News (Updated August 14, 2011)

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SWAZILAND : HIV prevalence among factory workers "50 percent"

11 Aug 2011 16:27

Source: Content partner // IRIN

MATSAPHA, 11 August 2011 - A new government study has found that more than half of workers in Swaziland�s garment industry are living with HIV, and officials are realizing that the once-hailed promise of manufacturing employment has become a financial and medical nightmare for tens of thousands of Swazi women.

�HIV prevalence among factory workers is 50.3 percent,� said Nhlanhla Nhlabatsi, an epidemiologist with the Ministry of Health. Nhlabatsi presented the data last week as preliminary findings for Swaziland�s first Behaviour Sentinel Surveillance Report to be released in its entirety later in the year.

About 30,000 Swazis, mostly women, are employed in garment factories financed by Taiwanese investors and operated by managers from mainland China .

The survey also found that most factory workers were well informed about HIV/AIDS, and 90 percent of workers interviewed were aware of the female condom and other methods of preventing HIV.

Government officials will now begin investigating the gap between knowledge of HIV/AIDS prevention and workers� susceptibility to HIV. The prevalence rate for textile industry employees is significantly higher than the 26 percent rate among sexually active adult Swazis.

�Women comprise the largest number of workers at the garment industry plants. They work long hours at wages so low some of them are known to turn to prostitution to support themselves and their families,� said Alicia Simelane, an HIV testing and counselling officer at the Matsapha Industrial Estate, where Swaziland�s industry is concentrated outside the commercial hub of Manzini.

The link between �sweatshop� wages and the risk of HIV has been known for years, but the statistical impact of the risk is only becoming apparent now.

The garment factories began renting government-built factory shells in the late 1990s and early 2000s to take advantage of Swaziland�s trade agreement with the United States , which under the African Growth and Opportunities Act (AGOA), allows textile goods made in the country to enter the US without import taxes.

According to the US Department of Commerce, the value of Swaziland 's AGOA exports increased nearly threefold, from US$65 million in 2001 to a peak of $199 million in 2005. Now the country�s fortunes have declined: by 2007 Swaziland 's AGOA exports were only $141 million, and by 2009 had almost halved to $101 million.

A strengthening of the local currency - the Lilangeni, which is pegged to the South African rand - combined with the global economic slowdown, resulted in a steep decline in orders. Factories, some of which were built at government expense and rented at very low cost to encourage businesses to set up in the country, have closed.

Poor conditions

Matsapha-based garment factories contacted by IRIN/PlusNews would not comment on the record, but indicated that they complied with health and safety standards.

�The activity that causes AIDS is not done at the workplace. We are not responsible for the private lives of our employees,� said the manager of one firm.

AIDS activists acknowledged that the factories had cooperated with HIV prevention campaigns, allowing NGOs to interact with the workers and distribute educational material at factories.

Although most of the workers knew how to prevent HIV, their circumstances did not allow them to practise this. Wages for part-time workers can be as low as $56 a month, and rarely top $223 a month for factory-floor workers.

�My dates do not like to use condoms, so I cannot make them,� said Thabsile Dlamini, a 28-year-old mother of two. She describes her relationships with men as informal, and says she accepts money and gifts from them.

�It helps me buy food for the little ones. They are old enough to enter school. They need to have their fees paid.�

Another worker who is married would not give her name for fear her husband would learn of her activities, although he provides no financial support for her and their two-year old daughter.

�Men come to Matsapha and find commercial prostitutes. But some prefer the working women because we are seen as �clean�. I have gone out with some men because I had to eat. I have gone for counselling. I have taken the HIV test. I am HIV negative now, but they told me it is only a matter of time before I become infected if I have [unprotected] sex. But I know this without anyone telling me,� she told IRIN/PlusNews.

 

HIV/AIDS: Female condoms slowly gaining popularity - report

11 Aug 2011 09:42

Source: Content partner // IRIN

NAIROBI , 11 August 2011 - Long seen as the ugly step-child [ http://www.irinnews.org/report.aspx?reportid=79699 ] of HIV prevention, the female condom seems to be gaining popularity through grassroots campaigns, according to a report [ http://www.unfpa.org/webdav/site/global/shared/documents/publications/2011/MomentumPDFforWeb.pdf ] by the UN Population Fund (UNFPA).

"For the fourth consecutive year, access to female condoms has increased dramatically, reaching a record number of 50 million... in 2009," the report states.

The female condom is a 17cm-long polyurethane sheath with a flexible ring at each end. It provides about the same protection from sexually transmitted infections - including HIV - and unwanted pregnancy as the male condom, but unlike the male condom, can be used with oil- and water-based lubricants without the risk of breakage.

The organization credits successful partnerships between governments and technical agencies for helping to increase access to female condoms. In 2005, UNFPA launched the Female Condom Initiative in 24 countries to ensure that female condom programming was integral to national AIDS policies and reproductive health programmes.

Creative approaches

"In a number of countries, governments... are applying highly creative approaches to educating the public about condoms and to overcoming the stigma and taboos sometimes associated with them," the report's authors said. "In the process, they are discovering that the female condom is a tool for women's empowerment, enabling women and adolescent girls to take the initiative to protect their own and their partners' health."

In Zimbabwe, billboards, radio spots and TV adverts helped boost female condom distribution by the public sector from about 400,000 in 2005 to more than two million in 2008, while the sales of female condoms went up from 900,000 in 2005 to more than three million in 2008.

Programmers in Zimbabwe used hairdressers to market the female condom, which proved highly successful.

"Often the hairdresser will work from a chair in her back yard. Such improvised salons stay open at all hours, so women can have their hair done � and discuss personal matters � in privacy," the authors reported.

UNFPA's partner, Population Services International (PSI), provides day-long training workshops around the country for the 2,000 hairdressers and 70 barbers who act as sales representatives for the female condom. PSI also employs 20 female condom promoters who distribute the condoms to hairdressers and barbers and spread the word about the training.

This approach was also used successfully in Guyana and Malawi .

In Ethiopia , the programme used coffee ceremonies, an age-old social custom, to reach married women. Because condoms - perceived to be used by promiscuous people and sex workers - are highly stigmatised in Ethiopian society, programmers highlighted the family planning benefits of the female condom.

In Myanmar , efforts targeted high-risk female sex workers and men who have sex with men, with PSI rebranding the condoms "Feel for Men" to make them more appealing to MSM.

Although not recommended for anal sex by the UN World Health Organization, some health authorities [ http://www.ebar.com/news/article.php?sec=news&article=5465 ] have opted to market it for use by MSM. In a 2002 US study [ http://www.ncbi.nlm.nih.gov/pubmed/12646796 ], men reported more frequent problems with female condoms than male latex condoms, particularly slippage, discomfort and rectal bleeding; the authors recommended more research on the safety of female condoms for anal sex.

Lagging behind the male condom

Despite these gains, the female condom still lags behind the male condom in popularity; according to UNFPA, more than 10 billion male condoms are used every year globally.

In Kenya , female condoms are part of the country's broader HIV and family planning programmes, but women have shown little interest. The country recently received three million female condoms from UNFPA and distributed them.

"We do not have reliable data on acceptability but we know that among sex workers there is a high demand," said Peter Cherutich, head of HIV prevention at the National AIDS and Sexually transmitted infections Control Programme. "Overall, the demand is low mainly due to general unavailability and [lack of] information.

"It is still more expensive [than the male condom] and we are yet to be confident that it is as widely popular as the male condom," he added. "Except for female sex workers and highly empowered women, most other women do not have the capacity to demand safe sex... the majority of women depend on their sexual partners to protect them."

The UNFPA report noted that female condoms can cost as much as US$1 each while male condoms are often distributed free of charge. In pharmacies in Nairobi , a pack of three male condoms costs just over $1.

Challenges

"In 2009, only one female condom was available for every 36 women worldwide," the report states.

One of the major complaints women had about the original FC1 female condom was that it was noisy [ http://www.plusnews.org/report.aspx?reportid=72690 ] during sex. The newer FC2 female condom is quieter [ http://www.plusnews.org/report.aspx?reportid=87526 ] and less expensive to produce but many women still feel it is more complicated than the male condom.

"We are trying to popularize it among sex workers, but they say if you have five or 10 customers in one night, the male condom is more convenient - with the female condom, it takes time to put on, then it has to warm up to your body temperature and the guy knows it's there," said Macklean Kyomya, executive director of the Ugandan NGO, Women's Organization Network for Human Rights Advocacy, which represents sex workers.

Lillian Mwamba, who lives in Nairobi , says she would use the female condom more often if it were more widely available.

"I have used a female condom on certain occasions but my partner and I prefer the male one because they are easy to come by and you can walk into any shop, even a kiosk, and get it; female condoms are very rare and expensive," she told IRIN/PlusNews. "But on the occasions I have used it, I can't say it was bad - it gives me as a woman some control."

Ignorance persists

Conversations with other Nairobians reveal that ignorance about the female condom is still widespread. "From the demonstrations I have seen, the female condom is inserted inside and your penis too goes inside. Now I am thinking to myself, what if I push it deeper inside and the woman gets hurt?" said Paul Mayaka. "And where do you get it even if you wanted your woman to have it?"

Mayaka added that he couldn't "trust my life with something that is washed like a cloth", referring to the practice of washing the female condom for reuse, which is not recommended by the UN World Health Organization.

NASCOP's Cherutich said the Kenyan government would need to market the female condom in new ways to increase use. "We have not placed the female condom as a family planning tool, which if we had, would make FC less stigmatizing since family planning is now an accepted concept within family settings," he said.

 

New York City schools to make sex education mandatory

Wed, Aug 10 2011

By Ray Sanchez

NEW YORK (Reuters) - New York City public schools will teach mandatory sex education classes to all middle- and high school students, part of a citywide initiative to help reduce teenage pregnancies, officials said on Wednesday.

The required classes, the first mandated sex education in nearly two decades, will be taught to children as young as 11 years old and tackle such topics as the proper use of condoms and ways to resist unwelcome sexual advances.

Public schools will be required to teach a semester of sex education to sixth or seventh grade classes and again to ninth and tenth graders, Chancellor Dennis Walcott said in a letter announcing the plans.

The move is part of an effort by the administration of Mayor Michael Bloomberg to improve the lives of black and Latino students who are disproportionately undereducated and unemployed, and far more likely to have unplanned pregnancies, according to city officials.

Research by the Centers for Disease Control and Prevention has shown that 41 percent of New York City youth said they were sexually active by 9th grade and 58 percent by 12th grade.

"We must be committed to ensuring that both middle school and high school students are exposed to this valuable information so they can learn to keep themselves safe before, and when, they decide to have sex," Walcott said.

Opposition from conservative groups and some school board members defeated a city mandate approved in the 1980s for a sex-education curriculum.

Separately, in 1987, New York state mandated an HIV/AIDS curriculum in every school from kindergarten through 12th grade which is still in effect.

New York state also requires middle and high school students take one semester of health education classes. But some schools do not include sex education in health classes.

"While many of our schools have already voluntarily taken steps to include sex education in their curriculum, some have not, leaving us with an uneven system that I believe does not serve our students well," Walcott said.

Walcott said parents can choose to take their children out of classes on birth-control methods if they want.

The New York Civil Liberties Union praised the plans, saying in a statement: "There is a consensus among public health experts and the public that age-appropriate, medically accurate comprehensive sex education is essential for providing teens with the tools to become healthy adults."

 

Drought forces people living with HIV to adopt drastic coping measures

Geneva , 09 August 2011

1.       Brief description of the emergency  

During July and early August 2011 reports were received of a worsening drought-caused hunger situation in the South Eastern area of Swaziland where the Lutheran Development Service operates. This is an area of endemic drought and perennial food insecurity. Drought during the period January to March withered crops and food supplies are now exhausted. Though grazing is still available the majority of the vulnerable population no longer has livestock.

Critically affected are those people who are HIV[1]  positive and have TB[2] and are on Anti Retroviral Treatment (ART) and TB medication. Taking these medications on an empty stomach produces serious side effects that has reduced patients to eating leaves and cow dung or stopping treatment altogether. IRIN, a humanitarian news and analysis service of the UN Office for the Coordination of Humanitarian Affairs reports that “The Swaziland National Network of People Living with HIV/AIDS (SWANNEPHA) confirmed that some of its members were consuming cow dung... It has come to this; the food insecurity most Swazis are experiencing has come up against the world’s highest HIV prevalence rate"[3].  Interruptions of ART and TB medication can be fatal. Likelihood of infecting other household members with TB is increased dramatically.

Food distributions by WFP[4] have been ongoing for several years to cover the food deficit. In 2009 WFP reduced its help to a small supply to neighbourhood care points catering for vulnerable children. Initially the government took over food distribution to the rest of the vulnerable population. This too has now ceased as the government has run out of money. Many families have reached the end of their traditional survival mechanism which comprise of remittances, wild vegetables, selling assets, community support among others.

This now leaves many vulnerable people very hungry. LDS has an ongoing evaluation in the area and verified the urgent need to get food to those on medication. Urgent applications to government for help have been unsuccessful so far. 

2.       Impact

Inadequate food supply has many ill effects.  Some people have started to exchange sex for money or food, this practice increases the HIV prevalence rate which is already high. Many families are skipping meals as a means of coping. Other families miss meals for a whole day.

Hunger is a huge problem for those taking medication for TB and Antiretroviral Treatment for AIDS. Both these medications have severe side effects when taken on an empty stomach. These are so severe that patients are reduced to eating leaves and even cow dung, or even worse stopping taking medication. “We have resorted to eating rubbish for purposes of taking our ARVs because they must be consumed after a meal” reports Plus News of IRIN OCHA[5]. The BBC of 27 July 2011also reports that “The drugs do not work on an empty stomach, so patients have to use the dung - mixed with water - instead of food, the activists say”[6] For the HIV positive a break in treatment accelerates the terminal phases of the illness whereas a break in TB treatment increases the prevalence of multi drug resistance TB strains.

 3.       National and international response 

The government is broke and has no funds to meet the crisis. Very small quantities of food are being distributed through the members of parliament and this has caused a lot of problems in the communities politicizing distribution.  Most of the affected people are left out or get very small quantities of food. WFP has stocks in country but is only giving food to Neighbourhood Care Points (NCPs). Other NGOs are trying to source food and funds for other areas.

There are some small stocks of food in government warehouses but has no means to distribute them. LWF through LDS is part of a food security consortium lobbying to get some of this food from warehouses to the most needy but this is taking too long for the worst affected.

 4.       ACT Alliance response 

LWF through LDS had some funds to assist “Home Based Care” to the terminally ill. We have used these to make initial purchases of high protein porridge (Morvite) and managed to eke out scarce transport to deliver. These resources are now exhausted.

The National Disaster Management Authority has requested the NGOs to assist them in counting the food in government warehouses so that they may know how much more is needed. The process is complicated and will take time and the affected people may be dying by then. We know that government is broke and we are not sure that this will develop into effective action in the forseeable future. 

 5.       Planned activities 

LWF through LDS plans to purchase a two months supply of food supplements (sufficient for one meal per day) for the people who are on medication and to make two distributions. During this time they would conduct a detailed assessment and will prepare longer term plans. They should by then be in a better position to know how much if anything will come from negotiations with government and World Food Programme (WFP).  They want the people to immediately continue to take the medication whilst they look for a longer term solution. The ideal would be two meals per day but one meal would be sufficient to avert disaster.

 This response will serve 1,200 people who are HIV or TB positive and receiving Anti Retroviral or TB treatment and who are unable to source regular meals due to the ongoing drought and lack of food distribution. It will give those 5 kg of “Morvite”, an energy nutritional supplement each month for two consecutive months. LWF will submit a Rapid Response Fund request to respond to this crisis.

Any funding indication or pledge should be communicated to Jean-Daniel Birmele, ACT Chief Finance Officer (Jean_Daniel.Birmele@actalliance.org).


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