Across The Nation

Washington Post Examines Effects of Faltering Economy on Whitman-Walker Clinic

[Jan 08, 2009]

The Washington Post on Thursday examined how the Washington, D.C.-based Whitman-Walker Clinic has been "struggling with declining revenue and increased expenses because of an increase in patient care for most of a decade." According to the Post, the recent economic downturn also has made the clinic "scale back even further." Whitman-Walker last month moved to a more consolidated location in an effort to address mounting debt, and the clinic the day after the move announced that it would outsource some programs, close a clinic in Northern Virginia and lay off up to 45 of its 178 employees by the end of March. The recent layoffs will reduce Whitman-Walker's staffing by 25%, and CEO Donald Blanchon said that the approximately 260 employees the clinic had in 2005 will be reduced by almost half by March. "The clinic is not immune to anything that is going on," Blanchon said, adding, "The days of Whitman-Walker Clinic being all things to all people is probably not practical now."

According to Blanchon, the sale of the clinic's former building helped to address only some previous financial issues and other measures were needed to cope with the arrival of new patients. He added that the layoffs will reduce the number of administrative and management positions at Whitman-Walker and would allow the clinic to focus on providing high-quality health care. However, with "steep declines in government funding, private donations and staffing, the clinic faces significant challenges in providing primary medical care to people living with HIV/AIDS," the Post reports. The number of new HIV/AIDS cases and deaths has decreased each year from 2002 to 2006, but the number of people living with the disease has increased by almost 50% during the same time period, according to the district Department of Health. The Post reports that this increase has prompted more people to access Whitman-Walker services. "We need more doctors, dentists, psychotherapists and addiction counselors," Blanchon said, adding, "Every one of our employees now understands the challenges we are facing. The quality of what we do matters" (Wilson, Washington Post, 1/8).

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Global Challenges

MSM Involved With HIV/AIDS Organization in Senegal Sentenced to Eight Years in Jail

[Jan 08, 2009]

A Senegalese court on Wednesday sentenced nine men who have sex with men to eight years in jail -- the highest sentence of its kind ever handed down in the country -- AFP/News24.com reports. The men were arrested in December 2008 and charged with "indecent conduct and unnatural acts and membership of a criminal organization." Consensual same-sex relations are illegal in Senegal and punishable by up to five years in jail. However, the judge increased the men's sentences to eight years because of their "membership of a criminal organization." Most of the men belonged to a group aimed at fighting HIV/AIDS, according to AFP/News24.com (AFP/News24.com, 1/7). Diadji Diouf, the head of an organization that provides HIV prevention services to MSM in Senegal, was among the men sentenced, the AP/Guardian reports (AP/Guardian, 1/8). One of the men's attorneys, Issa Diop, said that he plans to appeal the sentence.

Joel Nana of the International Gay and Lesbian Human Rights Commission said the organization is "in shock," noting that it is the first time he has seen MSM receive a sentence of this degree, AFP/News24.com reports (AFP/News24.com, 1/7). BBC News reports that Cary Alan Johnson of IGLHRC said he is "deeply disturbed" by the sentence, adding that although there have been "pretty consistent human rights violations in Senegal," the "extremity" of the sentence and the speed of the trial "really shocks us in a country that has been moving so positively towards rule of law and a progressive human rights regime" (BBC News, 1/8).

The head of a gay rights group in Senegal said that the sentence is discriminatory. "Many gays are already fleeing to neighboring countries because our living conditions (in Senegal) are getting worse and worse," he said. Many gay advocates have said that homophobic attitudes have increased over the past year, according to AFP/News24.com (AFP/News24.com, 1/7). Stigma and discrimination against MSM supported by the Senegalese government has hindered efforts by HIV/AIDS advocates and organizations attempting to reach the population. Senegal's National Council for the Fight Against AIDS in 2002 began to fund HIV prevention outreach for MSM, and it formally included the group in the national strategy against HIV/AIDS a few years ago. However, in March -- when the country hosted the summit of the Organization of the Islamic Conference -- Senegalese President Abdoulaye Wade launched a campaign against attendees of a gay wedding, which included the founder of the first MSM organization established in the country. According to studies conducted by researchers at a university in the capital of Dakar in conjunction with local MSM, about 20% of Senegalese MSM are HIV-positive, compared with 0.7% of the general population. In addition, about 80% of MSM in the country have female partners (Kaiser Daily HIV/AIDS Report, 6/4/08).

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More Effort Needed To Address HIV/AIDS-Related Stigma in India, Advocates Say

[Jan 08, 2009]

Some advocates in India are calling for increased efforts to end the social stigma and ostracism experienced by people living with HIV/AIDS in the country, LiveMint.com reports. Kapil Kaul, country head for the not-for-profit organization HelpAge India, said that the virus is continually linked with high-risk groups that do not have social standing in the country, adding that people "need to create sympathy and understanding" for those groups to end discrimination. He added that the country's "present approach is devoid of strategy," and that India needs a "huge campaign which must penetrate social norms" and "must have a five to 10 year perspective with definite milestones." Nirupama Rao, state youth coordinator for the Andhra Pradesh State AIDS Control Society, said stigma can decrease as knowledge about the virus increases, adding the "more you talk about it, the more stigma will come down." Rao also said that creating supportive communities for people living with HIV/AIDS and having visible testing centers would help reduce stigma in India.

According to Avnish Jolly -- an HIV/AIDS advocate and member of the country research team at the United Nation's India office -- it will take decades to reduce the stigma that is "attached to what is largely considered a sexually transmitted disease." He said that despite "centuries of reform and development," traditional Indian concepts like the caste system and untouchables "haven't vanished from our villages." Padmavati, a Chennai-based consultant at the Rajiv Gandhi Foundation, said that attitudes toward a person living with HIV/AIDS largely are determined by cultural and social taboos -- such as education and the status of women -- and that reactions toward people living with the virus vary throughout India. She said that stigma is greater in places like Punjab, Haryana and Rajasthan "where women do not have a voice in the family" and that "progressive states," such as Andhra Pradesh and Tamil Nadu, "report fewer cases of stigma" despite having high HIV prevalence (Bahl, LiveMint.com, 1/6).

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Papua New Guinea Officials Report Another Murder Following Accusations of Witchcraft, Spreading HIV

[Jan 08, 2009]

Officials in Papua New Guinea on Wednesday reported that a woman had been burnt alive at the stake after reportedly being accused of witchcraft, which often is linked to AIDS-related deaths in the country, AFP/Arab Times reports (AFP/Arab Times, 1/7). Papua New Guinea's Post Courier reports that there was speculation the woman was practicing sorcery or adultery, or had transmitted HIV to one of the suspects (Muri, Post Courier, 1/7). According to AFP/Arab Times, reports in recent years of women being tortured and killed after being accused of witchcraft have been linked with increasing AIDS-related deaths in the country. Witchcraft often is cited as the cause of death among some young people that village residents "have seen as otherwise inexplicable," AFP/Arab Times reports (AFP/Arab Times, 1/7).

Researchers with the Australian Center for Independent Studies in 2007 released a report that found that many women were being accused of practicing witchcraft to cause AIDS-related deaths among young people and, as a result, the women were tortured or murdered. The report estimated that there had been 500 such attacks in the previous year. According to a 2007 United Nations report, Papua New Guinea accounts for 90% of HIV cases in the Oceania region. High levels of sexual violence against women and inadequate access to sex education has contributed to the spread of the virus, according to the U.N. report. An estimated 60,000 people in the country were living with HIV in 2005 (Kaiser Daily HIV/AIDS Report, 7/25/07).

According to Reuters, women in Papua New Guinea's Highlands often are blamed for spreading HIV, killed for having extramarital affairs and accused of practicing sorcery. Witnesses reported that the woman was between ages 16 and 20 (Perry, Reuters, 1/6).

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Yemen's Low Education Levels, High Poverty Rates Increasing HIV/AIDS Risk, Experts Say

[Jan 08, 2009]

High poverty rates and low education levels are contributing to increased vulnerability to HIV/AIDS in Yemen, especially among commercial sex workers, according to some experts, IRIN/PlusNews reports. Abdul-Hafed al-Ward, secretary-general of the Integrated Care Association for People Living with HIV, said that most cases of HIV/AIDS involve people with low incomes and that "[p]overty and HIV/AIDS go together and wherever the former exists so does the latter." Khaled Abdul-Majid, a program officer at the United Nations Development Program's Sanaa office, said that government institutions do not have the capacity to tackle HIV/AIDS and that a lack of knowledge about the virus leads to fear. He also said that high illiteracy rates contribute to HIV/AIDS-related stigma and that local radio stations "should allocate one hour [a day] to educate people about HIV/AIDS."

Suad al-Qadasi, chair of the Women's Forum for Research and Training, said that there has been a rapid increase in commercial sex work over the past three years and that there will be an increase in the number of HIV/AIDS cases if Yemen does not acknowledge the situation. A WFRT survey on commercial sex work found that people were not willing to admit to its existence, she said, adding that "[d]enying it is a problem as awareness rests on acknowledging that the phenomenon exists."

According to IRIN/PlusNews, 2,493 HIV/AIDS cases were registered by the National Program for Combating AIDS as of September 2008, and UNDP reports that 15.7% of Yemen's population lives on less than $1 per day, with 45.2% living on less than $2 per day. Yemen is ranked 153 out of 177 countries on UNDP's 2007- 2008 Human Development Index. In addition, the Poverty Assessment Report 2007 prepared by UNDP, the World Bank and the Yemeni government found that 34.8% of the country's 21 million people were considered low income (IRIN/PlusNews, 1/7).

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Recent Releases

Report Examines Impact of Providing No-Cost Health Care to Children in Ghana

[Jan 08, 2009]

"Effect of Removing Direct Payment for Health Care on Utilization and Health Outcomes in Ghanaian Children: A Randomized Control Trial," PLoS Medicine: The report examines the impact of providing no-cost care on the health outcomes of children younger than age five in Ghana. According to the study, many deaths among children younger than age five in sub-Saharan African result from preventable diseases such as malaria and HIV/AIDS. For the study, researchers divided 2,592 children into two groups: the first group was provided with no-cost primary health care and drugs, and the control group required families to pay user fees for health care. The study found that families in the first group sought formal health care more frequently and informal health care less frequently than families in the control group. However, the study found no difference in health outcomes among children in the two groups. The researchers concluded that removing health care payments affected health care-seeking behavior but not health outcomes among Ghanaian families (Ansah et al., PLoS Medicine, January 2009).

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