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Kaiser Daily HIV/AIDS Report
Public Opposition Leads Westport, Mass., Board To Reverse Decision on Needle-Exchange Program
Globe and Mail Examines Factors Contributing to Lowered HIV Prevalence in Uganda
Canadian Bill Authorizing Sale of Generic AIDS Drugs in Low-Income Countries Stalled by Technicalities, Restrictions
New Jersey Counties Under NYC Boundary Risk Losing Federal HIV/AIDS Funding, Advocates Say
Public Health & Education
San Francisco Chronicle Series Examines How 'Down-Low' Phenomenon Affects Women in African-American Community
Mandela To Attend '46664 ARCTIC' AIDS Awareness Concert in Norway in June
Politics and Policy
Brazil Refuses $40M in U.S. AIDS Grants To Protest Policy Requiring Groups To Condemn Commercial Sex Work
[May 02, 2005]
Brazilian officials last week said that the country has refused $40 million in U.S. AIDS grants because of a Bush administration requirement that HIV/AIDS organizations seeking funding to provide services in other countries must pledge to oppose commercial sex work, the Wall Street Journal reports (Phillips/Moffett, Wall Street Journal, 5/2). Under the Bush administration policy, even groups whose HIV/AIDS work in other countries has nothing to do with commercial sex workers have to make a written pledge opposing commercial sex work or risk losing federal funding. In addition, the Bush administration might refuse to fund HIV/AIDS groups that do not accept Bush's social agenda on issues such as sexual abstinence and drug use. The new policy stems from two 2003 laws, one involving HIV/AIDS funding and another regarding sex trafficking (Kaiser Daily HIV/AIDS Report, 2/28). Brazilian officials last week wrote to USAID to explain its decision to refuse the remainder of a $48 million HIV/AIDS grant that began in 2003 and was scheduled to run through 2008. According to some HIV/AIDS advocates, Brazil has been a "model" for combating HIV/AIDS with its "accepting, open" policies toward commercial sex workers, injection drug users, men who have sex with men and other "high-risk" groups, the Journal reports. Brazilian authorities said that the Bush administration requirement that groups receiving funding must condemn commercial sex work would hinder the country's efforts to fight the disease, according to the Journal. "We can't control (the disease) with principles that are Manichean, theological, fundamentalist and Shiite," Pedro Chequer, director of Brazil's AIDS program and chair of the national commission that decided to refuse the grants, said, adding that the commission -- which includes cabinet ministers, scientists and AIDS advocates -- viewed the Bush administration policy as "interference that harms the Brazilian policy regarding diversity, ethical principles and human rights." Brazilian Strategy
Brazil's national AIDS program, which is considered to be one of the most progressive in the world, includes HIV/AIDS prevention, care and treatment services. The program manufactures and distributes generic versions of antiretroviral drugs, providing them at no cost to all HIV-positive people in the country (Kaiser Daily HIV/AIDS Report, 3/16). Although Brazil's HIV/AIDS prevention strategy emphasizes abstinence and sexual fidelity, it focuses more on condom education and distribution, according to the Journal. Commercial sex work is not a crime in Brazil, and advocates for commercial sex workers have been "among the most active" in the country's fight against HIV/AIDS, according to the Journal. The U.S. grants were to include $190,000 for eight groups that advocate for commercial sex workers in Brazil, according to Gabriela Leite, coordinator of the Brazilian Network of Sex Professionals. Leite said that she had "lengthy" discussions with USAID to assure U.S. officials that the grant money received only would be used for HIV/AIDS education and prevention and not for commercial sex worker rights issues, according to the Journal. However, despite a 50-page agreement between USAID and Leite's group, talks "broke down" when Leite's group refused to condemn commercial sex work, according to the Journal. "Why should we adopt a different orientation if we have been successful for the more than 10 years?" Sonia Correa, a Brazilian AIDS advocate and co-chair of the International Working Group on Sexuality and Social Policy, asked. Although experts in 1992 estimated that 1.2 million HIV-positive people would live in Brazil by 2002, the country's epidemic has been "far less serious" because of its prevention efforts, and by 2002 there were only about 660,000 HIV-positive people in the country, according to the Journal. Reaction
"Obviously, Brazil has the right to act however it chooses in this regard," Sen. Sam Brownback (R-Kan.), who has been a leader for "conservative cause[s]" in Congress, said, adding that he hopes the grants can be redirected to other countries with policies that are in line with the Bush administration, according to the Journal. "We're talking about promotion of prostitution, which the majority of both the House and Senate believe is harmful to women," Brownback added. USAID spokesperson Roslyn Matthews on Sunday said that the agency is "still reviewing" Brazil's decision, adding, "We are in the process of determining next steps." The U.S. grants were only a "small part" of the amount Brazil spends on HIV/AIDS programs, and Chequer said the Brazilian government will increase spending on the programs to make up for the lost funding, according to the Journal (Wall Street Journal, 5/2).
Public Opposition Leads Westport, Mass., Board To Reverse Decision on Needle-Exchange Program
[May 02, 2005]
The Westport, Mass., Board of Selectmen on Thursday unanimously reversed a decision they made on Monday to authorize a needle-exchange program to help prevent the spread of HIV among injection drug users in the area, the Boston Globe reports (Abel, Boston Globe, 4/29). The town had been the first in Massachusetts outside of the Boston area to authorize needle exchange as a method of preventing the spread of bloodborne diseases. In Westport -- which has a population of 14,000 -- 43% of HIV/AIDS cases can be traced to injection drug use. In addition, the town is located between the larger cities of New Bedford and Fall River, both of which are confronting simultaneous epidemics of illegal drug use and HIV. Two-thirds of HIV cases in New Bedford and 58% of cases in Fall River between 2001 and 2003 were attributed to sharing needles -- percentages that are substantially higher than the 25% state average. However, both New Bedford and Fall River have rejected needle-exchange programs (Kaiser Daily HIV/AIDS Report, 4/28). Reversal
The board's original decision to authorize a needle-exchange program in Westport "ignited a firestorm" of public protest, the Globe reports. As a result, the board on Thursday voted unanimously to reverse the decision and voted 3-2 to never allow a needle-exchange program in the town, according to the Globe. "There was fear, there was anger," board Chair Elizabeth Collins said, adding, "It was not right we didn't engage the town in debate. I take full responsibility for not being more aggressive in publicizing it." However, Collins, who is a registered nurse, said that she does not regret her vote to authorize the needle exchange, according to the Globe. "I believe in needle exchange very strongly," Collins said, adding, "I believe it saves lives. This is not an epidemic; it's a pandemic. The idea was to back off now and raise public awareness. We cannot even do that now." Collins said that it is possible that the board could approve a needle-exchange program in the future, according to the Globe. Board member Richard Tongue said that he was "disappointed" by the public protest of the program, according to the Globe. But Tongue said he voted to ban any future needle-exchange programs because he "just didn't think the town would really ever be ready" for such a program. Nancy Paull, a Westport resident and CEO of Stanley Street Treatment and Resources, which would have run the needle-exchange program, said, "I had read about mob mentality, and for the first time in my life I saw a mob," adding, "There was threatening behavior. There was screaming. There were slurs. It wasn't public pressure, it was mob pressure" (Boston Globe, 4/29).
Global Challenges
Globe and Mail Examines Factors Contributing to Lowered HIV Prevalence in Uganda
[May 02, 2005]
Toronto's Globe and Mail on Saturday examined factors that might have contributed to Uganda's lowered HIV prevalence over the past 20 years, sometimes referred to as the "Ugandan miracle." In the late 1980s, nearly one-third of Uganda's adult population was HIV-positive, but now the country's HIV prevalence is about 6%. Although most people attribute Uganda's declining prevalence to the government's implementation of the "ABC" HIV prevention method -- which advocates abstinence, being faithful and using condoms -- some recent studies suggest there might have been additional influences. According to researchers from Columbia University and Johns Hopkins University, the "single greatest factor" of the decline is the large number of HIV-positive people who died during the 20-year period, the Globe and Mail reports. Other research suggests that condoms are the primary reason for the slow of HIV transmission, according to the Globe and Mail (Nolen, Globe and Mail, 4/30). The complete article is available online.
Drug Access
Canadian Bill Authorizing Sale of Generic AIDS Drugs in Low-Income Countries Stalled by Technicalities, Restrictions
[May 02, 2005]
Nearly one year after Canada amended its patent laws to allow drug makers to manufacture and export less-expensive, generic versions of patented drugs -- including antiretroviral drugs -- to developing countries, no drugs have been exported as a result of the new law, the CP/Canada.com reports (Bueckert, CP/Canada.com, 5/2). The Canadian Senate in May 2004 approved Bill C-9, which former Canadian Prime Minister Jean Chretien introduced in November 2003 in the House of Commons (Kaiser Daily HIV/AIDS Report, 11/30/2004). Regulations under the Jean Chretien Pledge to Africa Act have yet to be published, and government officials say the legislation has been stalled by technicalities, according to the CP/Canada.com. According to Doug Clark, a senior official at Industry Canada, a committee in the Canadian Senate has discovered a "serious flaw" in the bill, and a new measure is expected to be considered this week, the CP/Canada.com reports. Clark said that the bill might have mistakenly assumed that drug makers would export drugs for humanitarian reasons, according to the CP/Canada.com. "There is room [in the bill] to make some money, but it definitely does not accommodate lucrative transactions," Clark said, adding, "The incentives are simply not significant because the money is not there. There was really no discussion of that at any point." Critics of Legislation, Delay
Critics of the measure say it "will never have any real impact" because of its restrictions, the CP/Canada.com reports. "There are many, many restrictions on [exporting generic drugs] that are actually not necessary according to the World Trade Organization," Canadian Generic Pharmaceutical Association President Jim Keon said. U.N. Special Envoy for HIV/AIDS in Africa Stephen Lewis said, "I think that the delay on issuing the regulations is just absolutely absurd and, frankly, intolerable," adding, "If in fact there's been no significant initiative for drug production and export thus far under the bill, then I think the bill is in danger of becoming a non-entity because it will be lost in the politics of Canada." Keon said that discussions over the bill are continuing, but that "there are no products waiting to be shipped." He added that the government should provide research funding to develop needed drugs, according to the CP/Canada.com (CP/Canada.com, 5/2).
Across The Nation
New Jersey Counties Under NYC Boundary Risk Losing Federal HIV/AIDS Funding, Advocates Say
[May 02, 2005]
HIV/AIDS advocates in three New Jersey counties that are included in the New York City metropolitan area following the federal government's redrawing of statistical boundaries are concerned that the counties could lose federal HIV/AIDS funding in the upcoming reauthorization of the Ryan White CARE Act, the Bergen Record reports. After the last census, the Office of Management and Budget included Bergen, Passaic and Hudson counties in the same area as New York City -- a move that will affect legislation and funding. AIDS advocates are concerned that North New Jersey might lose control of about $5 million in federal HIV/AIDS funding annually, and some advocates are worried that the state might lose the money altogether "in the shadow" of New York City, according to the Record. In addition, two national HIV/AIDS advocacy groups -- including the Washington, D.C.-based Communities Advocating Emergency AIDS Relief Coalition -- have proposed earmarking North New Jersey's HIV/AIDS funding as part of New York City's share. Robert Cordero, a CAEAR board member, said the counties would continue to receive "their proportionate share" of HIV/AIDS funding and have a voice in how the funding is appropriated. However, Karen Walker, director of HIV services at the Paterson Counseling Center in Paterson, N.J., said, "Statistically, New Jersey is beginning to be wiped off the map." She added that 25% of HIV-positive New Jersey residents will be "under the control and the whims and wishes of New York City." Some HIV/AIDS advocates in New Jersey are circulating petitions asking for legislators to intervene. U.S. Rep. Bill Pascrell (D-N.J.) on Wednesday in a statement said he will help to organize a New Jersey delegation to "fight the proposed change" and protect HIV/AIDS funding in the state, according to the Record. In addition, local organizations plan to meet with a CAEAR Coalition representative this week to express their concerns, according to Catherine Correa, who directs Ryan White funding for Paterson (Meagher, Bergen Record, 4/28).
Public Health & Education
San Francisco Chronicle Series Examines How 'Down-Low' Phenomenon Affects Women in African-American Community
[May 02, 2005]
The San Francisco Chronicle in a series of articles published on Sunday and Monday examined the "down-low" phenomenon -- when men have sex with both male and female partners but do not mention their male relationships to friends, family members or female partners -- in the African-American community. The articles are summarized below.
- "Secret Encounters of Bisexual Black Men Could Be Creating Wave of Infected Women": Because the phenomenon is "defined by secrecy," little is known about men on the down low, the Chronicle reports. CDC has launched five studies to help determine the size of the down-low population and whether these men play a role in the rising number of HIV cases among African-American women, according to the Chronicle. CDC's findings, along with the findings of other researchers, are expected to be important in the fight against HIV/AIDS in the African-American community, the Chronicle reports (Johnson, San Francisco Chronicle, 5/1).
- "The Stunned Wife: Preacher Husband Infected Her With HIV Knowingly": The Chronicle profiled Ava Gardner-Shipp, a 44-year-old African-American woman whose minister husband secretly had sex with other men and knowingly transmitted HIV to her. Since revealing her story, Gardner-Shipp says many other women have told her they "feared their husbands were on the down low" and shared similar experiences, the Chronicle reports (Johnson [1], San Francisco Chronicle, 5/2).
- "The Double Life: Former Sailor Dated Women, Also Had Secret Sex With Men": The Chronicle profiled Blue Buddha, a 38-year-old African-American man who for many years secretly had sex with men while dating women. His experience demonstrates the "hostility toward homosexuality" in the black community, which causes many men to keep their sexual activity secret, according to the Chronicle (Johnson [2], San Francisco Chronicle, 5/2).
Media & Society
Mandela To Attend '46664 ARCTIC' AIDS Awareness Concert in Norway in June
[May 02, 2005]
Former South African President Nelson Mandela on Friday announced he will attend the third "46664" HIV/AIDS awareness concert in Tromsoe, Norway, on June 11, Reuters reports. The concert, titled "46664 ARCTIC," aims to send a message to leaders of the Group of Eight developed nations, who will be meeting in Scotland in July, that more commitment is needed to fight the pandemic. The concert also hopes to raise awareness among youth in the region -- particularly in Russia -- where HIV/AIDS "endangers the lives of millions," according to Reuters (Reuters, 4/29). Former U.S. President Bill Clinton; Irish rock star Bono, co-founder of the debt, AIDS and trade advocacy group DATA; and actor Will Smith -- who serve as 46664 campaign ambassadors -- also will attend the concert to urge more to be done to address infant mortality and the impact of the pandemic on children (AFP/Yahoo! News, 4/29). No performers have been announced (Reuters, 4/29). The first 46664 concert was held in Cape Town, South Africa, in December 2003 to benefit Mandela's 46664 campaign -- named for his prison number during his nearly 20-year incarceration at the South African prison on Robben Island. A second concert was held in March at the Fancourt Hotel, Country Club and Golf Estate in George, South Africa (Kaiser Daily HIV/AIDS Report, 3/21).
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