"Demographers have noted that the South is one of the regions that have seen the most rapid influx of Latino workers," Marisa Trevio, who writes the blog "Latina Lista," writes in a USA Today opinion piece. She adds, "So with a steady influx of Latinos, and a growing number of them contracting HIV/AIDS, why aren't states making inroads via aggressive public awareness campaigns in attacking this preventable and treatable disease?"
According to Trevio, a recent study from the Latino Commission on AIDS "found that HIV/AIDS cases are rising at alarming rates among the two million Latinos in Alabama, Georgia, Louisiana, Mississippi, North Carolina, South Carolina and Tennessee." She adds, "Prevention education isn't keeping pace." Trevio writes that public awareness efforts likely are not having much effect among Hispanics because the "targets of these messages -- which include legal and undocumented workers -- don't trust the messenger." A report from Progressive States Network found that "every state identified by the study, with the exception of Alabama, has passed policies criminalizing undocumented immigration," according to Trevio. "These laws intimidate people from seeking any assistance," she writes, adding, "For example, South Carolina passed a series of laws that include establishing a hotline to report suspected nonresidents and making it a crime to transport or harbor undocumented immigrants." The report found that as a "result of this anti-immigrant climate and the high rate of people without health insurance," many HIV-positive Hispanics do not "seek medical attention until they are in its late stages," Trevio writes.
However, some "states are trying to confront this crisis," according to Trevio, who adds that North Carolina in October "conducted a bilingual campaign to encourage people to get tested. Even so, the report found that these states didn't have enough bilingual professionals to address the crisis." Trevio writes that the study "made several recommendations, all rooted in communication. Whether it's utilizing more Spanish-language media to market prevention programs, training more people to speak Spanish, partnering with Latino organizations to replicate their successful programs or connecting with Hispanic religious and community leaders, it all comes down to opening lines of communication to a population that has been forced to stay in the shadows of society." She concludes, "For their health and for the health of the country, these Latinos must come forward -- and the sooner the better" (Trevio, USA Today, 12/19).
Visit www.aids-drugs-online.com for treatment options
Saturday, December 27, 2008
South Carolina Medicaid Cuts $61 Million in Services, Ends Enrollment in HIV/AIDS
South Carolina's Medicaid agency will stop enrolling people living with HIV as part of a $61 million round of budget cuts, officials announced on Wednesday, the AP/Charlotte Observer reports. According to the AP/Observer, no longer enrolling HIV-positive people will save the agency $40,000. Some health care advocates argue the budget cuts mean that many people will become even sicker when left without care, leading to more costly emergency department visits "or worse," the AP/Observer reports. Carmen Julious, executive director of Palmetto AIDS Life Support Services in Columbia, said the Medicaid HIV/AIDS program provides "lifesaving medications," adding, "Compared to people's lives, that ($40,000) doesn't seem like a good balance to me." Sue Berkowitz, executive director of the low-income advocacy group South Carolina Appleseed Legal Justice Center, said that people "are going to die" because of the budget cuts.
The AP/Observer reports that other budget cuts include ending hospice care for Medicaid-only patients; decreasing the amount of assistance for prescription drug costs for low-income, elderly populations; reducing home health nurse visits from 75 to 50 per year; and reducing assistance to hospitals and nursing homes. The Medicaid program has lost $137 million since July while state spending has been reduced by $1 billion because of the economic situation and faltering tax collections (Davenport, AP/Charlotte Observer, 12/17). The Columbia State reports that the $61 million in state budget cuts will result in the loss of $398 million in federal matching funds. Jeff Stensland, a spokesperson with the state health department, said the budget cuts will affect patients but not essential care, adding that a proposed federal aid package for states could help fund some of the programs that will be eliminated or reduced (O'Connor, Columbia State, 12/18). Stensland also said that the department is "not happy about having to do any of these" cuts and that an increase in the demand for the state's Medicaid program is "just around the corner" because of the economic situation (AP/Charlotte Observer, 12/17).
The AP/Observer reports that other budget cuts include ending hospice care for Medicaid-only patients; decreasing the amount of assistance for prescription drug costs for low-income, elderly populations; reducing home health nurse visits from 75 to 50 per year; and reducing assistance to hospitals and nursing homes. The Medicaid program has lost $137 million since July while state spending has been reduced by $1 billion because of the economic situation and faltering tax collections (Davenport, AP/Charlotte Observer, 12/17). The Columbia State reports that the $61 million in state budget cuts will result in the loss of $398 million in federal matching funds. Jeff Stensland, a spokesperson with the state health department, said the budget cuts will affect patients but not essential care, adding that a proposed federal aid package for states could help fund some of the programs that will be eliminated or reduced (O'Connor, Columbia State, 12/18). Stensland also said that the department is "not happy about having to do any of these" cuts and that an increase in the demand for the state's Medicaid program is "just around the corner" because of the economic situation (AP/Charlotte Observer, 12/17).
Medicare Part D and Ryan White
"Ryan White Care Act: First-Year Experiences Under the Part D Administrative Expense Cap" (.pdf), Government Accountability Office: The report was conducted to examine the effect of the Ryan White HIV/AIDS Treatment and Modernization Act of 2006, which took effect in fiscal year 2007 and capped the amount of money that Part D grantees could spend on administrative services at 10%. In response to the GAO survey, 83 grantees reported that they provide a variety of medical and support services to clients, with the majority saying that they have not made changes in response to the cap. The majority of the respondents said that the cap has not affected services they provide. Four respondents reported increasing services and three reported reducing services because of the cap. The majority of grantees also said that the cap has had a negative impact on their Part D programs even if it has not affected services. For example, the cap has made it necessary for clinical staff to conduct administrative duties. About half of the grantees said that not all of their Part D administrative expenses were covered by the 10% allowance ("Ryan White Care Act: First-Year Experiences Under the Part D Administrative Expense Cap," Government Accountability Office, December 2008).
New Orleans Officials Should Ensure That 'Glitch' in Ryan White Process Will Not Create 'Problem' With 2009 Grants
"The grant process for agencies working with" HIV-positive people is "maddening," a New Orleans Times-Picayune editorial says. According to the editorial, it "took six months" for Mayor Ray Nagin's administration to "distribute $7 million in federal grant money this year," and the city's Office of Health Policy "received the money" from the Ryan White Program in March but did not "send out grant award notices to agencies until June." It adds that contracts were not "finalized until last month."
Following criticism from the City Council on the "slow-moving process," Health Policy Director Fran Lawless "promised that her office would do better with the next round of grants," the editorial says, adding, "Unfortunately, that hasn't been the case so far." According to the editorial, a "public notice published last week to launch the 2009 process included errors that forced the city to cancel the effort and push back its start." It adds, "Even the best operations can make the type of clerical errors in the failed notice. And there are points in the public notice process where things can occasionally go wrong." However, "these problems are worrisome considering the office's history of delays," the editorial says, adding that Nagin "needs to make sure the office's director and employees can efficiently accomplish this task or find some who can." Concerns from officials involved with the grant process "surely pal[e] in comparison with the anguish of more than 4,000 people with HIV/AIDS who get treatment and case management services from the entities that the grants fund," according to the editorial. It adds, "At least one of those agencies had to close during the summer because of the city's delays. That left hundreds of people without the help they need." The editorial concludes that city "officials promise that the glitch in the process won't cause a problem with the 2009 grants. They need to ensure that it doesn't" (New Orleans Times-Picayune, 12/22).
In the event that service disruptions affect your health care management plan, be sure to visit http://www.aids-drugs-online.com
Following criticism from the City Council on the "slow-moving process," Health Policy Director Fran Lawless "promised that her office would do better with the next round of grants," the editorial says, adding, "Unfortunately, that hasn't been the case so far." According to the editorial, a "public notice published last week to launch the 2009 process included errors that forced the city to cancel the effort and push back its start." It adds, "Even the best operations can make the type of clerical errors in the failed notice. And there are points in the public notice process where things can occasionally go wrong." However, "these problems are worrisome considering the office's history of delays," the editorial says, adding that Nagin "needs to make sure the office's director and employees can efficiently accomplish this task or find some who can." Concerns from officials involved with the grant process "surely pal[e] in comparison with the anguish of more than 4,000 people with HIV/AIDS who get treatment and case management services from the entities that the grants fund," according to the editorial. It adds, "At least one of those agencies had to close during the summer because of the city's delays. That left hundreds of people without the help they need." The editorial concludes that city "officials promise that the glitch in the process won't cause a problem with the 2009 grants. They need to ensure that it doesn't" (New Orleans Times-Picayune, 12/22).
In the event that service disruptions affect your health care management plan, be sure to visit http://www.aids-drugs-online.com
Thursday, December 18, 2008
Women More Susceptible to HIV/AIDS than Originally Thought
A new study has found that HIV appears to attack normal, healthy genital tissue in women and does not require breaks in the skin to infiltrate cells, offering new perspectives on how the virus is spread, researchers said on Tuesday, Reuters reports. Thomas Hope, a study author from Northwestern University's Feinberg School of Medicine, said that scientists have had little detailed understanding of how HIV is transmitted sexually in women and that it was "previously thought there had to be a break in [genital tissue] somehow" for women to contract the virus. He added that the study's findings show that "[n]ormal skin is vulnerable."
For the study, researchers in a partnership between Northwestern and Tulane University introduced HIV -- which carried fluorescent, light-activated tracers, a new method developed to better see how the virus worked -- to newly removed vaginal tissue taken from hysterectomy surgeries. A microscope was used to observe the virus as it penetrated the outer lining of the female genital tract -- also called the squamous epithelium -- and found that HIV was able to move quickly past the skin barrier to reach immune cells. The process also was observed in nonhuman primates, according to Reuters. In addition, the results of the study suggest that HIV focuses on areas of the genital tissue where skin cells recently had been shed, Hope said (Steenhuysen, Reuters, 12/16). Hope said the results are "an important and unexpected result -- we have a new understanding of how HIV can invade the female vaginal tract." He added, "We urgently need new prevention strategies or therapeutics to block the entry of HIV through a woman's genital skin" (BBC News, 12/17).
According to Reuters, researchers in the past have assumed that HIV sought out breaks in the skin -- like a herpes sore -- to gain access to immune system cells deeper in tissue, and some thought the normal lining of the vaginal tract could work as a barrier to transmission during sexual intercourse. Reuters reports that the study "casts doubt" on the theory that HIV transmission requires a break in the skin or that the virus gains access through the cervical canal's single layer of skin cells. The findings also "might explain why some prevention efforts" -- such as diaphragms or herpes treatment -- have "failed," Reuters reports (Reuters, 12/16).
Lisa Power from the Terrence Higgins Trust in the United Kingdom said the results are an "important finding" but "sadly, not surprising" because it has been "long known that it is easier for a man to transmit HIV sexually to a woman than for a woman to transmit it to a man." She added that the study "helps us understand why" and "will help in developing better prevention mechanisms -- but until then, it's more clear than ever that a condom is a vital part of safer sex." The British not-for-profit organization AVERT said that the study "serves to strengthen" the argument for condom use during heterosexual intercourse and "will hopefully give weight to the need for safer heterosexual sex to be advocated further by governments and practitioners worldwide" (BBC News, 12/17). According to Hope, the findings emphasize the importance of methods to prevent transmission, such as a vaccine and condom use. He said, "People need to remember that they are vulnerable. The sad part is if people just used a condom, we wouldn't have this problem" (Reuters, 12/16).
For the study, researchers in a partnership between Northwestern and Tulane University introduced HIV -- which carried fluorescent, light-activated tracers, a new method developed to better see how the virus worked -- to newly removed vaginal tissue taken from hysterectomy surgeries. A microscope was used to observe the virus as it penetrated the outer lining of the female genital tract -- also called the squamous epithelium -- and found that HIV was able to move quickly past the skin barrier to reach immune cells. The process also was observed in nonhuman primates, according to Reuters. In addition, the results of the study suggest that HIV focuses on areas of the genital tissue where skin cells recently had been shed, Hope said (Steenhuysen, Reuters, 12/16). Hope said the results are "an important and unexpected result -- we have a new understanding of how HIV can invade the female vaginal tract." He added, "We urgently need new prevention strategies or therapeutics to block the entry of HIV through a woman's genital skin" (BBC News, 12/17).
According to Reuters, researchers in the past have assumed that HIV sought out breaks in the skin -- like a herpes sore -- to gain access to immune system cells deeper in tissue, and some thought the normal lining of the vaginal tract could work as a barrier to transmission during sexual intercourse. Reuters reports that the study "casts doubt" on the theory that HIV transmission requires a break in the skin or that the virus gains access through the cervical canal's single layer of skin cells. The findings also "might explain why some prevention efforts" -- such as diaphragms or herpes treatment -- have "failed," Reuters reports (Reuters, 12/16).
Lisa Power from the Terrence Higgins Trust in the United Kingdom said the results are an "important finding" but "sadly, not surprising" because it has been "long known that it is easier for a man to transmit HIV sexually to a woman than for a woman to transmit it to a man." She added that the study "helps us understand why" and "will help in developing better prevention mechanisms -- but until then, it's more clear than ever that a condom is a vital part of safer sex." The British not-for-profit organization AVERT said that the study "serves to strengthen" the argument for condom use during heterosexual intercourse and "will hopefully give weight to the need for safer heterosexual sex to be advocated further by governments and practitioners worldwide" (BBC News, 12/17). According to Hope, the findings emphasize the importance of methods to prevent transmission, such as a vaccine and condom use. He said, "People need to remember that they are vulnerable. The sad part is if people just used a condom, we wouldn't have this problem" (Reuters, 12/16).
Two-Thirds of HIV-Positive Kenyan Children Do Not Have Access to Antiretroviral Treatment, Report Says
Although the Kenyan government runs a program to provide no-cost antiretroviral medication, about two-thirds of HIV-positive children in Kenya lack access to the drugs, according to a report released Tuesday by Human Rights Watch, Kenya's Daily Nation reports. According to the report, titled "A Question of Life or Death: Treatment Access for Children Living With HIV in Kenya," about 25,000 HIV-positive children in Kenya have access to antiretroviral medication but about 50,000 children under the country's HIV/AIDS care program lack treatment access. The report also states that 40,000 children likely will die in the next two years if they do not receive antiretroviral treatment. About half of all HIV-positive infants who do not receive treatment will die before reaching age two, the report said.
According to the report, many local health facilities do not test children for HIV or offer tham antiretroviral treatment. In addition, some medical staff "are often not trained to deal with HIV in children and there are too few community health workers to help children gain access to testing and treatment," the report said. Juliane Kippenberg, a senior researcher on Africa in HRW's Children's Rights Division, said that the Kenyan government has focused on providing treatment to adults living with HIV. Dorothy Ngacha, associate professor in the pediatric department of University of Nairobi's School of Medicine, added that another "barrier" to antiretroviral treatment access for children is a "lack of knowledge" about HIV status. Ngacha said there are "no concrete statistics" on the number of HIV-positive children in Kenya, only "mere estimates." According to Ngacha, the Kenya National AIDS/STD Control Program estimates that at least 60,000 children in Kenya need antiretroviral treatment. However, this number could be "considerably higher" when accounting for government guidelines that require all HIV-positive infants to receive treatment, the Daily Nation reports.
Kippenberg said that Kenya has taken a "step in the right direction" by expanding infant testing, "but the government needs to do much more to help children overcome treatment access barriers." According to Ngacha, Kenya's Ministry of Health Care and Medical Services plans to decentralize HIV/AIDS services to dispensary levels to allow more children to access treatment (Kumba/Mathenge, Daily Nation, 12/17). Ben Rawlence, HRW spokesperson, said cost should not be a factor in improving treatment access because antiretrovirals are "not that expensive." According to Rawlence, HIV/AIDS treatments "already exist" in Kenya, but the government must distribute the drugs, increase availability for children, train health workers and ensure that children attend clinics and follow-up appointments to guarantee treatment adherence. He added that partners such as the World Health Organization and the Clinton Foundation already provide support for HIV testing and treatment for Kenyan children (Lesser, VOA News, 12/17).
Online The report is available online.
According to the report, many local health facilities do not test children for HIV or offer tham antiretroviral treatment. In addition, some medical staff "are often not trained to deal with HIV in children and there are too few community health workers to help children gain access to testing and treatment," the report said. Juliane Kippenberg, a senior researcher on Africa in HRW's Children's Rights Division, said that the Kenyan government has focused on providing treatment to adults living with HIV. Dorothy Ngacha, associate professor in the pediatric department of University of Nairobi's School of Medicine, added that another "barrier" to antiretroviral treatment access for children is a "lack of knowledge" about HIV status. Ngacha said there are "no concrete statistics" on the number of HIV-positive children in Kenya, only "mere estimates." According to Ngacha, the Kenya National AIDS/STD Control Program estimates that at least 60,000 children in Kenya need antiretroviral treatment. However, this number could be "considerably higher" when accounting for government guidelines that require all HIV-positive infants to receive treatment, the Daily Nation reports.
Kippenberg said that Kenya has taken a "step in the right direction" by expanding infant testing, "but the government needs to do much more to help children overcome treatment access barriers." According to Ngacha, Kenya's Ministry of Health Care and Medical Services plans to decentralize HIV/AIDS services to dispensary levels to allow more children to access treatment (Kumba/Mathenge, Daily Nation, 12/17). Ben Rawlence, HRW spokesperson, said cost should not be a factor in improving treatment access because antiretrovirals are "not that expensive." According to Rawlence, HIV/AIDS treatments "already exist" in Kenya, but the government must distribute the drugs, increase availability for children, train health workers and ensure that children attend clinics and follow-up appointments to guarantee treatment adherence. He added that partners such as the World Health Organization and the Clinton Foundation already provide support for HIV testing and treatment for Kenyan children (Lesser, VOA News, 12/17).
Online The report is available online.
Ryan White Funding Delays
Errors in a public notice last week in New Orleans have forced city officials to delay the start of the 2009 process for distributing an expected $5 million in Ryan White Program funding for local HIV/AIDS agencies, the New Orleans Times-Picayune reports. The announcement of the delay comes after Fran Lawless -- who serves as director of Mayor Ray Nagin's Office of Health Care Policy -- in October testified before the city council's Housing and Human Needs Committee that 2008 funding distribution was delayed by six months and that service providers went without funding from March to October.
According to the Times-Picayune, City Council member Arnie Fielkow called on officials to begin the application process for 2009 earlier in the year. In an effort to meet this request, officials listed a public request for proposals in the Times-Picayune on Dec. 8, 9 and 10, which set the deadline for picking up applications as Dec. 5 -- a date that had already past. The deadline for submission also was listed incorrectly in the electronic notice sent directly to the service providers, which left many of them confused, according to the Times-Picayune. Carlos Butler -- Health Policy office manager and the contact who was listed in the public notice -- said that the request for proposals was canceled and referred questions to Lawless and a Nagin spokesperson, who did not respond to requests for comment, the Times-Picayune reports.
Several agencies that receive funding to provide assistance to more than 4,000 people living with HIV/AIDS in the city complained in October that they would be unable to operate if their funding continued to face delays as it had in 2008, according to the Times-Picayune. Doug Morgan, who administers Ryan White Program funding for the federal Health Resources and Service Administration, said, "Our hope is that some of the issues they faced in [2008] will not be repeated in [2009]." He added, "I'm unhappy to learn the initial draft of the (requests for proposal) had glitches in it. It sounds like they're close to repeating some of the timelines they had last year, and that makes me a little nervous."
A new notice appeared Tuesday in the Times-Picayune and the deadline for submitting requests was listed as Jan. 9. The notice also will appear Wednesday and Thursday in the newspaper. Dave Munroe of In This Together -- a not-for-profit agency serving 225 patients that was forced to shut down over the summer because of the delay in funding and reopened in October -- said that the agency will not apply for 2009 funding because of "continuing issues of truthfulness, transparency and professionalism" at the city level (Hammer, New Orleans Times-Picayune, 12/17).
In the event that funding runs out, and you require alternatives, please visit www.aids-drugs-online.com
According to the Times-Picayune, City Council member Arnie Fielkow called on officials to begin the application process for 2009 earlier in the year. In an effort to meet this request, officials listed a public request for proposals in the Times-Picayune on Dec. 8, 9 and 10, which set the deadline for picking up applications as Dec. 5 -- a date that had already past. The deadline for submission also was listed incorrectly in the electronic notice sent directly to the service providers, which left many of them confused, according to the Times-Picayune. Carlos Butler -- Health Policy office manager and the contact who was listed in the public notice -- said that the request for proposals was canceled and referred questions to Lawless and a Nagin spokesperson, who did not respond to requests for comment, the Times-Picayune reports.
Several agencies that receive funding to provide assistance to more than 4,000 people living with HIV/AIDS in the city complained in October that they would be unable to operate if their funding continued to face delays as it had in 2008, according to the Times-Picayune. Doug Morgan, who administers Ryan White Program funding for the federal Health Resources and Service Administration, said, "Our hope is that some of the issues they faced in [2008] will not be repeated in [2009]." He added, "I'm unhappy to learn the initial draft of the (requests for proposal) had glitches in it. It sounds like they're close to repeating some of the timelines they had last year, and that makes me a little nervous."
A new notice appeared Tuesday in the Times-Picayune and the deadline for submitting requests was listed as Jan. 9. The notice also will appear Wednesday and Thursday in the newspaper. Dave Munroe of In This Together -- a not-for-profit agency serving 225 patients that was forced to shut down over the summer because of the delay in funding and reopened in October -- said that the agency will not apply for 2009 funding because of "continuing issues of truthfulness, transparency and professionalism" at the city level (Hammer, New Orleans Times-Picayune, 12/17).
In the event that funding runs out, and you require alternatives, please visit www.aids-drugs-online.com
Government of Indonesian Province Rejects Plan To Implant Microchips in Some HIV-Positive People
The parliament in the Indonesian province of Papua has rejected plans to implant microchips in some HIV-positive people following opposition from government officials, health care workers and advocates, the AP/Google.com reports. According to lawmaker Weinard Watori, the parliament on Tuesday agreed to drop a section of the health bill currently under consideration that would have called for the tagging of some HIV-positive people with computer chips inserted under the skin (Karmini, AP/Google.com, 12/16).
The HIV/AIDS Handling bylaw would have allowed the implantation of microchips in "sexually aggressive" people living with HIV/AIDS, the Jakarta Post reports. According to Komarudin Watubun, deputy legislative council speaker, Papua's provincial legislative council earlier this week did not endorse the bylaw because the "legislative and executive branches had different perceptions on the use of microchips" for HIV-positive people. Komarudin added that the executive branch viewed the bylaw as violating human rights, while the legislative councilors saw it as "an effort to build awareness within society" (Somba, Jakarta Post, 12/16).
The AP/Yahoo! News reports that there had been strong opposition to the bylaw -- including from Papua's Vice Governor Alex Hasegem, who called the plan a "violation of human rights" -- as well as from health workers and advocates, some of whom called the bylaw "abhorrent." They added that sex education and increased condom use are the best ways to curb the spread of HIV in Papua (Karmini, AP/Yahoo! News, 12/16). Hasegem said that the plan to implant microchips into people living with HIV/AIDS was not "in accordance" with the "principles" that should be applied to addressing HIV-positive populations, adding that implanting microchips is a "form of stigmatizing" (Jakarta Post, 12/16). Papua's parliament is scheduled to conclude discussion of other issues in the health bill, including efforts to curb the spread of HIV, by the end of the week, according to Watori (AP/Google.com, 12/16).
The HIV/AIDS Handling bylaw would have allowed the implantation of microchips in "sexually aggressive" people living with HIV/AIDS, the Jakarta Post reports. According to Komarudin Watubun, deputy legislative council speaker, Papua's provincial legislative council earlier this week did not endorse the bylaw because the "legislative and executive branches had different perceptions on the use of microchips" for HIV-positive people. Komarudin added that the executive branch viewed the bylaw as violating human rights, while the legislative councilors saw it as "an effort to build awareness within society" (Somba, Jakarta Post, 12/16).
The AP/Yahoo! News reports that there had been strong opposition to the bylaw -- including from Papua's Vice Governor Alex Hasegem, who called the plan a "violation of human rights" -- as well as from health workers and advocates, some of whom called the bylaw "abhorrent." They added that sex education and increased condom use are the best ways to curb the spread of HIV in Papua (Karmini, AP/Yahoo! News, 12/16). Hasegem said that the plan to implant microchips into people living with HIV/AIDS was not "in accordance" with the "principles" that should be applied to addressing HIV-positive populations, adding that implanting microchips is a "form of stigmatizing" (Jakarta Post, 12/16). Papua's parliament is scheduled to conclude discussion of other issues in the health bill, including efforts to curb the spread of HIV, by the end of the week, according to Watori (AP/Google.com, 12/16).
Violence Against Women Contributes to Spread of HIV in Ghana
Violence against women in northern Ghana increases their vulnerability to HIV/AIDS, according to a study recently released by ActionAID Ghana, Public Agenda reports. For the study -- titled "Violence and HIV/AIDS: The Interface, Voices of Women in Northern Ghana" -- researchers led by Yaa Peprah Agyemang Amekudzi examined the association between violence against women and HIV/AIDS in six districts of northern Ghana. According to the report, HIV transmission sometimes can occur as a result of sexual violence. In addition, "Fear of violence prevents women from negotiating safe sex," Amekudzi said, adding that HIV-positive women often face additional stigma and violence, sometimes leading them to pursue commercial sex work. According to Amekudzi, violence against women and HIV can negatively impact social, economic and political development because it affects women as caregivers and financial supporters of their families. According to Public Agenda, of the approximately 33 million HIV-positive people worldwide in 2007, 15.4 million were women.
According to the report, violence against women can occur as a result of misinformation and misinterpretation of religious and cultural practices. In addition, "Poverty and lack of formal education were also identified as being used to perpetuate violence against women," Amekudzi said. The study determined that current HIV efforts are insufficient to stem the high HIV prevalence among girls and women in Northern Ghana, adding that female condom use is minimal in three northern regions because women do not make decisions about their use. The study recommends that the government provide housing and services for survivors of violence and people living with HIV/AIDS, and that religious groups support these populations. The report adds that indicators should be used to track awareness levels about HIV and domestic violence. Adwoa Kwateng-Kluvitse, country director of ActionAID, said that power dynamics must be addressed before Ghana can reduce domestic violence and HIV prevalence. She added that the organization is "working on building and strengthening the voice" of HIV-positive people with an aim "to increase their access to information and skills, especially the vulnerable ones" (Amankwah, Public Agenda, 12/15).
According to the report, violence against women can occur as a result of misinformation and misinterpretation of religious and cultural practices. In addition, "Poverty and lack of formal education were also identified as being used to perpetuate violence against women," Amekudzi said. The study determined that current HIV efforts are insufficient to stem the high HIV prevalence among girls and women in Northern Ghana, adding that female condom use is minimal in three northern regions because women do not make decisions about their use. The study recommends that the government provide housing and services for survivors of violence and people living with HIV/AIDS, and that religious groups support these populations. The report adds that indicators should be used to track awareness levels about HIV and domestic violence. Adwoa Kwateng-Kluvitse, country director of ActionAID, said that power dynamics must be addressed before Ghana can reduce domestic violence and HIV prevalence. She added that the organization is "working on building and strengthening the voice" of HIV-positive people with an aim "to increase their access to information and skills, especially the vulnerable ones" (Amankwah, Public Agenda, 12/15).
Needle-Exchange Programs 'Save' Lives, Money
The "simple truth about needle-exchange programs is that they save lives and save money," a San Antonio Express-News editorial says. It continues, "Numerous research studies and practical experience with such programs around the nation demonstrate the savings," adding, "The same studies and practical experience also refute the primary rationale for opposing needle-exchange programs -- the notion that they increase" injection drug use.
This notion was the "buzz saw advocates of safe, cost-effective needle-exchange ran into during the last legislative session" in Texas, according to the editorial. However, the "same bipartisan group of lawmakers who pushed the legislation" allowing for the establishment of needle-exchange programs in the state "plans to reintroduce similar measures in the upcoming session," it says, adding that there "can be little doubt that given the opportunity for floor votes in the Senate and House, Texas will join the 49 other states in making needle-exchange programs legal."
"Along with protecting law enforcement and health care workers who frequently come into physical contact with the [IDU] community, the case for needle change is overwhelming," the editorial says, concluding, "This time, a measure that saves lives and taxpayer dollars deserves a simple up or down vote in the Legislature" (San Antonio Express-News, 12/14).
This notion was the "buzz saw advocates of safe, cost-effective needle-exchange ran into during the last legislative session" in Texas, according to the editorial. However, the "same bipartisan group of lawmakers who pushed the legislation" allowing for the establishment of needle-exchange programs in the state "plans to reintroduce similar measures in the upcoming session," it says, adding that there "can be little doubt that given the opportunity for floor votes in the Senate and House, Texas will join the 49 other states in making needle-exchange programs legal."
"Along with protecting law enforcement and health care workers who frequently come into physical contact with the [IDU] community, the case for needle change is overwhelming," the editorial says, concluding, "This time, a measure that saves lives and taxpayer dollars deserves a simple up or down vote in the Legislature" (San Antonio Express-News, 12/14).
HIV/AIDS Envoy Calls on Caribbean Governments To Decriminalize Homosexuality
George Alleyne, the United Nations special envoy for HIV/AIDS in the Caribbean, on Thursday said that Caribbean countries should repeal laws that criminalize same-sex contact, EFE/Latin American Herald Tribune reports. "I believe that the existence of these laws contribute to infected and potentially infected men not coming forward to be tested, and I believe and I will propose that such laws be revised," Alleyne said at a multifaith meeting in Georgetown, Guyana. He also called for a "civil discourse" between the religious community and policymakers on the public health and moral aspects of criminalizing same-sex contact. According to Alleyne, "rampant homophobia" is one of the "most egregious manifestations of stigma and discrimination." In addition, he said that few officials in the Caribbean have the courage to call for the repeal of such laws.
Rudolph Cummings, program manager for Health Sector Development at the Caribbean Community, said at a later news conference that most people in the region continue to reject homosexuality. "It's a political mine-field fraught with a lot of difficulties for the regional governments at this particular juncture and time," he said, adding, "While we have made certain types of social advances in the region, this is an area where many governments have indicated that their citizens are not quite at a position where they can endorse some of the kinds of broad-based legislation which has been endorsed in Europe and other places." According to Cummings, "painstaking work" is needed to guarantee that vulnerable groups -- such as commercial sex workers and men who have sex with men -- are reached through Caricom's HIV/AIDS programs (EFE/Latin American Herald Tribune, 12/11).
Rudolph Cummings, program manager for Health Sector Development at the Caribbean Community, said at a later news conference that most people in the region continue to reject homosexuality. "It's a political mine-field fraught with a lot of difficulties for the regional governments at this particular juncture and time," he said, adding, "While we have made certain types of social advances in the region, this is an area where many governments have indicated that their citizens are not quite at a position where they can endorse some of the kinds of broad-based legislation which has been endorsed in Europe and other places." According to Cummings, "painstaking work" is needed to guarantee that vulnerable groups -- such as commercial sex workers and men who have sex with men -- are reached through Caricom's HIV/AIDS programs (EFE/Latin American Herald Tribune, 12/11).
Experimental Treatment Lengthens Lifespan of Monkeys With Simian Version of HIV
Macaque monkeys with simian immunodeficiency virus -- the simian equivalent of HIV -- that received a single dose of an experimental treatment survived nearly twice as long as monkeys who did not receive the drug, according to a study published Wednesday in the journal Nature, BBC News reports. Immunodeficiency viruses typically function by signaling the body to suppress immune responses; however, the new treatment blocks this signaling system and thus boosts immune cell function, according to BBC News.
For the study, researchers injected a blocking antibody into nine monkeys who had developed AIDS from SIV. The study found that monkeys who received the experimental treatment survived an average of two times longer than monkeys who did not receive the drug. In addition, the treated monkeys showed evidence of more active immune systems and reduced viral loads, both indicators that the experimental treatment helped control SIV more efficiently. Although the treatment did not fully suppress SIV for any of the monkeys, the researchers said the treatment might prove more successful when administered in multiple doses or in conjunction with antiretroviral treatment.
Rama Amara of the Emory University Vaccine Center, who led the study, said that it is "important to note" that the experimental treatment "was effective without antiretroviral drugs and in monkeys with severe AIDS." She added that stimulating protective immune responses is "critical" to the development of a "successful immune therapy to control" HIV/AIDS. Thomas Lehner, an immunologist from King's College London, called the study's findings "very interesting," adding that although the "safety of the drug is a concern," the treatment potentially could be modified for treating HIV-positive humans. Lehner added that multiple doses of the treatment could suppress the virus, "although the present experiment has not shown that." Ade Fakoya of the International HIV/AIDS Alliance said that although the study is "an important avenue" to pursue, there could be a "long process of many years" before SIV research could be applied to humans "on a large enough scale for it to be another useful tool in HIV treatments" (BBC News, 12/10).
Online An abstract of the study is available online.
For the study, researchers injected a blocking antibody into nine monkeys who had developed AIDS from SIV. The study found that monkeys who received the experimental treatment survived an average of two times longer than monkeys who did not receive the drug. In addition, the treated monkeys showed evidence of more active immune systems and reduced viral loads, both indicators that the experimental treatment helped control SIV more efficiently. Although the treatment did not fully suppress SIV for any of the monkeys, the researchers said the treatment might prove more successful when administered in multiple doses or in conjunction with antiretroviral treatment.
Rama Amara of the Emory University Vaccine Center, who led the study, said that it is "important to note" that the experimental treatment "was effective without antiretroviral drugs and in monkeys with severe AIDS." She added that stimulating protective immune responses is "critical" to the development of a "successful immune therapy to control" HIV/AIDS. Thomas Lehner, an immunologist from King's College London, called the study's findings "very interesting," adding that although the "safety of the drug is a concern," the treatment potentially could be modified for treating HIV-positive humans. Lehner added that multiple doses of the treatment could suppress the virus, "although the present experiment has not shown that." Ade Fakoya of the International HIV/AIDS Alliance said that although the study is "an important avenue" to pursue, there could be a "long process of many years" before SIV research could be applied to humans "on a large enough scale for it to be another useful tool in HIV treatments" (BBC News, 12/10).
Online An abstract of the study is available online.
Saturday, December 06, 2008
Microchips for Poz People?
Indonesia's National AIDS Commission last week said a provision that would require some people living with HIV/AIDS to be implanted with microchips in the province of Papua is unworkable and a violation of human rights, Reuters India reports. "We reject this bylaw because it is against human rights and technically cannot be done," Nafsiah Mboi, secretary of the commission, said, adding, "How can someone know if a person is having sex or jumping and dancing?" (Reuters India, 11/27).
The provision would require "sexually aggressive" people living with HIV/AIDS to be implanted with microchips. According to John Manangsang, a lawmaker who supports the bill, authorities would be able to identify, track and punish people living with HIV/AIDS in the country's province of Papua who intentionally spread the virus with a $5,000 fine or up to six months in jail. Manangsang said, "Aggressive means actively seeking sexual intercourse." Under the provision, a committee would be created to establish which HIV-positive people should be implanted with microchips and to monitor their behavior. The technical and practical details of the bill are still being decided by lawmakers. The provincial parliament of Papua has given its full support to the measure, which will be enacted next month if it receives the expected majority vote (Kaiser Daily HIV/AIDS Report, 11/25). Manangsang on Thursday said that the bylaw initially would only establish a Papua HIV/AIDS center to determine whether the microchip idea is feasible. Mboi said that the central government cannot stop the bylaw but that it is attempting to negotiate with lawmakers to drop articles that violate human rights. She added that said Papua's governor could refuse to sign the bylaw (Reuters India, 11/27).
In related news, the Indonesian Network of People Living with HIV/AIDS in Papua recently said that it will consider accepting the provision if lawmakers supporting it agree to undergo HIV tests and be similarly implanted with microchips if they are found to be HIV-positive. "If it is the best solution for Papua, we will accept it on one condition," Enita Rouw, a representative for the network, said, adding, "We will agree to be implanted with the chips once all of the council members agree to undergo HIV/AIDS tests as demanded by the bylaw." Rouw added that all authorities in Papua should be tested for HIV and that the results should be published to ensure that any human rights violations associated with the provision are dealt out equally (Flassy/Suherdjoko, Jakarta Post, 11/28).
Online AFP/Google.com on Saturday examined the spread of HIV/AIDS in Papua.
The provision would require "sexually aggressive" people living with HIV/AIDS to be implanted with microchips. According to John Manangsang, a lawmaker who supports the bill, authorities would be able to identify, track and punish people living with HIV/AIDS in the country's province of Papua who intentionally spread the virus with a $5,000 fine or up to six months in jail. Manangsang said, "Aggressive means actively seeking sexual intercourse." Under the provision, a committee would be created to establish which HIV-positive people should be implanted with microchips and to monitor their behavior. The technical and practical details of the bill are still being decided by lawmakers. The provincial parliament of Papua has given its full support to the measure, which will be enacted next month if it receives the expected majority vote (Kaiser Daily HIV/AIDS Report, 11/25). Manangsang on Thursday said that the bylaw initially would only establish a Papua HIV/AIDS center to determine whether the microchip idea is feasible. Mboi said that the central government cannot stop the bylaw but that it is attempting to negotiate with lawmakers to drop articles that violate human rights. She added that said Papua's governor could refuse to sign the bylaw (Reuters India, 11/27).
In related news, the Indonesian Network of People Living with HIV/AIDS in Papua recently said that it will consider accepting the provision if lawmakers supporting it agree to undergo HIV tests and be similarly implanted with microchips if they are found to be HIV-positive. "If it is the best solution for Papua, we will accept it on one condition," Enita Rouw, a representative for the network, said, adding, "We will agree to be implanted with the chips once all of the council members agree to undergo HIV/AIDS tests as demanded by the bylaw." Rouw added that all authorities in Papua should be tested for HIV and that the results should be published to ensure that any human rights violations associated with the provision are dealt out equally (Flassy/Suherdjoko, Jakarta Post, 11/28).
Online AFP/Google.com on Saturday examined the spread of HIV/AIDS in Papua.
Poor Grades for Developed Nations
Although wealthy countries might be better equipped to provide antiretroviral treatment to HIV-positive people than some developing nations, wealthy nations often are less effective at collecting the data necessary to understand and curb HIV/AIDS, according to a study released last week by AIDS Accountability International, the Financial Times reports. In this first attempt to assess countries' compliance with commitments they made at the United Nations in 2001 and 2006 to ramp up their response to HIV/AIDS, the score card highlights that many high-income nations -- including most European countries and the U.S. -- are "worse at monitoring and/or reporting on the fundamentals of their epidemics and their responses" than their low-income counterparts. In addition, AAI found that although developed countries insisted on monitoring and reporting when they provided funding for antiretroviral treatment in the developing world, they failed to meet the same standards at home (Jack, Financial Times, 11/25).
The U.S., along with countries such as North Korea and Saudi Arabia, received an "E" on the score card, which is one step above the lowest grade possible, Bloomberg reports. AAI said the main reason for the score was the lack of information provided to UNAIDS. According to Bloomberg, the absence of data from the U.S. and other developed countries -- including Denmark, Ireland and Italy -- makes it difficult to determine which governments are having success against the disease and why others are not. Per Strand, AAI's scientific director, said, "Reporting may be poor for a number of reasons, and there may be, if I may say, a certain amount of arrogance from rich countries." Strand added, "It is clear that in some cases the reporting does not reflect the response." Officials from HHS did not immediately return calls for comment, Bloomberg reports.
According to Bloomberg, countries including Mexico and Tajikistan received "A" grades from AAI, indicating they reported on measures such as financial resources allocated to HIV prevention and treatment; engagement of nongovernmental organizations; human rights protections for people affected by HIV/AIDS; and coordination of efforts (Lauerman, Bloomberg, 11/25).
According to the Times, AAI said that the current data made available are inadequate to assess international progress, and it called for auditing to ensure that data provided by national governments on their HIV/AIDS policies are independently validated. AAI also said that the existing 25 indicators recommended by the United Nations are "necessary but insufficient" because they fail to monitor issues such as the quality of implementation of policy. This creates "major obstacles to holding governments accountable," according to the report (Financial Times, 11/25).
The U.S., along with countries such as North Korea and Saudi Arabia, received an "E" on the score card, which is one step above the lowest grade possible, Bloomberg reports. AAI said the main reason for the score was the lack of information provided to UNAIDS. According to Bloomberg, the absence of data from the U.S. and other developed countries -- including Denmark, Ireland and Italy -- makes it difficult to determine which governments are having success against the disease and why others are not. Per Strand, AAI's scientific director, said, "Reporting may be poor for a number of reasons, and there may be, if I may say, a certain amount of arrogance from rich countries." Strand added, "It is clear that in some cases the reporting does not reflect the response." Officials from HHS did not immediately return calls for comment, Bloomberg reports.
According to Bloomberg, countries including Mexico and Tajikistan received "A" grades from AAI, indicating they reported on measures such as financial resources allocated to HIV prevention and treatment; engagement of nongovernmental organizations; human rights protections for people affected by HIV/AIDS; and coordination of efforts (Lauerman, Bloomberg, 11/25).
According to the Times, AAI said that the current data made available are inadequate to assess international progress, and it called for auditing to ensure that data provided by national governments on their HIV/AIDS policies are independently validated. AAI also said that the existing 25 indicators recommended by the United Nations are "necessary but insufficient" because they fail to monitor issues such as the quality of implementation of policy. This creates "major obstacles to holding governments accountable," according to the report (Financial Times, 11/25).
AIDS Cases in Asia Could Reach 10 Million by 2010
The number of HIV/AIDS cases in Asia could reach 10 million by 2010 -- more than double current estimates -- unless countries take increased action to curb the spread of the disease, health officials said on Friday at the launch of an online database on HIV/AIDS in the Asia-Pacific region, AFP/Google.com reports. The database -- available at aidsdatahub.org -- includes information on HIV/AIDS prevalence, risky behaviors and government responses in various Asian countries and regions within certain countries (AFP/Google.com, 11/28). It was launched by officials from UNICEF, UNAIDS, the World Health Organization and the Asian Development Bank in Manila, the Philippines (Xinhuanet, 11/28).
According to the officials, there could be 500,000 new HIV/AIDS cases annually unless countries take increased action against the disease. In addition, Amala Reddy of UNAIDS said that about 50 million women in the region are at risk of the disease because of the behaviors of their husbands and partners. Reddy added that HIV/AIDS prevalence in Asia likely would reach 3% to 5% at most and is still concentrated among groups such as commercial sex workers, injection drug users and men who have sex with men. In addition, an estimated 75 million men in the region frequent sex workers, who number about 10 million, Reddy said, adding that there are 20 million IDUs and MSM in Asia. ABD Special Advisor Ian Anderson said that HIV/AIDS could have a serious effect on the region because many people living with the disease are in their economically productive years. "Because it is relatively small, this is the time to keep it small," he said, adding, "So we won't have to put the genie back in the bottle later."
In some Asian countries, such men may continue to have sex with their wives and other women, Reddy added (AFP/Google.com, 11/28). WHO Regional Advisor on HIV/AIDS Massimo Ghidinelli said WHO cannot determine a "fully accurate picture" on how MSM are contributing to the spread of HIV/AIDS because of the sensitivity of the issue and government neglect. "It is a new phenomenon, and we have insufficient understandings and studies," Ghidinelli said, adding, "The problem may be much greater than what we have believed." Reddy said that there should be "aggressive promotion of condom usage" to address the issue. She added, "We know the ways. It is only that political leaders have to have the political will to do the right things" (Xinhuanet, 11/28).
According to the officials, there could be 500,000 new HIV/AIDS cases annually unless countries take increased action against the disease. In addition, Amala Reddy of UNAIDS said that about 50 million women in the region are at risk of the disease because of the behaviors of their husbands and partners. Reddy added that HIV/AIDS prevalence in Asia likely would reach 3% to 5% at most and is still concentrated among groups such as commercial sex workers, injection drug users and men who have sex with men. In addition, an estimated 75 million men in the region frequent sex workers, who number about 10 million, Reddy said, adding that there are 20 million IDUs and MSM in Asia. ABD Special Advisor Ian Anderson said that HIV/AIDS could have a serious effect on the region because many people living with the disease are in their economically productive years. "Because it is relatively small, this is the time to keep it small," he said, adding, "So we won't have to put the genie back in the bottle later."
In some Asian countries, such men may continue to have sex with their wives and other women, Reddy added (AFP/Google.com, 11/28). WHO Regional Advisor on HIV/AIDS Massimo Ghidinelli said WHO cannot determine a "fully accurate picture" on how MSM are contributing to the spread of HIV/AIDS because of the sensitivity of the issue and government neglect. "It is a new phenomenon, and we have insufficient understandings and studies," Ghidinelli said, adding, "The problem may be much greater than what we have believed." Reddy said that there should be "aggressive promotion of condom usage" to address the issue. She added, "We know the ways. It is only that political leaders have to have the political will to do the right things" (Xinhuanet, 11/28).
MSM and Infection Rates in Massachusets
Men who have sex with men are the most affected by HIV/AIDS in Massachusetts, according to a report released by the state Department of Public Health ahead of World AIDS Day, the AP/Worcester Telegram reports. According to the report, although Massachusetts has seen success in curbing the spread of HIV/AIDS among injection drug users and heterosexual men and women, it has had less success among MSM. "The message of prevention is missing too many men in Massachusetts," Kevin Cranston, director of the health department's HIV/AIDS Bureau, said.
The report found that more than half of HIV cases between 2004 and 2006 occurred among MSM. Four to nine percent of men in Massachusetts report having sex with other men in annual surveys, according to the AP/Telegram. It also found that 56% of MSM who participated in a 2005-2006 health survey reported regular condom use -- an increase compared with 36% in 2000.
In addition, the report said that 17,295 people in Massachusetts were living with HIV/AIDS as of May 2008, and male-to-male sexual contact is the primary mode of HIV transmission in the state. The proportion of MSM living with HIV/AIDS was 25 times greater than men who reported sex with only female partners, according to the report. Sixty-eight percent of white men reported exposure to HIV through same-sex contact, compared with 25% of black men and 25% of Hispanic men.
To improve the fight against HIV/AIDS in the state, the health department plans to merge its HIV/AIDS Bureau with its Communicable Disease Control Bureau. In addition, the report recommends that Massachusetts increase its efforts to promote condom use, including "widespread free condom availability" to MSM, including high-school students. "Condoms save lives, so it is a good sign that we are seeing an increase in condom use," health department Commissioner John Auerbach said, adding, "However, it is clear given the data in this report that more needs to be done with respect to reaching men who have sex with men with important HIV prevention messages."
The report also calls for increased access to rapid HIV tests and routine screening in hospital emergency departments, community health centers and private practices. It also recommends increasing HIV/AIDS prevention resources directed at MSM; expanding HIV testing efforts that target MSM; making prevention messages available at public, private and commercial venues, including the Internet; and preserving the availability of treatment (LeBlanc, AP/Worcester Telegram, 11/30).
The report found that more than half of HIV cases between 2004 and 2006 occurred among MSM. Four to nine percent of men in Massachusetts report having sex with other men in annual surveys, according to the AP/Telegram. It also found that 56% of MSM who participated in a 2005-2006 health survey reported regular condom use -- an increase compared with 36% in 2000.
In addition, the report said that 17,295 people in Massachusetts were living with HIV/AIDS as of May 2008, and male-to-male sexual contact is the primary mode of HIV transmission in the state. The proportion of MSM living with HIV/AIDS was 25 times greater than men who reported sex with only female partners, according to the report. Sixty-eight percent of white men reported exposure to HIV through same-sex contact, compared with 25% of black men and 25% of Hispanic men.
To improve the fight against HIV/AIDS in the state, the health department plans to merge its HIV/AIDS Bureau with its Communicable Disease Control Bureau. In addition, the report recommends that Massachusetts increase its efforts to promote condom use, including "widespread free condom availability" to MSM, including high-school students. "Condoms save lives, so it is a good sign that we are seeing an increase in condom use," health department Commissioner John Auerbach said, adding, "However, it is clear given the data in this report that more needs to be done with respect to reaching men who have sex with men with important HIV prevention messages."
The report also calls for increased access to rapid HIV tests and routine screening in hospital emergency departments, community health centers and private practices. It also recommends increasing HIV/AIDS prevention resources directed at MSM; expanding HIV testing efforts that target MSM; making prevention messages available at public, private and commercial venues, including the Internet; and preserving the availability of treatment (LeBlanc, AP/Worcester Telegram, 11/30).
AIDS Advocate Evicted from Home
An HIV-positive Chinese advocate on Tuesday was forced back to her home in central Henan province after participating in ceremonies in Beijing marking World AIDS Day, Reuters India reports. Li Xige, who had previously been under house arrest for more than two years because of her search for compensation and judicial action, contracted HIV from a blood transfusion in 1995 and transmitted it to her daughters, one of whom died from AIDS-related illnesses. Henan province was the center of numerous HIV/AIDS cases in the 1990s, when unhygienic blood-buying schemes and a lack of testing allowed the virus to spread to recipients of blood transfusions. The Henan government often has sought to block media coverage of the issue to avoid embarrassment from discontentment of people there living with HIV/AIDS, Reuters India reports (Hornby, Reuters India, 12/3).
In addition, "[a]fter years of denying that AIDS was a problem, Chinese leaders have shifted gears in recent years, confronting the disease more openly and promising anonymous testing, free treatment for the poor and a ban on discrimination against people with the virus," the AP/Google.com reports. However, advocates "walk a thin line in their work and are often detained, threatened or even attacked" (Sanderson, AP/Google.com, 12/3).
According to Reuters India, Li was escorted to her home Tuesday and warned to stop speaking out or she would be imprisoned. Li said she was being prevented from leaving her home by five officials (Reuters India, 12/3). She had escaped her home about 10 days ago and went to Beijing to also give a statement to the Supreme Court after a local court refused to hear her case demanding compensation from a local hospital where she contracted HIV; the Supreme Court turned her away, the AP/Google.com reports (AP/Google.com, 12/3). Li said she wants the Chinese government "to take responsibility for not having told me so many years that I had [HIV] ... I've been from government offices to court to government offices again, bounced about like a ball" (Reuters India, 12/3). Wan Yanhai, founder of a not-for-profit organization working on HIV/AIDS education and awareness, said that Li's case exposes how attitudes toward the disease in China need to change. "Every year on the AIDS Day we see leaders visiting AIDS patients. But we also see people who contracted AIDS and asked for compensation taken away by police" (AP/Google.com, 12/3).
In addition, "[a]fter years of denying that AIDS was a problem, Chinese leaders have shifted gears in recent years, confronting the disease more openly and promising anonymous testing, free treatment for the poor and a ban on discrimination against people with the virus," the AP/Google.com reports. However, advocates "walk a thin line in their work and are often detained, threatened or even attacked" (Sanderson, AP/Google.com, 12/3).
According to Reuters India, Li was escorted to her home Tuesday and warned to stop speaking out or she would be imprisoned. Li said she was being prevented from leaving her home by five officials (Reuters India, 12/3). She had escaped her home about 10 days ago and went to Beijing to also give a statement to the Supreme Court after a local court refused to hear her case demanding compensation from a local hospital where she contracted HIV; the Supreme Court turned her away, the AP/Google.com reports (AP/Google.com, 12/3). Li said she wants the Chinese government "to take responsibility for not having told me so many years that I had [HIV] ... I've been from government offices to court to government offices again, bounced about like a ball" (Reuters India, 12/3). Wan Yanhai, founder of a not-for-profit organization working on HIV/AIDS education and awareness, said that Li's case exposes how attitudes toward the disease in China need to change. "Every year on the AIDS Day we see leaders visiting AIDS patients. But we also see people who contracted AIDS and asked for compensation taken away by police" (AP/Google.com, 12/3).
Tuesday, December 02, 2008
Generics Really Do Measure up to Brand Name Drugs
Brand-name drugs for treating cardiovascular disease don't appear to be clinically superior to generic versions, say U.S. researchers who reviewed studies comparing the drugs.
Some doctors and patients have expressed concerns that the drugs may not be equivalent in their effects, although generic drugs are chemically equivalent in terms of active ingredients, the study's authors said.
In Wednesday's issue of the Journal of the American Medical Association, Dr. Aaron Kesselheim of Brigham and Women's Hospital and Harvard Medical School in Boston and his colleagues combined the results of 30 studies done since 1984 that compared nine subclasses of cardiovascular medications, 81 per cent of which were randomized controlled trials.
"The studies in our sample concluded that generic and brand-name cardiovascular drugs are similar in nearly all clinical outcomes," the researchers concluded.
Brand-name prescription drugs are sold at high prices after approval by the U.S. Food and Drug Administration and while under patent protection, the study's authors said. Brand-name cardiovascular drugs may cost as much as a few dollars per pill while generics may be as little as a few cents a pill, Kesselheim added.
"If a patient is prescribed a generic drug because that's what's appropriate for their condition, then they should feel confident taking that drug. And physicians themselves should also feel confident prescribing generic drugs where appropriate," Kesselheim said in a telephone interview.
The review of randomized clinical trials found clinical equivalence in:
* 7 of 7 trials for beta-blockers.
* 10 of 11 trials of diuretics.
* 5 of 7 trials for calcium-channel blockers.
* 3 of 3 trials for antiplatelet agents.
* 2 of 2 trials of statins.
* A single trial for angiotensin-converting enzyme or ACE inhibitors.
* A single trial for alpha-blockers.
Cost questions
Of 43 editorials and commentaries reviewed, 23 or 53 per cent expressed a negative view of the interchangeability of generic drugs compared with 12 (28 per cent) that encouraged substitution of generic drugs, with the remaining eight not reaching a conclusion, Kesselheim and his colleagues said.
As for why, commentaries may be more likely to highlight doctors' concerns based on anecdotal experience, and the conclusion of the editorial writers could be skewed by financial relationships, the team said in noting that nearly half of the editorials and commentaries did not identify sources of funding.
Generic medications account for 65 per cent of all prescriptions dispensed in the U.S. and less than 21 per cent of money spent on prescriptions, according to IMS Health, a company that tracks prescription drug sales.
"The contention that brand-name medicines drive up the cost of health care is fatally flawed," Ken Johnson, senior vice-president of the Pharmaceutical Research and Manufacturers of America, or PhRMA, which represents brand-name drug makers, said in a statement released in response to the study.
"Without today's innovative brand-name drugs to legally copy, there would be no generic drug industry," he said.
The study's authors reported no financial disclosures.
With files from Reuters
Some doctors and patients have expressed concerns that the drugs may not be equivalent in their effects, although generic drugs are chemically equivalent in terms of active ingredients, the study's authors said.
In Wednesday's issue of the Journal of the American Medical Association, Dr. Aaron Kesselheim of Brigham and Women's Hospital and Harvard Medical School in Boston and his colleagues combined the results of 30 studies done since 1984 that compared nine subclasses of cardiovascular medications, 81 per cent of which were randomized controlled trials.
"The studies in our sample concluded that generic and brand-name cardiovascular drugs are similar in nearly all clinical outcomes," the researchers concluded.
Brand-name prescription drugs are sold at high prices after approval by the U.S. Food and Drug Administration and while under patent protection, the study's authors said. Brand-name cardiovascular drugs may cost as much as a few dollars per pill while generics may be as little as a few cents a pill, Kesselheim added.
"If a patient is prescribed a generic drug because that's what's appropriate for their condition, then they should feel confident taking that drug. And physicians themselves should also feel confident prescribing generic drugs where appropriate," Kesselheim said in a telephone interview.
The review of randomized clinical trials found clinical equivalence in:
* 7 of 7 trials for beta-blockers.
* 10 of 11 trials of diuretics.
* 5 of 7 trials for calcium-channel blockers.
* 3 of 3 trials for antiplatelet agents.
* 2 of 2 trials of statins.
* A single trial for angiotensin-converting enzyme or ACE inhibitors.
* A single trial for alpha-blockers.
Cost questions
Of 43 editorials and commentaries reviewed, 23 or 53 per cent expressed a negative view of the interchangeability of generic drugs compared with 12 (28 per cent) that encouraged substitution of generic drugs, with the remaining eight not reaching a conclusion, Kesselheim and his colleagues said.
As for why, commentaries may be more likely to highlight doctors' concerns based on anecdotal experience, and the conclusion of the editorial writers could be skewed by financial relationships, the team said in noting that nearly half of the editorials and commentaries did not identify sources of funding.
Generic medications account for 65 per cent of all prescriptions dispensed in the U.S. and less than 21 per cent of money spent on prescriptions, according to IMS Health, a company that tracks prescription drug sales.
"The contention that brand-name medicines drive up the cost of health care is fatally flawed," Ken Johnson, senior vice-president of the Pharmaceutical Research and Manufacturers of America, or PhRMA, which represents brand-name drug makers, said in a statement released in response to the study.
"Without today's innovative brand-name drugs to legally copy, there would be no generic drug industry," he said.
The study's authors reported no financial disclosures.
With files from Reuters
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