Kaisernetwork.org (Washington, DC)
20 March 2008
Public Health & Education
Communities Nationwide Commemorate National Native HIV/AIDS Awareness Day
[Mar 20, 2008]
Thursday marks the second annual National Native HIV/AIDS Awareness Day, which seeks to increase education and reduce the spread of HIV/AIDS among American Indian, Native Hawaiian and Alaska Native populations, Indian Country Today reports.
Roughly 11 out of every 100,000 American Indians and Alaska Natives were diagnosed with HIV or AIDS in 2005, according to CDC data based on reports from 33 states. Eleven percent of Native Hawaiians have been diagnosed with AIDS, and the infection rate for the group has increased about 3% since 1995.
Although the total infection rate for American Indians and Alaska Natives represents less than 1% of total HIV/AIDS cases in the U.S., the combined group is the third most affected population in the nation, behind blacks and Hispanics.
In addition, the life expectancy of American Indians and Alaska Natives with HIV/AIDS is shorter than any other racial or ethnic group, according to the National Native American AIDS Prevention Center.
Warren Jimenez, executive director of NNAAPC, said infection rates among native populations are probably higher than the CDC figures indicate. Increases in rates of drug and alcohol abuse, as well as in rates of sexually transmitted infections such as gonorrhea, chlamydia and syphilis, suggest that HIV/AIDS rates are likely increasing for the group, according to Jimenez. "There are significant gaps in reporting around this issue," he said, adding, "I think that stigma is an issue to face, the issue of sexuality or being two-spirited or being gay, lesbian, bisexual or transgender." Jimenez said drugs that prolong the life expectancies of people with HIV/AIDS are a positive development, but the "downside to that is that people have grown numb (to the danger of infection)." Decreasing media coverage of HIV/AIDS-related issues also has lowered awareness about behaviors that increase the risk of infection, he said.
NNAAPC and more than 55 American Indian, Native Hawaiian and Alaska Native community organizations around the country will hold events to mark the awareness day. The Native Capacity Building Assistance Network, which includes the NNAAPC, the Center for Applied Studies in American Ethnicity and the Inter Tribal Council of Arizona, has developed an online 'tool kit' of fact sheets and promotional material to help communities plan events. An interactive map of national events is available online (LeMay, Indian Country Today, 3/19).
The National Alliance and State and Territorial AIDS Directors recently released a report about ways to address HIV/AIDS in American Indian communities. The report is available online (.pdf).
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Global Challenges
HIV/AIDS Threatening Democracy, Governance in Southern Africa, Study Says
[Mar 20, 2008]
The Institute for Democracy in South Africa recently released a study that found HIV/AIDS is threatening democracy and governance in some Southern African countries, South Africa's Mercury reports.
For the study, Kondwani Chirambo, head of the Governance and AIDS Program at IDASA, and colleagues examined the impact of HIV/AIDS in Malawi, Namibia, South Africa, Tanzania, Zambia and Zimbabwe (Savides, Mercury, 3/19). The study, titled "The Political Costs of AIDS in Africa," found that in Malawi, Tanzania, Zambia and Zimbabwe, deaths from undisclosed causes among Members of Parliament younger than age 55 was the main cause of vacancies during the last 15 years. In South Africa, 23 MPs had died of various causes since 1994, the study found.
"Not a single elected representative has been known to" have died of AIDS-related causes, "despite that this mortality profile seems to mimic the pandemic's effect," the study said (SAPA/Polity.org.za, 3/19). The study said that "because there is no further information on whether these deaths were as a result of disease, car accidents or other causes, no inferences have been drawn by IDASA regarding trends." However, the study noted that there are "higher levels of stigma and discrimination" related to HIV/AIDS "among political elites, given that not a single elected representative has been known to live with or die" from AIDS-related illnesses (Mercury, 3/19).
Because of the increased number of deaths among MPs in the countries studied, organizational and financial restraints have left the positions vacant for longer periods of time, the SAPA/Polity.org.za reports. The vacancies also have "opened the door" to less qualified replacements, which might affect the quality of service, the SAPA/Polity.org.za reports. "A viable option would be to simply allow political parties to replace the deceased through appointment," IDASA said (SAPA/Polity.org.za, 3/18). In addition, Chirambo said that new electoral models should be developed to address the effect of HIV/AIDS on Africa (Mercury, 3/19).
The study also found that deaths from AIDS-related causes among voters have hindered the ability to maintain registers. "AIDS is a much bigger problem than simply a health crisis," Chirambo said. He added that there are a "number of worrying revelations in this study," including the "large number of younger voters who have died; the rising deaths among MPs and the loss of representation attributed to these deaths; the impact on small or under-resourced opposition parties; and the implications for democratic accountability (SAPA/Polity.org.za, 3/18).
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Advocates Request Support for HIV-Positive People Affected by Floods in Namibia
[Mar 20, 2008]
The Solidarity Community Care Organization is requesting urgent support for HIV-positive people affected by recent flooding in northern areas of Namibia, the Namibian reports. The organization in a recent statement voiced concerns that HIV-positive people who require antiretroviral treatment might be forced to discontinue their medicines because health centers are inaccessible. SCCO Chair Hishiyukifa Mwandingi also said that flood damage has hindered access to checkups and treatment appointments at health facilities.
"We are therefore calling upon all HIV-positive people, especially those on [antiretrovirals] in the affected regions, to take responsibility for their treatment by keeping to their appointments and adhering to their treatment at all times," SCCO said, adding, "Those who are strong must assist the weaker ones to reach health facilities." The group also called on community health workers in the country's Ohangwena and Oshana regions to help ensure that people remain on their antiretroviral regimens. In addition, members of the organization thanked national and regional health authorities for their help in addressing health issues in affected areas, the Namibian reports (Namibian, 3/18).
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Science & Medicine
Male Circumcision Does Not Offer Protection Against Some STIs, Study Finds
[Mar 20, 2008]
Although male circumcision has been found to offer men some protection against HIV, the procedure does not protect against other common sexually transmitted infections -- such as chlamydia, genital warts and genital herpes -- according to a study published in the March issue of the Journal of Pediatrics, Reuters Health reports.
For the study, Nigel Dickson of the University of Otago Dunedin School of Medicine and colleagues examined 499 men born in 1972 and 1973. About 40% of the participants had been circumcised in early childhood, Reuters Health reports. The study found that up to age 32, there were no statistically significant differences in rates of STIs other than HIV between the two groups, with 23.4% and 23.5% of the circumcised and uncircumcised men, respectively, reporting having had any type of STI. The most common STIs reported were genital warts, chlamydia and genital herpes, the study found.
According to the researchers, there is "compelling evidence" that male circumcision offers men a level of protection against HIV, but it is unclear whether the procedure lowers the risk of other types of STIs. The researchers noted that although another recent study found that circumcision decreased the rate of STIs among men up to age 25 by 50%, the study was done in a smaller group of participants with a lower rate of STIs than that reported in the current study. In addition, fewer men in that study had been circumcised, according to the researchers.
"Although the reason for the different findings in the two cohorts is unclear, when our findings are considered in the context of other recent population-based studies in developed countries, it appears unlikely that circumcision has a major protective effect against common [STIs] in these populations, although a smaller effect cannot be ruled out," the researchers concluded (Reuters Health, 3/19).
An abstract of the study is available online.
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HIV Among MSM in London Spreading in 'Bursts,' Study Finds
[Mar 20, 2008]
HIV among men who have sex with men in London is spreading in "bursts," according to a study conducted by researchers at the University of Edinburgh and London's Chelsea and Westminster Hospital and recently published in PLoS Medicine, BBC News reports (BBC News, 3/18).
For the study, Andrew Brown of the university and colleagues compared the sequences of HIV genes of more than 2,000 HIV-positive people, primarily MSM, who received treatment at a London clinic between 1997 and 2003. The study found that 402 sequences closely matched at least one other sequence. In addition, the study found that the participants whose HIV sequence matched other sequences had formed six clusters of 10 or more people, as well as several smaller clusters (United Press International, 3/19).
According to the study, many MSM who contracted HIV transmitted it to another person within a few months, often before they realized they were HIV-positive. "What we have discovered is that some of the spread occurred in bursts, with groups of people becoming infected within a short period of time," Brown said. He added that by studying changes in HIV, the researchers were "able to pinpoint its progress in stages."
Brown added that such transmission patterns have been found before among injection drug users but had not previously been found in people who contracted HIV through sexual contact. He said the "tightness of the clusters" is "frightening" and brings up concerns about the possibility that a drug-resistant form of HIV could "spread quickly, spreading a mini-epidemic" (BBC News, 3/18).
According to Brown, the findings suggest that messages about safer sex practices are "not getting through." The researchers recommended that HIV prevention programs target bars and night clubs and be communicated over the Internet to curb sexual transmission of the virus (PA/Arbroath Herald, 3/19). "It is important that information on the virus is available to [MSM] in the local areas where they are known to meet, to try to arrest the spread of HIV/AIDS," Brown said (BBC News, 3/18).
The study is available online.
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Opinion
South Carolina Should Make 'Serious, Conscious Choices' To Address HIV/AIDS, Opinion Piece Says
[Mar 20, 2008]
South Carolina "must make some serious, conscious choices about how to handle" problems associated with HIV/AIDS, Jacqueline Fox, an assistant professor at the University of South Carolina School of Law, writes in a Columbia State opinion piece.
According to Fox, South Carolina has registered about 16,000 HIV/AIDS cases; however, stigma and a "lack of testing resources may be preventing" state officials "from knowing the full breadth of" HIV/AIDS in the state. Fox writes that the state should "remove the mystery and stigma" associated with the disease, adding that it is "critically important" for the state to "decide now" about its "commitment to ongoing treatment of HIV."
According to Fox, South Carolina "can do better both medically and ethically" in providing HIV treatment and support services. The state "needs to take a hard look at itself and decide what" it needs to do to address HIV/AIDS, she writes, concluding that the state "can set the tone for how the rest of the South should grapple with these issues about justice and HIV" (Fox, Columbia State, 3/19).
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