Kaisernetwork.org (Washington, DC)
1 August 2008
Global Challenges
Washington Post Examines HIV Epidemic in Tijuana, Mexico
[Aug 01, 2008]
The Washington Post on Friday examined the HIV/AIDS epidemic in the border town of Tijuana, Mexico, where HIV prevalence is about three times that of the national average, with about one in 125 adults living with HIV. Mexico has one of the lowest HIV prevalences in the Americas, and according to UNAIDS, the percentage of people living with HIV/AIDS in Mexico is about half that of the U.S. and one-third that of El Salvador, Guatemala and Panama, the Post reports.
According to a survey by researchers at the University of California's Division of International Health and Cross-Cultural Medicine, 64% of 116 HIV-positive Tijuana residents came into the U.S. at least once monthly. About half of men who have sex with men living in Tijuana and 75% of MSM living in San Diego reported having sex partners across the border, the survey found. In addition, of 1,000 commercial sex workers interviewed in Tijuana, 69% reported having U.S. clients who crossed the border for sex. Steffanie Strathdee, a HIV/AIDS researcher at IHCCM, said HIV is the "uninvited hitchhiker."
According to the Post, HIV advocacy groups have implemented needle-exchange programs and condom distribution campaigns in Tijuana to curb the spread of HIV. The government has "quietly" supported such programs, the Post reports. Although the country is traditionally conservative, health leaders persuaded the government to support such programs and discuss issues such as condom use in a scientific, rather than moral, context. "Before, it was taboo to even talk openly about condoms," Jorge Saavedra -- director of Censida, the National Center for the Control of HIV/AIDS in Mexico -- said, adding, "Groups still oppose condom use, but at least we can mention the word." According to Saavedra, needle-exchange programs also are sound public health strategies. "We are not giving needles to people who are not drug users," he said, adding, "We're giving needles to people who are already using those drugs. This is a way to avoid HIV infections." The article also profiles Angel Cabrera, who conducts HIV/AIDS outreach in Tijuana (Connolly, Washington Post, 8/1). The article was supported by a Kaiser Family Foundation mini reporting fellowship.
Link to this story.
Mexican Officials Promote Sex Education Among Young People
[Aug 01, 2008]
Mexican officials on Wednesday announced their intention to promote sex education among young people in the country in an effort to reduce the spread of HIV, Xinhuanet reports.
Speaking at a youth presentation in advance of next week's XVII International AIDS Conference in Mexico City, Ricardo Baruch, International AIDS Society youth program coordinator, said that sex education is a "right" and "should be promoted by all means available." Baruch added that sex education has a wide reach but is inexpensive and therefore cost efficient, Xinhuanet reports. Jorge Saavedra -- director of Censida, the National Center for the Control of HIV/AIDS in Mexico -- said that improving sex education among teenagers is a challenge. According to Saavedra, sex education should cover the proper use of condoms and safer-sex relations among young people. Priscila Vera, director of the Mexican Youth Institute, said that condoms will be handed out at no cost to young people in the coming months (Xinhuanet, 7/31).
Kaisernetwork.org is the official webcaster of the XVII International AIDS Conference in Mexico City. Click here to sign up for your Daily Update e-mail during the conference.
Link to this story.
Reuters Examines How Laws, Conservative Attitudes Are Hampering Efforts To Fight HIV/AIDS in Malaysia
[Aug 01, 2008]
Reuters on Thursday examined how some laws and widespread conservative attitudes are hindering efforts to fight the spread of HIV/AIDS in Malaysia, a predominantly Muslim country where high-risk groups are driven "deeper underground" because of the situation. Soliciting sex work and sodomy are illegal in Malaysia, and the country has heavy punishments for illegal drug use, according to Reuters. In addition, although efforts from some advocates have garnered government support for HIV/AIDS programs and the distribution of condoms and clean needles, "implementation is far from easy," Reuters reports.
Celine Ng, who runs a needle-exchange program, said that her biggest challenge is the police. "Even my staff encounter problems with them. We have the endorsement of the narcotics (authorities) and we give needles, not drugs," she said, adding, "So if they catch our clients with drugs, we can't stop them, but you can't catch those with just needles." Laws make it difficult to distribute condoms to sex workers and men who have sex with men. In addition, oral and anal sex is illegal in all circumstances and is punishable by up to 20 years in prison. Although sex work is not illegal, solicitation is punishable by up to 10 years in prison. Drug trafficking carries a mandatory death sentence, according to Reuters.
People in high-risk groups are "driven underground, so you can't reach them," Adeeba Kamarulzaman, president of the government-supported Malaysian AIDS Council, said. He added, "We have (our) outreach workers getting arrested. They (authorities) raid and catch everyone, we are forever trying to bail out our outreach workers from the lockup, which is a major headache on a day-to-day basis." Injection drug users comprise the largest risk group for HIV in Malaysia and accounted for 65% of the 4,549 new cases recorded in 2007. Malaysia recorded a total of 80,938 people living with HIV at the end of 2007, but many sources say that the actual number of cases could be much higher. "Infections are going up, but surveillance is very poor in Malaysia," Raymond Tai of the Pink Triangle Foundation said, adding, "Many young [MSM] only know of their illness for the first time when they are warded with AIDS. How long have they been positive, how long have they been infectious? It is critical."
There also are concerns that HIV/AIDS is spreading from high-risk groups to women in the general population in the country. High-risk groups do not "exist in isolation," Kamarulzaman said, adding that IDUs "have wives, drug users patronize sex workers, they buy sex, they sell sex." Some groups are attempting to promote HIV/AIDS prevention messages, which can be difficult because advertisements are under government control, according to Reuters. Ads for condoms are not permitted on national television, except in certain circumstances such as promoting use for married couples. Advocates also are stressing that increased action should be taken and that the government should acknowledge the situation and cooperate with nongovernment organizations (Lyn, Reuters, 7/31).
Link to this story.
Politics and Policy
Federal Health Plan, Medicare Do Not Cover Routine HIV Screening as Recommended by CDC, Bloomberg Reports
[Aug 01, 2008]
Medicare and federal health care plans that provide coverage under the Federal Employees Health Benefit Plan do not offer payment for routine HIV screening of people ages 13 to 64 -- a practice that was recommended by CDC in 2006 -- Bloomberg reports. According to Bloomberg, FEHBP provides coverage for 8.5 million employees, and Medicare provides coverage for 7.1 million disabled people under age 65. CDC revised its recommendations because risk-based HIV screening often was not covered by insurance, and doctors often did not know which of their patients were considered high risk. In addition, more people outside high-risk groups -- including women, minority groups and people living outside cities -- were contracting the virus.
FEHBP, which costs $35 billion annually, pays 230 regional health plans nationwide to provide care for federal workers, including those employed by CDC, elected officials and their family members. FEHBP does not follow the CDC HIV screening guidelines but instead adheres to an alternative protocol adopted by the U.S. Preventive Services Task Force, which only covers high-risk individuals. In order to support screening recommendations, the task force requires that studies already have demonstrated the testing provides benefits, Ned Calonge, chair of the task force's advisory panel, said. He added that although the CDC guidelines aim to identify more undiagnosed HIV cases, the agency has not proved yet that the guidelines will be successful. "I don't think they have evidence that a universal testing strategy is going to lead to lower infection rates and less HIV," Calonge said, adding, "There are some indications to be optimistic, but optimism and promise aren't proof."
Be the first to Write a Comment!
AllAfrica aggregates and indexes content from over 125 African news organizations, plus more than 200 other sources, who are responsible for their own reporting and views. Articles and commentaries that identify allAfrica.com as the publisher are produced or commissioned by AllAfrica.
