Kaisernetwork.org (Washington, DC)
10 October 2008
Special Notice
Kaiser Daily HIV/AIDS Report Will Not Publish Monday, Oct. 13
[Oct 10, 2008]
The Kaiser Daily HIV/AIDS Report will not publish on Monday, Oct. 13, in observance of the Columbus Day holiday. The report resumes publication on Tuesday, Oct. 14.
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Drug Access
Drug Companies Plan To Invest in HIV/AIDS Drug Development, Improve Access, U.N. Secretary-General Says
[Oct 10, 2008]
United Nations Secretary-General Ban Ki-moon on Thursday said that many large pharmaceutical companies -- including Abbott Labs, Boehringer Ingelheim, GlaxoSmithKline and Pfizer -- plan to increase their efforts to develop HIV/AIDS drugs and diagnostics for impoverished regions, Reuters reports. The companies have promised to invest more in prevention efforts -- including vaccine development and pre- and post-exposure prophylactics -- Ban said in a statement after he met with senior pharmaceutical executives from 17 companies and other U.N. officials. "We noted that despite the gains, the epidemic continues to outstrip our best efforts," Ban said, adding, "Only one-third of those who need antiretroviral treatment in low- and middle-income countries are getting it. Each day, for every two people who are placed on antiretroviral treatment, five more are infected. Collectively, we still have more work to do."
The companies also agreed to work toward adapting medicines and treatment for "resource-limited settings to be used safely in children, adolescents, adults and pregnant women," according to Ban. He added that the drug companies and the United Nations jointly agreed that increasing access to vaccines and medicines is "essential in scaling up prevention and treatment efforts" (Charbonneau, Reuters, 10/9).
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Global Challenges
HIV Drug Resistance Spreading in China, Researcher Says
[Oct 10, 2008]
As HIV spreads beyond high-risk groups into China's general population, drug-resistant strains of the virus also are appearing in parts of the country, Chen Zhiwei of the AIDS Institute in Hong Kong said recently, Reuters reports. According to Chen, the two trends are "alarming" and people living with HIV in China could face treatment obstacles because relatively few antiretroviral drugs are available in the country. "All these drug-resistant mutations are in China now, they are emerging in Chinese patients," he said, adding, "The major worry is whether the drug-resistant virus will spread. We are studying whether that is happening, but that will be the case if you don't provide proper treatment. If drug-resistant virus (strains) spread in China, we don't have enough selection of (drugs) that are made available."
According to Reuters, about seven of the more than 20 different antiretrovirals are available in China, meaning that HIV-positive people might be left with limited options if they develop resistance to certain drugs. In addition, treatment adherence can be low in rural parts of China because of a lack of knowledge among patients, low access to health care and inadequate numbers of health care workers to explain the importance of adherence.
Chen's comments follow a study published last week in the journal Nature that found how HIV cases are increasing among women and men who have sex with men in the country. "The virus is moving into the general population," Chen said, adding, "Signs are prevalent among women and" in mother-to-child transmission. Chen also said if "there is no good prevention, transmissions will suddenly explode." According to Chen, China's open southern border is a concern, and an HIV strain recorded in Yunnan province also has been detected in Thailand and Myanmar. He added that this could be explained by women working as commercial sex workers in other countries and returning to China. In addition, travelers crossing China's southern border could be contributing to the situation, Chen said (Ee Lyn, Reuters, 10/10).
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Panel Discusses How Asian Migrant Women Are Vulnerable to HIV
[Oct 10, 2008]
Although Asian migrant women working in Arab countries generate significant economic benefits for both their home and host countries, many of them are at risk of HIV because of the unsafe conditions under which they migrate and live, according to a panel of experts organized by the United Nations Development Programme Regional Center in Colombo, Sri Lanka, The Hindu reports. According to the panelists -- which included senior government officials and representatives of civil society in Lebanon, the Philippines and Sri Lanka; representatives of key diplomatic missions in Sri Lanka; U.N. officials; and migrant welfare organizations -- it is critical that the HIV vulnerabilities of this demographic are addressed so that the economic gains of both home and host countries, as well as the health and rights of migrant women, are protected.
Ajay Chhibber, assistant secretary-general and director of UNDP's Regional Bureau for Asia and the Pacific, said that women account for 43% of the 54 million people who at any given time are on the move within Asia and to destinations outside the region. "Women often migrate under unsafe conditions, live under very difficult circumstances, and can be targets of sexual exploitation and violence," Chhibber said, adding, "With little or no access to health services and social protection, these factors can make them highly vulnerable to HIV." He said that an increasing number of migrant workers from Asia who have contracted HIV in various host countries in recent years have been deported, which causes economic loss for the workers and their families. According to Chhibber, "There is a need for strategic national, regional and international action to ensure safe movement and access to HIV programs for migrants and mobile populations." In addition, Chhibber said that addressing the HIV vulnerabilities of migrants is key to achieving universal access to treatment and the U.N. Millennium Development Goals' aim of halting and reversing the spread of HIV/AIDS by 2015.
UNDP Releases Summary of HIV Vulnerabilities Among Migrant Women
During the round table, an executive summary of a UNDP study -- titled "HIV Vulnerabilities Faced by Women Migrants: From Asia to the Arab States" -- also was released. According to Caitlin Wiesen, UNDP's HIV/AIDS regional program coordinator and practice leader, although migrant women are among the most vulnerable to HIV, it is important to emphasize the fact that the conditions under which people migrate -- such as being separated from families and social support systems -- rather than the actual act of migration are what make women vulnerable to contracting the virus. Wiesen said, "Women, particularly domestic workers, are among the most vulnerable. They experience basic rights violations, in terms of pay and conditions of work. Many respondents reported physical violence, verbal and sexual abuse."
Malu Marin -- study coordinator and director of the nongovernmental organization ACHIEVE, which works for migrants' welfare in the Philippines -- said that restricting the movement of female migrants would force migration underground and increase women's risk of exploitation and HIV transmission. Marin added that in some cases, domestic workers are tested for HIV without consent and counseling and are deported if they are found to be HIV-positive. "This needs to change in favor of a migrant-friendly testing policy," Marin said.
According to The Hindu, the study recommends dialogue and coordination between ministries of health, labor, foreign affairs and social welfare in both countries of origin and destination to reduce vulnerabilities of HIV, as well as facilitation of multi-country negotiations between origin and host countries. The Hindu reports that the study examines HIV-susceptibility among female migrants from Bangladesh, Pakistan, the Philippines and Sri Lanka to Bahrain, Lebanon and the United Arab Emirates and explores ways to address their HIV risks without compromising their right to movement and livelihood. The study was based on research comprising more than 500 interviews over nine months using focus group discussions and key informant interviews with migrant workers; senior officials of the ministries of health, labor and foreign bureaus of employment; embassy officials; service providers; and recruitment agencies in both origin and host countries (The Hindu, 10/9).
The executive summary of the study is available online.
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35% of Annual New HIV Infections in Spain Occur Among Immigrants, Researcher Says at Conference
[Oct 10, 2008]
Thirty-five percent of the 2,000 to 2,500 new HIV infections in Spain last year occurred among immigrants, Daniel Zulaika, president of the AIDS Interdisciplinary Society of Spain, said Wednesday at the XI National Congress on AIDS in Cordoba, Spain's El Pais reports. A focus of the conference, which will continue through Friday, is the increasing number of HIV/AIDS cases among the country's immigrant population (El Pais, 10/9).
According to Zulaika, the percentage of new HIV/AIDS infections among immigrants -- who make up 10% of Spain's 45 million inhabitants -- is much higher than it was in 2002 when immigrants accounted for 5% of new HIV/AIDS infections. The group is vulnerable to the disease because they often have low incomes and come from different cultures, which create barriers to obtaining medical care, Zulaika said.
In terms of transmission modes, Zulaika said that there is no difference between how immigrants and Spaniards contract HIV, adding that the increase in new cases among immigrants paralleled the growth in the country's foreign-born population. According to Zulaika, 50% of new HIV/AIDS cases in 2007 were transmitted through heterosexual relations, while 25% were transmitted through male-to-male sexual relations and 12% were the result of injection drug use.
The conference is being attended by nearly 1,000 HIV/AIDS experts -- including physicians, nurses, members of nongovernmental organizations, public health officials -- as well as some HIV-positive individuals. Zulaika said that in order to fight the disease, there should be efforts to adapt treatment within the health care system, especially in the area of sexually transmitted infections, adding that campaigns should be created to target the spread of HIV/AIDS among immigrants (EFE News Service, 10/8).
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Empowering People Living With HIV/AIDS Can Address Poverty in Nigeria, Advocate Says
[Oct 10, 2008]
Alhaja Roli Daniju, executive director of the nongovernmental organization Ajegunle Community Project, recently called on Nigerian government officials and other stakeholders to help reduce poverty in the country by empowering people living with HIV/AIDS, This Day/AllAfrica.com reports. Daniju spoke in the capital of Lagos at the organization's one-day program, which was supported by the Global Fund for Women and called "Positive Living and Income Generation." It aimed to address the stigma surrounding women living with HIV/AIDS in Nigeria, as well as to create awareness among HIV-positive women about how to manage the virus on their own.
According to Daniju, people living with HIV/AIDS are "part and parcel of the society. They are just victims of circumstances but notwithstanding what an HIV-negative person can do, they can also do even better, because they have a vision, mission and are full of hope for a greater future." ACP is "keen on showing love and concern to positive living women in society" because of the HIV/AIDS-related stigma they face, Daniju said, adding that poverty in the country could be alleviated or eliminated by empowering these women (Olojo, This Day/AllAfrica.com, 10/8).
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Opinion
Women's Independence Necessary To Address HIV/AIDS in Uganda, Opinion Piece Says
[Oct 10, 2008]
Although Uganda had many achievements to celebrate on the anniversary of its independence on Wednesday, the country must "focus on independence on the individual level," especially among women affected by HIV/AIDS in the country, Milly Nattimba of the Makerere University School of Public Health writes in a New Vision opinion piece. When looking at "the real situation on the ground in this area and what more needs to be done," women account for more than half of the almost one million HIV/AIDS cases in the country, Nattimba writes, adding that women are most affected by the disease because of their "inherent dependence on men and the subsequent vulnerability."
According to Nattimba, women have no inheritance rights in Uganda, and they are discriminated against in regard to education and economic opportunities. She adds that as a result, they become more dependent on men. According to Nattimba, "the majority of women, especially in Third World countries, do not control their sexuality." Women cannot control when they have sex or how many children they have, leaving them at an increased risk of HIV because they "cannot negotiate safe sex" and "they cannot say no to sex even when they are sure their partner is having sexual relations elsewhere," Nattimba writes. She adds that although many women receive HIV tests in Uganda, "they are afraid to share the results with their husbands" because of "extreme" repercussions. "This affects their adherence to treatment," Nattimba writes, adding that there is a "culture of silence" surrounding HIV among married couples. "A truly independent nation is a result of the good health of its people, especially the women on whose shoulders most of the production in this country rests," Nattimba concludes (Nattimba, New Vision, 10/8).
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