Global Challenges

China Increasingly Using Condoms in Fight Against HIV/AIDS, Wall Street Journal Reports

[Nov 18, 2008]

The Wall Street Journal on Tuesday examined how China is increasingly promoting condoms as a method of HIV prevention. While HIV "has long thrived quietly on the fringes of Chinese society" among injection drug users and tainted blood recipients, there is now a risk of HIV spreading further into the general population. One reason is the "booming " sex work industry in China which "has helped make sex the most common form of" HIV transmission in the country, according to the Journal. This has given rise to increased promotion of condom use to prevent HIV from spreading. A recent survey by UNAIDS conducted in six major cities in China found that 54% of respondents said they would use a condom when having sex with a new partner

China's "hopes of stopping the disease from turning into the country's next health crisis may rest with the efforts of people like Guan Baoying," who has "defied standard government attitudes about high-risk groups" such as sex workers, the Journal reports. Guan first encountered HIV/AIDS in the mid-1980s when she worked at Beijing's Center for Disease Control. She then began visiting detention centers in Beijing that held sex workers to educate women about HIV/AIDS prevention. According to the Journal, "[t]ens of thousands of massage parlors and karaoke bars double as brothels, where businessmen and migrant workers can contract the disease and carry it to their hometowns and families." Sex workers are "disadvantaged people in society," Guan said, adding, "No one cares about them."

In 2004, Guan garnered support from 12 government departments for a regulation that aimed to increase condom access in Beijing. In March 2006, a regulation issued by the State Council required government-designated public places, including hotels, to install condom vending machines or provide access to condoms through another method. Beijing in May 2008 began requiring that condoms be placed in all public places, such as restrooms, karaoke bars and large construction sites. "It is by no means easy for Beijing to take this step, and I am very happy to see it happen finally," Guan said.

Guan in 2007 retired as the head of disease control at the Beijing Municipal Health Bureau and now works for the Beijing office of the HIV/AIDS program of the Global Fund To Fight AIDS, Tuberculosis and Malaria. Although many parts of China have not adopted her approach to HIV/AIDS prevention, the Bill & Melinda Gates Foundation in 2007 adopted Guan's prevention and outreach model and began replicating it in 12 provinces. "We have done our best to make people aware of the importance of wearing condoms, but it's hard to judge how many of them will actually do it," she said (Zamiska/Fowler, Wall Street Journal, 11/18).

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Indian Law Criminalizing Homosexuality Remains 'Major Obstacle' in Fight Against HIV/AIDS, Piot Says

[Nov 18, 2008]

UNAIDS Executive Director Peter Piot on Sunday said that an Indian law criminalizing sex between men is a "major obstacle" to the country's efforts to curb the spread of HIV/AIDS, News Track India reports. Piot called the law a "violation of human rights" and said that it should have been abolished a long time ago. The law is being deliberated during hearings on a petition to decriminalize homosexuality.

The United Nations last week called on India to decriminalize homosexuality, effectively overturning the law that has been in place since British colonial rule and carries either a lifetime prison sentence, 10-year prison sentence or a fine. The law poses obstacles to providing HIV/AIDS services in India because of a taboo against men who have sex with men and a fear of speaking out about sexual preferences. Piot said, "For India now, the focus area is the MSM population. This is a problem, which is common to other Asian countries also. It has become quite an epidemic among this group -- just as it was in the Western countries in the 1980s."

He added that the law could "pose a problem for public health preparedness" by hurting the efforts of HIV/AIDS workers and advocates. Piot also recognized the work of India's Health Minister Anbumani Ramadoss, who has called for the law to be overturned (News Track India, 11/17).

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Global HIV Testing Campaign Launched in Cambodia, Uganda

[Nov 18, 2008]

The AIDS Healthcare Foundation in Cambodia last week launched the first phase of a program that aims to test 10,000 people in the country for HIV, the Phnom Penh Post reports. The campaign is part of an AHF program to test one million people worldwide for HIV by World AIDS Day on Dec. 1. Mam Sophal, president of the HIV/AIDS program at the Municipal Health Department in the capital of Phnom Penh, said that 579 people have been tested so far. Chhim Sarath, country program manager for AHF Cambodia, said HIV testing is "very important," and that people who test positive are provided with counseling, prevention education and care services. Sophal said that positive responses from people being tested eased his initial concerns that the campaign would not be successful. "I thought people would be afraid of the results and would not join the program, but when it started, people came to the test with smiles on their faces," he said.

Sarath said that the campaign is an "opportunity to reach people and teach them about HIV/AIDS," adding that an estimated 1,000 people daily were educated through the campaign during a recent festival. The testing campaign also will expand to eight provinces in Cambodia. Government statistics show that HIV prevalence in the country among people ages 15 to 49 has decreased from 1.9% in 2003 to 0.9% in 2007, the Post reports. AHF officials say that HIV/AIDS has spread from high-risk groups such as injection drug users and commercial sex workers to the general population (Shay/Chakrya, Phnom Penh Post, 11/14).

Uganda To Participate in Testing Campaign

In related news, the AHF campaign recently was launched in Uganda and plans to test at least 10,000 people for HIV by Dec. 1, Uganda's Daily Monitor reports. Emmanuel Ziraba, the event's coordinator, announced last week that testing centers would be established at strategic sites throughout the capital of Kampala. Event coordinators also are working with stakeholders in Kampala who have "agreed to intensify their daily work to capture more people during the week," Ziraba said. He added that people who test HIV-positive will be put in contact with care providers and given information on living with the virus. Ziraba added that people who test negative for HIV "will be equipped with knowledge on keeping away from infection."

According to the Monitor, estimates show that about one million Ugandans are living with HIV/AIDS but less than 20% are aware of their status (Kirunda, Daily Monitor, 11/15).

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Officials Say More Rwandan Children Receiving Access to HIV/AIDS Services; New Strategies To Be Discussed at Pediatric Conference

[Nov 18, 2008]

The Rwandan government is increasing efforts to provide HIV/AIDS testing and treatment to children who are living with or vulnerable to the disease in the country, Health Minister Richard Sezibera said recently, Rwanda's New Times reports. Sezibera said that more children living with HIV now have access to antiretroviral drugs and that 12% of young people received HIV tests in 2006, an increase from less than 1% in 2000.

Anita Asimwe, executive secretary of the National AIDS Control Commission, said that an increasing number of government measures to control HIV/AIDS in Rwanda have been instituted to protect children and young people from contracting the virus, in addition to promoting wider access to treatment and care programs for youth living with HIV/AIDS. According to a commission statement, three out of 100 people in Rwanda are living with HIV/AIDS, including 20,000 children younger than age 14. Mother-to-child transmission is the cause of 90% of pediatric HIV/AIDS cases in the country, according to the Times.

In an effort to address issues associated with pediatric HIV/AIDS, the commission will hold its fourth annual Pediatric Conference in the capital city of Kigali from Nov. 19 to 21. The conference, which is sponsored by UNICEF and other partners of the Rwandan government, will take place under the theme "Equity in financing services for HIV infected and affected children." The focus of the conference will be to generate concrete strategies to decrease the negative impact the virus has on children and achieve equity in financing pediatric HIV/AIDS services. More than 300 delegates are expected to attend the conference (Mugabe, New Times, 11/17).

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Media & Society

Tanzania Media Houses Launch HIV/AIDS Workplace Policies

[Nov 18, 2008]

Eighteen Tanzanian media houses on Sunday launched HIV/AIDS workplace policies in response to news from the Tanzania Health Index Survey that the country could lose 9% of its most economically productive population to the disease by 2020, the Tanzania Daily News reports. According to Fatima Mrisho, chair of the Tanzania Commission for AIDS, the policies will focus on prevention, treatment, care, support, and the reduction of stigma and discrimination.

Halima Shariff, country director for USAID's Health Policy Initiative, said that her organization over the past year has collaborated with the AIDS Business Coalition of Tanzania and the Media Owners Association of Tanzania to launch the workplace policies. Shariff added that an assessment of media houses in 2006 -- which was conducted in collaboration with the Association of Journalists Against HIV/AIDS in Tanzania -- "revealed that despite their commendable role in promoting HIV/AIDS education and advocacy, media houses lacked defined HIV/AIDS workplace programs and policies." Following the assessment -- which also found "gaps" such as low HIV/AIDS knowledge and risky behaviors and practices -- HPI distributed the findings to media houses and other stakeholders, according to Shariff.

Following the 2006 assessment, Shariff said that MOAT executives committed to "join forces in ensuring that media houses instituted workplace policies and/or programs." Meetings were held among senior media managers to garner support and determine methods of engaging media houses, according to Shariff. MOAT Executive Secretary Henry Muhanika noted that the new policies will create awareness; help fight stigma; teach about HIV/AIDS treatment; encourage voluntary counseling and testing; and teach how to maintain confidentiality. ABCT CEO Richard Kasesera said, "We need to sensitize the media and since media are on the forefront of communication, once we sensitize them, we can also educate the nation" (Tanzania Daily News, 11/16).

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Drug Access

Togo Begins Distributing No-Cost Antiretrovirals, Government Says

[Nov 18, 2008]

The government of Togo on Monday announced that it has begun distributing no-cost antiretroviral drugs through the network of the Central Supply of Essential and Generic Medicines, Reuters reports. Augustin Dokla, who represents a network of people living with HIV/AIDS, said that approximately 25,000 people will receive antiretrovirals through the program, up from 8,000 who currently have access to the drugs through CAMEG.

Reuters reports that antiretrovirals purchased privately cost between 3,000 and 25,000 CFA francs, or about $47.53, monthly. In order to receive the no-cost drugs, patients have to register with local medical committees.

According to official figures, HIV/AIDS prevalence in Togo since 2006 has remained steady at about 3.2% (Zodzi/Magnowski, Reuters, 11/15).

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