God, AIDS, Africa & HOPE

Reflections / Gedanken

21.10.2009 Need a doctor

Need a doctor? Call a nurse.

by Laura Whitehorn

Nurses rival doctors at keeping HIV-positive patients healthy. That’s what a South African study concluded after nearly two years of observation.

First, 812 people had an HIV combo prescribed by a doctor. Then they were divided into two groups. One group was regularly monitored and treated by doctors, the other by nurses. After 96 weeks, the groups were almost identical in viral load, CD4 counts and number of regimen switches, side effects and deaths—and how many clinic appointments they missed.

These results bode well for places with few doctors but many HIV-positive people. And if you were worried that you got inferior care because you saw the nurse instead of the MD at your last clinic visit, relax. The nurse is in.

read more:
POZ-159

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

21.10.2009 Take the survey if you are HIV positive

A survey about stigma and HIV and AIDS – help to assess the problem with your own experience:

THE TROUBLE WITH STIGMA

http://www.poz.com/phpESP/public/survey.php?name=POZ158_October_2009_Survey

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

21.10.2009 More than four million…

More than 4 million people in low and middle-income countries were receiving antiretroviral therapy (ART) at the close of 2008, representing a 36% increase in one year and a ten-fold increase over five years, according to a report released by the WHO, UNICEF and UNAIDS.

Towards universal access: scaling up priority HIV/AIDS interventions in the health sector highlights other gains, including expanded HIV testing and counselling and improved access to services to prevent HIV transmission from mother to child.

“This report shows tremendous progress in the global HIV/AIDS response,” said WHO Director-General Margaret Chan. “But we need to do more. At least 5 million people living with HIV still do not have access to life-prolonging treatment and care. Prevention services fail to reach many in need. Governments and international partners must accelerate their efforts to achieve universal access to treatment.”

Treatment and care

Access to antiretroviral therapy continues to expand at a rapid rate. Of the estimated 9.5 million people in need of treatment in 2008 in low- and middle-income countries, 42% had access, up from 33% in 2007. The greatest progress was seen in sub-Saharan Africa, where two-thirds of all HIV infections occur.

Prices of the most commonly used antiretroviral drugs have declined significantly in recent years, contributing to wider availability of treatment. The cost of most first-line regimens decreased by 10-40% between 2006 and 2008. However, second-line regimens continue to be expensive. Despite recent progress, access to treatment services is falling far short of need and the global economic crisis has raised concerns about their sustainability. Many patients are being diagnosed at a late stage of disease progression resulting in delayed initiation of ART and high rates of mortality in the first year of treatment.

Testing and counselling

Recent data indicate increasing availability of HIV testing and counselling services. In 66 reporting countries, the number of health facilities providing such services increased by about 35% between 2007 and 2008. Testing and counselling services are also being used by an increasing number of people. In 39 countries, the total reported number of HIV tests performed more than doubled between 2007 and 2008. Ninety-three percent of all countries that reported data across all regions provided free HIV testing through public sector health facilities in 2008.

Nevertheless, the majority of those living with HIV remain unaware of their HIV status. Low awareness of personal risk of HIV infection and fear of stigma and discrimination account, in part, for low uptake of testing services.

Women and children

In 2008, access to HIV services for women and children improved. Approximately 45% of HIV-positive pregnant women received antiretroviral drugs to prevent HIV transmission to their children, up from 35% in 2007. Some 21% of pregnant women in low- and middle-income countries received an HIV test, up from 15% in 2007. More children are benefiting from paediatric antiretroviral therapy programmes: the number of children under 15 years of age who received ART rose from approximately 198 000 in 2007 to 275 700 in 2008, reaching 38% of those in need.

Globally, AIDS remains the leading cause of mortality among women of reproductive age. “Although there is increasing emphasis on women and children in the global HIV/AIDS response, the disease continues to have a devastating impact on their health, livelihood and survival,” said Ann M. Veneman, UNICEF Executive Director.

Most-at-risk populations

In 2008, more data became available on access to HIV services for populations at high risk of HIV infection, including sex workers, men who have sex with men and injecting drug users. While HIV interventions are expanding in some settings, population groups at high risk of HIV infection continue to face technical, legal and sociocultural barriers in accessing health care services. “All indications point to the number of people needing treatment rising dramatically over the next few years,” said Michel Sidibé, Executive Director of UNAIDS. “Ensuring equitable access will be one of our primary concerns and UNAIDS will continue to act as a voice for the voiceless, ensuring that marginalized groups and people most vulnerable to HIV infection have access to the services that are so vital to their wellbeing and to that of their families and communities.”

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

20.10.2009 vatican meeting

A real experience. Joachim and myself arrived in time at the papal council’s seat close to St. Pieter’s. Last Friday we were told by email that Bishop Jose will be out for another meeting and that Monsignor Jean Marie, undersecretary will be available to discuss the matters with us. After 1 hour of waiting I enquire and find out, that the undersecretary has not arrived yet. When he arrived we quickly discover that we need somebody to translate from English into Italian as he is francophone. To organise that it takes another hour – at 11 we finally are sitting together to discuss matters, not a very good start into good business.

The first point is quickly resolved. The press text to be published in the council’s magazine about the cape2cape is in some points not completely adherent with the teaching of the magisterium, so we are told and I take the text to have a second look and promise to re-submit. I will spend one of the next evenings to do so…
Then we discuss a planed project where we wish the involvement of the Holy Sea, the council and the pope. We agree to submit a written proposal and meet again in May next year.

The last point is the question of HIV positive priests, religious, clergy and I explain our project, our pastoral aims. This is met with a serious discussion and the recognition that there is surely a tricky but important task ahead, which has not been started in the church yet. We discuss possible steps forward, which I will take to our project group and I promise to send a report back to Bishop Jose and again: May would be a good time to discuss this further, maybe even with other departments of the Vatican.

The two hours waiting was a difficult time, specially for Joachim, who is simply not used to be treated like this. In all fairness I must say that both representatives of the council apologised profoundly at the end for letting us wait so long. I attributed the wait rather in a not very good preparation and hand over for the meeting – and I make it very clear at the end of the meeting that my way from Cape Town to Rome is not just for fun but that I mean serious business and we are really interested in engaging in meaningful discussions and solutions which will be beneficial for all concerned.

I had the impression that at the end we might have a good starting point for a further engagement and possible cooperation in one matter and starting a process of serious consideration for the matter regarding HIV positive clergy. I don’t want to go into detail about the way forward regarding the POZ initiative as I think it should first concern the project group in Cape Town and I will report back to them. But I can tell without telling too much that our planed strategy seems to fit in very nicely to bring the process forward.

Back to Wolfsburg were I will stay the next two days discussing cooperation with Joachim Franz and his team – and after an almost sleepless night in Rome I will now sleep this evening very tight. The flights with Swiss Air have been rather nightmares than pleasures – but flying hasn’t been a pleasure for a long time…

Filed under: HIV and AIDS, Networking, , , , , , , , , , , , , ,

19.10.2009 news in between: Condoms are not reliable in fight against HIV, says African cardinal

It just crossed my laptop screen while in Rome and I want to share it without further comment:

VATICAN CITY (CNS) : Condoms are not always effective in preventing the spread of HIV/AIDS in Africa, said Cardinal Peter Turkson of Cape Coast, Ghana.

Abstinence, fidelity in marriage and universal access to antiretroviral drugs are the strategies the church continues to promote in the fight against AIDS, he said. The cardinal, who Cardinal Turkson  copyright CNSwill turn 61 Oct. 11, made the comments during a Vatican press conference Oct. 5, presenting some of the issues to be discussed during the second special Synod of Bishops for Africa. Cardinal Turkson was asked about the AIDS epidemic in Africa and what position the synod will take, specifically concerning the use of condoms in HIV prevention. He said when “people propose the use of condoms it becomes effective only in families where they are going to be faithful.” However, condoms give “people a false sense of security, which rather facilitates the spread of HIV/AIDS,” he said.

Condoms cannot be relied upon to provide 100-percent protection against HIV transmission because “there are condoms which arrive in Ghana, which in the heat and whatever burst during sex,” he said. Because there is always a chance condoms might break during sexual intimacy, he is reluctant to recommend condom use even to married couples in which one partner is affected with HIV, he said. The priorities for African bishops at the synod will remain “abstinence and loyalty and fidelity” within marriage, he said. During pastoral counseling, he said he presents the issues and discusses them with the person seeking advice, which “allows the person to decide, to (make) his own decision.” He said he does not “undervalue the possibility that somebody who has AIDS recognizes his own Christian commitment (and) would simply just decide to refrain from sex,” even if he or she were in a faithful marriage, in order to prevent the spread of HIV. “Some would in such a situation have advised the use of condoms by a partner who has HIV so that it doesn’t spread, but again, in our part of the world, even the use of condoms is sometimes risky,” he said.

“If we have proper, top quality condoms, then one can probably with certainty speak about” the effectiveness of an infected partner using condoms, “but that is also not the case” in Ghana, he said. Cardinal Turkson said he would rather see the resources spent on manufacturing and providing prophylactics to Africa be earmarked for subsidizing antiretroviral drugs for the people there. “Let us use those resources to support the production of antiretroviral drugs so (they) would be more available to people,” he said. “That’s probably the big favor that we can do for the people suffering from HIV/AIDS.”

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

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