God, AIDS, Africa & HOPE

Reflections / Gedanken

12.08.2010 Reflection

Today reflection of a different sort: I am presenting to my Rotary Club of Signal Hill a Powerpoint presentation highlighting the history and success of HOPE Cape Town. In 2001, Signal Hill was part of the launch and I remember well the ladies of the Rotary Club preparing the sandwiches and cool drinks after the official act.
For those present in those days in 2001 it was good to hear how the project developed and what has been achieved in the last years. Even if Rotary is sometimes very complicated in their way of donating and supporting in form of a matching grant there is no doubt that a lot of good comes out of the spirit of Rotary and all the activities of thousands of clubs around the world. I am glad to be part of such a great movement.

Also good news from Trier today. The book of Dr. Nebe of the University of Trier about Africa is in the final stages. I was glad to be able to contribute one chapter on HIV and AIDS in Africa. I personally like such contributions as they challenge me also to work in an academic way again.

Otherwise the day was a day of preparation for my next trip to Germany. The Lutheran Community in  Hamburg Blankenese and St. Gerold in the “Walzertal” in Austria will be two locations, where I will be able to talk about the work, HOPE Cape Town is doing. I am looking forward to meet people interested in our work and to exchange ideas and gain new ones as I always do when I engage with people through question and answers after such talks.

I am specially thrilled to participate – even only shortly- at the “Bundespositivenkonferenz 2010” in Bielefeld, the federal conference of people living with HIV in Germany and to contribute to a podiums discussions on the way, HIV is seen in the media and in the public eye.

Filed under: HOPE Cape Town Association & Trust, , , , , , , , ,

POZ Magazine: Global Fund Seeks Contributions From China, India

China, India and other countries with fast-growing economies should begin contributing to the Global Fund to Fight AIDS, Tuberculosis and Malaria, said the head of organization, Agence France Presse (AFP) reports. The Global Fund is gearing up to collect $20 billion from 2011 to 2013 and is fighting a cutback on donations from western countries. To fill the gaps in financing, the Global Fund is asking for innovative financing, but also for help from emerging economies.

Source: http://www.poz.com/rssredir/articles/Global_Fund_Funding_1_18880.shtml

Filed under: HIV and AIDS, HIV Prevention, HIV Treatment, Politics and Society, , , , ,

POZ Magazine: Using Faith-Based Groups to Fight HIV/AIDS in Africa

Source: http://www.poz.com/rssredir/articles/FBO_Fights_AIDS_1_18881.shtml

Since faith-based organizations (FBOs) provide an estimated 30 percent to 70 percent of health care in Africa, they should be used to help fight HIV/AIDS, according to a study of nongovernmental organizations reported by PlusNews. FBOs have established relationships and trust in their communities, according to the report, and they can quickly respond to situations, send messages and identify those most in need. Study authors recommend FBOs be used to address stigma, cultural practices (such as not taking meds to let God heal disease) and the distribution of services.

Filed under: HIV and AIDS, Networking, Society and living environment, , , , ,

POZ Magazine: Late HIV Diagnosis Is Substantially Higher in People Over 50

Source: http://www.poz.com/rssredir/articles/hiv_age_older_761_18888.shtml

People age 50 and older are nearly 2.5 times more likely to be diagnosed late with HIV than younger adults, according to a study published in the August 24 issue of AIDS. What’s more, older people who are diagnosed late are 14 times more likely to die prematurely than people who are diagnosed promptly after infection.
Researchers are increasingly concerned about the HIV epidemic in older adults. For one thing, people are living much longer—and into old age—than in the early years of the epidemic. The Centers for Disease Control and Prevention estimates that by 2015 more than half of all adults living with HIV in the United States will be older than 50. Older adults are also becoming infected and getting diagnosed with HIV at increased rates.

A study published in the July 1 issue of the Journal of Acquired Immune Deficiency Syndromes indicated that older adults respond well to antiretroviral treatment, though CD4 responses to therapy were blunted in seniors diagnosed after the age of 50—likely because they were not tested earlier and entered care only after their CD4s were abnormally low.
Additional research has been needed to verify these observations, as most resources for testing and access to care are currently targeted toward younger adults.
To determine trends in HIV infection, diagnosis and mortality in older adults, Ruth Smith, a senior scientist at the Health Protection Agency Centre for Infections in London, and her colleagues conducted an analysis of epidemiological data on all adults 15 and older who were newly diagnosed or were accessing HIV-related care between 2000 and 2007 in England, Wales and Northern Ireland.

Adults 50 and older increased from 8.3 percent in 2000 to 9.7 percent in 2007, and the absolute number of older adults diagnosed with HIV more than doubled during the period from 2000 to 2007.
Smith and her colleagues found that late diagnosis was a serious problem overall, but particularly so for older people. While 48 percent of older adults had a CD4 count less than 200 at the time of diagnosis, this was true of only 33 percent of younger adults. Among men who have sex with men, the number of older men who were diagnosed late was nearly twice that of younger men: 40 percent compared with 21 percent. Older heterosexual women were about 50 percent more likely to present late as well.
Age also played a significant role in early mortality—older adults with a late HIV diagnosis were 2.4 times as likely to die within a year of diagnoses as younger adults. Smith’s team did not have sufficient data to ascertain the reasons for the increased risk in older adults. In addition, there was a decline between 2000 and 2007 in short-term mortality among younger adults diagnosed late with HIV disease, but no decline among older adults.

Another statistic makes painfully clear the need for greater early testing efforts in people older than 50. Older adults who were diagnosed with a CD4 cell count less than 200 were 14 times more likely to die within a year of diagnosis than those diagnosed promptly (14.4 percent versus 1 percent). While this study was conducted in Great Britain, similar data have been noted in the United States.
“These findings highlight the need for increased targeted prevention efforts and HIV testing strategies among older adults to ensure earlier testing and treatment and reduce transmission of HIV,” the authors concluded. “Adults aged 50 years and over account for a significant number of persons living with HIV in developed countries, and it is important that global and national surveillance outputs include older age groups.”

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

POZ Magazine: Global Survey: Stigma, Isolation and Discrimination Still Pervasive

Source:  http://www.poz.com/rssredir/articles/hiv_stigma_discrimination_761_18850.shtml

HIV-associated stigma, isolation and discrimination remain pervasive problems in the United States and other parts of the world and continue to have profound effects on people’s willingness to disclose their serostatus to key individuals in their lives. This is the finding of a global survey of 2,035 people living with HIV conducted by the International Association for Physicians in AIDS Care (IAPAC) on Thursday, July 22, at the XVIII International AIDS Conference in Vienna.
Suniti Solomon, MD, director of the YR Gaitonde Center for AIDS Research and Education in Chennai, India, presented the survey results on behalf of IAPAC. The survey found that stigma, isolation and discrimination are first among unique obstacles facing people living with HIV around the world. There is no shortage of research indicating that they affect HIV prevention and testing efforts, along with initiatives to link and retain people diagnosed with HIV in care and on treatment.
“An environment of tolerance in which an individual can take an HIV test and live with an HIV diagnosis is of paramount importance to effective HIV prevention and treatment programs at local and national levels,” Solomon said. “Health care providers bear the responsibility of ensuring compassionate and nonjudgmental care of patients.

“Society—or all of us—have a responsibility to break down the barriers of stigma, isolation and discrimination that persist almost 30 years into the global HIV pandemic,” she added.

Indeed, the IAPAC survey results illustrate that HIV-associated stigma, isolation and discrimination remain pervasive issues all over the world.

The AIDS Treatment for Life International Survey (ATLIS 2010) was conducted in the same manner as a similar survey reported in 2008 at the XVII International AIDS Conference in Mexico City, which found that people living with HIV around the globe still live in fear of the societal stigma that surrounds the disease, and that some are so concerned about side effects of medication that they have chosen to stop their antiretroviral (ARV) drug regimens. The ATLIS 2010 data reported in Vienna were based on Internet, telephone and face-to-face interviews conducted with 2,035 HIV-positive adult men and women residing in five global regions: 201 people residing in North America, 201 in Latin America, 1,133 in Europe, 200 in Asia and the Pacific and 300 in Africa. A second set of results from the survey, evaluating patient-physician communication, was also reported in Vienna.  The survey was conducted with support from Merck. According to ATLIS 2010, Solomon reported, the emotional toll of HIV/AIDS is still considerable. More than one third of respondents (37 percent) reported strong feelings of isolation, with the highest prevalence rates in North America and Asia-Pacific. Depression was also prevalent.

Societal and cultural stigmas also continue to affect people living with HIV around the world. According to Solomon, 38 percent of respondents felt as if others were judging them. What’s more, nearly half of respondents had encountered someone who was afraid to have casual contact with them—25 percent reported that someone would not share food or drink with them, and 24 percent reported that someone would not kiss them, simply because they are living with HIV. Forty-two percent of ATLIS 2010 participants also reported “strong concerns” about others learning their HIV status. Seventy-nine percent, for example, cited social discrimination as a reason for their reluctance to disclose. Other drivers included the impact on establishing future relationships (46 percent), impact on current relationships (42 percent), reputation (42 percent), risk of losing job (36 percent) and risk of losing family or friends (35 percent). Though 96 percent of respondents reported having disclosed their HIV status to at least one person, Solomon’s team made some sobering discoveries. For example, 17 percent of respondents in long-term relationships had not disclosed their HIV status to their spouse or partner. In addition, 16 percent of Asia-Pacific respondents and 8 percent of Latin-American respondents had never told anyone about their HIV status. Understandably, many respondents stressed the need for more public education around stigmas. The three most common stigmas in need of combating, Solomon reported, are: a person with HIV has or does engage in risky behavior, people with HIV or AIDS should be avoided, and HIV is easily transmitted through normal everyday activities. “Despite great strides, 29 years into the HIV pandemic, HIV-associated stigma, isolation and discrimination persist,” Solomon said in her concluding remarks. “Addressing these challenges can benefit individual, community and public health.”

by Tim Horn

Filed under: HIV and AIDS, Reflection, Society and living environment, , , , , ,

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