News

Early Treatment for HIV-Positive Infants Reduces Death Risk by 76%, Study Says

HIV-positive infants who begin receiving antiretroviral therapy immediately after being diagnosed with the virus are 76% less likely to die than HIV-positive infants who do not receive treatment until the disease has progressed, according to a study published Thursday in the New England Journal of Medicine, Reuters reports.

For the study, Avy Violari of the University of Witwatersrand in South Africa and colleagues assigned 377 HIV-positive infants to two groups. One group began antiretroviral treatment at about seven weeks of age, while the second group did not begin treatment until their CD4+ T cell counts dropped or they began showing symptoms of AIDS. Among the infants in the early treatment group, 4% died after 40 weeks of treatment, compared with 16% in the group that did not receive treatment until later (Emery, Reuters, 11/19). The study also found that early treatment reduced progression of the disease by 75%, from 26% in the late treatment group to 6% in the early treatment group (BBC News, 11/19).

The researchers halted the study early because the results were so conclusive and provided all infants in the study with antiretrovirals. In addition, the study led officials from Europe, the U.S. and the World Health Organization to recommend immediate antiretroviral treatment for HIV-positive infants.

According to Reuters, 370,000 children were newly diagnosed with HIV in 2007, and two million children worldwide are living with the virus (Reuters, 11/19).

Comments, Reaction
Violari said the findings "reinforce the view that there are no reliable predictors" on disease progression for infants younger than age one and that CD4 counts do not determine with "enough accuracy" if infants "are becoming sick." The researchers were "alarm[ed]" at how fast the disease progressed in young infants, Violari said, noting that "some infants could seem fine in the morning and get sick and die by nightfall." She added that after analyzing the study data, it "became clear that treating all infants at the earliest opportunity after diagnosis was the best course of action" (BBC News, 11/19).

Violari said that it will take a "few years" to implement early HIV testing and treatment programs for infants because testing for infants is expensive and it will be difficult to identify HIV-positive infants in developing countries (Reuters, 11/19). Mark Cotton of the Comprehensive International Program of Research on AIDS said that implementing such programs will require "both manpower and resources."

Diana Gibb of the Medical Research Council in the United Kingdom said the No. 1 priority should be preventing mother-to-child HIV transmission. "The drug regimens are no picnic for these babies and even with improved outcomes in early life, there is still no cure for AIDS," Gibb said (BBC News, 11/19).

The study is available online. read more

Health Care Workers Face Increased Risk of Mortality From HIV, Other Bloodborne Diseases, Study Finds

A new CDC study published in the American Journal of Industrial Medicine has found that health care workers face an increased risk of dying from bloodborne diseases, such as HIV, and related illnesses compared with workers in other fields, Reuters reports. The study also found that male health care workers face a more than twofold risk of dying from HIV/AIDS-related causes. According to researchers Sara Luckhaupt and Geoffrey Calvert of CDC's National Institute for Occupational Safety and Health, accidental needle sticks and other workplace accidents can put health care workers at an increased risk of exposure to bloodborne diseases. Luckhaupt notes that evidence over the past 20 to 25 years shows that health care workers have been more likely to die from bloodborne diseases than workers in other fields, Reuters reports.

The study examined data from the National Occupational Mortality Surveillance system from 1984 to 2004, which included 248,550 deaths from HIV/AIDS, hepatitis B and C, liver cancer and cirrhosis. According to Reuters, the researchers in a previous study found that male health care workers were at an increased risk of HIV and hepatitis but conducted the new study to determine if deaths from these infections also were higher in the health care field.

Results pointed to a more than doubled risk of dying from HIV/AIDS-related causes for male health care workers -- as well as a nearly doubled likelihood of dying from hepatitis B -- compared with workers in other fields. Hepatitis C and cirrhosis deaths were also more likely among male health care workers. For female health care workers, hepatitis C was more frequent than in other occupations. An analysis of mortality risk based on occupation showed that male nurses faced the highest risk of HIV/AIDS and hepatitis B mortality, while female nurses were 31% less likely to die from HIV/AIDS-related causes than women outside of the health care industry, Reuters reports.

Luckhaupt said that the researchers are unable to say how much the increased risk is because of occupational or non-occupational exposure but added that it is "important to look at both." The researchers wrote, "The greatest limitation to our study was that information was not available on possible confounding factors, such as sexual risk behaviors, history of blood transfusions, intravenous drug use and alcohol use." They added that previous studies indicate that most infections among health care workers are not contracted on the job and that occupational factors could be a stand-in for other risk factors. They suggest that "interventions to decrease the risk of bloodborne pathogens among health-care workers may need to be gender-specific" in order to better understand why male health care workers show an increased risk for bloodborne disease mortality (Harding, Reuters, 11/19). read more

Young Travelers in Australia At Risk of HIV, Other STIs Because of Drinking Habits, Specialists Report

Young travelers in Australia who engage in binge drinking and unsafe sexual activity are contributing to increasing rates of sexually transmitted infections, including HIV, according to specialists, the Herald Sun reports (McLean, Herald Sun, 11/19). According to the Sydney Morning Herald, the rise in STIs has prompted the New South Wales' Department of Health, four Sydney councils and the NSW Backpackers Operators Association to target the group with no-cost condoms and safer-sex messages over the summer holiday period (Wallace, Sydney Morning Herald, 11/19).

Lynne Wray, acting director of the Sydney Sexual Health Centre, said the trend is consistent with recent research showing that backpackers are more likely to report drinking alcohol to excess and not using condoms, thus increasing their risk of contracting an STI. Wray said that the "number of heterosexual backpackers coming to the clinic with new" STIs "is of great concern" and that a "small proportion of these also have HIV infections that they acquired in other countries on the way to Australia." She added that the trend revealed that basic safer-sex messages have not been effective and that it "is important for people to pack condoms while traveling and remember that many countries popular with backpackers have higher rates of HIV and STIs than Australia" (Herald Sun, 11/19). read more

Toronto Health Officials Tackle Rise in Number of HIV, STI Cases

Health officials in Toronto are attempting to address an increase in the number of reported sexually transmitted infections, including HIV, in the city, the National Post reports. STI figures through September from Toronto Public Health show that 405 HIV cases, 5,480 chlamydia cases, 1,293 gonorrhea cases and more than 200 new cases of infectious syphilis have been diagnosed.

Jane Greer -- counselor and administrator at Hassle Free Clinic, which specializes in diagnosing and treating STIs -- said, "We're just swamped, both with people seeking testing and people testing positive for things like gonorrhea, chlamydia, herpes, first [human papillomavirus] diagnosis." She added that the issues surrounding syphilis cases are "ongoing" and that she is especially alarmed by the number of syphilis cases diagnosed at the clinic, usually among HIV-positive people.

Rita Shahin, an associate medical officer of health for the city, said that the rise in chlamydia might be attributable to a campaign aimed at increasing testing. She said, "We're trying to find more. So that's, in a way, a good thing that the rates of chlamydia are going up." Chlamydia can increase a person's risk of contracting other STIs, including HIV (Alcoba, National Post, 11/19). read more

Sex Work Increasing on Colombia's Caribbean Coast, Contributing to Increased HIV Prevalence, IRIN/PlusNews Reports

The sex tourism industry is expanding in the Colombian city of Cartagena, which could be contributing to an increase in HIV prevalence in the region, IRIN/PlusNews reports. According to IRIN/PlusNews, a combination of wealthy tourists and local residents has driven the rise in commercial sex work in Cartagena, which is located on Colombia's Caribbean coast. Mayerlin Verqara Perez, a program coordinator at Fundacion Renacer -- a nongovernmental organization that aims to prevent the sexual exploitation of children and adolescents -- said the situation has become "a lot worse in the last 10 years."

Fundacion Renacer estimates that about 650 children in the city are working in the sex trade industry. Perez added that more children are participating in sex work and at younger ages than in previous years. The organization recruits about 400 children annually to participate in a psycho-social assistance program, which provides testing and treatment for sexually transmitted infections, counseling, skills training, and education about sexual and reproductive health. Many young people who use the organization's services are diagnosed with STIs, but only three have tested positive for HIV, IRIN/PlusNews reports. However, many young people might be afraid to undergo testing, Fabian Cardenas, regional director of Fundacion Renacer, said. According to Cardenas, many young sex workers "don't take any protective measures" because of limited knowledge about HIV and difficulties in obtaining condoms. In addition, under age sex workers often comply with their clients' preference for condom use, Cardenas said, adding that some clients consider condoms unnecessary because they believe younger sex workers do not have STIs.

According to IRIN/PlusNews, Colombia's HIV prevalence is less than 1%, and the disease primarily affects men who have sex with men. However, heterosexual transmission has increased in recent years in the Caribbean region, where one in three HIV-positive people is a woman, compared with the national rate of one in four. Ricardo Garcia, UNAIDS country director, said the region's macho culture -- under which it is socially acceptable for men to have multiple sex partners -- could account for the increased HIV prevalence on the Caribbean coast. He added that sex work also could be a contributing factor (IRIN/PlusNews, 11/18). read more

Scottish Study Shows One-Third of Men with HIV Unaware of Status; NHS Launches HIV Awareness Campaign

More than one-third of HIV-positive men in Scotland's capital of Edinburgh are unaware of their status, according to a recent study conducted by the Dutch group Wolters Kluwer Health, the Edinburgh Evening News reports. According to the News, HIV tests were conducted among 599 men at universities and gay bars throughout Edinburgh, and 33 men tested positive for HIV. Of these men, 12 were unaware that they were living with the virus. The study said, "A high proportion of the HIV-positive men were undiagnosed and not receiving benefits of clinical care." The study also said clinics should "proactively" offer testing to decrease the number of undiagnosed cases.

The release of the study coincides with a new HIV awareness campaign conducted by NHS Lothian in partnership with the Edinburgh-based Gay Men's Health to warn people with multiple sexual partners and men who have sex with men against complacency regarding the virus. The campaign, called the HIV Comeback Tour, will promote condom use and regular HIV testing, as well as attempt to discredit myths surrounding the virus. Steve O'Donnell, spokesperson for NHS Lothian, said, "In many cases, HIV transmission occurs within relationships, so we are reminding [MSM] that it is dangerous simply to assume that neither they nor their partner has HIV or that unprotected sex will be safe."

According to the News, the campaign's messages will be displayed on 20 city buses and 200 posters throughout the city, and posters and postcards will be distributed to bars, physicians' offices and libraries. The campaign's timing overlaps with World AIDS Day on Dec. 1. "The HIV Comeback Tour is now a well established and effective Lothian campaign highlighting the re-emergence of HIV as a continuing sexual health risk for [MSM]," Jim Sherval, a public health specialist for NHS Lothian, said. "World AIDS Day is a day to combat prejudice and remind people to protect themselves. It seemed absolutely right that we should bring both campaigns together."

According to the News, an estimated 5,000 people in Scotland are living with HIV (Morris, Edinburgh Evening News, 11/18). read more

Higher Risk of Certain Cancers Being Recorded in HIV-Positive People

Physicians in the U.S. are reporting a higher risk for certain types of cancers -- such as liver, head, neck and lung -- in people living with HIV/AIDS, raising concerns that a cancer epidemic is imminent in the population, the Baltimore Sun reports. According to the Sun, Meredith Shiels, a doctoral candidate at the Johns Hopkins Bloomberg School of Public Health, presented a paper on Tuesday at the seventh annual American Association for Cancer Research International Conference on Frontiers in Cancer Prevention Research that said people living with HIV are twice as likely as the general population to develop cancers not previously linked with the virus. Other studies have found that people living with HIV have as much as a 10 times greater chance of developing certain cancers compared with the general population. William Blattner, an associate director of the University of Maryland Institute of Human Virology, said researchers are "really at the first stages of systematically looking at the epidemic and fully looking at cancer." He added that "[b]efore, you died from AIDS, so you didn't have time to develop cancer. ... The unusual observation is the cancers are occurring at a much younger age."

Although researchers do not know the exact reasons for the increased risk of developing some cancers, there are several theories as to why HIV-positive people are more susceptible, such as the increased life expectancy due to antiretroviral drugs; weakened immune systems related to the virus or the effects of antiretrovirals; and the likelihood of increased high-risk behaviors in people living with HIV. The Sun reports that a well-known researcher "wonders" if antiretrovirals could be a carcinogen. In addition, many cancers found in people living with HIV are known to be caused by viruses, such as anal, head, neck and cervical cancers -- which have been linked to the human papillomavirus -- and liver cancer, which has been linked to hepatitis. Mark Wainberg, director of the McGill University AIDS Center in Montreal, said, "There's a real concern about all these cancers and what they portend. Obviously, we don't want an epidemic of cancers in long-term HIV-infected people."

According to the Sun, physicians have discovered that treatments for cancer do not work as well in patients who have compromised immune systems, and some researchers have suggested that cancer develops regularly in all people but the immune system is able "to keep most of them in check." A person living with HIV may not have an immune system that is able to do this as effectively, the Sun reports. However, people with HIV who develop cancer do not "always have the weakest immune systems, further confounding researchers," according to the Sun. Eric Engels, a researcher at the National Cancer Institute studying HIV/AIDS and lung cancer, said research into how the immune system and cancer interact could provide a wider application than just helping people living with HIV. "This research has implications for people who have a healthy immune system, too," he said.

The Sun also reports that cases of lung cancer among people living with HIV are increasing, and a 2003 study conducted by Johns Hopkins thoracic surgeon Malcolm Brock found 80 cases of HIV-positive lung cancer patients out of a total 12,000 lung cancer patients who received treatment at Johns Hopkins Hospital dating back to 1950. Brock said people living with HIV have a three to five times higher risk of developing lung cancer than the general population, with a high risk even when controlled for smoking. He also said the median age of lung cancer patients who are living with HIV is 46, compared with 64 among the general population. "The deaths here were overwhelmingly cancer-related. They were not due to AIDS," Brock said, adding that "these patients die and they die quickly," with an average period of six years between HIV diagnosis and lung cancer diagnosis. Engels said that although the cancer is not caused by a virus, it could be the result of an unknown infection, scarring of the lungs or some type of inflammation, which could explain why it is increasingly being found in people living with HIV.

Shiels said that the trend in cancer development in HIV-positive people might have been detected earlier if antiretrovirals were developed sooner. "Perhaps if they had lived longer, we would have seen this 10 years ago," she said. Kevin Cullen, director of the University of Maryland Greenebaum Cancer Center, said that 10 or 20 years ago "virtually no one [living with HIV] who developed cancer could survive rigorous cancer treatment," but antiretrovirals have allowed people to successfully undergo cancer treatment.

Wainberg said that recent gains in HIV/AIDS treatment have given some people who are at high risk for contracting the virus a false sense of security. "There is no doubt that there are people among vulnerable groups who now have a bit of an attitude of ... 'If I get HIV, the drugs are going to help me anyway,'" he said, adding that high-risk groups need to know about the risks of cancers associated with HIV. Engels said that recent findings involving an increased risk of cancer among people living with HIV should not reduce the developments in HIV/AIDS treatment in the U.S. He said, "If you had to pick a time and a place to live with HIV infection, America today would be the best time and place we've ever had. But we're finding these problems coming to the surface that we didn't see before" (Desmon, Baltimore Sun, 11/19). read more

Study Finds HIV-Positive People Taking Some Antiretrovirals Are at Increased Risk of Diabetes, Heart Disease

HIV-positive people receiving treatment for the virus might be at an increased risk of developing heart disease and type 2 diabetes because some antiretroviral drugs can cause fat on the arms, legs, face and buttocks to move to the stomach, researchers at Australia's Garvan Institute said Monday, the Sydney Morning Herald reports. According to the Herald, excess weight around the waist can increase a person's chances of developing cardiovascular and metabolic disorders, but physicians say newer classes of drugs, which do not cause fat redistribution, are too expensive for most people.

Katherine Samaras -- lead author of the study, which was published in the journal Obesity -- said the findings indicate that older antiretrovirals, still commonly used in Australia, can give many HIV-positive patients the same level of heart disease risk seen in obese people with sedentary lifestyles. The Herald also reports the study found that antiretrovirals can cause fat cells to create inflammatory molecules promoting certain diseases. Samaras said, "When fat cells are healthy, they help maintain our metabolism, but if they become too large or are affected by drugs, such as HIV medications, they can produce" numerous chemicals linked to heart disease. She added, "We also have the problem that the older drugs are off-patent now and very cheap, so they are the frontline treatment" in developing countries. According to Samaras, "There are drugs on the market which do not have these side effects, but they are not yet on" Australia's pharmaceutical benefits programs and are "too expensive for most people. The primary concern is to optimize viral suppression, that is reduce the virus load in the body, to minimize its effects." She added that physicians should ensure that their HIV-positive patients are regularly screened for diabetes (Benson, Sydney Morning Herald, 11/18). read more

Gannett/Desert Sun Examines Antiretroviral Isentress

Gannett/Desert Sun on Monday examined Merck's antiretroviral drug Isentress, which was approved by FDA last year. According to Gannett/Desert Sun, since FDA approved the drug, some HIV-positive people and "medical experts say it appears to work, improving the condition of some HIV patients and sparking hope that drugmakers may develop similar medications."

Isentress, which is known generically as raltegravir, has been shown to be effective for people who have developed resistance to other available drugs. The medication is part of a new class of drugs called integrase inhibitors. Homayoon Khanlou, chief of medicine for the AIDS Healthcare Foundation, said, "We do need the new class of drugs. There are not many newer agents in the pipeline." Roy Steigbigel -- a professor of medicine at Stony Brook University in New York who recently co-authored a study on Isentress in the New England Journal of Medicine -- said the drug shows "great promise in people whose virus is resistant to many of the other available drugs." He also said studies are "ongoing" to determine if similar results would be seen in patients who have never taken antiretrovirals.

According to Gannett/Sun, Isentress was approved in six months under an FDA fast-track process, which some advocates and lawmakers say they would like the agency to use more frequently to increase approval of HIV/AIDS drugs. Mark Milano, an HIV treatment educator at the AIDS Community Research Initiative of America, said, "People are dying now. If we wait five more years to get the drugs out, people will avoid the risks but they will also be dead." Gannett/Sun reports that the Desert AIDS Project for six months last year participated in a clinical trial of Isentress, during which participants were offered the new drug along with other medications (Barfield Berry, Gannett/Desert Sun, 11/17). read more

Misconceptions Continue To Contribute to Discrimination Against HIV-Positive People in China, UNAIDS Official Says

People living with HIV/AIDS in China continue to experience discrimination based on public misconceptions of the disease, Bernhard Schwartlander, UNAIDS China country coordinator, said on Tuesday, Xinhuanet reports. Commenting on the results of a survey about HIV/AIDS-related knowledge and behavior among the Chinese -- which indicated that misconceptions and discrimination remain high despite years of public education efforts -- Schwartlander said that many people are unwilling to live with an HIV-positive person, or have meals or work with an individual living with the virus.

Xinhuanet reports that the survey of more than 6,000 students, white- and blue-collar workers and migrant workers found that 48% still believe HIV can be transmitted through a mosquito bite. It also found that although 80% of respondents know HIV can be transmitted through injection drug use or unsafe sex, 18% thought they could contract the virus through a sneeze or cough. In addition, when asked about their attitude toward an HIV-positive family member, nearly 16% said they would no longer contact or speak to the person, although more than 50% said they would encourage the relative to seek treatment and support. Schwartlander said, "These data are really a cause for concern," adding, "We see that there are still many misconceptions around AIDS among the population, which contribute to stigma and discrimination."

According to Xinhuanet, the survey also found that 57.2% of young respondents between ages 15 and 24 said they did not know how to correctly use condoms. Schwartlander said that this is a "worrying contradiction between knowledge and behavior." He added, "Though people know that HIV can be transmitted through unprotected sex, many still do not protect themselves with a condom when engaging in risky behavior." Xinhuanet reports that sexual activity is the most common mode of HIV transmission in China, with 19% of respondents reporting that they would use a condom if they had sex with a new partner.

The survey also found that half of respondents believed that HIV/AIDS was a serious problem in China but 88% regarded their chance of contracting the virus as zero. Furthermore, the survey suggested that more information about HIV testing is needed in the country.

The survey was conducted in Beijing, Shanghai, Shenzhen, Wuhan, Zhengzhou and Kunming by the Global Business Coalition on HIV/AIDS, Tuberculosis and Malaria; the China HIV/AIDS Media Partnership; Renmin University; and UNAIDS (Xinhuanet, 11/18). read more

Lesotho's HIV Testing Program Has Not Met Goals, Groups Say

An HIV testing campaign launched in Lesotho in 2005 has failed to meet its goals because of a lack of funding and administrative issues, according to a report released on Tuesday by Human Rights Watch and the AIDS and Rights Alliance for Southern Africa, AFP/Yahoo! News reports. The campaign aimed to test 1.3 million people over age 12, but as of August 2007, about 25,000 people had been tested for HIV. Training counselors and expanding support services for people living with HIV/AIDS also were part of the campaign's goals, but inadequate funding and administrative failures deterred progress in both areas, the report said (AFP/Yahoo! News, 11/18).

Although the groups noted that Lesotho was one of the first nations to implement a mass testing campaign, the report also found that the campaign did not take adequate steps to ensure confidentiality and other rights (Georgy, Reuters South Africa, 11/18). According to the report, Lesotho's testing program did not ensure that people undergoing HIV tests gave informed consent. In the report, the groups also called for access to follow-up counseling and care after testing. "Lesotho's program was noble in ambition but weak in action," the groups said in a statement (AFP/Yahoo! News, 11/18). Michaela Clayton of ARASA said, "The administrative failures also meant that the program was unable to adequately safeguard people's rights" (Reuters South Africa, 11/18).

AFP/Yahoo! News reports that Lesotho is among the countries most affected by HIV/AIDS in Southern Africa, with 23.2% of people ages 15 to 49 living with the disease (AFP/Yahoo! News, 11/18). "Community-based HIV testing programs have real potential for reaching people who are otherwise unlikely to test," Joseph Amon, director of the HIV/AIDS and human rights program at HRW, said, adding, "It sounds like a simple approach, but for these programs to be truly successful, they must provide counseling, ensure confidentiality and link people to HIV prevention and treatment services" (Reuters South Africa, 11/18).

The report is available online. read more

PEPFAR 'Most Impressive' of Bush's Efforts in Africa, Opinion Piece Says

President Bush "did better than most people are willing to admit in his dealings with Africa, a continent long victimized by the geopolitical tug of war between America and its adversaries," columnist DeWayne Wickham writes in a USA Today opinion piece. "Most impressive of these efforts" has been the President's Emergency Plan for AIDS Relief, Wickham writes, adding that Bush earlier this year signed a bill to reauthorize PEPFAR at $48 billion over five years. In addition, Wickham writes that the Bush administration since 2003 has provided funding to increase the number of HIV-positive people in Africa with antiretroviral drug access from 50,000 to about 1.4 million, according to Jendayi Frazer, assistant secretary of the Bureau of African Affairs. He concludes that what should not "go unnoticed by historians is what Bush did to combat the scourge of AIDS in Africa" (Wickham, USA Today, 11/18). read more

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

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). read more

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

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). read more

Global HIV Testing Campaign Launched in Cambodia, Uganda

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). read more

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