Kaisernetwork.org (Washington, DC)
4 November 2008
Election 2008
Magazine Calls on Next President To Develop National HIV/AIDS Plan
[Nov 04, 2008]
Whichever candidate wins the U.S. presidential election should develop a national HIV/AIDS strategy, POZ magazine editor-in-chief Regan Hofmann said recently, VOA News reports. According to POZ, more than one million people in the U.S. are HIV-positive, and 14,000 people died from AIDS-related causes in 2006. In addition, about 25% of people in the U.S. who are living with HIV are unaware of their status, VOA News reports. According to Hofmann, the next president should "acknowledge" that there is an HIV/AIDS epidemic in the U.S. and put "forward a plan immediately to deal with it. The funding is not commensurate with the need in the United States." She added that several state and federal HIV/AIDS programs have seen budget cuts in recent years.
"For the entire epidemic to date, now almost 28 years, we've had sort of a combination of small grassroots work being done and then large-scale projects and initiatives, but there hasn't been the coordination that is needed to make sure that all of the people who are living with HIV can access care and treatment," Hofmann said, adding, "AIDS is not going away in America. It's a preventable disease. So, something's broken here because we know how to stop the disease. We can prevent the transmission of HIV and yet we're not. We know how to keep people alive and yet people are still dying of AIDS in America."
POZ put forth seven steps to address HIV/AIDS in the U.S., such as addressing stigma and discrimination, as well as identifying "evidence-based prevention tactics that work and tailor[ing] them to individual audiences." Hofmann also said that the blame and condemnation associated with HIV/AIDS should end. "This is a retrovirus," she said, adding, "It's nothing more and nothing less, but we have to change the way that people think about AIDS so that people aren't afraid to get tested. They aren't afraid to go and get care. People who have HIV didn't do anything bad. And yet society, and even those living with the disease, sometimes think otherwise."
According to Hofmann, many young people who were born after the initial fears surrounding HIV/AIDS are not aware of prevention measures and therefore are engaging in risky sexual behavior. She added that more funding should be devoted to developing a vaccine or cure for HIV/AIDS because of the rising costs of treatment and prevention. "This has become a global economic crisis," Hofmann said, adding, "It's been a humanitarian crisis for a long, long time. ... We're looking at how in the world the world is going to be able to pay for all of these people. So, there's absolutely incentive, I think, to look for the answer to this disease. We can't bear the cost of AIDS" (De Capua, VOA News, 11/3).
The related POZ article is available online.
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Science & Medicine
Study Examines Why Merck Vaccine Candidate Might Have Increased Likelihood of Contracting HIV
[Nov 04, 2008]
Trials of Merck's experimental HIV vaccine were halted in September 2007 because the drug might have increased the likelihood of contracting the virus rather than preventing it, according to a study published Monday in the Journal of Experimental Medicine, AFP/Google.com reports.
The vaccine was based on the idea that a modified form of a common cold virus -- Adenovirus 5 -- would carry elements of HIV into the body, which would then trigger the immune system to start fighting a subsequent HIV infection. An initial concern was that widespread immunity to the vaccine might cause it to be rejected by the body before the body could develop an effective response against HIV. However, three years after the trial began, researchers at the Montpellier Institute of Molecular Genetics in France said that more of the recipients who had prior immunity to the Ad5 virus had contracted HIV than those who had not received the vaccine. The study found that the presence of long-lasting antibodies specific to the Ad5 virus, which were generated during natural infections with the common cold, could have altered the response to the vaccine. Furthermore, HIV spread through cell cultures three times faster in the presence of antibodies from individuals immune to the Ad5 virus because HIV came in contact with an increased amount of CD4+ T cells to infect. In addition, the study found that the problem was not documented during Phase II trials because nonhuman primates, which were used in Phase I trials, do not naturally come into contact with the human common cold (AFP/Google.com, 11/3).
The study is available online.
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Global Challenges
First National Conference for People Living with HIV/AIDS Held in Papua New Guinea
[Nov 04, 2008]
Papua New Guinea's first national conference for people living with HIV was opened Sunday in the capital of Port Moresby by Jamie Maxtone-Graham, chair of the Special Parliamentary Committee on HIV/AIDS, the Papua New Guinea Post-Courier reports. The three-day event -- which is funded by the Australian government through Sanap Wantaim, Australia's HIV/AIDS program with Papua New Guinea -- is expected to draw about 150 people living with HIV. According to the Post-Courier, about 60% of HIV-positive people in the country have not publically disclosed their HIV status. Participants include 47 representatives from Papua New Guinea's 20 provinces, as well as international representatives from the National Association of People with AIDS in Australia, the Aboriginal and Torres Strait Islands, the Solomon Islands and the Pacific Islands Association Federation in the Cook Islands.
Annie MacPherson, coordinator for Igat Hope, said the event marks the first time people who are living with HIV/AIDS in Papua New Guinea are being brought together to "develop a way forward on how they can work with each other in the national HIV response." The focus of the conference will be discussions on universal access to treatment, leadership and support for people living with HIV. According to the Post-Courier, more than 1,000 people living with HIV/AIDS in the country have access to antiretroviral treatment.
Anne Malcom, team leader for Sanap Wantaim, said that Australia recognizes the HIV epidemic in Papua New Guinea and is committed to helping the country increase its long-term response to the virus. Community Development Minister Dame Carol Kidu said the conference is possible because of the few people living with HIV in Papua New Guinea who publically reveal their status. She added that years ago, there was an even greater fear surrounding HIV in the country. Kidu also urged advocates to include issues such as tuberculosis drug access in their efforts to increase HIV/AIDS drug access in the country (Gerawa, Papua New Guinea Post-Courier, 11/3).
Link to this story.
Glaser Foundation Program Trains HIV-Positive Pregnant Women To Administer Nevirapine to Infants Following Home Births
[Nov 04, 2008]
The Elizabeth Glaser Pediatric AIDS Foundation has completed the pilot phase of a home-based program in Uganda that teaches HIV-positive pregnant women how to administer the antiretroviral nevirapine to their infants immediately after birth to prevent mother-to-child transmission of the virus, New Vision reports. According to New Vision, the pediatric form of nevirapine can reduce an infant's risk of HIV by 50% when given after birth.
Under the program, nevirapine is repackaged to allow pregnant women who do not give birth at a heath facility to administer the formula at home. The package consists of a sealed syringe of the medication wrapped in foil paper that prevents sun exposure and includes instructions in local languages. It will be integrated into existing prenatal programs, New Vision reports.
According to Edward Bitarakwate, the foundation's technical director, a "big challenge" for the program will be to ensure the medication is not given to women early in their pregnancies because it could expire before the women give birth. The foundation is "discussing training [and] dispensing technicalities with the Ministry of Health," Bitarakwate said. "It is pointless to give [nevirapine] to the mother in early pregnancy as it may expire before the baby comes," Bitarakwate added.
In addition, pregnant women must receive training on how to properly store and dispense the drug. According to William Salmond, the foundation's director in Uganda, HIV-positive pregnant women who have not disclosed their HIV status to their husbands or caregivers "may hide the drug in weird places ... consequently destroying it." Salmond said that the government must train midwives to administer the drug if the pregnant woman is unable to, adding that male involvement and support is "very important."
According to Bitarakwate, the program targets women who are 32 weeks' pregnant, under the assumption that they will deliver at home between 36 weeks' and 42 weeks'. Women who do not deliver within the specified time frame are advised to return to the clinic for a new dose of the formula to ensure the infant is not given expired medicine.
Some critics have said the home-based approach will discourage women from delivering in hospitals, but Bitarakwate said that the government must address the challenges that prevent women from delivering in hospitals. He said the program is necessary because the health system has "failed to address the factors that deter mothers from delivering from hospitals."
According to Godfrey Esiru, the national coordinator of prevention of MTCT programs, MTCT is the second most common mode of HIV transmission in Uganda, accounting for 15% of all new HIV cases and 95% of cases among children younger than age two. He added that although nevirapine reduces the risk of MTCT and has prevented more than 12,000 HIV cases among children, challenges such as voluntary counseling and testing remain (Nabusoba, New Vision, 11/3).
Link to this story.
Food Shortages Pose Obstacles to HIV/AIDS Treatment in Haiti
[Nov 04, 2008]
Many HIV-positive people in Haiti face challenges in adhering to their antiretroviral drug regimens because of a lack of food throughout the country, IRIN/PlusNews reports. According to IRIN/PlusNews, antiretrovirals are more effective and cause fewer side effects when taken with food, and proper nutrition helps delay the progression of HIV. However, rising food prices, high poverty rates, a troubled agricultural sector and recent hurricanes have exacerbated existing food shortages and created challenges for HIV-positive people seeking treatment.
According to IRIN/PlusNews, more than 60% of Haitians live below the poverty line of less than $2 per day. The country's National Food Security Council reports that an estimated 2.7 million of the country's population of 9.2 million faced food shortages before the hurricanes this year, and an additional 800,000 people faced food shortages following the storms. Alan Isaac, program director at Catholic Relief Services, said the situation in Haiti was "already precarious because of the food prices and low agricultural production; the hurricanes just made it worse."
Reynold Grand Pierre of GHESKIO -- a non-governmental organization that supports HIV/AIDS treatment sites in Haiti -- said, "It's difficult to assure [antiretroviral] adherence without that food support." Michel Bertrand -- GHESKIO coordinator in Jacmel, Haiti -- added that antiretrovirals are "not the priority" for people with social and economic problems, who may skip drug consultations to attend food distributions. Gladys Lauture, founder of Espoir Anaise -- a charity that uses donations from the United Nations' World Food Program and Catholic Relief Services to distribute food to 6,500 people living with HIV/AIDS and their families -- said, "Treatment is available now. The strategy is to give them food to motivate them to get the treatment." Lauture estimates that the food distributed to HIV-positive people by Espoir Anaise reaches less than one-tenth of those in need of food assistance. Isaac agreed that many people living with HIV did not receive food aid even before the hurricanes. "People who are nutritionally compromised are going to die, whether they're on [antiretrovirals] or not," Isaac said.
According to UNAIDS figures, an estimated 2.2% of Haiti's population is HIV-positive (IRIN/PlusNews, 10/31).
Link to this story.
Public Health & Education
Boston Globe Profiles Advocate Who Promotes HIV/AIDS Awareness Among Teenagers
[Nov 04, 2008]
The Boston Globe on Monday profiled John Chittick, who in 1997 founded TeenAIDS-PeerCorps, a not-for-profit group that teaches teens worldwide about HIV/AIDS. Chittick reaches out to teens about the disease through his "World Walks" -- yearly international trips to countries with high HIV/AIDS burdens. In two weeks, Chittick will travel to Sudan, Rwanda, the Democratic Republic of Congo and Angola. He estimates that he has spoken with 300,000 teens in more than 80 countries since his first trip ten years ago and said he hopes to add 10,000 teens to that list during his next trip.
The Globe reports that Chittick's approach -- which he calls an "AIDS Attack" -- is to wear a "tourist-in-a-Hawaiian-shirt disguise"; hand teenagers a business card that includes information about HIV in their native language; and, with the help of a translator, say, "This info here could possibly save your best friend's life. Do you want to hear it?" Barry Ansin -- who founded Common Sensitivity, a central Massachusetts organization that conducts HIV/AIDS education -- said that Chittick "gets teens to really respond by treating them in an intelligent manor. He gives them the facts and allows them to make their decisions."
TeenAIDS relies on private funding, and does not receive government funding because Chittick said that he does not want "any strings attached." Chittick said, "I am certain that I'm saving lives, and I'm enabling kids to do the same," adding, "Every time I leave a kid, I look them in the eye and say: 'You're now a teacher. You have the ability to save lives. Go out and do it' (Baker, Boston Globe, 11/3).
Link to this story.
Opinion
African Broadcast Media Partnership 'Good News' in Fight Against HIV/AIDS, Opinion Piece Says
[Nov 04, 2008]
The African Broadcast Media Partnership Against HIV/AIDS -- a coalition of broadcasters from 35 African countries -- has had "several successes since its inception three years ago," which is "good news" in the fight against HIV, columnist Guy Berger writes in a Mail & Guardian opinion piece.
According to Berger, ABMP participants have agreed to an HIV prevention project that "capitali[zes] on young people's anticipated interest" in the 2010 World Cup, which will be held in South Africa. The project -- called Football for an HIV-Free Generation, or F4 -- will broadcast a World Cup-themed message about HIV testing to the large audience of young people interested in the event, Berger says. He adds that ABMP is an "encouraging sign of broadcasters taking seriously the need to jointly roll-out programming to tackle" HIV/AIDS in Africa, concluding that "[a]nyone concerned" about HIV/AIDS "should celebrate that." Berger adds that incorporating "HIV/AIDS messages into the core business practice of each of the 57 member broadcasters" is a "challenge given the denialism, passivity and bureaucracy afflicting many African broadcasters" (Berger, Mail & Guardian, 10/30). AMBP was formed at an October 2005 summit of African broadcasters organized by the broadcasters, the Kaiser Family Foundation and the Nelson Mandela Foundation in an effort to reinvigorate the role of African broadcasters in combating HIV/AIDS (Kaiser Daily HIV/AIDS Report, 10/04/06).
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