I know what they expect from me," he says.
Vinh is from Hue, one of the most traditional cities in Vietnam, but this attitude is found throughout the country, according to the authors of the first survey into sex and sexual attitudes carried out in the communist state for 50 years.
By turning it into a joke, some parents and children find it is easier to talk about sex without being judged or getting embarrassed.
This attitude seems to apply to all - young and old - in Vietnam.
But for some, the subject really is no laughing matter. The communist state is deeply conservative and sex is a highly sensitive subject.
Dilemmas
Economic liberalisation and development have made Vietnam a more open society and there has been a noticeable change in sexual behaviour.
Medical experts say increasing numbers of people are having sex below the age of consent, leading to rising numbers of unmarried women having abortions.
There is also the problem posed by unprotected sex and more people contracting HIV.
Faced with these dilemmas, there have been discussions about putting sex education on the school curriculum at an early age.
Based on the findings of the sex survey, some people think that may not be such a bad idea.
Researchers spoke to 245 people in both rural and urban areas over six years.
They discovered that teenagers or young adults "never" or "hardly ever" talked to their parents about sex.
The parents too admit that they do not speak to their children about it.
For those who do feel they should discuss the subject with their children, just how to broach it is difficult.
Diep Hoa, a mother of two, is typical in this regard. She says she used a letter to talk to her 17-year-old daughter about sex.
"I wrote to her and gave the letter to her on the day she left home to go to study abroad. I told her that I would like her to read it while on the plane," explains Mrs Hoa.
"I mentioned a lot of things in the letter, including sex and relationships. I would like her to understand what love is, what sexual relationships are and the consequences when one loses control of their sexual desires."
Gender prejudice
The survey also found that what is okay for a man is not okay for a woman.
Hong Hanh is a 22-year-old presenter of a live radio programme on HIV and Aids prevention targeted at young people.
"All male callers said that sex before marriage for men is normal and okay, but they would not want to get married to someone who has lost her virginity through sex," Hanh says.
According to Dr Khuat Thu Hong, one of the three authors of the research, "Vietnamese people have a very poor, misperceived and somehow one-sided view about sex, because there is no open or serious discussion of the matter."
She says this is very dangerous because "it leads to a lot of wrongly imposed sexual perceptions toward men and women, and it limits both sexes from enjoying a sexual relationship."
Some experts say that sex education, which is only taught in some schools, should be made compulsory because young people would benefit from the knowledge provided to them in a serious manner rather than through jokes.
However, there has been opposition to this suggestion from those who uphold what they call "traditional values".
The funny side
Teachers too find the subject highly embarrassing, and some parents and children see nothing wrong with discussing a highly taboo subject in a humorous way.
Back in his very traditional hometown, Vinh smiles and gives some examples of what his parents tell him.
"They say: 'If you get her pregnant before marriage, you both won't be allowed to go in the house by the front door', or 'you won't be allowed to go near our ancestors' altar'.
"Another favourite is: 'We will have to make a small shed near the pigsty for you to live in!'"
This indirect and light-hearted way that some parents use to talk to their children about sex as a means of educating them is also a warning to children of the consequences of sex before marriage.
But faced with rising underage sex and HIV, Dr Hong says it is about time that Vietnamese learned to talk openly about the subject.
And she hopes that the findings of the first sex survey in half a century will help change social perceptions and understanding of what remains an extremely delicate matter.
2
Punishing success in tackling AIDS: Funders' retreat could wipe out health gains in HIV affected countries
Reuters, UK
05/11/2009
Source: Medecins Sans Frontieres (MSF) - International
Johannesburg - A retreat from international funding commitments for AIDS threatens to undermine the dramatic gains made in reducing AIDS-related illness and death in recent years, according to a new report by Médecins Sans Frontières (MSF).
The MSF report highlights how expanding access to HIV treatment has not only saved the lives of people with AIDS but has been central to reducing overall mortality in a number of high HIV burden countries in southern Africa in recent years. In Malawi and South Africa, MSF observed very significant decreases in overall mortality in areas where antiretroviral therapy (ART) coverage was high. Increased treatment coverage has also had an impact on the burden of other diseases, for example tuberculosis cases have been significantly reduced in Thyolo, Malawi and Western Cape province, South Africa.
"After almost a decade of progress in rolling out AIDS treatment we have seen substantial improvements, both for patients and public health. But recent funding cuts mean doctors and nurses are being forced to turn HIV patients away from clinics as if we were back in the 1990s before treatment was available", says Dr Tido von Schoen-Angerer, Director of MSF's Access to Essential Medicines Campaign.
International support to combat HIV/AIDS is faltering as reflected in significant funding shortfalls. The board of directors of the Global Fund, a key financer of AIDS programmes in poor countries is unable to respond to countries' needs and will next week in Addis Ababa vote whether or not to suspend all new funding proposals in 2010; and PEPFAR, the US AIDS programme is flatlining funding for two more years.
"The Global Fund must not cover up the deficit caused by its funders", says von Schoen-Angerer. "The proposed cancellation of the 2010 funding round and other measures to slow the pace of treatment scale-up are punishing the successes of the past years and preventing countries from saving more lives."
In 2005, world leaders promised to support universal AIDS coverage by 2010, a promise that encouraged many African governments to launch ambitious treatment programmes.
"What about the promise made to people with AIDS? We gave them hope and life. We have to be there for them, we all knew from the beginning that this treatment was for life," says Olesi Ellemani Pasulani, MSF Clinical Officer in Thyolo District Hospital, Malawi. "Passing on the bill for treating AIDS to very poor countries would be a colossal betrayal."
Reducing funding at this time will leave people in urgent need of treatment to die prematurely and can lead to dangerous interruption of treatment. In Uganda, cuts have already begun to hit home with some facilities forced to stop treating new patients with HIV. Other countries are backing away from their earlier treatment coverage targets. In Free State, South Africa, past funding problems that have now been resolved led to disruption of treatment and a moratorium on treating new patients which resulted in an estimated 3,000 deaths.
The report provides evidence that, particularly in high HIV-prevalence settings, treating AIDS has a positive impact on other important health goals, in particular maternal and child health.
"A stronger commitment to other health priorities must happen, but this should be in addition to, not instead of, continued, increased commitment to HIV/AIDS", adds von Schoen-Angerer.
At present, over four million people living with HIV/AIDS in the developing world receive antiretroviral therapy. An estimated six million people who are in need of life-saving treatment, are still waiting for access. MSF operates HIV/AIDS programmes in around 30 countries and provides antiretroviral treatment to more than 140,000 HIV-positive adults and children.
[ Any views expressed in this article are those of the writer and not of Reuters. ]
3
Circumcision protects gay men who have a 'preference' for insertive sex from HIV
AidsMap News, UK
05/11/2009
Circumcision may protect gay men who are exclusively insertive for anal sex from infection with HIV, an Australian study published in the November 13th edition of AIDS suggests.
But this finding is based upon just seven infections amongst men who expressed a preference for insertive sex. The investigators found that amongst the men who reported only insertive sex as a behaviour, circumcision did not significantly reduce the risk of infection with HIV.
The study also showed that overall circumcision did not protect gay men from infection with HIV. < a href="http://aidsmap.com/en/news/6F898D49-BF01-4E6E-AFAC-2C3D274D91EB.asp">Earlier data from the study presented to the conference of the International AIDS Society in Sydney in 2007 showed that circumcision had no protective effect.
Gay and other men who have sex with men continue to be one of the groups most affected by HIV. Consequently, there is a need for new approaches to HIV prevention in this population.
Studies in Africa have shown that circumcision reduces the risk of HIV infection for heterosexual men. However, a recent meta-analysis found no conclusive evidence that circumcision was protective for gay men.
Researchers from the Health in Men (HIM) study therefore investigated the relationship between circumcision and the risk of HIV infection in a population of 1426 HIV-negative gay men in Sydney. In total, 938 of these men were circumcised
The men were recruited between 2001 and 2004 and followed until the end of 2007. On entry to the study, the men reported their circumcision status and this was confirmed by clinical examination.
Every six months the men attended for a follow-up visit when they were tested for HIV and the men were asked if they had had unprotected anal intercourse. In addition, individuals were also asked to say if they were insertive or receptive, and if they had a strong preference for adopting the insertive position.
A total of 5161 person years of follow-up were available for analysis, and the median duration of follow-up for each man was 3.9 years.
There were 53 HIV infections, providing an overall incidence of 0.78 per 100 person years.
Statistical analysis that included the entire study population showed that circumcision did not provide any significant protection against infection with HIV.
Only 10% of the study's person years of follow-up was contributed by men who reported insertive unprotected sex but not receptive sex without a condom. There were only four HIV infections in these men. Analysis showed that circumcised men who only reported insertive unprotected sex did not have a significantly reduced risk of HIV.
Next the investigators restricted their analysis to men who stated a preference for the insertive position in all anal intercourse. These 435 men (279 of whom were circumcised) contributed 1710 person years of follow-up.
There were a total of seven HIV infections in these men, five of which were in the uncircumcised men.
Statistical analysis showed that circumcision was associated with a significant reduction in the risk of HIV infection for men with a preference for insertive anal sex (p = 0.049). This association was strengthened when the investigators adjusted for age and potentially serodiscordant unprotected anal intercourse.
However, three of the men with a preference for insertive sex reported unprotected receptive anal intercourse. But the study's lead author, Dr David Templeton, told aidsmap.com that men expressing a preference for insertive sex adopted this position in almost 99% of instances of anal intercourse.
It is of note, however, that the investigators so not comment on the possibility of study participants providing inaccurate information about their sexual preferences or behaviour to the investigators. It is of note that for reasons of social desirability receptive anal sex is consistently under reported by gay men.
Nevertheless, the investigators comment: "Being circumcised was associated with a significant reduction in HIV incidence among the one-third of participants who reported a preference for the insertive role in anal intercourse".
A total of 9% of HIV infections in the cohort could, the investigators conclude be attributed to being uncircumcised. "Among participants who preferred the insertive role in anal intercourse, the estimate proportion of HIV infections that could be attributed to being uncircumcised by 75.7%."
They do however acknowledge that "the key limitation of our analysis was lack of power due to relatively small numbers of HIV infections in the HIM cohort and the low incidence of HIV infection among predominately insertive men."
The investigators call for randomised controlled trials to further explore the relationship between circumcision and the risk of HIV for gay men.
Such studies could, however, be difficult to design and the investigators question if they would be worthwhile. They note that the studies "would require high HIV incidence, low baseline circumcision prevalence and large numbers of participants exclusively or predominately practicing the insertive role." The investigators emphasise that "such attributes are necessary for sufficient study power to detect an association between circumcision status with the relatively infrequent outcome measure of HIV acquisition via insertive anal intercourse."
Reference
Templeton DJ et al. Circumcision and risk of HIV infection in Australian homosexual men. AIDS 23: 2347-51, 2009
4
Lutte anti-sida, tuberculose, paludisme: inquiétudes sur le financement
AFP
04/11/2009
PARIS - Des associations ont lancé mercredi un cri d'alarme sur les problèmes de financement du Fonds mondial de lutte contre le sida, la tuberculose et le paludisme, qui ne devrait pas être à même de répondre aux demandes de subvention après 2010.
"Les besoins de financement de ces maladies ne sont pas couverts", a souligné Eric Fleutelot, de Sidaction, au cours d'une conférence de presse. Il a rappelé que 4 millions de personnes ont accès à un traitement anti-sida sur 11 millions de personnes qui en ont besoin, qu'il y a eu en 2007 9 millions de nouveaux cas de tuberculose et que le paludisme, qui a fait plus de 900.000 morts en 2006, concerne 247 millions de personnes.
La réduction des financements mondiaux, a-t-il dit, a entraîné par exemple une réduction de 25% du budget de lutte contre le sida de la Tanzanie. Il a signalé aussi des ruptures d'approvisionnement en antirétroviraux dans plusieurs pays d'Afrique comme l'Ouganda ou le Malawi.
En fin de semaine, le Fonds mondial doit tenir son Conseil d'administration à Addis-Abeba où il décidera du financement sur trois ans des projets déposés cette année. Or "il ne reste quasi rien en caisse", a souligné Emmanuel Trenado, de la coalition Plus.
En juillet le directeur exécutif du Fonds Michel Kazatchkine s'était alarmé de la baisse des financements, soulignant qu'il lui manquait trois milliards de dollars pour 2010 à cause d'une demande accrue de soins.
"J'espère que l'argent promis pour 2008-2010 arrivera (...) mais je suis inquiet que les bailleurs ne soient pas capables d'augmenter leurs financements", déclarait alors le Pr Kazatchkine.
Selon les associations, les pays donateurs souhaiteraient en outre une annulation en 2010 du processus de présentation des projets. Quarante-neuf associations africaines de lutte contre le sida ont lancé mercredi un appel d'urgence pour qu'ils renoncent à ce projet.
Les pays industrialisés du G8 s'étaient engagés en 2005 à aider l'Afrique à atteindre l'accès universel aux antirétroviraux d'ici 2010. "Il y a urgence à ce que les pays riches répondent à leur engagements", a noté Pauline Londeix, de Act-up Paris.
Selon les associations, la députée UMP Henriette Martinez a suggéré dans un rapport de réduire la contribution de la France au Fonds mondial, pour mettre les sommes dégagées à disposition des opérateurs français, plus visibles.
Copyright © 2009 AFP. Tous droits réservés
5
L'Afrique du Sud en quête d'un "nouvel homme" pour lutter contre le sida
AFP
04/11/2009
JOHANNESBURG - "Un nouvel homme est arrivé en Afrique du Sud: c'est un homme qui prend ses responsabilités!". Cet encart dans la presse sud-africaine compte parmi les multiples initiatives qui cherchent depuis peu à enrôler la population masculine dans la lutte contre le sida.
Cet homme "se contente d'une partenaire", "ne se trouve pas d'excuses s'il a un rapport non protégé" et "respecte sa femme", précise l'encart qui vise à transformer les stérétotypes sur la virilité.
L'image positive associée au séducteur, n'ayant peur de rien et grand consommateur d'alcool est particulièrement nocive en Afrique du Sud, pays le plus touché au monde par le sida, avec 5,7 millions de séropositifs sur 48 millions d'habitants.
La campagne de communication, baptisée "Frère pour la vie", s'y attaque avec un double objectif: convaincre les hommes -- qui gardent la main haute dans le choix des pratiques sexuelles -- d'utiliser des préservatifs, mais aussi améliorer leur accès aux traitements.
Jusqu'à présent, l'essentiel des programmes sur le sida se sont construits autour des centres de soins, qui sont principalement utilisés par les femmes. "C'est difficile pour un homme d'aller dans une clinique et de reconnaître sa vulnérabilité", explique l'un des promoteurs de la campagne, Dean Peacock.
En conséquence, trois quarts des tests de dépistage concernent des femmes et deux tiers des traitements antirétroviraux vont à des séropositives. De plus, les hommes se mettent sous traitement plus tard, quand leur système immunitaire est déjà très affaibli.
"Rien n'est conçu pour les hommes. On se devait de faire quelque chose pour les atteindre", commente Mzi Lwana, coordinateur d'un projet "hommes et sida" mené par l'Unité de recherche sur la santé reproductive et le VIH (RHRU) de l'université de Witwatersrand.
Depuis février, le RHRU organise trois fois par semaine, dans une clinique du centre de Johannesburg, des consultations dédiées aux hommes. Les patients peuvent prendre rendez-vous avec un infirmier, un assistant social ou un éducateur. Tous de sexe masculin.
"Je suis plus à l'aise avec un homme, j'ai l'impression de pouvoir parler librement", confirme Victor Makhitsa, reçu dans le cabinet de Luthando Qobo pour un problème intime.
Face à lui, l'infirmier ne porte pas de blouse pour "conserver une dimension amicale", encourage les confidences et prodigue ses conseils en zoulou si le patient le souhaite.
"La plupart viennent pour des maladies sexuellement transmissibles, des pertes de libido, des problèmes de fertilité ou de sida. Il faut pouvoir aller au coeur du problème", explique-t-il.
Le RHRU organise aussi des campagnes de sensibilisation autour de matchs de foot, dans les bars, dans les logements collectifs pour hommes ou auprès des chauffeurs de mini-taxis collectifs, réputés pour leur machisme.
Une autre action a le vent en poupe: la circoncision qui, selon plusieurs études, divise au moins par deux les risques de contamination par le VIH pour les hommes.
Un grand projet est en cours dans le township de Orange Farm au sud de Johannesburg. "Il suscite beaucoup d'enthousiasme parce qu'il permet aussi d'attirer les hommes dans le système de soins", souligne Lauren Jankelowitz du RHRU.
Le ministère de la Santé, qui a reconnu en 2007 le besoin d'un effort ciblé sur les hommes, soutient ces initiatives, mais n'a pas encore mis en place de programme national cohérent, regrettent les acteurs du secteur.
"Les autorités commencent tout juste à changer de politique", selon Lauren Jankelowitz. "Mais les campagnes sont encore associatives, pas gouvernementales."
Copyright © 2009 AFP. Tous droits réservés
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LATIN AMERICA AND CARIBBEAN
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AIDS Committee supports free movement of people living with disease
Kaieteur News, Guyana
04/11/2009
The Guyana National AIDS Committee (NAC) has signaled its support to the decision by President of the United States of America, Barack Obama, to remove restrictions on people infected with HIV from visiting the United States.
Along with a range of other organizations around the world, NAC members have added their signatures to many petitions over the years for this unjustified restriction to be removed.
A press statement from NAC, on Monday, stated that in 2007, a delegation from the NAC met with the American Ambassador to query HIV testing taking place in the Embassy compound of persons applying for visas to the United States.
The NAC was assured at the time that the rapid-testing at the embassy did not relate to any misguided goal of only accepting HIV free immigrants.
The NAC is hopeful that the leadership demonstrated by the US Government on this issue will encourage the remaining countries which have retained similar restrictions to remove them quickly.
"Apart from respect for the rights of those directly affected, namely HIV-positive persons wishing to visit the United States, today's decision will also help undermine stigma and discrimination in general against HIV positives, enabling greater tolerance and respect for difference," the NAC statement noted.
NAC is a voluntary body which promotes HIV/AIDS policy and advocacy issues and advises the Minister of Health, while it assesses the work of the National AIDS
Programme Secretariat (NAPS).
The NAC also encourages the formation of Regional AIDS Committees (RACs) and networking amongst NGOs involved in the fight against the HIV/AIDS pandemic.
2
Jamaica AIDS Support applauds Obama - US entry ban on HIV-positive persons nears end
Jamaica Gleaner
05/11/2009
Kimesha Walters, Gleaner Writer
Jamaica AIDS Support for Life (JASL) has welcomed a move by United States President Barack Obama to end a 22-year-old ban on persons who have tested positive for HIV from entering that country.
"We are ecstatic about it," said Stacy-Ann Jarrett, executive director of JASL. "It actually speaks to addressing the issue of universal access to all of our target groups, to persons who are living with AIDS."
She added: "It is the beginning of things to happen in terms of non-discrimination, the inclusion of HIV-positive people."
Obama had promised to end the ban before the end of the year, but said a rule cancelling the ban would be published on Tuesday and take effect early next year.
Once lifted, foreigners applying to become residents in the United States will no longer be required to take a test for AIDS.
Ending the stigma
According to The Associated Press, "Obama said that by lifting the ban, the US will take a step toward ending the stigma against people with HIV/AIDS, something he said has stopped people from getting tested and has helped spread the disease."
Meanwhile, Jarrett noted that there were several benefits awaiting HIV-positive persons who want to travel to the United States. Among those benefits were opportunities to visit family and attend international conferences.
The JASL head noted that conference organisers have, in the past, had to re-route people through other territories, costing more money than if they were able to stop over in the US.
"It's going to cost less to participate in international conferences or meetings and other support group sessions that are made to empower persons who are living with the virus all over the world," Jarrett explained.
Jarrett said people would now have easier access to drugs and diagnostic tests that are not readily available in Jamaica.
Now that one stepping stone has been laid, Jarrett is looking forward, noting that people who were HIV-positive were not able to access health coverage or health insurance plans.
"The next step that we are anticipating is for insurance companies to start having more policies geared at supporting persons who are living with HIV and AIDS," she said.
kimesha.walters at gleanerjm.com
3
Director de UNFPA en la región participará de estudio abierto de Radio Viva
Juku'éke, Paraguay
05/11/2009
La 90.1 FM realizará un estudio abierto denominado "Hablando claro sobre el VIH y el SIDA" este jueves 05 de noviembre de 09:00 a 11:00 horas en la Plaza Héroes del Chaco de este barrio capitalino ubicado al costado del recientemente inaugurado Telecentro ZeballosCue.com. La actividad es organizada por la Federación de Entidades Vecinalistas del Paraguay (FEDEM), en el marco del proyecto "Información, Educación y Comunicación a adolescentes y jóvenes sobre derechos Sexuales y reproductivos con énfasis en VIH/ SIDA", apoyado por el Fondo de Población de Naciones Unidas (UNFPA).
De la programación especial participará Harold Robinson, director del UNFPA para Paraguay, Argentina y Brasil, quien se encuentra visitando el país por primera vez, tras haber asumido este cargo en el mes de agosto de este año, lo acompañarán Manuelita Escobar, Representante Auxiliar, y Mirtha Rivarola, Oficial de Género y Adolescencia del UNFPA.
El proyecto tiene como objetivo fomentar en los y las jóvenes, el deseo de mejorar la autoestima favoreciendo las relaciones interpersonales y el encuentro con el otro sexo, propiciando el respeto y la igualdad de género. Además apunta a colaborar con las comunidades del cono urbano a fin de formar una masa crítica conocedora de sus derechos, que se constituya en agente de cambio y transformador de su futuro, según Mariano Bareiro, presidente de FEDEM.
La actividad, según explicaron los organizadores apunta también a que los y las participantes intercambien experiencias y planteen sus dudas sobre salud sexual y reproductiva e infecciones de transmisión sexual, a la Asesora de VIH y sida del UNFPA, Patricia Aguilar.
En ese sentido, destacaron la importancia de este espacio para ofrecer toda la información necesaria, sobre estos temas, así como lo relacionado a la prevención del VIH y SIDA, teniendo en cuenta que según datos de la última encuesta nacional de salud sexual y reproductiva, los y las jóvenes inician su vida sexual cada vez a más temprana edad.
4
Migración, factor de riesgo en el aumento del VIH
Diario CoLatino, El Salvador
04/11/2009
Alma Vilches
Redacción Diario Co Latino
Día a día, decenas de salvadoreños abandonan su país en busca de una mejor oportunidad de vida para ellos y sus familias, a pesar de poner en riesgo su integridad y exponerse, durante el trayecto, a una serie de peligros, como: abusos físicos, violaciones, extorsiones, trabajos forzados y enfermedades de transmisión sexual.
Estudios nacionales y regionales muestran un significativo aumento de la población migrante, entre hombres y mujeres, en su mayoría jóvenes, quienes son afectados en su salud sexual, ya que está condicionada por factores biogenéticos, socioculturales y económicos.
Los problemas de salud de los migrantes, tienden a aumentar debido al bajo estatus socioeconómico, ya que la situación legal de estas personas en el país de residencia determinan el acceso a los servicios sociales y de salud.
Estudios revelan que las mujeres migrantes presentan tasas de fecundidad no deseadas, uso menor de anticonceptivos modernos y un menor acceso a los servicios de salud sexual y reproductiva, como de exámenes de papanicolao y mamografía.
Luis Mora, Director Regional Adjunto de la Oficina para América Latina y el Caribe del Fondo de Población de las Naciones Unidas (UNFPA), dijo que la población migrante, en los últimos años, ha sido más vulnerable a padecer enfermedades de transmisión sexual y especialmente el VIH/Sida, debido a no tener acceso a los servicios de salud básicos, por la condición de ilegalidad en que se encuentran.
Según estudios realizados en la zona Sur fronteriza entre México y los Estados Unidos, con trabajadoras sexuales, camioneros y población migrante, hay una relación entre alta movilidad poblacional y mayor diseminación de VIH/Sida.
"Los resultados muestran que en su mayoría los migrantes son jóvenes que viajan solos y que adoptan prácticas de riesgo que favorecen la diseminación del VIH". "Muchas mujeres son víctimas de abuso y violencia durante el trayecto migratorio o en el país de destino, y falta de conocimiento de las leyes, hacen esta población más vulnerable de contagio al SIDA" , afirmó Mora.
Desde 2008, la UNFPA fortalece las capacidades de instituciones involucradas en el proceso de desarrollo de modelos de atención a la salud sexual y reproductiva de mujeres y jóvenes migrantes, en diez países de la región Latinoamericana.
========================
NORTH AMERICA
========================
Editorial: Overturning HIV immigration ban brings benefits
University of Pittsburgh The Pitt News
04/11/2009
By Staff Editorial
Earlier this week, President Barack Obama said the United States plans to abolish a travel and immigration ban against those with HIV. At face value, this means more people with HIV could potentially enter the country and disseminate the disease - but let's not be paranoid here.
More than 1 million people in the United States live with HIV or AIDS. The Center for Disease Control estimates that in 2006 there were approximately 56,300 new cases of HIV. AIDS and HIV certainly aren't as prevalent in the United States as in parts of Southern Africa where, in some regions, more than 15 percent of the adult population is living with HIV. But we're far from disease-free.
While the ban's repeal theoretically allows for an increase of HIV cases in the United States, there are benefits that outweigh the detriment. The ban formerly denied entry to travelers with visas or those seeking a green card. In some scenarios, families that have been apart for years can now reunite.
Currently, there are 11 other countries that have similar bans against HIV-positive immigrants. Among the list are Armenia, Iraq, Libya, Russia and South Korea - none are Western countries. Despite the ban's long existence in the United States, there are more reasons to overturn this policy than siding with the majority.
Some HIV researchers are living with HIV themselves. Under the ban, however, they've been prevented from coming to the United States. As a result, the United States has not held a major international conference on the disease since 1993, according the Associated Press. By lifting the ban and allowing entry to these activists, their subsequent contributions to battling and spreading knowledge about HIV seem an adequate repercussion.
Obama stressed that by lifting the ban, the United States is helping to assuage the stigma against those with HIV. The ban was initiated in the late '80s - a time when HIV was still a new disease and hysteria over its spread even dictated law. Now the law seems antiquated. In 1987, HIV was placed on the U.S. Public Health Services list of "dangerous and contagious diseases," and HIV positive individuals were consequentially banned. HIV is contagious, but it isn't spread through casual contact like, say, active cases of tuberculosis - which remains on the list.
Not taking action to lessen the stigma against HIV helps to perpetuate the stigma and subsequently the disease itself. Because of the stigma against those with HIV, some who might be carrying the disease avoid getting tested. Perhaps they'd rather not know or assume they're disease-free. As of 2008, more than one in five people living with HIV in the United States don't know they have the disease. If there's a measure that will increase the likelihood of getting tested, it's worth passing as this is one of the best countermeasures in combating the disease
2
Tackling HIV/AIDS in Africa: From Knowledge to Behavior Change
The Brookings Institution
04/11/2009
Richard Joseph, Nonresident Senior Fellow, Global Economy and Development
There is greater frankness today about development policy failures in Africa. It was reflected in President Barack Obama's speech in Accra, Ghana on July 11 when he stated: "Development depends on good governance. That is the ingredient that has been missing in far too many places for far too long." And it is also seen in President Jacob Zuma's surprising declaration to the South African Parliament on October 29 for the need to "respond with urgency and resolve" to the "devastating impact of HIV and AIDS" on the nation.
It has taken many years for a South African president to speak frankly to his fellow citizens of the need to convert "knowledge into behavior change." Unlike his predecessor, Thabo Mbeki, who refused to acknowledge how HIV was actually transmitted, Jacob Zuma now encourages South Africans to learn their HIV status and "take informed decisions to reduce their vulnerability to infection." While estimates of new infections in South Africa are an astounding 750,000, they are also climbing relentlessly in Nigeria where latest annual estimates are put at 370,000.
In January 2006, the Bill & Melinda Gates Foundation made a large grant to support the Research Alliance to Combat HIV/AIDS (REACH), a collaborative program between Northwestern University and the University of Ibadan, Nigeria. Survey research has been completed in 12 communities in four Nigerian states on two projects: the social and cultural factors that influence vulnerability to infection and the willingness, or inhibition, regarding the use of testing and care facilities. A third pilot project on adolescents and HIV prevention was started when preliminary findings showed the high vulnerabilities of, and insufficient attention being devoted to, this age group.
This month, teams of REACH researchers will return to the twelve communities to report on the research findings. These studies could not have been conducted without the active cooperation of local authority figures: government, traditional and religious. In spring 2010, comprehensive reports of the three projects, along with policy recommendations, will be made available in Nigeria and internationally.
The four Nigerian states in which the REACH research was conducted-Oyo, Lagos, Cross Rivers and Benue-have prevalence rates of 2.2, 5.1, 8 and 10.6 percent, respectively. Understanding the reasons for these disparities requires probing the economic, cultural, normative and other factors involved. Even with this information, inducing the necessary remedial action must overcome great barriers.
One of the notable achievements of this era has been the provision of billions of dollars annually so that millions of HIV-infected persons worldwide can receive anti-retroviral drugs. However, a report just published predicts that unless there are drastic changes in infection rates, tackling AIDS and its consequences in poor countries could cost $35 billion annually in two decades.[1] Since sub-Saharan Africa still accounts for two-thirds of persons infected with HIV, much more vigorous efforts are needed to curb transmission of the disease in the continent.[2]
President Zuma told South Africans that "knowledge will help us to confront denialism and the stigma attached to the disease." That is no easy charge after decades of disinformation and distrust. I was confounded in a tour of our research sites in Nigeria earlier this year when a man in one community complained that, as a result of drug treatment, it was now difficult to know who was infected and therefore whom to avoid. In that remark, knowledge, stigma, and behavior were tightly interwoven. Unwinding them to facilitate effective and humane action will require enhanced collaboration, at the level of communities, among government, social, religious, business and academic actors.
Richard Joseph is Principal Investigator of REACH.
[1] Donald G. McNeil, Jr., "Panel warns that without new direction, epidemic will remain out of control at 50," New York Times (November 2, 2009).
[2] For a strategy of wider testing and earlier drug treatment in Washington, DC and the Bronx, whose prevalence rate of about 5 percent is close to the Nigerian average, see Susan Okie, "Fighting H.I.V., a Community at a Time," New York Times (October, 27, 2009).
3
Beauty at the Ball
New York Times
04/11/2009
By JOYCE WADLER
"MY clams are not in place," the pregnant mermaid in the ladies' room at the New York Design Center Masquerade Ball was saying, adjusting the homemade shell-and-string brassiere she was wearing over her clingy gown. Her long red hair was a magnificent Venus-rising mane, intertwined with seashells, and a blue-green fish tail trailed fetchingly from underneath her skirt. But her bra was somewhat askew and so was her extremely protuberant belly.
"My husband is a sea captain," the mermaid added. "We don't know what to expect."
What are they hoping for?
"I don't know," she said. "I just hope it's a good swimmer."
On land, the mermaid goes by the name Maria Capotorto and does publicity for the interior designer Jamie Drake. But the ball held last week to benefit the Alpha Workshops, an organization that trains people with H.I.V. and AIDS for careers in the decorative arts, was that rare New York party in which shop talk was not paramount.
The theme was 1930s musicals, and members of a few design firms came identically costumed. Dennis Miller, of Dennis Miller Associates, and three of his colleagues wore lampshades on their heads, with a drawing of the body of a lamp on their chests.
"They're all lamps we sell," said Mr. Miller, who was dressed as a model called the Delphi, adding that the lamps range in price from $1,000 to more than $4,000.
They didn't actually denude those expensive lamps for their costumes? asked the reporter, who had come that evening as Credulous Beyond Redeeming.
"Target, $20," Mr. Miller said. "We're bringing them back tomorrow morning."
The interior designer Amy Lau and four of her staff members came as cheerleaders. Having gotten the arrival time wrong, they went to a neighborhood bar to kill an hour, which might have been why one staff member literally leaped into the interview with a triumphant whoop, and fell to one knee.
The disco music was not correctly themed, but many of the designers were: Joan and Jayne Michaels, the sisters who run the firm 2Michaels, and their good friend Kate Korten, a textile designer, came as the Marx Brothers. The furniture designer Richard Wrightman and his wife, Elaine, came as Bonnie and Clyde, or rather, Clyde and Bonnie.
Then there were those like the enviably lean Tori Mellott, creative deputy of merchandising for Martha Stewart, who came as contemporary figures. Ms. Mellott was the trimmed-down Karl Lagerfeld, with big sunglasses, a white fan and her mailbox keys worn around the neck.
"I Google-imaged him a million times," Ms. Mellott said. "A lot of the time, he wears a key around his neck."
Her snazzy racing-style gloves did have one flaw: her boss - no, of course not Martha! - had cut three knuckle openings instead of four. Still, Ms. Mellott was hopeful that Mr. Lagerfeld would approve.
"I think I'm going to send him a picture," she said. "Maybe he'll send me some of his Chanel."
Meanwhile, across the room, the interior designer Dennis Rolland was a languorous and elegant Fred Astaire, in white tie and tails. Except for the spats, the costume was entirely his, for Mr. Rolland is a competitive ballroom dancer, which made the pounding disco a bit frustrating.
And yes, he said, in answer to a question, he believes there is a similarity between ballroom dancing and design.
"I think the whole concept of style, elegance, a love of beauty and beautiful movement is just as beautiful as beautiful objects," Mr. Rolland said.
While some might find that sentence overburdened with the use of the word "beautiful," we understood completely and waltzed off.
A version of this article appeared in print on November 5, 2009, on page D2 of the New York edition
4
Southern Researchers Fill Gap on Neglected Diseases
IPS Terra Viva
04/11/2009
Stephen Leahy
CANCUN, Mexico, Nov 3 (IPS) - With HIV/AIDS, malaria and tuberculosis occupying the global health spotlight, few resources are devoted to the "neglected tropical diseases" like dengue fever, hookworm infection and schistosomiasis that afflict some one billion people. Now, small medical companies in emerging economies offer real hope to bring innovative and affordable treatments, a new study has found.
"Everyone thinks multinational drug companies can provide the vaccines and diagnostics for neglected tropical diseases. Our research shows that it's small biomedical companies in the developing world that are doing it," said Peter Singer of the McLaughlin-Rotman Centre (MRC) for Global Health at the University of Toronto and a co-author of the study.
Singer and his colleagues document for the first time the innovative products and capabilities of 78 homegrown, small to medium-sized health biotechnology companies in Brazil, China, India and South Africa. Collectively, these companies produced 123 products, including vaccines, drugs and diagnostic tests, for all neglected tropical diseases (NTDs), as well as the "Big 3" - malaria, tuberculosis and AIDS.
Roughly half specifically target NTDs and are largely new products, not generics, they report in the study published Tuesday in the journal Health Affairs.
"These are diseases of the poor and these local companies base their business model on affordable innovation to meet local needs," Singer told IPS. "The owner of one such company told me 'What for you are diseases of the poor are market opportunities for us'".
NTDs include trachoma, the leading cause of preventable blindness worldwide, elephantiasis, leprosy, dengue fever, hookworm infection and schistosomiasis. World spending to battle such illnesses, however, amounts to a relative drop in the bucket - just 500 million dollars in 2007 - or about five percent of the total invested in new drugs, vaccines and diagnostics worldwide.
These neglected diseases rarely make headlines, but they cripple the economic productivity of affected communities and stunt national development, the report notes. Multinational drug companies simply cannot make a profit developing products to meet this need except on a donation basis, it says.
"We are not calling for replacement of the charity of multinationals. Rather, we are pointing out that there is a well of affordable innovation in developing countries themselves that has not been fully tapped," Singer said.
Companies in emerging economies are filling a void by creating innovative products to address NTDs. Many such firms are successful at reaching local and regional markets. This pipeline in developing countries is like a rich new deposit of gold that needs to be fully mined, said Singer.
"What they urgently require is help getting these products and their benefits to distant places," he said.
The authors propose a not-for-profit service to provide much-needed expertise to help Southern firms get their products from the lab to additional villages worldwide.
The Global Health Accelerator (GHA) project would help get innovative NTD-related health products to distant markets by connecting a diverse international community of biotech innovators, facilitate public-private partnerships, provide business support services, and operate as an independent hub linking companies, investors, and interested parties.
It will use the power of networking to link to funding agencies, foundations, development finance institutions, private individuals, and venture capitalists interested in financing innovative Southern companies, the report states.
The proposal also includes an annual prize, the Global Health EnterPrize, to encourage and recognise new diagnostics, drugs, vaccines, or devices with global health impact developed by Southern companies.
"We think of the Global Health Accelerator as a FedEx for new drugs, vaccines and diagnostics to combat neglected tropical diseases," said Singer.
According to MRC researcher and co-author Sarah Frew, firms in emerging economies see neglected diseases as significant business opportunities but typically lack expertise in such areas as international regulatory environments, market assessments, positioning products, including pricing, accessing financing, and identifying international commercialisation partners.
The research and development potential of the South is far greater than the 78 firms documented in the study.
"There are more than 500 health biotechnology companies, in addition to many more academic institutes and universities in other countries like Malaysia, Indonesia and Mexico," Frew told IPS. "The creative talent is there but obstacles, of which financing is just one, impede progress and hamstring current efforts."
In same issue of Health Affairs, the leading journal on health policy, deputy editor Philip Musgrove and coauthor Peter Hotez argue that concerted efforts - from mass drug administration to nondrug interventions - could conquer many neglected diseases.
"Neglected diseases affect millions of lives, yet can be treated or eliminated at a relatively small cost," said Musgrove. "It's time for the world to act."
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