Kaiser Daily HIV/AIDS Report
Economic Recession, Emerging Diseases Should Not Replace Efforts To Fight HIV/AIDS, IAS President Says
Sex Education Programs in Singapore's Schools Should Provide Teens With Objective, Reliable Information, Education Ministry Says
U.K. City To Participate in Pilot Home-Based HIV Testing Program
Deworming Drug Could Help Reduce Spread of HIV in Africa, Study Finds
U.N. System Lacks 'Serious Focus on Gender' Issues, Opinion Piece Says
Global Challenges
Meeting Addresses MTCT of HIV in Africa
[May 26, 2009]
Health officials recently held a regional consultation in Kenya to examine mother-to-child HIV transmission services and pediatric HIV/AIDS care in nine Eastern and Southern African countries, IRIN/PlusNews reports. The consultation -- hosted by UNICEF, UNAIDS and the World Health Organization -- included representatives from Ethiopia, Kenya, Malawi, Mozambique, South Africa, Swaziland, Tanzania, Uganda and Zambia.
The meeting addressed issues in MTCT prevention services -- including the continued use of single-dose nevirapine instead of more effective combination therapies, as well as delays in diagnosing and initiating treatment -- that are weakening prevention programs in focus countries. According to IRIN/PlusNews, 70% of pregnant women in Eastern and Southern African countries are seen by a health care provider at least once during pregnancy. However, 43% of HIV-positive pregnant women have a health care worker present during labor who can administer PMTCT treatment.
In Uganda, a national policy calls for all sub-county level health facilities to provide PMTCT services, but only 53% offer such services because of health worker shortages. Janet Kayita, regional PMTCT adviser for UNICEF, said, "We are doing a bad job of testing women for HIV and then following them up, and an even worse job of ensuring that infants receive appropriate prevention and treatment services." She added that national PMTCT guidelines have not reached local levels. "These policies must become a reality for the people they were designed to help," Kayita said, adding that primary health care systems at all levels must be strengthened (IRIN/PlusNews, 5/25).
Some officials at the meeting called on African governments to reach 80% of pregnant women, mothers and children with services; reduce by 50% the number of women and infants who do not receive follow-up care; and double the number of HIV-positive children who receive antiretroviral treatment. Xinhuanet reports that prevention services currently reach about 50% of pregnant women in all Eastern and Southern African countries.
At the close of the consultation, officials issued a set of recommendations for meeting PMTCT goals, including increased community involvement in prevention programs; reduced workloads for health workers; and increased coverage of and compliance with PMTCT regimens. In addition, the experts urged governments to prioritize regions with high HIV burdens and strengthen data management to better understand trends (Ooko, Xinhuanet, 5/25).
James Kamau, coordinator of the Kenya Treatment Access Movement, recommended that more women in the country deliver in hospitals in order to ensure that they receive PMTCT services (Mwaniki, Daily Nation, 5/25). David Alnwick, a UNICEF regional adviser, said, "It is critical at this juncture, when many countries are faced with shrinking budgets and competing demands, that we do not lose the momentum of what needs to be done to create an AIDS-free generation" (Xinhuanet, 5/25).
Economic Recession, Emerging Diseases Should Not Replace Efforts To Fight HIV/AIDS, IAS President Says
[May 26, 2009]
Concerns regarding the H1N1 flu strain or the current global economic recession should not take attention away from the long-term fight against HIV/AIDS, Julio Montaner, head of the International AIDS Society, said recently, VOA News reports. Montaner said global health issues need to be "put ... into the proper perspective," adding, "No doubt that ... whatever new flu or any other epidemic that may show up the day after tomorrow ... is something that we need to respond to. But it cannot be at the expense of a proven, established killer" like HIV/AIDS. He said that although it is important to remain vigilant in detecting emerging epidemics and infectious diseases, "we're (doing) ourselves a very serious disservice" when resources are taken away from combating HIV/AIDS and given to "the next new potential epidemic."
Montaner said that although it is "clear that we failed to meet original targets" in the global fight against HIV/AIDS, there has been an increase in the number of HIV-positive people in developing countries receiving antiretroviral treatments from about 500,000 in 2003 to more than three million by the end of 2007. In addition, he said that antiretrovirals are "saving lives of people" and "preserving the social network, the family structure ... that is so severely compromised by HIV and AIDS." Despite this progress, Montaner said that "[w]e need to recognize more [people] are being infected every day by a factor of nearly two than the number of people accessing antiretroviral therapy."
Montaner urged members of the World Health Assembly -- who recently met in Geneva -- to honor HIV/AIDS commitments, noting that the gains in fighting the pandemic cannot be reversed. He said that he is concerned the global recession, worries over the H1N1 flu and other "competing needs or hypothetical epidemics" could lead to donor nations "losing their interest" in fighting HIV/AIDS. Montaner said that he is disappointed with President Obama's recent $63 billion, six-year proposed global health initiative, adding that it falls short of his campaign promises. He said that IAS is asking leaders from the Group of Eight industrialized nations to "refocus their efforts" and "meet their commitments." He warned that if the commitments are not met, "[h]istory is going to judge us very harshly," adding, "We've been distracted by the epidemic of the day without recognizing that we have a killer within our midst that we can control" (DeCapua, VOA News, 5/21).
Sex Education Programs in Singapore's Schools Should Provide Teens With Objective, Reliable Information, Education Ministry Says
[May 26, 2009]
The number of teenagers contracting HIV and other sexually transmitted infections has increased over the past several years, Singapore's Education Minister Ng Eng Hen said on Thursday, the Straits Times reports. In 2008, 787 STIs were recorded among teenagers, a more than threefold increase from the 238 cases in 2002. In addition, nine new HIV cases were reported among teenagers in 2007, compared with one in 2002. According to Ng, the figures highlight the need for sex education programs.
The programs also are needed because of increases in sexual activity and unintended pregnancies among teens, the Times reports. According to a 2006 Health Promotion Board and education ministry survey of 4,000 students between ages 14 and 19, about 8% reported being sexually active. In addition, less than one-quarter of sexually active teenagers reported using contraception to protect against STIs and unintended pregnancies.
Changes in attitudes toward sex -- as well as the increased exposure teens have to information about sex -- only increase the need for schools to provide students with objective and reliable information about sex, according to Ng. He added that sex education programs in schools have changed since the programs were introduced in 2000. He said, "When we started, the key message was abstinence, reflecting the conservative social tone of our Asian society, where liberal values on sex are not espoused," adding, "This is not a negative facet of our society. It is not prudish, regressive or naïve."
Ng said that two years ago, the focus of sex education programs changed from abstinence to include information about how to prevent unintended pregnancies and STIs. He said, "In 2007, messages were added -- beyond knowing how to say no -- students were also taught the repercussions of unwanted pregnancies and STIs and HIV and how to prevent them. This is now a key focus of sexuality education, and should continue to be moving forward" (Tan, Straits Times, 5/22).
U.K. City To Participate in Pilot Home-Based HIV Testing Program
[May 26, 2009]
The United Kingdom government has selected the city of Sheffield to participate in a three-month pilot program aimed at increasing HIV detection rates by offering home-based test kits, the Sheffield Star reports. The initiative, which will target men who have sex with men, will allow people to obtain the test kits through Web sites or community outreach centers. To take the HIV test, individuals must take a mouth swab and send it to a laboratory for testing. The lab then confidentially notifies the individual of the test results with a call or text message, Steve Slack, director of Sheffield's Centre for HIV and Sexual Health, said. The city aims to launch the program in June. According to the Star, Sheffield is the only city in the northern part of the country to be included in the pilot program.
Nearly one-third of HIV-positive U.K. residents are unaware of their status and therefore not accessing early treatment, the Star reports. Slack said the pilot program will be "an unrivalled way to engage with hard-to-reach communities to encourage more people to come forward for testing." He added that the "great thing" about home-based testing is its "ease" and that it is "completely confidential." Christine Bowman, consultant physician at Sheffield Teaching Hospitals, said, "HIV testing is not something people should be afraid to come forward for." She added, "Thousands of people in the U.K. are tested each year, but we would like to test more" (Lahive, Sheffield Star, 5/21).
Science & Medicine
Deworming Drug Could Help Reduce Spread of HIV in Africa, Study Finds
[May 26, 2009]
Providing girls in rural Africa with a deworming drug could help reduce the spread of HIV, according to a study recently published in PLoS Neglected Tropical Diseases, the New York Times reports. The drug, called praziquantel, costs about 32 cents per pediatric dose and prevents schistosomiasis, a worm disease that starts as a urinary tract infection. If untreated, schistosomiasis can lead to female genital sores that can facilitate HIV infection. Because the drug can kill the worms but cannot cure genital sores, girls should be protected before they reach sexual maturity, according to the Times.
"For this relatively small investment, the reproductive health of young women would be improved," the authors from the Sabin Vaccine Institute, Imperial College London and Oslo University wrote, adding that "there is a reasonable chance that HIV/AIDS transmission can be reduced." There are about 207 million schistosomiasis cases worldwide, 90% of which occur in Africa, where humans are exposed usually through snail-infested water. According to a pilot program conducted in Burkina Faso, all 70 million cases among young children in Africa could be treated for $22 million, and repeating universal treatment every two years for 10 years would cost $112 million (McNeil, New York Times, 5/26).
 The study is available online.
Opinion
U.N. System Lacks 'Serious Focus on Gender' Issues, Opinion Piece Says
[May 26, 2009]
"The most lamentable and heart-breaking dimension of multilateralism" is the "absence of any serious focus on gender throughout" the United Nations system, Stephen Lewis, founder of AIDS-Free World, writes in a London Independent opinion piece. He adds, "I can cite chapter and verse, but let me start by telling you that whether it is poverty alleviation, or HIV and AIDS, or sexual violence and conflict, the whole panoply of discrimination visited on women around the world, particularly in developing countries, the U.N.'s agencies and the Secretariat have been profoundly delinquent in their response."
According to Lewis, the "struggle for gender equality has become the most important struggle on the planet; the continuing marginalization of 52% of the world's population is simply unacceptable." He adds, "So we're now engaged in an effort to create a new international agency for women, a fascinating undertaking that I hope will engage" governments. "Nothing approximates the possibility of finally having a vehicle that would give voice and resources and support to the struggles of women around the world," Lewis writes, adding, "Everyone knows what's happening in these areas about women's vulnerability but there is never a consistent voice to bring it to the attention of the world community, to continue to hammer it home, to demand action from government." He concludes, "So the emergence and creation of a women's agency I think would be a godsend internationally and would overcome the record of the United Nations on gender" (Lewis, Independent, 5/22).
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