Kaisernetwork.org (Washington, DC)
6 August 2008
AIDS 2008
Governments Overlook Behavior Change in HIV Strategies, Experts Say at AIDS Conference
[Aug 06, 2008]
When formulating their HIV strategies, governments worldwide overlook research showing the importance of behavior change in HIV prevention, several experts said Tuesday at the XVII International AIDS Conference in Mexico City, the New York Times reports.
Experts discussed a variety of behavior modifications, including promoting safer sex practices, decreasing injection drug use, providing needle-exchange programs and promoting male circumcision. Although "none of the measures alone offer a simple solution to preventing infection with HIV," combining interventions and making their use more widespread is crucial to fighting HIV/AIDS, the experts said, the Times reports. They added that there is an increasing need to combine prevention and treatment efforts. Myron Cohen of University of North Carolina said researchers in the respective fields "need to get married," adding, "we need to be one community."
The Global HIV Prevention Working Group, a panel convened by the Bill & Melinda Gates Foundation and the Kaiser Family Foundation, on Tuesday released a report calling for a greater focus on behavior change. According to the Times, the report addressed misconceptions about behavior change interventions, including: "misplaced pessimism about the effectiveness of HIV prevention strategies," confusion between "the difficulty in changing human behavior" and the ability to accomplish that, and "misperception that because it is inherently difficult to measure prevention success, those efforts have no impact" (Altman, New York Times, 8/6).
Also on Tuesday, the Lancet released a series produced in collaboration with UNAIDS that examines how global efforts to control HIV/AIDS cannot succeed without a comprehensive prevention package. The series includes six papers -- which focus on combination prevention, decreasing the infectiousness of HIV-positive people, reducing risky behaviors, structural factors, targeting resources effectively, and the social and scientific movement needed to implement combination prevention -- as well as two commentaries (Lancet release, 8/5). In one of the articles, to be published Saturday, Thomas Coates of the University of California-Los Angeles, wrote, "Behavioral strategies need to become more sophisticated." He also called on governments to ensure that they have put in place "the right programs" to prevent HIV.
Jorge Saavedra, director of Mexico's HIV/AIDS program, said political leaders worldwide need to follow epidemiological and scientific evidence when planning HIV strategies and must involve more men who have sex with men in planning how to reach groups at high risk of HIV. Saavedra added that the world "will lose the fight against HIV" if governments do not follow the epidemiological and scientific evidence (New York Times, 8/6).
The Global HIV Prevention Working Group report is available online.
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. Related webcasts from Tuesday include:
A plenary session featuring Saavedra and Cohen.
A briefing to release the working group report.
A briefing on the series from the Lancet.
A video roundup featuring the day's highlights from the conference, with a focus on prevention.
Link to this story.
Former African Leaders Launch Regional Campaign To Pressure Politicians on HIV/AIDS
[Aug 06, 2008]
Former leaders of Botswana, Mozambique, Tanzania and Zambia, as well as other well-known African figures, launched an initiative Tuesday at the XVII International AIDS Conference in Mexico City to put pressure on politicians whom they believe have not done enough to fight HIV/AIDS, Reuters reports (Rosenberg, Reuters, 8/6). The campaign is called "Champions for an HIV-Free Generation." Its founding members include former Botswanan President Festus Mogae; Joaquim Chissano, former president of Mozambique; former Zambian president Kenneth Kaunda; South African Archbishop and Nobel peace laureate Desmond Tutu; and Miriam Were, head of the Kenyan National AIDS Control Council (Ingham, AFP/Khaleej Times, 8/6). The initiative calls for more government actions and public education campaigns to prevent new HIV cases in countries where up to one in four people are living with HIV/AIDS (Reuters, 8/6). Mogae also said the campaign's members would aim to launch "a dialogue" with governments about changing behavior, unsafe sex, stigma and discrimination against women. He added that the campaign would be open to prominent leaders all over Africa, as well as people "from all walks of life" (AFP/Khaleej Times, 8/6).
Mogae said, "The fact that we are prominent individuals from all parts of Africa, if we strongly disagree with someone, I think we can mobilize shame against that person," adding, "Some countries appeared to ignore the problem" (Reuters, 8/6). He added that the initiative hopes to reach a consensus with current political leaders, "but even if it doesn't emerge, we will advocate things we believe (in)" (AFP/Khaleej Times, 8/6). Mogae also said he would set up a small technical office in Botswana to develop HIV/AIDS prevention programs that will be funded by the World Bank, the U.S. and other organizations.
Were said, "Not everyone might be comfortable with it, but we need to talk about HIV, about stigma, about our behavior, because silence and inaction are fatal."
Stephen Lewis, a former UN special envoy for AIDS in Africa, said, "This will be interesting. Former presidents can wield a lot of influence" (AFP/Khaleej Times, 8/6).
Edwin Cameron, a prominent South African HIV-positive judge who is supporting the initiative, said, "What we have lacked is sufficient visibility of leadership. Just as my own country was mired in ghastly nightmare of President Mbeki's AIDS denialism, President Mogae in Botswana was rolling out very scientific responses."
Reuters reports that during Mogae's 10 years as president, Botswana reduced mother-to-child HIV transmission from 40% to 4%. In addition, of the 300,000 people in the country living with HIV/AIDS, about 100,000 are receiving antiretrovirals. The United Nations said that despite government education campaigns in the country, misconceptions about the disease remain. Nearly one-third of people surveyed in 2004 said they thought HIV can be acquired through supernatural means, and more than half said it can be transmitted through mosquitoes (Reuters, 8/6).
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. A webcast of the opening session of the conference, featuring Mogae, is available online. In addition, an interview with Mogae is available online.
Link to this story.
Advocates Discuss Travel Restrictions Around the World for People Living With HIV/AIDS
[Aug 06, 2008]
HIV/AIDS advocates on Tuesday at the XVII International AIDS Conference in Mexico City discussed travel restrictions around the world for people living with HIV/AIDS, the AP/Los Angeles Times reports.
Developed countries say such restrictions help them avoid the cost of caring for HIV-positive people from other nations, but advocates say research shows that countries without restrictions have not had to do so on a significant scale. According to the European AIDS Treatment Group, seven nations -- Brunei, Oman, Qatar, Sudan, South Korea, United Arab Emirates and Yemen -- deny entry for people living with HIV and 30 countries deport foreigners reported to have HIV. In addition, more than 65 nations enforce some degree of travel restriction for HIV-positive individuals.
Australia currently allows people living with HIV to enter the country but requires testing for those intending to work in the medical field and for sub-Saharan Africans seeking to study (Watson, AP/Los Angeles Times, 8/5). Australian Prime Minister John Howard in a radio interview last year said that his initial reaction was to oppose the immigration of HIV-positive people but added that he needed "more counsel" on the issue (Kaiser Daily HIV/AIDS Report, 4/13/07).
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