Public Health & Education

Binge Drinking Among MSM in New York City Linked to Increased HIV Risk, Study Says

[Jan 07, 2009]

Binge drinking -- or the consumption of five or more alcoholic beverages on one occasion -- may be contributing to an increased risk of HIV among men who have sex with men in New York City, according to a study released Monday by the city's Department of Health and Mental Hygiene, the New York Times' "City Room" reports. For the study, titled "Alcohol Use and Risky Sex in New York City," the city's health department used data from its 2007 Community Health Survey and the National HIV Behavioral Surveillance project (Chan, "City Room," New York Times, 1/5).

According to the study, 24% of MSM in New York reported engaging in binge drinking at least once monthly, compared with a rate of 15% among the city's total adult population (Bindrim, Crain's New York Business, 1/5). The study found that binge drinkers were 50% more likely than non-binge drinkers -- and three times more likely than non-drinkers -- to report having two to four sexual partners in the previous year. In addition, 40% of MSM who engaged in binge drinking reported having five or more sexual partners in the past year, compared with 21% of non-binge drinking MSM. The report also used data from the surveillance study, which is based on interviews with MSM at gay bars and is not necessarily "representative of the gay population as a whole," according to the "City Room." This data indicate that 27% of MSM who had casual partners reported being under the influence of alcohol during their last sexual encounter, and 12% reported being under the influence of both alcohol and drugs. In addition, 48% of MSM who reported having 20 or more sexual partners in the past year reported being under the influence of alcohol during their last sexual encounter. The study also found that 65% of MSM who consumed alcohol were likely to use a condom during receptive anal intercourse, while 86% of non-drinking MSM were likely to use a condom during receptive anal sex.

Thomas Frieden, New York City's health commissioner, said, "Heavy drinkers are more likely to have multiple partners -- increasing their risk of HIV, [STIs] and unplanned pregnancy." According to Frieden, the prevalence of HIV and syphilis is rising among MSM in New York City ("City Room," New York Times, 1/5). Frieden added, "Many New Yorkers recognize that drinking increases the risk of injuries and auto accidents, but they may not recognize these other risks." Sean Cahill -- managing director of public policy, research and community health at Gay Men's Health Crisis -- said there is a "wide body of evidence" that consuming alcohol can lead to "lowered inhibitions and impaired judgment." He added that "people forget" that a "legal substance" such as alcohol can lead to an increased risk of HIV. According to Cahill, addressing binge drinking among MSM in New York City might prove difficult, because "gay bars are a site of social interaction and a site of community" among many MSM in the city.

The study also reported on binge drinking among teenagers and found that more than 25% of teens who drank alcohol in the last month reported having multiple sexual partners, compared with 11% of teens who did not drink. In addition, 60% of teens reported using condoms during sex while under the influence of drugs or alcohol, compared with 72% of teens not under the influence. About 14% of teens reported binge drinking during the past month (Crain's New York Business, 1/5).

The study is available online (.pdf).

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Global Challenges

UNFPA, Local NGO Partner for HIV Education Efforts Aimed at Pakistani Sex Workers

[Jan 07, 2009]

The United Nations Population Fund is partnering with a local Pakistani nongovernmental organization in an effort to educate female commercial sex workers in the city of Karachi -- where thousands of such women are at high risk for contracting HIV and other sexually transmitted infections through unprotected sex -- on prevention methods and condom use, IRIN/PlusNews reports. Mizra Alim Baig, president of the Gender and Reproductive Health Forum, said the organization has been able to distribute hundreds of UNFPA-provided condoms daily "in the hope that somewhere a life might be saved." Baig also said that it "used to be a thankless job" but that he is "happy" female commercial sex workers have the "tools and knowledge to better protect themselves against HIV/AIDS, STIs and hepatitis." The forum also utilizes a group of outreach workers that includes former sex workers. "These women know what these [female sex workers] are going through and can relate to them in a better way," Baig said.

According to a 2007 UNFPA survey, 1,015 out of 11,324 female sex workers in Karachi had taken HIV tests, and two tested positive for the virus. IRIN/PlusNews reports that the first reported case of an HIV-positive female sex worker in Karachi "created a scare in the city's brothels," and although many sex workers tried to insist on condom use, "the customers mostly refused." Baig said that women in Pakistani society are "regarded as second class citizens" and the "situation is worse" for female sex workers, who often have unprotected sex with members of other high risk groups, such as injection drug users and male sex workers who also have sex with men. He added, "We may not be on the brink of an epidemic when it comes to [female sex workers], but the facts remain that these women are vulnerable" (IRIN/PlusNews, 1/6).

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Children Increasingly Living With HIV/AIDS in Cambodia; Officials Focusing on Prevention

[Jan 07, 2009]

Cambodia has shifted the focus of its HIV/AIDS prevention efforts from young adults to children in response to 2008 statistics that show an increase in rates of antiretroviral use among children and mother-to-child transmission of the virus, the Phnom Penh Post reports. Mean Chhi Vun -- director of the National Center for HIV/AIDS, Dermatology and STDs -- said that the government has begun a program to provide "HIV testing for 6,745 pregnant women [this year] in 68 health centers across five of our operational districts." Thirty-five of the women tested positive for HIV and received follow-up care and medicine from the center, according to Vun. Teng Kunthy, general secretary of the National AIDS Authority of Cambodia, said that the government also is focusing on a national registration program to coordinate treatment for children living with HIV. The program "has been running smoothly so far and has encouraged more children to seek treatment," he said.

Vun said that between January and September of 2008, about 2,913 children received antiretroviral drugs, an increase from about 1,800 in 2007. He added that nationwide pediatric HIV/AIDS figures are determined by the number of children receiving antiretroviral treatment through the nation's clinics, adding that the figures do not include the estimated 600 children living with HIV who are not yet receiving treatment or who have not been tested for the virus. Chan Ry, deputy director of the National Pediatric Hospital, said that 300 children were treated at the facility in 2007 and now it is providing treatment to 1,155 children.

The increase in the number of cases involving MTCT "testif[ies] to the fact that women are not able to access good" prenatal care to prevent transmission, the Post reports. A 2006 UNAIDS report shows that while prevalence among young people ages 15 to 49 has decreased to 1.9% in 2003 -- compared with 3% in 1997 -- one-third of new HIV cases are because of MTCT. According to the Post, there are about 461,000 live births annually in Cambodia -- mostly outside of health centers and hospitals -- and an estimated 9,700 pregnant women are living with HIV. UNAIDS data indicates that without any intervention, about 3,000 infants may be born with HIV through vertical transmission. According to Tan Vouch Chheng, an undersecretary of state at the Ministry of Health, antiretroviral drugs are dispensed at 26 locations and HIV testing is offered at another 212 facilities. However, she added, "We have to expand our programs for prevention and the spread of HIV/AIDS from mothers to children."

The Post reports that the exact number of children living with HIV/AIDS is unknown but "experts support the proposition" that it is "rising fast." Seng Chhunleng, coordinator for the Orphans and Vulnerable Children program at World Vision, said the number of children living with HIV/AIDS will continue to increase if something is not done to stop vertical transmission. "This is a problem that we still have to commit to solving," he said, adding that Cambodia "should provide better education and more medicine to stop transmission between mothers and children" (Leakhana/Kunthear, Phnom Penh Post, 1/6).

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State Pension Plan in India Will Benefit Low-Income HIV-Positive People

[Jan 07, 2009]

Low-income residents of the Indian state of Andhra Pradesh who are living with HIV/AIDS are eligible for a monthly pension from the state to pay for antiretroviral treatment, Ramnarayan Reddy, the state's information minister, announced on Monday, The Telegraph reports (The Telegraph, 1/6). The Times of India reports that the government has found that 80% of the state's 50,000 HIV/AIDS patients receiving antiretroviral treatment fall below the poverty line (Times of India, 1/5). Under the initiative, which is the first of its kind in the country, about 41,000 people currently taking antiretrovirals will receive the pension, The Telegraph reports. To qualify for the monthly pension of 200 rupees, or about $4.08, a patient must have received antiretrovirals from a government facility for at least six months, have a ration card for use by families living below the poverty line and should not be part of another pension system. Families with more than one HIV-positive person will receive a pension for each family member living with the disease.

The initiative is part of a larger effort in the state to curb the spread of HIV/AIDS, as Andhra Pradesh has one of the largest populations of people living with the disease in the country (The Telegraph, 1/6).

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HIV/AIDS Affecting Formerly Low-Risk Populations in Indonesian Province

[Jan 07, 2009]

Formerly low-risk groups such as married women and young children are contracting HIV/AIDS at higher rates in Indonesia's West Nusa Tenggara province during the past year, the Jakarta Post reports. According to the province's AIDS Eradication Commission, or KPAD, 25 married women and six young children contracted HIV last year. As of November 2008, 10 people had died from the disease, Rohmi Khoiriyati, KPAD secretary, said. KPAD as of November 2008 also recorded 25 new HIV cases, including three among people who had developed AIDS.

Rohmi said the province's HIV prevalence is "a matter of grave concern," particularly because the virus has affected married women and young children "despite the fact that they are not included in the high-risk category." According to KPAD, more married women contracted HIV in 2008 than people from populations considered at "high-risk" for the disease, including injection drug users and commercial sex workers. However, the actual HIV prevalence in the province could be greater than the reports indicate, Rohmi said. According to KPAD, it is difficult to know how many people are living with HIV in the country because many people are unaware of their status and there are a limited number of voluntary counseling and testing centers. Four sites in West Nusa Tenggara currently provide HIV testing, the Post reports. Rohmi said that encouraging people to seek medical attention for HIV will require a concerted effort to raise awareness and combat stigma associated with the disease.

West Nusa Tenggara province has reported 137 HIV cases and 70 AIDS cases since 2001, the Post reports. Since that time, 49 people have died from AIDS-related illnesses, Rohmi said. She added that people living with HIV in the province are able to receive medical treatment (Panca, Jakarta Post, 1/6).

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Health Official Urges HIV/AIDS Testing Among Elderly Population in Tanzania

[Jan 07, 2009]

Make Msuya -- a district health officer in Korogwe, Tanzania -- recently called on elderly people to be tested for HIV/AIDS in order to help curb the spread of the disease in the country, Guardian/IPP Media reports. Msuya made the announcement during a training course for 50 elderly district residents, which was organized by Tanga Elderly Women Resource Center -- an organization that aims to raise awareness of the impact of HIV/AIDS on older people. In addition, Msuya also called on elderly populations to avoid harmful practices that increase the risk of spreading HIV, including female genital mutilation and widow inheritance. He also called on older people to continue to serve as care givers to children whose parents have died from AIDS-related causes. "Your role as care givers is exemplary, and the community was banking on you to win the war against HIV/AIDS," Msuya said. He also urged health care officials in the district to provide gloves and condoms in their villages in order to combat the spread of the disease (Kigwangallah, Guardian/IPP Media, 1/2).

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