News (Updated April 4, 2010)

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After the panic, HIV travel bans remain

April 2, 2010

Laws written 30 years ago during the first hysteria about the AIDS epidemic are out of date, writes Ben Doherty in Bangkok .

They are barriers that ignorance built. Dismantling the US law that banned HIV-positive people from entering his country, the US President, Barack Obama, said it was ''rooted in fear rather than fact'', and the Australian author Robert Dessaix, recently a victim of China 's law, described it as ''mediaeval''.

Michel Sidibe, the executive director of the United Nations AIDS body, believes the laws ''are a tragedy for each and every person they affect''.

Nearly 30 years after the initial global outbreak of the AIDS epidemic, many of the travel laws enacted in those first few fearful months are still an impediment to the free movement of HIV-positive people around the world.

Fifty-two countries, including Australia , impose travel restrictions of varying rigour on people based solely on their HIV status.

The US repealed its decades-long entry ban this year, but five jurisdictions - Egypt, Iraq, Qatar, Singapore and the Turks and Caicos Islands - still refuse HIV-positive people entry in any circumstance.

Twenty-three countries deport people if their HIV-positive status is discovered.

Speaking to the Inter-Parliamentary Union in Bangkok , Sidibe said almost all the laws were remnants of old legislation, enacted when AIDS was spreading exponentially, and the disease was poorly understood and basically untreatable.

''There is no reason to have these travel restrictions now,'' he says. ''There is no public health rationale behind them. They are simply depriving people of their basic human rights.''

Some governments do not even know their laws exist, or that their immigration officials are enforcing legislation unchanged for three decades. ''It is not until UNAIDS makes contact with these governments and explains what these laws are doing and why they are not needed, that they realise they even have these laws.''

Sidibe cites the example of a Canadian national, teacher John Newman, who was voted Teacher of the Year in California . In the 1990s he contracted HIV and was forced to leave the US . With the ban lifted, he has returned.

''There was the Filipino man, working in one of the Gulf countries,'' says Sidibe. ''His annual HIV test came back positive so he was then arrested and held in detention for three weeks before he was deported. All for no reason at all.''

Robert Dessaix was to participate in Australian Writers' Week in China last month, but was denied a visa to enter the country because of his HIV status, sparking widespread controversy and diplomatic tensions.

''It's mediaeval. I feel snubbed and insulted, of course, and also humiliated,'' Dessaix says. ''But, if out of all this, the Chinese are encouraged to look again at their blanket ban on people with HIV entering the country … then it's been worthwhile.''

Anecdotally, stories abound of people being publicly interrogated in airport immigration halls, of having medications searched by officials, and of having to lie on immigration forms.

Travel restrictions were most rigidly enforced in the Gulf states , says Sidibe, but not for reasons of religious or cultural intolerance. ''When you have a country of 1 million people and you have almost 800,000 migrant workers, it becomes a major issue for those states. They become scared about the cost of taking care of these people.''

For Australia , there is no requirement for tourists to declare their HIV status. But people aged over 15 who wish to migrate are tested when they apply for permanent residency and can be rejected. And refugees are required to take an HIV test before they come to Australia and are automatically refused entry if they are found positive.

A parliamentary inquiry into migration for people with disabilities is examining the rights of people with HIV. The executive director of the Australian Federation of AIDS Organisations, Don Baxter, says the government should reconsider the way it judged the financial impact of HIV immigrants, taking into account that with improved treatment, most would lead full working lives.

''And the refugee regulation should be changed. The purpose of considering people for refugee status is to remove them from an intolerable situation. And yet, for refugees who turn out to be HIV positive, nearly always in an internment camp, we are just condemning them to stay there and get sick there.''

The Immigration Department has warned the inquiry that any change ''would need to be considered in the context of potential impacts on health and welfare expenditure … particularly in terms of prejudice to the access of … citizens and permanent residents''.

Sidibe says he is optimistic that Australia would lift its restrictions, which he said contradicted the policies of other ''progressive'' governments.

 

HIV charity opens online chatroom for gay men

April 1, 2010 - 11:16

HIV charity Terrence Higgins Trust is to open an online chatroom for gay men to discuss their experiences of HIV, sex and condoms.

The charity hopes that discussions on the forum can be used as a focus group to inform its future safe sex campaigns and estimates that 1,500 men will sign up.

It will be open between mid-April and mid-May and THT says the information gathered will be kept confidential.

The £35,000 campaign has been funded by the Department of Health and will be launched with adverts online, in print and on the London Underground.

Alan Wardle, head of health promotion at the charity, said: “While we’ve always ensured gay men are involved in our campaigns, this is the first time we’ve sparked a conversation with such large numbers. It’s also the first time we’ve used social media to listen.

“For almost 30 years we’ve talked to men from all walks of life, but we are now asking gay men to join in on the conversation, to talk to each other about what matters to them, so we can develop campaigns that will really have an impact on HIV.

"It’s vital to our work that we talk to gay men on their terms, and we are encouraging them to log on and tell us exactly what they think.”

National statistics suggest that one in ten gay men in London and one in eight in Brighton are living with HIV/AIDS.

 

The heroin epidemic advancing on Russia

 Rupert Wingfield-Hayes
BBC News, Russia

Since the fall of the Taliban regime in 2001, opium production in Afghanistan has risen dramatically. Russia 's geographic proximity to the region has made it a huge consumer - sending thousands of Russians to an early grave every year.

Igor's body is delivered to his family

Igor is just one of 30,000 Russians who will die from heroin this year

A couple of weeks ago, and three time zones east of Moscow , I sat and watched another mother as she cried over the lifeless body of her 20-year-old son. It felt like an affront being there, intruding on her inconsolable grief.

The reason I was there, the reason she'd let me be there, is that her son, Igor, had been killed by heroin.

It is a sad fact in Russia that men, in particular, go to an early grave. On average a Russian man is lucky to make it to 60.

In the frozen heart of Siberia they die even younger - around 57.

Alcohol is by far the biggest killer. More than half a million Russians drink themselves to death every year.

But since the early 2000s, another killer has been spreading at frightening speed across Russia .

Actually there are two of them, one closely stalking the other. The first is heroin. The second is HIV.

Straddling Afghanistan

In the US , there are around 800,000 heroin addicts. In the UK , between 200,000 and 300,000.

In Russia , there are now two and a half million.

Why? What makes Russia so different? Perhaps it has something to do with the climate. In a country that spends half the year in gloom, depression is a big problem.

But by far the biggest reason is geography. Take a look at a map of the world and draw a line north from Afghanistan .

I had buried every single one of my family. I had no more reason to live, I just lay down on a bed and injected and injected

Sergei

The vast bulk of Russia straddles the Eurasian continent from end to end.

We hear a lot about the effects of Afghan heroin on the streets of Europe . But the countries that are really suffering are the ones on Afghanistan 's doorstep, places we know little about, and care even less - Tajikistan , Kyrgyzstan , Kazakhstan , and the biggest of all - Russia .

Continue along that line north and you will eventually arrive at the Siberian city of Novokuznetsk .

New life

It was there that I met a remarkable group of young men. Vlad has the shoulders and bull neck of a nightclub bouncer. But today he is training to become a Protestant priest.

He is also a virtual father to 25 young men. Vlad is a former heroin addict, as are all his staff and all the young men in his care.

Among them is an intense young man called Sergei - his face cast in a seemingly permanent frown.

Former heroin addict, Sergei

Sergei was one of Novokuznetsk 's 30,000 heroin addicts

Sergei gave up heroin about nine months ago. That he was able to - as well as choose a new life - speaks volumes of the work that Vlad and his staff are doing.

Sergei's father was an alcoholic who beat his mother, stole and ended up in prison. He died there from liver failure.

His mother killed herself when Sergei was a teenager. He found her body hanging from a light fitting in the hallway of their flat. By the age of 15, Sergei and his brother were alone, and dealing drugs.

By the age of 20 he was a major heroin dealer. Then in 2007 his brother was killed, beaten to death in a fight with other drug dealers. What was left of Sergei's world collapsed.

"I had buried every single one of my family," he tells me. "I had no more reason to live, I just lay down on a bed and injected and injected."

That is were Vlad found him a year ago, unwashed, surrounded by filth and close to death.

Building coffins

In the last year, his transformation has been extraordinary. Today Sergei is healthy, strong, and even talks of perhaps contacting his long-lost girlfriend.

But he is one of the few.

In the basement of the rehabilitation centre Vlad shows me the drying-out cell. A terribly ill looking young man is slumped on a bed.

We have to make money somehow, and round here there's never any shortage of business for an undertaker

Vlad

"He came in last night - new arrivals stay here for the first two weeks."

I immediately knew what he was talking about - cold turkey. Heroin withdrawal is an extremely traumatic experience. But it is staying off for the long term that is really difficult.

"Half the young men won't make it," Vlad says. "They'll go back to the streets."

It is perhaps not surprising that Vlad and his band of ex-addicts have a rather bleak sense of humour.

They have turned one room in to a workshop, where I found three young men building what I could swear were coffins.

"Why are you building coffins?" I ask, rather surprised.

"We run an undertakers business," Vlad replies, very matter-of-fact.

"An undertakers? Isn't that a bit morbid given what you've all been through?"

"We have to make money somehow, and round here there's never any shortage of business for an undertaker."

 

Sir Elton spends birthday raising AIDS awareness in South Africa

Saturday, March 27 2010

Sir Elton spends birthday raising AIDS awareness ...Sir Elton John spent his 63rd birthday on Thursday in South Africa visiting a HIV awareness centre to see how the money from his AIDS Foundation has been spent.

The veteran musician has donated £10 million from his charity to help set up projects in the country, to educate youngsters about the dangerous disease and help prevent its spread.

And the Rocket Man timed this week's visit to coincide with his birthday celebrations - spending the big day with his partner David Furnish and a group of football-loving teenagers at the Football for Hope Centre (FFH), set up by the Grassroots Soccer charity, just outside Cape Town .

The singer says, "Soccer stars are the most powerful role models for young people today so it's fantastic that organisations like Grassroots Soccer are harnessing that power to educate young people about HIV. I can't think of a better way to celebrate my birthday."

 

Religious Leaders Vow To Fight HIV/AIDS Stigma, Discrimination

25 Mar 2010   

A two-day gathering in The Hague, Netherlands, of religious leaders to discuss the role people of faith can play in the fight against HIV/AIDS concluded Tuesday with a pledge to prevent discrimination against those living with the disease, the Associated Press reports.

"Representatives of some 40 religions and faith groups including Christianity, Judaism, Islam, Hinduism and Buddhism… sign[ed] a 'personal commitment to action' in which they vowed to 'be clear in my words and actions that stigma and discrimination towards people living with or affected by HIV is unacceptable,'" the news service writes.

United Nations Population Fund's Executive Director Thoraya Ahmed Obaid said the release of the statement marked "a sea change," according to the AP. "There is no talk about sinning or repentance," she said. "It is more about acceptance of people living with HIV" (Corder, 3/23).

"Religious leaders can play a vital role in the AIDS response," UNAIDS Executive Director Michel Sidibe, said in a statement, Deutsche Presse Agentur/The Hindu reports. "By promoting community solidarity they can prevent new HIV infections and ensure that people living with HIV are treated with dignity and respect," he said (3/22).

"During the Summit , participants addressed the realities of how stigma and discrimination are perpetuated both in religious communities and society at large," according to a UNAIDS article. The leaders worked to identify "best practices to strengthen the voice and action of religious leaders and bring about collaboration among different faiths and with other sectors involved in the response to HIV," the article states.

"The leaders gathered at this summit have the ability to inspire and empower change - within their own communities, across countries, and throughout wider communities," said Rev. Richard Fee of the Ecumenical Advocacy Alliance. "In the midst of what appears to be 'AIDS fatigue' they have the potential to galvanize efforts against a disease that continues to spread, driven by silence, fear, violence and injustice" (3/23).

"The religious response to HIV/AIDS has sometimes been hindered by issues such as HIV prevention methods, including the use of condoms, and attitudes towards people at increased risk of HIV infection, such as men who have sex with men," VOA News writes in a piece that examines the meeting that encouraged "religious leaders to talk openly about the disease." The article includes comments by church leaders in Africa (Hennessy, 3/23).

A second AP story reports that religious leaders continue to "struggl[e] with how to balance between communicating the religious messages that talk about morality and spirituality (and) public health challenges on the ground," said Canon Gideon Byamugisha, an Anglican priest from Uganda living with HIV, who participated in the meeting. While the meeting did address the use of condoms to reduce the spread of HIV, it was not the main focus of the days' talks, Byamugisha said, according to the news service (Corder, 3/23).

© Henry J. Kaiser Family Foundation. All rights reserved.

 

Teen Users Of Crack And Cocaine At Significant Risk For HIV

02 Apr 2010   

Teens with a history of crack or cocaine use are significantly more likely to engage in unprotected sex than youth who have never used these drugs, putting themselves at increased risk for HIV, according to a study in the April issue of the Journal of Child and Adolescent Substance Abuse.

Researchers from the Bradley Hasbro Children's Research Center report that teens in psychiatric care who used crack and/or cocaine at least once were six times more likely to use condoms inconsistently, which was defined as "sometimes," "never" or "rarely." The findings suggest that crack cocaine appears to have more of an influence on risky teen behaviors than other factors, like alcohol and marijuana use, which are more routinely incorporated into adolescent HIV prevention interventions.

The study is one of the first to look at the link between crack and cocaine use and HIV risk behaviors in adolescents. Previous research has demonstrated this association in adults.

"Unprotected sex is the most common way that HIV is transmitted among teens, so if we can develop a clearer picture of why some kids engage in high-risk sexual behaviors, we will be better prepared to educate them about safe sex," says lead author Marina Tolou-Shams, PhD, of the Bradley Hasbro Children's Research Center. "Our findings suggest that future HIV prevention interventions should include content specific to crack and cocaine use, just as they do with drugs that are more commonly used by teens, like alcohol and marijuana."

Overall, nearly 280 teens between the ages of 13 and 18 from therapeutic psychiatric day programs took part in the study. Participants exhibited a range of psychiatric diagnoses, including mood disorders, post-traumatic stress disorder and disruptive behavior disorders. More than half of all adolescents were male, and more than three-quarters were Caucasian. Approximately 13 percent of teens in the study reported trying crack or cocaine at least once.

After controlling for known adolescent HIV risk factors, such as gender, race, age and psychiatric status, researchers found that only 47 percent of teens with a history of crack and/or cocaine use said they used condoms "always or almost always." In addition, 15 percent of these adolescents have a history of sexually transmitted diseases (STD), nearly three-quarters reported using alcohol at least once and more than half indicated prior marijuana use.

In comparison, 71 percent of teens who never used crack or cocaine reported using condoms consistently.

Tolou-Shams says it was important to look at the association between crack and cocaine use and HIV risk behavior in adolescents with psychiatric disorders, since previous research has shown that teens in mental health treatment have high rates of risky sexual behavior and are more likely to engage in substance use.

"Our study clearly shows that youth in psychiatric treatment are using other drugs - and not just alcohol or marijuana - at high rates and that a history of drug use should alert clinicians to a wide variety of possible behavioral risks in their young patients," she adds.

The authors recommend that all clinicians who treat adolescents - including pediatricians, social workers and psychologists - routinely discuss their patients' mental health history, lifetime use of all substances and sexual activity, as well as provide appropriate interventions when necessary in order to reduce their HIV risk.

The research is supported by grants from the National Institute of Mental Health and the Lifespan/Tufts/Brown Center for AIDS Research (CFAR).

Tolou-Shams is also an assistant professor of psychiatry at The Warren Alpert Medical School of Brown University. Study co-authors include Larry K. Brown, MD, and Nicholas Tarantino, BS, both from the Bradley Hasbro Children's Research Center and Alpert Medical School , and Sarah W. Feldstein Ewing, PhD, at the University of New Mexico .

Source:
Jessica Collins Grimes
Lifespan


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