Global Challenges

MSM Remain Most At-Risk Group for HIV in Beijing, Official Says

[Sep 10, 2008]

Beijing's community of men who have sex with men are most at risk of contracting HIV, He Xiong, deputy director of the Beijing Center for Disease Control and Prevention, said Friday, China Daily reports. According to He, 5% of MSM in the city are HIV-positive.

He said that 43% of all newly reported HIV/AIDS cases are attributed to unprotected sex. China Daily reports that research during the past three years has shown that less than 50% of MSM use condoms, which He said creates challenges in promoting better health awareness. Xiao Dong, chief of the Chaoyang Chinese AIDS Volunteer Group, said MSM "must voluntarily practice safe sex and take regular tests."

He said that the efforts of groups such as Xiao's are crucial to reducing the health risks MSM in Beijing face, adding that groups often work closely with MSM and provide no-cost condoms, confidential counseling and testing services. Between January and July, more than one million people in Beijing received an HIV test, He said.

Despite the risk of HIV/AIDS that the MSM community still faces, He on Friday said that the incidence of the disease among drug users has declined. Based on figures for the first seven months of 2008, 1.5% of the city's drug users are HIV-positive, compared with 5% in 2001, He said. Although He did not give comparable figures from 2001, he said 0.5% of unlicensed commercial sex workers are living with HIV/AIDS in Beijing.

According to He, 563 new HIV/AIDS cases were reported in Beijing during the first seven months of 2008, 118 of which were among local people and the remainder among migrant workers. In addition, new cases in each of Beijing's 18 districts and counties totaled 1,190 in 2007, up slightly from 2006.

Xiao said that although the development of a comprehensive HIV/AIDS monitoring network -- comprising 69 clinics and 128 laboratories -- has helped keep the spread of the disease in check, high-risk groups should become more knowledgeable about risks. According to He, prevention and treatment clinics throughout Beijing have created intervention teams to work with high-risk populations to help them with medical treatments, as well as other issues (Xie, China Daily, 9/9).

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Depression Common Among Youth in Rwanda Orphaned by AIDS, Genocide, Survey Finds

[Sep 10, 2008]

Depression is common among teenage and young adult orphans in Rwanda who head households and provide care for younger children, according to a survey conducted by researchers at Tulane University that was published last month in the Archives of Pediatrics and Adolescent Medicine, the New York Times reports. Rwanda is thought to have the highest percentage of orphans worldwide, primarily because of HIV/AIDS and tribal genocide in 1994, according to the Times.

Tulane researchers working with Rwanda's national School of Public Health surveyed 539 orphans ages 12 to 24 caring for others in a rural province. They found that 53% of respondents met the criteria for depression on a psychiatric screening scale. In addition, 76% said that their communities rejected orphans, 26% said that they had a close friend and about 40% said that life was meaningless or that they had lost their faith in God since their parents died. The survey also found that 77% were subsistence farmers and that 93% had fewer than six years of education. Almost half had eaten one meal daily in the last week, according to the survey.

Although orphans in several African countries are cared for by relatives or neighbors, "such systems are increasingly overwhelmed" in Rwanda, the authors wrote, adding that young people without parents or close adult relatives have to develop their own households or be homeless. The researchers said that large-scale programs are needed if the "next generation of youth is to thrive" in Rwanda (McNeil, New York Times, 9/9).

The survey is available online.

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Irish Times Examines HIV/AIDS Efforts in Moldovan Region

[Sep 10, 2008]

The Irish Times on Tuesday examined the efforts of a Medecins Sans Frontieres mission in Transdniestria -- an enclave in Moldova that supports Russia and declared its independence from Moldova in 1990 -- to improve its health care system and implement an HIV/AIDS center in light of the region's high prevalence of the disease, which is four times that of the national average.

According to the Times, health care in Transdniestria has deteriorated greatly largely because of isolation from the international community. The Moldovan Ministry of Health reports that at the end of 2007 there were 1,192 HIV/AIDS cases in the region out of 4,131 total cases in all of Moldova. However, medical professionals believe the actual figure is at least two to three times higher. In addition, although Moldova was receiving tens of millions of dollars in HIV/AIDS assistance from the Global Fund To Fight AIDS, Tuberculosis and Malaria, the World Bank and other agencies, none of the money reached those living in Transdniestria unless they traveled to Moldova's capital of Chisinau. The Times reports that such a journey was impossible for prisoners in Transdniestria, as well as for those too sick to travel or without proper documentation. MSF also discovered that access to health care was being denied to Transdniestrians for political reasons, the Times reports.

The program includes a customized, modern HIV/AIDS unit at a hospital in Transdniestria's capital of Tiraspol; weekly clinics at both a men's and women's prison; and outpatient treatment in a clinic in the northern city of Rybernzita. Prior to the initiative, local health care providers had almost no knowledge of HIV/AIDS, but following training provided by MSF, they began referring patients to the mission, the Times reports. In addition, MSF began lobbying the Global Fund, the World Health Organization and other potential stakeholders to visit the region and see that it is possible to operate successfully there. MSF's goal was to have international donors encourage Moldova to extend HIV/AIDS programs to Transdniestria and, eventually, the two sides began to share some resources, including antiretroviral drugs supplied by the Global Fund.

As the mission prepares to end in 2009, its head, Mark Walsh, said, "We have shown that it is possible to work in Transdniestria and have seen a burgeoning interest by other agencies to extend existing programs to the region." Walsh said the main achievement is that the mission "succeeded in prolonging the lives of hundreds of HIV/AIDS patients ... who might otherwise have died" (Fleming, Irish Times, 9/9).

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Across The Nation

Stigma Deters HIV-Positive People From Seeking Treatment, Panelist Says at Arkansas HIV/AIDS Minority Task Force Meeting

[Sep 10, 2008]

The stigma surrounding HIV/AIDS in the Arkansas Delta prevents people living with the disease from coming forward and makes it difficult for the state to help the population, a University of Arkansas for Medical Sciences researcher told the Arkansas HIV/AIDS Minority Task Force earlier this week, the Arkansas Democrat-Gazette reports. Katharine Stewart of UAMS' College of Public Health told the task force that there is a high level of stigma surrounding HIV/AIDS in the black community, adding that community leaders need to become involved in the fight against the disease. She added that sexually transmitted infections and HIV cases are disproportionately higher among blacks compared with whites, with HIV/AIDS rates among blacks throughout Arkansas recorded at levels five times higher than those among whites. Stewart also said that people living with HIV/AIDS and other STIs often are low-income drug users who do not use condoms. In addition, some women living in poverty engage in commercial sex work and do not have the power to negotiate condom use, Stewart said.

The task force should examine recommendations it might make in terms of changing sex education in the state, Stewart said, adding that sex sometimes is discussed by children as early as in the second grade and that it is important for children to receive adequate information from their parents and teachers rather than misinformation from their peers. Stewart said she is studying best practices for providing education to blacks living in rural Arkansas who do not believe they are at risk of HIV and refuse to use condoms. The task force was created by Arkansas Gov. Mike Beebe (R) in 2007 and will hold its next public forum on Sept. 22 in West Memphis (Blomeley, Arkansas Democrat-Gazette, 9/9).

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Public Health & Education

Starpharma, SSL International Reach Marketing Agreement Over VivaGel Condoms

[Sep 10, 2008]

The Australia-based Starpharma on Tuesday announced that its VivaGel-coated condom will be sold by SSL International, the owner of the Durex condom brand, Bloomberg reports. Starpharma expects to earn more than $81 million in royalties and other payments through the deal with SSL. VivaGel is a microbicide designed to prevent the transmission of sexually transmitted infections, including HIV and genital herpes, according to Bloomberg. Starpharma also aims to develop the gel for use on its own as a vaginal microbicide. The agreement provides the rights to sell the VivaGel condom in "most of the world," including Europe and the U.S., Starpharma said in a release (Bennett, Bloomberg, 9/9).

"We are particularly pleased to be working with a company such as SSL, which has the capabilities and marketing strength to rapidly move the product through registration and into the market," Starpharma CEO Jackie Fairley said. SSL has an approximate 30% share of the branded condom market worldwide and sells in more than 100 countries. Global condom retail sales have been estimated at approximately $3.2 billion (Starpharma release, 9/9).

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Opinion

More Effective HIV/AIDS Prevention, Education Efforts Needed To Reach Black, Hispanic Girls, Women, Letter Says

[Sep 10, 2008]

An "otherwise excellent" editorial recently published by the New York Times did not "mention the rapid spread of HIV among women and girls of color," Tracie Gardner, director of New York state policy and coordinator of the Women's Initiative To Stop HIV-New York at the Legal Action Center, writes in a Times letter to the editor. Young black and Hispanic women "make up almost 30% of newly reported HIV infections in New York City," Gardner writes, adding, "Today's HIV epidemic among women and girls is fueled largely by heterosexual transmission." Recent figures from CDC indicate that "more than one in four American teenage girls" has a sexually transmitted infection, but the "infection rate for black girls is 48%," according to Gardner. More "effective education, prevention and outreach that reaches" girls "where they are" is needed, Gardner writes, adding that HIV/AIDS information should be made "accessible in barber shops, nail salons and community restaurants" and that HIV testing should be offered in a 'broader range of health and social service settings." She concludes that there "should not be a fourth decade of new infections" (Gardner, New York Times, 9/10).

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Black Clergy 'Committed' To Addressing HIV/AIDS Epidemic in Community, Opinion Piece Says

[Sep 10, 2008]

The Fort Worth Star-Telegram's "recent series on HIV/AIDS accuses [black clergy] of being unaware, inert and unconcerned about the AIDS pandemic" and did not note a "very important truth: The church is changing in response to this challenge, and people of faith are making a difference," Valda Jean Combs, a local pastor who heads the FullProof HIV Ministry, writes in a Star-Telegram opinion piece.

According to Combs, "Once educated on the depth and breadth of the challenge," the black religious community has "become aware of the truth about HIV and the truth about transmission, risk factors and the devastating toll the disease is taking on" the black community and has reached out to those "people who are hurting, meeting them where they are, every single day." She notes that the World AIDS Day Service in 2006, the "Seven Days ... Seven Churches" initiative in 2007, and the Black Church Week of Prayer in 2008 are "proof that the Black Church is committed to this struggle."

The series also "made no attempt to gauge support for HIV/AIDS initiatives among local black elected officials," who as "community leaders, ... have a responsibility to shine a light on community challenges," Combs writes. She adds that "there is often a deafening silence among [local] black elected officials about the pandemic."

She continues, "The Star-Telegram could have written about the dearth of [blacks] employed in decision-making positions by AIDS organizations in Fort Worth" or addressed the reasons why outreach efforts have been ineffective, instead of "repeat[ing] the same trite accusations that have been lodged against the Black Church since the beginning of this epidemic." According to Combs, some HIV/AIDS organizations have a history of difficulty hiring and retaining black workers, which "translates to an inability to plan culturally sensitive effective programs targeting" the black community.

Combs says she hopes the paper will "dig deeper, ask the hard questions and hold our collective feet to the fire." She concludes, "And while you're at it, visit some of the 'silent' churches in Fort Worth. I think you might be compelled to write a different story next time" (Combs, Fort Worth Star-Telegram, 9/8).

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