Over the last few years, since the roll-out of antiretroviral therapy (ART), there has been a substantial decrease in HIV-related stigma in Botswana, according to a population-based study presented on Monday at the Sixteenth International AIDS Conference in Toronto. Although there could be several possible explanations for this (including anti-stigma campaigns, the higher visibility of people living with HIV and AIDS and routine HIV testing), survey participants who knew that ART was accessible in Botswana were the least likely to stigmatise people with HIV.
Equity and HIV/AIDS
Since the launch of Botswana’s national antiretroviral therapy (ART) programme, there was a decline in the country’s adult mortality rate between 2003 and 2005 according to a report presented on Thursday 17 August 2006 at the Sixteenth International AIDS Conference in Toronto. The declining mortality rate was most pronounced in the districts of the country where ART first became available and where ART coverage is the most extensive.
Dr Paulo Teixeira Senior Adviser of the São Paulo’s STD/AIDS State Program argues the importance of the adoption of clear targets as one of the main factors that accounted for a dramatic change in access to treatment under the 3x5 program. He argues that access to ARV treatment has become an international consensus but that extreme measures still have to be taken to make this process irreversible and universal in the next few years. Some of these measures are technical support, the provision of international funds, the reduction in the prices of second line medications, and the inclusion of the most vulnerable groups like MSM, IDU, SW and inmates. He expressed concern at a weakening of measures towards addressing universal access to prevention and treatment.
In Stephen Lewis's last speech as UN Envoy for HIV and AIDS to the International HIV/AIDS conference in Toronto in August 2006 he comments on areas that have previously been of political controversy in the approach to the prevention of HIV/AIDS, including abstinence-only programmes, harm reduction programmes, circumcision, microbicides and nutrition and to the South African response to AIDS. He gives particular emphasis on gender and child inequalities in the acquisition and management of HIV/AIDS.
Tuberculosis (TB) that is resistant to practically every medication that can be used to treat it is alarmingly common in South Africa, and proved uniformly and rapidly fatal in one outbreak in rural South Africa, warned Dr Neel Gandhi, Assistant Professor of Medicine at Albert Einstein College of Medicine of Yeshiva University, at the Sixteenth International AIDS Conference in Toronto, Canada.
Individuals coinfected with HIV and hepatitis C virus are more likely to develop end-stage liver disease (ESLD) compared to patients with hepatitis C virus, alone, according to a study presented at the Sixteenth International AIDS Conference in Toronto on August 15th. However, the investigators found that coinfected patients who achieved a sustained response to hepatitis C therapy were no more likely to progress to end stage liver disease than their hepatitis C monoinfected peers. This could have important implications for prioritising recipients of hepatitis C therapy in resource-poor settings.
The International Rescue Committee (IRC) in Northern Uganda has begun operating home-based HIV counselling and testing in ten camps for internally displaced persons in the Kitgum region. The IRC intends to reach about 100,000 camp residents in their homes. HIV has spread rapidly in the region because the situation in the camps has adversely changed the way people behave.
Warning signs that Uganda's HIV prevalence may be on the rise again were presented to the Sixteenth International AIDS Conference in Toronto. Data on both HIV prevalence and incidence show rising trends since 2000, which the investigators attribute to increased sexual risk behaviour, the natural epidemiological cycle, and "other factors". These may include a chronic condom shortage and the hotly debated 'ABC' policy which appears to focus on abstinence and faithfulness rather than condom use.
South Africa's Health Ministry spokesman Sibani Mngadi dismissed harsh criticism of its AIDS policy by a top UN official "with contempt" and said he was no Messiah for Africa's HIV/AIDS crisis. UN special envoy on AIDS in Africa Stephen Lewis closed a global conference with probably the most blistering attack ever on South Africa's "lunatic fringe" approach to AIDS, calling it immoral and ineffective.
In the fight against HIV/AIDS, think 'DRC' and not 'ABC', a new Southern African Development Community (SADC) report says. The report said the old model of controlling the lethal virus through a programme of ABC (Abstinence, Being faithful and Condom use) should be replaced by 'DRC' - Delaying sex, Reducing partners and continued Condom use.