God, AIDS, Africa & HOPE

Reflections / Gedanken

06/18/2010 • 2:27 pm 1

HIV @ the work place – 17.06.2010

Talk at the economic forum “Bavaria meets Western Cape” in Cape Town – outline of the talk  – as usual “check against delivery”

HIV/AIDS in the workplace – I am sure when you saw the topic some of you were considering a second coffee break – what new can come from this topic – even presented by a priest who has no dealing with business affairs.. And you are right… I do not have any hard core dealings… and when I present this, I have in mind on one surely your business interest – a dying worker is not a very productive worker… – and even with all our turn around in the month before the world cup – thousands are dying still every week as a result of HIV and AIDS – round about 800 per day to be more precise – and on the other hand – you should be aware and taking on the duty to realise, that you offer your employers much more than just a money earning scheme – you offer them meaning in life. Without getting to philosophical – with your workplace you offer your employers also meaning and purpose in life and you owe them a deeper understanding and commitment than only the salary sleep at the end of the week or month.

So let’s see this 20 minutes rather as a time of reflection – which fits a priest much more I guess…

Not only since the World Economic Forums in Switzerland we know and you are aware, that HIV/AIDS is impacting on economic benefits and social progress around the world. The CIA calls it in one of their reports one of the major threats to stability on our planet – and when you want to do business – there must be stability and people who produce and people who buy… That is the easy circle to have revenue and success with your business. Besides all costs for an individual company, HIV is known to delay human resource development, it undermines certainly the skills base and for South Africa it means that investors have to look twice before investing in a country with almost 6 million infected people.

Companies are obviously also direct affected ranging from lower productivity, greater absenteeism till less reliable supply chains and distribution channels – another consideration is surely the question of medical coverage, funeral covers and pension funds. I guess that most small and medium companies never made the effort to calculate the costs of this pandemic for there business – the bigger companies are running since years programs to tackle the pandemic – Daimler Chrysler, BMW, Volkswagen, De Beers, Anglo American and many more. They – and as big companies they are able – to use the direct access to the most affected, the productive members of our society, to tackle the pandemic by education, training and treatment. And in doing so they also prevent more erosion of our society – breadwinner of the family, who die away means that others in the family have to stand in, abandoning as youngsters for example their school education to provide an income which creates a circle of non education – difficult to employ – unemployed with all the consequences of alcohol abuse, drugs, prostitution etc. If you meet a 14 year old responsible for a family then you know what I mean…

You might realise by now – looking at and confronting HIV means not only a direct benefit for the company but also to the society, your company is working in. Healthy worker in a stable and healthy family environment and they again in a stable social environment are the basics for good business.. So what can you do as a small, medium and big company?

Be aware of the pandemic – don’t be ignorant – that’s the first rule – and if I say ignorant I mean not only that you acknowledge that HIV / AIDS is also around you – but that also this is not a black pandemic, but a south African one, a rainbow one.. The virus is an ideal South African – he does not discriminate against race or gender or profession or education or sexual preferences… Be focused like you are focused on other aspects of your business: If you are a big company – consider a proper HIV / AIDS programme, if you have not done yet. Do it yourself or get in touch with those doing it already – gain from their expertise in setting up mechanism within your company to deal with prevention, treatment, care and support.

60-80% of mining, manufacturing, financial services and transport companies have implemented HIV and AIDS awareness programmes, the most hard hit companies have full fledged  workplace HIV programmes that now even develop in so called wellness programs and they stretch further than just the employee covering also his/her family. As a smaller firm, you cannot do it – it is financially not feasible. But you can connect with your nearest clinic and make sure that your employees are knowledgeable about HIV and AIDS and that they are aware of the services of the neighbouring clinic. VCT should be always on the agenda and a proper HIV/AIDS policy – every company is able to spell out to their employees how stigma and discrimination is not an option and that the moral codex of the company and the mission statements starts with the fellow colleagues and not only with the customer.

HOPE Cape Town, my organisation is more than willing to give advice or assist in setting up such a policy.

All in leading positions in a company should also lead in this field. Senior staff, GM, CEO’s, Board members should be able and without shyness to talk to their employees about HIV and AIDS. Even if you organise prevention workshops or there like, I am always amazed to see that the senior staff seems to know it all and that there is a definite “no show” from a certain level of the hierarchy onwards. Not sure that this is leading by example.. Or the senior staff knows it all – but why then invite an expert…? Or do you think that there is no transmission for CEO’s and managers? I can tell you something: HIV and AIDS is such a dynamic field that information you gathered last year might not be correct this year. To give you an example: Until recently the criteria for commencing treatment was a CD 4 count of 250 and lower – which meant that in most in instances the person had to become very sick before treatment was offered. That changed and now people receive much earlier treatment with the result

I guess that is enough for now, thanks for listening to this for South Africa very serious topic – and help that we can get to a new generation of South Africans without HIV or AIDS.

Information and figures are taken from various websites

Filed under: HIV and AIDS, HIV Treatment, HOPE Cape Town Association & Trust, Politics and Society, Reflection, Society and living environment, , , , , , , ,

06/13/2010 • 3:16 pm Comments Off on POZ magazine: Anal Warts Should Be Tested for Cancerous Cells

POZ magazine: Anal Warts Should Be Tested for Cancerous Cells

Anal warts in men who have sex with men (MSM) often contain cancerous and precancerous cells, an “unsettling” finding of a study reported in the July 1 issue of Clinical Infectious Diseases. The authors indicate that simply treating anal warts isn’t enough among MSM—they should be surgically removed and tested for high-grade cells that can potentially cause serious disease. Anal warts are typically caused by two non-cancerous strains of the same virus: human papillomavirus (HPV) types 6 and 11. Because of the perceived low risk of serious disease, many people with anal warts avoid treatment or opt for less invasive ablation procedures, such as cryotherapy (freezing the warts) or laser removal. The new findings, reported by Hans Schlecht, MD, of Drexel University College of Medicine in Philadelphia and his colleagues, suggest that surgical removal may be necessary in order to test for pre-cancerous and cancerous clusters within the warts. These high-grade patches of cells are often caused by two cancerous HPV strains, types 16 and 18. The study conducted by Schlecht’s group was designed to look for hidden, or “occult,” pre-cancerous or cancerous cells in anal warts surgically removed from 320 MSM. Fifty percent of the men enrolled in the study were living with HIV. About 34 percent of the men had anal warts containing pre-cancerous cells. In fact, 3 percent of the men were found to have anal cancer. The high-grade cells were more likely to be documented in the warts taken from the HIV-positive men—47 percent compared with 26 percent of the HIV-negative men in the study. What’s more, seven of the eight men in the study diagnosed with anal cancer were coinfected with HIV. Unfortunately, neither a high CD4 cell count nor an undetectable viral load appeared protective against pre-cancerous and cancerous lesions among the HIV-positive men in the study. CD4 cell counts averaged 431, and about 50 percent of the men had viral loads below the level of detection at the time the high-grade lesions were detected. “The present study demonstrates that, in a large urban population of MSM, condylomata [anal warts] requiring surgical excision frequently harbored occult high-grade anal intraepithelial neoplasia or anal squamous cell cancer,” the authors concluded. “These data emphasize the importance of obtaining tissue for histopathological examination in MSM presenting for treatment of anogenital condylomata. Prevention of recurrences and careful clinical follow-up of anal condylomata harboring high-grade anal intraepithelial neoplasia may be a method of anal cancer prevention in MSM, particularly in those with HIV infection.”

Source: http://www.poz.com/rssredir/articles/anal_warts_neoplasia_761_18534.shtml

Filed under: HIV and AIDS, HIV Treatment, Medical and Research, , , ,

06/12/2010 • 1:07 am Comments Off on POZ magazine: Fatigue Common in People With HIV, Often Linked to Psychological Factors

POZ magazine: Fatigue Common in People With HIV, Often Linked to Psychological Factors

Up to 88 percent of people with HIV experience fatigue, and psychological problems appear to be one of the most likely culprits, according to a study published online June 2 in AIDS. Fatigue has historically been a common problem among people living with HIV, with prevalence rates approaching 90 percent in some studies. Untreated fatigue can lead to unemployment and social isolation, and it can reduce people’s ability to effectively care for themselves. To examine fatigue in HIV disease in the modern treatment era, Eefje Jong, MD, of Slotervaart Hospital in Amsterdam, and her colleagues analyzed data from 42 studies published between January 1996 and August 2008. In addition to wanting to learn more about the prevalence of fatigue in more recent years, the researchers set out to understand the factors—including demographic, physiological, psychological and HIV-specific issues—associated with the condition. They also hoped to gain a better sense of the most effective treatment modalities for the condition. In previous studies, researchers have found that between 20 and 60 percent of people with chronic HIV infection, and up to 85 percent of people with an AIDS diagnosis, have suffered from fatigue at one time or another. In the studies reviewed for Jong and her colleagues’ analysis, fatigue prevalence rates ranged from 33 to 88 percent. The demographic factors most consistently predictive of fatigue were younger age and unemployment. The authors hypothesized that older people might report less fatigue because they had more effective coping strategies or more time to adjust to medication regimens. Studies that examined race, sex and income were not consistent, though lower income was associated with greater fatigue in at least one study. In terms of HIV-related issues, CD4 and viral load were not consistently linked with fatigue, though people with more HIV-related symptoms were more likely to have the condition. Studies on comorbid conditions—such as diabetes and hepatitis B or C—were mixed, with some studies finding a connection with fatigue and others showing no connection at all. Surprisingly, body weight and composition appeared to have no bearing on fatigue, nor did blood levels of proteins related to inflammation, such as interleukin-6 (IL-6) or tumor necrosis factor (TNF) alpha. Some studies showed that lower testosterone levels predicted fatigue, but others did not. Of all the factors considered, psychological disorders—particularly depression and anxiety—had the strongest and most consistent connection with fatigue. Sleep problems also predicted fatigue. Though the total hours a person slept didn’t have an impact, people who napped during the daytime were more likely to suffer with the problem. Finally, while a number of treatments for fatigue were explored in the studies, medication was not consistently helpful. Medications with the strongest evidence of fatigue treatment were testosterone and psychostimulants, including Adderall (dextroamphetamine) and Ritalin (methylphenidate hydrochloride). Non-medicinal interventions were more helpful, however, especially cognitive behavioral therapy. Graded exercise therapy (GET) is another possible option to fight fatigue. With GET, a person logs his or her daily activity and increases it to the point where the exercise begins to worsen symptoms. GET has been successful in HIV-negative people with chronic fatigue syndrome, but no good recent studies focused on HIV-positive people. Though exercise and fatigue studies have been conducted in people with HIV, the authors chose not to include any of them in their analysis, because none used a validated instrument for assessing fatigue either before or during the exercise intervention. “Currently the evidence for interventions with medication is not strong,” the authors said. “Behavioral interventions and GET seem more promising.” Because fatigue is so common, and so dramatically reduces a person’s quality of life, the authors urge care providers to assess their patients for the condition. The researchers state that “in case of fatigue, clinicians should not search only for physical mechanisms, but should question depression and anxiety in detail.” Finally, the authors are calling on researchers to develop an evidence-based approach to screening and treating fatigue in people with HIV.

Source: http://www.poz.com/rssredir/articles/hiv_fatigue_psychological_761_18540.shtml

Filed under: HIV and AIDS, HIV Treatment, Medical and Research, , , ,

05/04/2010 • 6:47 pm Comments Off on 04.05.2010 News on medical dagga

04.05.2010 News on medical dagga

The POZ magazine reports:
The Washington, DC, City Council approved a medical marijuana bill allowing doctors to prescribe marijuana to patients with chronic conditions such as HIV, glaucoma and cancer, The Washington Post reports. Under the bill, doctors would be able to prescribe patients up to 2 ounces of marijuana in a 30-day period. According to the article, patients’ prescriptions would be filled at city-sanctioned distribution centers, which receive their marijuana supply from private cultivation centers licensed by the city.  The bill, approved April 20, does include restrictions. Patients aren’t allowed to grow their own marijuana, and distribution and cultivation centers can’t be located within 300 feet of schools or preschools. The council is scheduled to vote a second time on the bill next month, after which it could take several months for the program to go into effect.
http://www.poz.com/articles/medical_marijuana_bill_1_18313.shtml

In my opinion a great decision.

Filed under: HIV and AIDS, HIV Treatment, Medical and Research, Politics and Society, , , , ,

04/15/2010 • 10:38 pm 1

POZ.com – Treatment News : New Therapy Shows Potential as an Anti-HIV Medication

New Therapy Shows Potential as an Anti-HIV Medication

A new antibody-based therapy prevents HIV from infecting CD4 cells and could become a potent antiviral treatment, according to an announcement by Peregrine Pharmaceuticals, which is developing the therapy. The new data are from a study published online ahead of print in The Journal of Experimental Medicine.

Peregrine’s experimental agent works by blocking phosphatidylserine (PS), a molecule normally found on the inside of cell membranes but can become exposed on the outside of the membranes of viruses and virally infected cells. Exposed PS, researchers believe, enables viruses such as HIV to evade immune recognition and dampens the body’s normal response to infection.

In previous experiments, researchers found that an anti-PS antibody called bavituximab had antiviral activity against a number of viruses as well as anti-cancer properties. That drug is in Phase I and II studies for HIV, hepatitis C virus (HCV) and several types of cancer.

In the most recent published experiment, Anthony Moody, MD, from Duke University in Durham, North Carolina, and his colleagues studied four antibodies targeted to PS. When the antibodies bound with PS on the surface of an immune cell called a monocyte, the researchers explained, the monocyte released chemical messengers called chemokines that blocked HIV from docking with CD4 cells.

“This publication is the latest in a series of presentations and publications that supports the potential of PS as a target in HIV infection and provides new insights into the unique mechanisms of action of our PS-targeting antibodies,” said Steven W. King, president and CEO of Peregrine. “While past studies have focused on the broad nature of the PS target, these new data reveal that some of these antibodies may also have highly specific effects.”

Moody and his colleagues found that the antibodies, in test tubes, blocked HIV infection of CD4 cells about 85 percent of the time. The specific area on the CD4 cell where the chemokines blocked entry was the CCR5 receptor—which is the target of the antiretroviral drugs Selzentry (maraviroc) and vicriviroc, and which is the receptor used by most strains of HIV to infect cells.

Moreover, Barton Haynes, MD, director of the Duke Human Vaccine Institute and senior author of the study, commented, “These results indicate that targeting a host cell lipid such as PS as an anti-viral strategy is a promising concept of relevance to new therapeutic and possibly prophylactic innovations for HIV.”

Source:

POZ – POZ Magazine – POZ.com – Treatment News : New Therapy Shows Potential as an Anti-HIV Medication.

Filed under: HIV and AIDS, HIV Treatment, Medical and Research, , ,

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