Africa: Daily HIV/Aids Report

May 2, 2008

Kaisernetwork.org (Washington, DC)

2 May 2008

Politics and Policy

Canadian Government Committed 'Breach' of Scientific Standards by

Interfering in Vancouver's Supervised Drug-Injection Site,

Researchers Say

Across The Nation

Magic Calls for More HIV Testing Among Blacks in D.C.

Global Challenges

Rapid Population Growth in Uganda Affecting Efforts To Fight HIV/AIDS

Shanghai, China, To Establish Four New Methadone Clinics To Curb

Spread of HIV, Health Officials Say

Times of Central Asia Examines HIV/AIDS Epidemic, Related Stigma,

Discrimination in Tajikistan

Politics and Policy

Canadian Government Committed 'Breach' of Scientific Standards by

Interfering in Vancouver's Supervised Drug-Injection Site,

Researchers Say

[May 02, 2008]

Canadian government officials committed a " serious breach of

international scientific standards " by intervening in an independent

scientific review of the supervised drug-injection facility Insite in

Vancouver, British Columbia, according to an article recently

published in the International Journal of Drug Policy, Toronto's

Globe and Mail reports (Picard, Toronto's Globe and Mail, 5/2).

Insite, which is funded by the British Columbia provincial government

and has received research funding from the Canadian government,

includes 12 booths for injection drug users to inject drugs as well

as a " chill-out " room, in which users can be monitored for overdoses.

At the site, drug users receive clean needles, tourniquets, water and

cotton balls, and a nurse supervises their activities and provides

them with referrals to detox centers and homeless shelters. Vancouver

has one of the highest illegal drug use rates in North America, with

as many as 12,000 IDUs in the Vancouver metropolitan area, 30% of

whom are HIV-positive and 90% of whom have hepatitis C.

When the facility opened in September 2003, it received a three-year

exemption from the Controlled Drugs and Substances Act, which bans

heroin use, to conduct a pilot study on the site's role in reducing

drug use and crime in Vancouver's Downtown Eastside. Health Canada,

the country's health ministry, in October of last year announced it

would extend the exemption until June 2008 (Kaiser Daily HIV/AIDS

Report, 10/4/07). According to the Globe and Mail, Insite operators

are currently appealing to the British Columbia Supreme Court to

extend the exemption for the facility.

Health Ministry Involvement

An independent scientific body advised Health Canada in 2006 to

recommend that funding for the project be extended and that similar

programs be established in other cities, the Globe and Mail reports.

However, Health Minister Tony Clement said he could not approve the

recommendations, citing inadequate research and unsound public health

policy. The government later offered grants to further research the

effectiveness of drug-injection sites in preventing HIV, under the

condition that investigators not release their findings until after

the exemption expires. Evan Wood -- a research scientist at the B.C.

Centre for Excellence in HIV/AIDS and lead author of the journal

article -- said the offer amounted to " muzzling researchers. " The

University of British Columbia considered that condition ethically

unacceptable, and its researchers did not apply for the grants.

The journal article states that Clement's actions were taken on the

advice of police organizations and based on political concerns over

sound health policy, according to the Globe and Mail. Wood noted that

there have been 22 peer-reviewed studies published on the Insite

program that found it reduces rates of HIV/AIDS and increases

opportunities for IDUs to seek rehabilitation. " From a scientific

perspective, it's descipable, " Wood said, adding, " Governments should

not handpick grants based on ideology. "

Relevant Links

HIV-Aids and STDs

Health and Medicine

Rita , a spokesperson for Clement, said on Thursday that the

researchers' comments were " completely inaccurate. " She added that

Clement " commissioned more research " about safe drug-injection

facilities and had Health Canada form an independent committee to

compile a report on domestic and international research on the

subject.

Reaction

Kendall, British Columbia's provincial health officer, said he

agreed with the journal article. " I'm a realist enough to know that

public policy is not based solely on science, but you would hope that

policy would be strongly swayed by science, particularly in health

care, " he said. Kendall said that injection drug use has caused

government to intervene as it would never do in other areas. " If

there was a validated intervention for hernia repair, would we accept

that the government steps in and says, 'We don't like hernia repair'?

I don't think so, " he said.

In a related IJDP commentary, MacCoun of the Goldman School of

Public Policy at the University of California-Berkeley, called the

Insite issue a " policy horror story. " He wrote that the evidence

demonstrates that a " well-executed piece of policy research on a

promising innovation was discontinued for unstated but blatant

political reasons. " MacCoun also wrote that Clement's questioning of

whether Insite lowers drug use and addiction misses the point that

such programs are designed to reduce harm that IDUs do to themselves

and others, which a law cannot achieve (Globe and Mail, 5/2).

Link to this story.

Across The Nation

Magic Calls for More HIV Testing Among Blacks in D.C.

[May 02, 2008]

As part of his " I Stand With Magic " campaign, former National

Basketball Association player Earvin " Magic " on Wednesday

during a roundtable discussion at University encouraged blacks

residing in Washington, D.C., to be tested for HIV, WTOPnews.com

reports.

The " I Stand With Magic " campaign, a partnership between the Magic

Foundation and Abbott Laboratories, aims to reduce the number

of new HIV cases among minority communities by increasing awareness

and knowledge about the disease. In 2006, the district had the

highest rate of new AIDS cases among blacks in the country,

WTOPnews.com reports.

said it is a challenge within the black community for people

to get tested for HIV. He added, " We finally get over the fear of

getting tested, and then we finally go get tested, and then people

say, 'Uh-oh, I don't want to know the results.' " noted that

if the black community " did know, in terms of educating ourselves

about HIV, then we would know we can still high-five [an HIV-

positive] person, we can still play basketball against them. "

According to WTOPnews.com, no-cost, rapid HIV tests were provided at

the forum. Hader, head of the city's HIV/AIDS

Administration, said there are a lot of HIV/AIDS services available

for people in the district, adding, " But that doesn't mean people

know about them or believe in them " (Basch, WTOPnews.com, 5/1).

Essence Profiles Health Workers' Efforts To Fight HIV/AIDS in the

District

In related news, Essence magazine on Thursday examined the HIV/AIDS

epidemic in the district and the efforts by some community health

workers to reduce the spread of the disease. According to Essence,

community health workers from the Family and Medical Counseling

Service and other groups have set up mobile HIV testing centers and

travel throughout the city providing information on the epidemic

(Owens, Essence, 5/1).

Link to this story.

Global Challenges

Rapid Population Growth in Uganda Affecting Efforts To Fight HIV/AIDS

[May 02, 2008]

Rapid population growth in Uganda is undermining efforts to fight the

spread of HIV/AIDS, Uganda AIDS Commission Director General Kihumuro

Apuuli said Wednesday at a press briefing in the capital of Kampala,

New Vision/Allafrica.com reports. Apuuli spoke with journalists ahead

of the four-day HIV/AIDS global implementers meeting scheduled to

start June 3 in Kampala.

There are an estimated 30 million people living in Uganda, New

Vision/Allafrica.com reports. Apuuli said about 1.1 million of them

are HIV-positive, but 90% are not aware that they are living with the

disease. He also noted that more than 30,000 new HIV cases occur

there annually. In addition, HIV-related deaths had increased 30% to

100,000 last year from 72,000 a few years ago, when a national survey

was conducted.

Relevant Links

HIV-Aids and STDs

Health and Medicine

According to Apuuli, mother-to-child HIV transmission accounts for

22% of new HIV cases in Uganda, and 25% of infants born to HIV-

positive women contract the virus. Women in Uganda have an average of

seven children, according to New Vision/Allafrica.com. Apuuli said

that people often engage in risky behavior under the assumption that

new medications to treat HIV/AIDS will soon be available. " If we do

not prevent new infections, we will be chasing a mirage, " he said.

The country's AIDS commission has created a five-year plan that

focuses on HIV prevention, according to Apuuli. He added, " There are

120,000 people on antiretroviral drugs out of an estimated 240,000

who need it. We intend to make the drugs available to 300,000 people "

(Mugisa, New Vision/Allafrica.com, 4/30).

Link to this

story.http://www.kaisernetwork.org/daily_reports/rep_index.cfm?

DR_ID=51892

Shanghai, China, To Establish Four New Methadone Clinics To Curb

Spread of HIV, Health Officials Say

[May 02, 2008]

Health officials in Shanghai, China, on Wednesday at a public health

conference said the city will establish four new methadone clinics in

an effort to control the spread of HIV/AIDS, the Shanghai Daily

reports. The new clinics -- which will be located in the city's

Minhang, Nanhui, Pudong New Area and Xuhui districts -- will bring

the total number of methadone facilities in Shanghai to 12.

Officials at the conference also said that the city's 42 HIV testing

and counseling centers, as well as maternity and child health

hospitals, provided 14,771 counseling sessions and 13,279 HIV tests

last year. Officials added that the city's public health priorities

for this year include controlling the spread of infectious diseases,

such as HIV, and reducing deaths among pregnant women and infants

(Cai, Shanghai Daily, 5/1).

Link to this story.

Times of Central Asia Examines HIV/AIDS Epidemic, Related Stigma,

Discrimination in Tajikistan

[May 02, 2008]

The Times of Central Asia on Friday examined the state of HIV/AIDS,

and the stigma and discrimination associated with the disease in

Tajikistan. Recent data indicate that the number of officially

recorded HIV cases in the country increased eightfold from 2001 to

2007. There were 339 new recorded HIV cases last year, bringing the

total number of confirmed HIV cases to more than 1,000. However, some

health care professionals believe the number of people living with

HIV/AIDS is much higher. According to the Times of Central Asia, the

country is " struggling to cope " with the spread of HIV/AIDS, which is

hindered by a lack of medical services and " conservative moral

attitudes which encourage shame and secrecy. "

Although the most common route of HIV transmission in Tajikistan is

through injection drug use, health officials said that the number of

women contracting the virus by their husbands who work as migrant

laborers is increasing, the Times of Central Asia reports. Matluba

Rahmonova, head of the country's National AIDS Center, said the

traditional gender stereotypes and the subordinate status of women do

not allow women to receive information on reproductive issues and

sexual health, including HIV prevention. She added that as a result,

there also is a high rate of mother-to-child transmission of the

disease. Amonullo Ghoibov, secretary of the National Coordination

Committee To Prevent and Fight HIV/AIDS, TB and Malaria, said, " The

mentality of the Tajik people, their culture and traditions, do not

allow for an open discussion about sex education issues, HIV

transmission routes and protection from infection. " He added, " Many

labor migrants get infected with HIV by casual sexual partners, as a

result of their own ignorance about sexual hygiene. "

A 2007 survey conducted by Tajikistan's Center for Strategic Studies

and UNAIDS found that HIV-positive children and adults experienced

various forms of discrimination. The survey found that about 50% of

all secondary school teachers in the country said that HIV-positive

children should not be allowed to be in classes with other children

and that 60% of physicians said they would not want their children to

have any contact with children living with the disease. More than 60%

of doctors said they did not believe HIV-positive staff should be

allowed to work in health care institutions. The majority of

religious leaders in the survey said they were against HIV-positive

people holding religious posts.

Manija Haitova, director of the HIV/AIDS Center for Mental Health,

said, " Our society is not ready to accept HIV-positive people, and,

as a result, they are exposed to a double stigma -- from society and

from themselves. " She added, " Even when they know their rights, HIV-

positive people often don't use them because they fear revealing

their status. " Haitova said that campaigns that aim to raise

awareness should " encourage people to break down the wall of silence

and clear away the barriers to effective prevention and treatment for

HIV/AIDS. " She added, " Only by declaring war on stigma and

discrimination is it going to be possible to work on a solution of

the problems that arise because of HIV/AIDS " (Majidova, Times of

Central Asia, 5/2).

Link to this story.

Jill Braden Balderas, managing editor, kaisernetwork.org

Vince Blaser, associate editor, Kaiser Daily HIV/AIDS Report

Beth Liu, senior web writer, kaisernetwork.org

Kimberley Lufkin, editor, Kaiser Daily HIV/AIDS Report

Kate Steadman, web writer, kaisernetwork.org

Simone Vozzolo, senior web producer, HealthCast

Justyn Ware, editorial specialist-multimedia, Kaiser Daily Reports

Wolfe, editor-in-chief, Kaiser Daily Reports

Francis Ying, web producer, HealthCast

Mann, Mandy McAnally, Rottler, staff writers,

Kaiser Daily HIV/AIDS Report

Alyssa , Picillo, copy editors, Kaiser Daily Reports

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May 2, 2008