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San Francisco area HIV/AIDS organizations are urging lawmakers to restore millions of dollars in funding for HIV/AIDS prevention and treatment programs that were cut from the California budget by Gov. Arnold Schwarzenegger (R) this week, KCBS.com reports. “The governor has removed a substantial amount of our capacity to make sure that people know their HIV status,” Dana Van Gorder of Project Inform said, adding “Services that are keeping people who are already HIV positive healthy will be reduced with a major impact on their health.” A rally is planned to take place next week at the state building in San Francisco to protest the cuts, according to the article (7/30). David Brinkman of the Desert AIDS Project in Palm Springs, “says the budget cuts are literally a matter of life and death,” KESQ.com reports. The Desert AIDS Project is hoping that planned fundraising will temporarily offset the cuts to services in the Palm Springs area (Diaz, 7/30).

This information was reprinted from dailyreports.kff.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily U.S. HIV/AIDS Report, search the archives and sign up for email delivery at dailyreports.kff.org.

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An estimated 50 million women in Asia are at risk of becoming infected with HIV from their intimate partners. Evidence from many Asian countries indicates that these women are either married or in long-term relationships with men who engage in high-risk sexual behaviours. These findings are published in a new report by UNAIDS, its Cosponsors and civil society partners entitled HIV Transmission in Intimate Partner Relationships in Asia, being released today at the 9th International Congress on AIDS in Asia and the Pacific in Bali.

The HIV epidemics in Asia vary between countries in the region, but are fuelled by unprotected paid sex, the sharing of contaminated injecting equipment by injecting drug users, and unprotected sex among men who have sex with men. Men who buy sex constitute the largest infected population group - and most of them are either married or will get married. This puts a significant number of women, often perceived as ‘low-risk’ because they only have sex with their husbands or long-term partners, at risk of HIV infection.

It is estimated that more than 90% of the 1.7 million women living with HIV in Asia became infected from their husbands or partners while in long-term relationships. By 2008, women constituted 35% of all adult HIV infections in Asia, up from 17% in 1990.

“HIV prevention programmes focused on the female partners of men with high-risk behaviours still have not found a place in national HIV plans and priorities in Asian countries” said Dr Prasada Rao, Director, UNAIDS Regional Support Team Asia and the Pacific, speaking at the launch of the report. “Integration of reproductive health programmes with AIDS programmes and the delivery of joint services to rural and semi-urban women are the key to reducing HIV transmission among intimate partners.”

In Cambodia, India and Thailand, the largest number of new HIV infections occur among married women. In Indonesia, where HIV was initially concentrated among drug users, the virus is now spreading quickly into sex work networks, including long-term partners and sex workers. Research from several Asian countries indicates that between 15% and 65% of women experience physical and/or sexual violence in intimate partner relationships, placing them at increased risk of HIV infection. According to studies in Bangladesh, India and Nepal, women exposed to intimate partner violence from husbands infected with HIV through unprotected sex with multiple partners were seven times more likely to acquire HIV compared to women not exposed to violence and whose husband did not have sex with multiple partners.

The strong patriarchal culture in Asian countries severely limits a woman’s ability to negotiate sex in intimate partner relationships, according to the report. While there is a societal toleration of extramarital sex and multiple partners for men, women are generally expected to refrain sex until marriage and remain monogamous thereafter.

“Discrimination and violence against women and girls, endemic to our social fabric, are both the cause and consequence of AIDS,” said Dr Jean D’Cunha, Regional Director, UNIFEM South Asia. “Striking at the root of gender inequalities and striving to transform male behaviours are key to effectively addressing the pandemic.”

The report also indicates that the female partners of migrant workers have been shown to be at increased risk of HIV infection when the latter return from working in countries with high HIV prevalence. A study in Viet Nam showed that married migrant workers reported having commercial sex partners and low condom use.

To prevent HIV transmission among intimate partner relationships, the report outlines four key recommendations:

1. HIV prevention interventions must be scaled-up for men who have sex with men, injecting drug users, and clients of female sex workers and should emphasize the importance of protecting their regular female partners.
2. Structural interventions should be initiated to address the needs of vulnerable women and their male sexual partners. This includes expanding reproductive health programmes to include services for male sexual health.
3. HIV prevention interventions among mobile populations and migrants must be scaled-up and include components to protect intimate partners.
4. Operational research must be conducted to obtain a better understanding of the dynamics of HIV transmission among intimate partners.

“The work that has been started around prevention of HIV transmission in intimate partner relationships is incredibly important because it means a new way of doing our work,” said Vince Crisostomo, Regional Coordinator, Seven Sisters (Coalition of Asia Pacific Regional Networks on HIV/AIDS). “The ultimate goal is the empowerment of women and it shows that the responsibility is on both sides.”

UNAIDS, its Cosponsors, including UNDP and UNFPA, and partners are organizing a symposium today at the conference to address HIV and intimate partner transmission. The aim is to take stock of evidence showing the increasing vulnerability of women to HIV transmission from their intimate partners and address critical policy and programme challenges.

Source
UNAIDS

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Former National Basketball Association player Earvin “Magic” Johnson gave the opening address of the CDC’s 2009 HIV Prevention Conference in Atlanta, the Southern Voice blog “The Latest” reports. He “spoke frankly about being HIV positive for nearly 20 years,” and discussed the impact black religious leaders have on addressing HIV/AIDS in the black community, according to the blog. Johnson said, “We now have a major problem in urban America, in inner cities - the face of AIDS has changed from a gay white man’s disease to a black and [Hispanic] disease. And if we don’t get the black church involved, there is no way we can bring these numbers (of new HIV cases) down.” The Magic Johnson Foundation “is working to partner with black churches … because African-Americans are disproportionately impacted by the disease,” according to the blog. Johnson said, “We all have to get black churches involved. If we do, we will see change quickly. One constant in the black community is the church” (Bagby, 8/24).

This information was reprinted from dailyreports.kff.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily U.S. HIV/AIDS Report, search the archives and sign up for email delivery at dailyreports.kff.org.

© Henry J. Kaiser Family Foundation. All rights reserved.

‘Prevention is the best cure’ is a common expression, but what happens if preventative measures are not used? A large proportion of pregnant Ugandan women are going out of their way not to be HIV tested, increasing the risk of mother-to-child transmission.

A recent paper by Larsson et al. in AIDS journal discussed how mother-to-child transmission of HIV can be easily and cost-effectively prevented using a short course of antiretroviral therapy. However, this is effective only if the mother is willing to be screened for HIV.

Anne Buve, a member of Faculty of 1000 Medicine, discusses the recent and “worrying” findings of this study, which she describes as “quite sobering”. There is currently an opt-out policy for HIV testing even though the HIV prevalence in Uganda is 6.4%.

One year after the implementation of the opt-out policy, fewer than 60% of pregnant women were tested for HIV in 2007 in the majority of countries in Eastern and Southern Africa, the exception being Botswana where voluntary counseling and subsequent testing rates are higher.

Programmes of syphilis screening during pregnancy already faced the same problem in Uganda. However, the authors of the study suggest that women who attended an antenatal clinic that did not have HIV testing on site, did so in order to avoid HIV testing. If confirmed, this finding is worrying.

More studies that identify and tackle the problems that exist with HIV screening need to be carried out, especially in parts of the world that have a high prevalence of HIV. Dr Buve goes on to say, “there should be more studies like this one that look into why people do not have access to or refuse to accept interventions that could prevent HIV infection among their offspring”.

Source: Steve Pogonowski

Faculty of 1000: Biology and Medicine

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“In the past few months, we’ve experienced near hysteria over swine flu and almost constant media attention to scares about tainted food,” syndicated columnist Marie Cocco writes in the Oregonian, adding, “These are genuine health hazards - but they aren’t necessarily deadly, nor do they affect nearly as many people in the United States and around the world as does AIDS.” Cocco discusses a recent finding by researchers from Columbia University and the Alan Guttmacher Institute that links a drop in condom use among teenagers “in part to waning public concern about transmission of HIV.” She writes, “The clear increase in the proportion of teenagers using condoms came during years when public health and media messages about the dangers of HIV were at a height.” Cocco continues, “You can argue, based on hard data, that when it comes to teenagers and sex, good policy and genuine leadership get better results than moralizing or ignoring signals that an upsurge in HIV infections may emerge” (Cocco, 7/2).

This information was reprinted from dailyreports.kff.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily U.S. HIV/AIDS Report, search the archives and sign up for email delivery at dailyreports.kff.org.

© Henry J. Kaiser Family Foundation. All rights reserved.