PrEP: Prevention Revolution or Magical Thinking

One of the most exciting developments in the fight against HIV is a recent study that concluded that gay men could significantly reduce their risk of infection by taking an existing anti-HIV medication on a daily basis.


Earlier this month our friends at Feast of Fun and Lifelube hosted a forum in Chicago to discuss the iPrEx study published this winter. It was an energetic and exciting discussion with scientists, advocates, and real people taking the pill on the possibilities and concerns surrounding PrEP. For those too far or too busy to make it, Feast of Fun recorded the forum as a podcast, available for free on their website. Please check out the podcast and share your thoughts on the study.



Keith Green, Marc Felion, Dr. Bob Grant and Fausto Fernós - Forum Hosts and Participants


[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

If you're HIV positive, safe sex isn't just about condoms

Via The Guardian, by Deborah Jack.

As the HIV epidemic has evolved over three decades, the "just use a condom" message has remained the cornerstone of prevention. But stubbornly high levels of new HIV infections in the UK show we've struggled to always translate this simple message into real life.

Most monogamous couples will decide to stop using condoms at some point, but what if one half of the couple is HIV positive? Until recently, it has been assumed there is no safe option other than condoms for life. But new research into the preventive benefits of HIV treatment (antiretroviral therapy) is set to change this, and could potentially revolutionise the way we think about HIV prevention and safer sex advice.

HIV treatment works by reducing the level of HIV in the body (the viral load) to such an extent that a person's infectiousness is almost zero (clinically referred to as "undetectable"). A big effect of this – in addition to keeping the person healthy – is that the risk of transmitting HIV to another person is dramatically reduced.

Last month we heard the conclusive results of the first global study into HIV "treatment as prevention" – a 96% reduction in transmission risk when the HIV-positive partner received treatment and responded effectively. When put into practice, this means people living with HIV who are on treatment can, like everyone else, consider giving up condoms when their relationship is committed and monogamous.

But before we get carried away, it is not time to throw away our condoms altogether. They are still the best protection against other sexually transmitted infections, so any couple wanting to rely on treatment rather than condoms to prevent HIV transmission must be confident they are both STI free and monogamous. Other STIs in the body can make HIV levels spike upwards, which seriously compromises the effects of treatment as prevention and significantly increases risk of transmission.

Read the rest here.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

David Kato: Lawyer Demands Speedy Trial in Letter to High Court Registrar

Via Behind the Mask.

Six months after the murder of gay rights activist, David Kato, a Ugandan lawyer has written to the Registrar of the High Court demanding a speedy trial.

Mr Francis Onyango, Kato’s lawyer, told Behind the Mask on Thursday June 23, that [if the case took any longer] prosecution witnesses to the case were likely to forget the sequence of events or relocate to other areas in the country. He explained that he had chosen to write to the Registrar in Jinja town because the Mukono High Court where the case is expected to be heard is under the Jinja High Court jurisdiction registry.

Mr Onyango said, the Registrar should take into account the circumstances surrounding Mr. Kato’s death and fix the hearing in the next Criminal season of the high court criminal session. It is not known when the criminal session will begin, although it had earlier been anticipated to start in April this year.

The main suspect, Mr Nsubuga Sydney was charged with Mr Kato’s murder, which is thought to have taken place at Kato’s home in Mukono district, about 25 km east of Kampala.

Judicial officers, who spoke on condition of anonymity because they are not allowed to make media statements, said there was a back log of election petitions in Uganda’s country court systems resulting from February’s General Election and that these were overwhelming Uganda’s court system.

However, other lawyers said it was most likely the criminal court season would begin in July when courts receive a financial disbursement at the beginning of the government’s fiscal year. Courts need money from government to facilitate witnesses coming to court.

"This (the delay in hearings) will occasion a miscarriage of Justice as the key witnesses will be unavailable to testify,” Mr Onyango said in a letter to the Registrar.

Mr Nsubuga Sydney, Alias Enoch, was recently committed to the High Court from a lower magistrate’s court to begin hearings of the case.

Under Uganda’s Constitution, capital offenders including rape, defilement and rape suspects are not allowed to enter into any plea before magistrates, because the High Court is the only institution with Jurisdiction to try them.

However, legal experts note that it could take four to five years, before the suspect’s trial is completed. On average, suspected criminals in capital spend an average of about two and half years awaiting trial.

Read the rest here.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Rush For Male Circumcision in Rural Areas

Via the Daily Monitor, by Evelyn Lirri.

Godfrey Aganza had never considered getting circumcised. The misconceptions that came with a circumcised non-Muslim man, including being considered a covert or the alleged future risk of impotence largely discouraged him from the cut. But that has changed now.

On June 7, this year, the 18-year-old senior three student of Kayunga Secondary School, joined the long queue of other men at a mobile circumcision clinic currently stationed at Bbaale Health Centre IV in Kayunga District, 74 kilometres northeast of Kampala.

Together with his peers, they arrived at the mobile clinic as early as 8am in the morning to halfheartedly give it a try.

It was only after the operation that Mr Aganza felt satisfied with the decision that he had made.

“I am happy I have done it now. It wasn’t painful and I feel okay,” he said moments after coming out of the “operating room”- a large, well equipped truck with the essential tools needed to carry out an operation.

“I have also been told of the health benefits of being circumcised and of course a circumcised man has a lower chance of contracting HIV/Aids,”he added.

Mr Anganza is not alone. I met Aaron Lubega, a 30-year-old police officer five days after he had been circumcised. When he first arrived at the mobile clinic, he did not know what to expect. Like all the other men who come to the mobile clinic, he was taken through a session of counseling so that he could fully understand the health benefits of circumcision.

Mr Lubega had heard about the free circumcision services from fellow residents in Kayunga town, many of who have already gone through the surgical procedure. “At the trading centre, the men talked about the mobile clinic and the benefits of being circumcised that’s why I came here to first hear from the health workers and then get circumcised myself,”he said.

Simple task

Mr Lubega, a single father of one, said the process was so simple and painless that shortly after being circumcised, he managed to ride a motorcycle on a 10km-long journey. In this remote region, residents have embraced circumcision almost 100 per cent.

The free medical male circumcision programme which has been rolled out in the districts of Kayunga and Mukono is being implemented by the Makerere University Walter Reed Project (MUWRP) in partnership with local governments. It’s funded through the US President’s Emergency Plan for Aids Relief.

Mark Breda, a programme manager at MUWRP, said since the initiative was rolled out in February, close to 7,000 men have been circumcised in the various sub counties in Kayunga and Mukono districts.

“We shall continue with the mobile clinic. The demand is nowhere close to being met,” said Mr Breda.

The target, he says, is to have to have up to 4.5 million men circumcised over the next five years across the various sites.

Read the rest here.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Infection-resistant monkeys could be crucial in the fight against HIV

Via Io9, by Alasdair Wilkins.

Sooty mangabeys are a monkey species found on the western coast of central Africa. Their unique immunity to SIV, a relative of HIV, has intrigued medical researchers for decades. Now we know just how their immunity works.

SIV and HIV function in much the same way - the viruses find two molecules on the surface of the cell, which are known as co-receptors. These molecules function much like gates. One of these molecules is CD4, which is found on immune cells known as T cells. The immune response triggered by the appearance of the virus stimulates these T cells, which boost the level of the other co-receptor, CCR5, which in turn facilitates the deadly infection.

But sooty mangabeys are able to avoid that chain of events, thanks to a unique type of T cell called a central memory T cell. When this particular type of T cell responds to the virus, it does so without activating CCR5. This helps the T cells survive the SIV infection, and it's a crucial reason why these monkeys are able to avoid the onset of AIDS. Best of all, central memory T cells are long-lived in the body, and their positioning in the lymph nodes makes them particularly effective in stopping the spread of SIV.

Emory University researcher Mirko Paiardini explains what this means:

Read the rest here.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

POZ love for IRMA - The Anal Dialogues

The July/August 2011 issue of POZ Magazine belongs to IRMA and rectal microbicides. Check it out for a nice history of our work and a snapshot of the science, including important information on lubricant safety.

via POZ.com, by Trenton Straub

Excerpt:

Perhaps IRMA’s most visible work is three game-changing reports it published in conjunction with the biennial International Microbicides Conference. The first, Rectal Microbicides: Investments & Advocacy in 2006, compiled what research was being done and where—a tricky task. “A lot of researchers were concerned that if ‘anal’ or ‘rectal’ appeared in research proposals or reports, they wouldn’t get funded, so they’d scrub their papers so those words wouldn’t show up,” LeBlanc says. “Instead, they would refer to ‘topical use of products’ or other language.” And because of the dangers surrounding the subject—male-to-male sex is illegal in many countries, including 31 in sub-Saharan Africa—IRMA first had to gain researchers’ trust, proving they were not raging advocates who would alienate and antagonize. Their professionalism paid off, and the report was a hit. “It showed we were serious,” Pickett says, “and we got hundreds of new members.” 


Read the rest.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

“In it to save lives”

Via Science Speaks, by Meredith Mazzotta.

To the sound of a ticking metronome, Dr. Caroline Ryan of the Office of the Global AIDS Coordinator gave an update on the scale up of voluntary medical male circumcision in sub-Saharan Africa Wednesday morning at the premiere of the new short film “In It to Save Lives: Scaling Up Voluntary Medical Male Circumcision for HIV Prevention for Maximum Public Health Impact.”

The metronome was timed to tick once for each of the five new HIV infections that occur every minute worldwide, 3.5 of which occur in sub-Saharan Africa, Ryan said. During her ten-minute talk, fifty people around the world became infected, and of the 35 infections that would occur among those in sub-Saharan Africa, 12 could be averted through the scale up of voluntary medical male circumcision (MC), she said at the end of her presentation.

Clinical trials have shown MC to provide men 60 percent more protection from acquisition of HIV through vaginal sex than their uncircumcised counterparts. The one-time, relatively simple procedure is inexpensive and cost-effective, and governments in sub-Saharan Africa are encouraging men to get the procedure by offering it for free or very little cost with the help of funding from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and other programs.

Dr. Caroline Ryan of the Office of the U.S. Global AIDS Coordinator gives the opening remarks at Tuesday's premiere of the film "In It to Save Lives."

Dr. Ryan joined with other HIV/AIDS experts at the panel discussion and premiere of the film, produced by AIDSTAR-One with support from PEPFAR, which tells the story of how Kenya and Swaziland are turning the tide of the HIV/AIDS epidemic by embracing voluntary medical MC as prevention. Scale up was especially tricky in Kenya’s Nyanza province where Luo elders, the “custodians of culture” in the province, had to be convinced that the procedure was of benefit to its people. According to the film, assuring the elders that the procedure was voluntary was key to winning their approval.

Read the rest here.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

New Guidelines on HIV Programming for MSM

Via IRIN.

HIV and gay rights activists say new guidelines released by the UN World Health Organization (WHO) on HIV programming for men who have sex with men (MSM) will not only improve health service provision for MSM, but will also act as an advocacy tool in the fight for the rights of this marginalized population.

"The document provides well-researched and evidence-based recommendations for HIV prevention and treatment of MSM, which will be useful for clinicians," said Kevin Rebe, a doctor with Health4Men, a South African health service provider which caters specifically for MSM. "The language of the paper is couched in human rights, and makes a strong call for decriminalization of same sex sexual activity, so it will also be useful for activists seeking to end discrimination."

The guidelines are designed for use by national public health officials and managers of HIV/AIDS and STI (sexually transmitted infections) programmes, NGOs and health workers. They contain MSM-specific programme activities such as the use of water- and silicone-based lubricant for the correct functioning of condoms during anal sex.

The guidelines do not advise medical male circumcision - a measure WHO recommends for HIV prevention among heterosexual men - for HIV prevention among MSM due to the lack of sufficient research on its effect of its use in MSM sexual activity.

They further recommend that health services adhere to the principles of medical ethics and the right to health, and ensure that MSM feel comfortable enough to seek medical care, with MSM-specific health needs catered for within national health systems.

"Like many other African countries, all men in South Africa are assumed to be straight, so health workers are not aware of the need to identify people of different sexualities during consultations; outside of centres like ours, there is little competency in providing health care to MSM," said Rebe. "By availing this knowledge, the guidelines will empower health workers to provide better care to MSM."


Wake-up call

In countries like Uganda, where homophobia is deeply entrenched both within society and the law, gay rights groups hope the new guidelines will serve as a wake-up call to the government about the need to include MSM in HIV programming.

"I hope the new guidelines will be an eye-opener to the government, who have so far ignored MSM within HIV prevention, treatment and support; it should show them that MSM exist in Uganda and are at high risk," said Frank Mugisha, executive director of the NGO Sexual Minorities Uganda. "They therefore cannot be ignored and urgently require HIV interventions."
 
Read the rest here.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

HIV Risk of Anal Sex Misunderstood Among Heterosexuals

This news article features our very own Zoe Duby, an IRMA advocate and valued member of our community! Congratulations to Zoe, and thank you for working so hard as an advocate for rectal microbicides and HIV prevention in South Africa and worldwide.

Via PlusNews.

Vaginal sex, thigh sex, even armpit sex - people have sex in lots of ways, but in heterosexual anal sex, HIV prevention programming is silent about the high risk of infection that goes with it, and people may have mistaken this silence for safety.

The risk of contracting HIV through unprotected receptive anal sex is almost 20 times greater than the HIV risk associated with vaginal intercourse.

While this fact is often a focus in HIV prevention programming aimed at men-who-have-sex-with-men (MSM), it has been largely left out of programmes for heterosexuals, according to Zoe Duby of the University of Cape Town, South Africa, and the Desmond Tutu HIV Foundation.

Duby presented the findings of her study, which interviewed almost 400 people in Tanzania, Uganda and Kenya, at the 1st HIV Social Sciences and Humanities Conference held recently in Durban, South Africa.

“Safer sex programming has, in my opinion, failed to take into account varying definitions of sex. The omission of anal sex in safe sex messaging has been interpreted as meaning that anal sex is safe,” she told IRIN/PlusNews.

“What people preach out there, it’s just vaginal sex - not information on anal [sex],” said a young woman from Salgaa, Kenya, who was quoted in the research. “So somebody thinks, ‘if I do [sex] this other way, then I will not get HIV.’”

Even more worrying was that research showed healthcare workers often held similar views, and some incorrectly believed HIV was only present in vaginal fluid. The virus is, in fact, also present in male sperm and blood.

“Me, I do not want to practice vaginal sex because that is the highest [risk] sex that transmits HIV, so it is a belief… that non-vaginal sex does not transmit HIV,” one Kenyan healthcare worker reported.

A nurse in Malaba, Uganda, said: “As you go and have sex vaginally you can get HIV, but these other methods, they do not expose you [to HIV].”

Read the rest here.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

WHO Urges India to Address Medical Needs of Gay Men, Transgenders

Via The Hindu.

India must make an “extra effort” in addressing the medical needs of men who have sex with men (MSM) and transgender people affected by HIV and sexually-transmitted infections, a top WHO official said on Tuesday.

“Though India has addressed the HIV problem among MSM and transgender people, it has to make an extra effort in scaling up treatment and prevention services for HIV and sexually transmitted infections,” Dr. Gottfried Hirnschall, Director of HIV Department in World Health Organisation, told PTI.

In India, around 1.5 million transgender people and around 30.5 million MSM are vulnerable to the HIV and sexually-transmitted infections.

“In Asia, the odds of MSM being infected with HIV are 18.7 times higher than in the general population and the HIV prevalence ranges from 0 per cent to 40 per cent,” he said.

The WHO on Tuesday issued, for the first time, new public health recommendations to sensitise governments and health pressure groups in the developing world about the need to provide adequate medical treatment and prevention services to MSM and transgender people affected by HIV and sexually transmitted infections.

The guidelines call on governments to develop anti-discrimination laws and measures and provide more inclusive services for MSM and transgender people.

Health pressure groups must provide HIV testing and counselling followed by treatment for patients with CD4 count 350 or below.

Dr. Hirnschall said “criminalisation, and legal policy barriers play a key role in the vulnerability of MSM and transgender people to HIV.”

Read the rest here.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

New Light Shed on Male Sex Work

Via PlusNews.

Commercial sex work, dominated by a focus on women, could be redefined as new research launched today in Nairobi, Kenya, sheds light on the complicated HIV prevention needs of what may be Africa’s most deeply underground group at high risk of HIV - male sex workers.

The report co-authored by the United Nations Development Programme (UNDP) and South Africa's Sex Workers Education and Advocacy Taskforce (SWEAT) seeks to better understand the social contexts, sexual practices and risks, including that of HIV, among these men.

The professional debut of many of the 70 male sex workers surveyed in Kenya, Namibia, South Africa, Uganda and Zimbabwe was often prompted by the family rejecting the men’s sexual orientation; for others, it was a way to survive in a foreign country.

Men reported being at risk of HIV in many ways, including the unavailability of speciality health services, the premium clients placed on unprotected sex, violence and the lure of substance abuse. Although the work often placed them at risk of substance and physical abuse as well as HIV infection, the researchers found that it also provided the men with a sense of freedom and empowerment.

The report cautions that mitigating these risks may require specialised HIV prevention services unlike those targeted at female commercial sex workers or men who have sex with men (MSM).

A series of interviews with male sex workers at a five-country workshop in Johannesburg, South Africa, and country visits to Kenya and Namibia has produced a significant addition to the paucity of data on male sex workers, according to Paul Boyce, a UNDP researcher.

While data on MSM from Malawi, Namibia and Botswana indicated that about 17 percent were HIV positive - almost twice the national prevalence rates of their respective countries - not much has been written on the specific HIV risks of male sex workers, which may be higher than those of MSM.

While male sex workers reported working at a range of venues, including Namibian truck stops and Zimbabwean mines, most of the available information on male sex work has come from those operating in the sex tourism hot spot of Mombasa, Kenya, with limited data from a 2009 study in South Africa that showed male sex workers were twice as likely to engage in anal sex than MSM who were not selling sex.


Not necessarily the same old risks:

Unprotected receptive anal sex carries almost 20 times the HIV risk associated with unprotected vaginal sex.

Interviewees told researchers that the unavailability of water-based lubricant, which reduces the risk of condoms breaking during anal sex, and the higher financial reward of unprotected anal sex, made consistent condom use difficult.

Some clients forced unprotected intercourse on sex workers, while others admitted to practicing unsafe sex due to the disinhibition often brought about by the drug and alcohol abuse that is reportedly part of the social scene in sex work. Drugs and alcohol also helped the men mentally cope with the omnipresent risks of this lifestyle, including police harassment.

South African male sex workers said substance abuse - not HIV infection - was the greatest threat to their health.

Those who tried to access health services for HIV testing and treatment, or the diagnosis of sexually transmitted infections (STIs), reported being ridiculed and stigmatized by health workers, even in countries like Kenya, where the Ministry of Health has introduced new guidelines on MSM and sex work, and health and HIV.

"[At the] government hospital, the nurses just [stand] in front of everyone and shout out loud to the people waiting for assistance: 'If you have HIV, go to room nine, TB room 12, STD [sexually transmitted disease] room 8,'" said one man quoted in the report.

Read the rest here.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Anti-AIDS Gel Also Boosts Sexual Pleasure

Via Times of India.

 South African scientists, who launched a 24-month trial to confirm the efficacy of a microbicide gel that would reduce the risk of women getting HIV, have found an unexpected spin-off – it also boosts sexual pleasure.

Wits professor Helen Rees, of the university's reproductive health and HIV institute, said the R300m trial would involve about 2,200 sexually active women at seven locations countrywide.

The Tenofovir gel study - known as Follow-on African Consortium for Tenofovir Studies (Facts) study - would be a follow-up to the Caprisa 004 study, which showed that a highly consistent use of the microbicide by women resulted in a 59 per cent reduction in the risk of HIV infection.

Rees said during a previous study involving another gel - that proved unsuccessful in the fight against HIV - participants had noted the gel improved their sexual pleasure.

"One of the big messages we got, was many women said 'We liked this', News24.com quoted her as saying. 

 

Read the rest here. 

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

AIDS Summit at the UN: Not Enough Talk About Sex

Via the Huffington Post, by Evelyn Leopold.

World leaders gathered at the United Nations to mark the 30th anniversary of the HIV/AIDS epidemic and put out a 102-paragraph declaration. Adrienne Germain, the president of the International Women's Health Coalition (IWHC), has been working on women's issues all her adult life and was active in the 1994 Cairo conference on women, also known as the CPD (International Conference on Population and Development). In an interview with the Huffington Post, Germain and Alexandra Garita, an international policy program officer at IWHC, discuss the declaration and the controversies that arise whenever sex is on the agenda. The declaration, produced every five years, gives U.N. agencies a mandate for their programs and advises governments where best to spend monies.

Q: What about access to family planning, to birth control?

AG: We lost reproductive rights and reproductive health language from the 1994 Cairo document and from early drafts here. Reproductive rights, for example, also includes the right to freely and responsibly decide on the number and spacing of one's children. If you lose that and you have no reference to family planning services in the document, then you basically have no reference to contraception for women. You also don't have protection for women living with HIV who are sterilized without their consent and who are forced to have abortion. It is not a rare occurrence in southern Africa (including South Africa).

Q: And how about the new studies on early intervention of Antiretroviral drugs (ARV) to reduce transmission, which are welcomed as a major breakthrough?

An important development is using ARV treatment much earlier in a person's life in order to reduce the amount of virus in the body. Therefore the person will be less able to transmit the virus to someone else and you can use treatment as prevention. In this document, it is treated as a miracle breakthrough. We don't look at it that way. Probably about half the people in the world who are living with HIV don't know it. You are most infectious right after you have been infected. But at that time you have no symptoms at all so why would you go forward with testing? So to think that a medicine, a drug, is going to end this epidemic when we don't even know how to get more people to come forward for testing -- is really foolish. But debates on how best to end the epidemic go on all the time -- how we should all be giving much more time to prevention. Yet this document ends up with four paragraphs -FOUR!-on prevention. Does that make much sense? No. Not in our book.

Q: Homosexuals and prostitutes were a big issue five years ago, even among some delegates from the Bush administration. Has this changed?

They are in the document for the first time. There was one paragraph that names the community of drug users, men who have sex with men and sex workers. That is very good. But this listing is used once only and then there is UN mumbo-jumbo in other paragraphs where you should have specific references about the kinds of interventions needed to reach this population and what they face in their lives. And there is nothing on human rights for these people (despite the UN secretary-general's speech).

Read the rest here.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

30 Years: The Changing Face of AIDS in the US

by Aldona Martinka

IRMA is drawing the focus to the thirtieth anniversary of HIV/AIDS with a short series on AIDS history. It will explore where we began, where we are now, and where we are going as we continue to battle this disease with hope and determination. This is part four of five.

People living with HIV and AIDS in the United States today are in a position that was completely unforeseeable to those living with the disease in the eighties. Today a positive diagnosis is far from a death sentence to most Americans, and there are daily pills one can take that will subdue the virus for decades if the routine is followed closely. People in their fifties, many of whom were diagnosed in those terrifying early years, will soon most likely make up the majority of people living with AIDS in the US. New prevention technologies have moved from condoms to a plethora of exciting possibilities such as topical microbicides and treatment as prevention. AIDS stigma, while still a problem in many instances, is so much less ignorant than what it was even 20 years ago.

As the face of AIDS in the US changes, life for those living with the disease and their loved ones has become much more bearable. But with these positive changes come a whole host of new problems that no one could have foreseen a quarter of a century ago.

The illnesses which most commonly affect AIDS patients, for instance, have shifted from the opportunistic cancers and infections which killed so many early victims, to heart conditions, neurological disorders, and other illnesses typical of the elderly. Pre-mature aging has become the more likely scenario today as patients in their fifties and above face problems most often experienced by those twenty to thirty years older than them.

Another new issue facing people with AIDS that no one could foresee thirty years ago is the criminalization of those with the virus. There are far too many instances of scared and ignorant people accusing past and current sexual partners of being criminals for having sex while being HIV positive. For an excellent account of criminalization of the HIV/AIDS community read Sean Strub’s blog post at Poz Magazine.

As we adapt to AIDS, in America and worldwide, we will have to be resourceful, understanding, and hopeful to face whatever the virus will throw our way next. As a country and a world united, we can try to end AIDS before another 30 years has passed.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

KENYA: Rural MSM Too Afraid to Access HIV Health Services

Via PlusNews.

Discriminatory laws and a largely homophobic society mean that men who have sex with men (MSM) in Kenya generally find it difficult to access HIV-related information and health services, but rural MSM have an especially hard time.

When Kibet Kipsowen*, 30, a cattle keeper in Kenya’s Rift Valley Province, and his partner have sex, they use the oil-based jelly he applies when milking his cows; he’s never heard of a water-based lubricant, let alone used one. “Milking jelly is the only lubricant I have known for the last four years,” he told IRIN/PlusNews at his home in the village of Lanjuera.

Health practitioners discourage the use of oil-based lubricants for anal sex, as the oil degrades condoms, increasing the likelihood that they will break. Studies have found that most African MSM use oil-based lubricants, heightening their risk of contracting HIV.

According to a 2008 Modes of Transmission study conducted by UNAIDS and the government, MSM and prisoners account for 15.2 percent of new HIV infections in Kenya annually.

Kipsowen and his partner have been an item for a few years now, but dare not let anyone in their village know they are a couple. “Even people who have ‘normal’ sex do not speak about it - I can never reveal my sexuality or else I would risk being an outcast, or even be killed,” he said.

The only other person in the village who knows about his sexuality is Soita Wellapondi, a local nurse and social worker, and that’s only because Kipsowen visited her when he developed a sexually transmitted infection.

“At that time I had a lot of wounds in my anus; I felt so much pain that I thought I would die, yet I could not even confide to my own mother, brother or sister, and I could not visit a health centre,” he said.

He knew that by confiding in Wellapondi he risked his secret being revealed to the community, but he felt she was his only chance of accessing health care. “I bought him some antibiotics and pain killers; it was absolutely impossible to convince him to visit a health centre, even one far away where he is not known,” said Wellapondi.

Local health workers have very little experience and no training in dealing with MSM. A clinical officer at the Mogotio health centre near Lanjuera says he has only ever had one MSM client.

Even people who have 'normal' sex do not speak about it - I can never reveal my sexuality or else I would risk being an outcast or even be killed“He came here for treatment of injuries resulting from anal sex, and was advised to come for further treatment but he never came back,” said the clinical officer, who declined to be named.

Read the rest here.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

World Bank Study: Better HIV/AIDS Programs for Men Who Have Sex with Men Could Significantly Slow Global Epidemic

Source (press release, dated June 8, 2011)

On the eve of a UN summit to renew global efforts to reverse the HIV/AIDS pandemic, 30 years after the first discovery of the HIV virus, a new World Bank study urges governments and their development donors to provide better HIV prevention, care, and treatment services for men who have sex with men (MSM) as an essential step toward reversing the global epidemic. More than 25 million people have died of HIV/AIDS since the virus was first clinically identified in 1981.

Written in close partnership with the United Nations Development Programme (UNDP) and the Johns Hopkins Bloomberg School of Public Health, the new study―Global HIV Epidemics Among Men Who Have Sex with Men (MSM): Epidemiology, Prevention, Access to Care and Human Rights―provides the first comprehensive economic analysis of evidence that MSM are at significantly higher risk for HIV infection than other groups in many low- and middle-income countries, where fewer than 1 in 10 MSM worldwide have access to even basic HIV/AIDS prevention, care, and treatment services.

Research among MSM has been limited by social discrimination and the criminalization of their behavior, along with limited funding for HIV/AIDS programs that help MSM. The study suggests that these social factors make MSM vulnerable to HIV infection as well as limiting their access to HIV/AIDS treatment and care.

“We see that in many developing countries, the HIV/AIDS epidemic today looks like the early years of the epidemic in the West in the 1980s, when ignorance and stigma were rampant,” said David Wilson, Global HIV/AIDS Director at the World Bank. “This study provides the best evidence yet that failure to address MSM will continue to thwart efforts to reverse the global HIV/AIDS epidemic.”

The study authors identify four scenarios that describe the current state of the HIV epidemic among MSM in low- and middle-income countries, and assess the cost to improve the situation for MSM. The authors conclude that achieving high rates of coverage of HIV/AIDS prevention and treatment services among MSM has a significant positive impact on the overall trajectory of a country’s HIV epidemic.

The four regional scenarios are: 1 – Where MSM have the most numbers of HIV infection in the population (South America); 2 – Countries with large numbers of infections among intravenous drug users, in which infections among MSM are also substantial (Eastern Europe and Central Asia); 3 – MSM risks of infection occur within widespread HIV epidemics among heterosexuals (sub-Saharan Africa); and 4 – MSM, intravenous drug users, and heterosexual transmissions all contribute significantly to the HIV epidemic (Southeast Asia).

“In too many countries, the neglect of HIV epidemics among men who have sex with men has undermined the effectiveness of HIV responses,” said Jeff O’Malley, Director of UNDP’s HIV Group. “These new data offer development partners an opportunity to refocus their planning efforts and to ensure that HIV responses are in line with the burden of HIV in their countries.”

In Peru, for example, the study authors project that if coverage of MSM interventions and antiretroviral therapies (ARVs) remain constant, the number of new HIV infections in the general population will result in nearly 20,000 new infections by 2015. Increasing MSM-specific interventions to 100% coverage and providing HIV-positive MSM with full access to ARVs may dramatically decrease the epidemic in the entire population.

“This report demonstrates the scale, scope, and intensity of the HIV epidemics now underway among MSM in too many countries,” said Chris Beyrer, Director of the Center for Public Health and Human Rights at Johns Hopkins University and lead co-author of the study. “But the findings also make clear that responding to these epidemics can have powerful impacts on global AIDS. It is time to act."

To better protect MSM from HIV risks, the authors recommend a minimum package of essential services, including: counseling, distribution of condoms and other safe sex measures, community-based prevention efforts, HIV testing, and increased use of antiretroviral therapy treatment or ARV. Equally important are policy efforts to decriminalize MSM behavior, institute anti-homophobia policies, and programs to educate health care workers and reduce stigma in health care settings.

The authors also recommend careful evaluation of mainstreaming MSM programs, since laws and policies designed to promote universal access and gender equality for HIV services often do not adequately protect MSM and other sexual minorities. Ensuring community participation in providing essential services for MSM is also critical to producing policies that promote the human rights of MSM and expand their access to HIV testing, treatment, and care.

Summary and full report

Click to learn more about the Center for Public Health and Human Rights at Johns Hopkins

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Gay sex became legal in India two years ago, but attitudes change slowly

via guardian.co.uk

The day the high court in Delhi ruled that being gay was no longer a crime was the day that Krishna Gurram Kouda finally came out to his family.

Despite having set up a state-wide network for gay men in Andhra Pradesh, the 39-year-old had never told his relatives about his sexuality. "I live with my parents," he explains as the fan above whirs in an ineffectual attempt to stave off the 40C Hyderabadi heat. "I have a good relationship with my brothers and their children." He looks at me. "I thought they would accept me," he pauses, "but I was a little afraid."

I first met Kouda in 2008 when I was reporting on how discrimination puts gay men at greater risk of HIV in Andhra Pradesh (which has one of India's highest rates of the virus) for the Guardian's international development journalism competition. At that time, section 377 of the Indian penal code made gay sex illegal, and strong social stigma drove gay men underground. Now the law has changed, I wanted to know whether their lives had also altered course.

For Krishna, the answer is yes. On the day of decriminalisation – 2 July 2009 – Krishna went public, spending hours on local TV and radio, talking about gay issues and rebutting religious leaders. When he got home at 10 o'clock that night, his mother and brother congratulated him. "You speak about your community's problems so well," they said, recognising for the first time that they knew he was gay. Since then, Krishna and Avinash, his partner of seven years, have received joint invitations to family parties and an annual couples-only Puja [prayer].

Read the rest.


[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Ghana - Investigating "Growing Rate of Homosexuality"

via Ghana News

The Bureau of National Investigations (BNI) has begun investigations into the growing rate of homosexuality in the Western and Central regions, Western Regional Minister, Mr. Paul Evans Aidoo has revealed.

According to the minister, there is the need for a thorough investigation into what he terms a "social canker" which has contributed to the growing rate of HIV/AIDS in the country.

About eight thousand homosexuals were registered by non-governmental organization (NGOs) at a day’s workshop in the Western and some parts of the Central regions after they (homosexuals) underwent voluntary counseling and testing with majority of them infected with sexually transmitted diseases (STDs), including HIV/AIDS.

Read the rest.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

30 Years: Epidemic to Pandemic

by Aldona Martinka

This Sunday was the thirtieth anniversary of the CDC report that would become the first mention of HIV/AIDS. IRMA is commemorating this with a short series on AIDS history. It will explore where we began, where we are now, and where we are going as we continue to battle this disease with hope and determination. This is part three of five.

Today everyone realizes that AIDS is a global issue, from the First World to the Third World. In 1999, AIDS became the fourth most common cause of death in the world. To the average American, however, AIDS as a global issue did not seem so important until the turn of the century. The United Nations began to hold increasingly frequent meetings to discuss HIV/AIDS-related issues, and American politicians and activists began to turn their gaze outward.

The Joint United Nations Programme on HIV/AIDS (UNAIDS) was launched in 1996, and by 2000 the UN was a vital player in the global fight against the disease. In that year alone the UN, the WHO, and UNAIDS worked to negotiate pharmaceutical prices for HIV/AIDS drugs in the developing world, the UN Security Council met regarding AIDS and its effects on peace/security in Africa, and the UN announced its Millennium Development Goals. The same year the G8 met and announced a need for more resources to battle the pandemic. The UN would, in the next few years, hold its first Special Session on AIDS (reviewed in 2005), launch the Global Coalition on Women and AIDS, and continue to reinforce its commitment to providing prevention and treatment options for HIV/AIDS worldwide.

The United States also began fighting AIDS on a global scale during this time. In 200 President Clinton announced his administration’s Millennium Vaccine Initiative, declared HIV a national security threat, and issued an executive order to aid developing countries in producing and importing generic treatments for HIV/AIDS. He and his legacy would continue to work to provide these drugs at a low cost to developing countries worldwide for years to come. In 2001, the Bush administration vowed to continue a commitment to fighting AIDS both nationally and globally. The CDC created a plan to halve US infections within five years. Early in 2003, President Bush announced the creation of the President’s Emergency Plan For AIDS Relief (PEPFAR), a five year plan devoting $15 billion dollars to fight AIDS internationally. This was, and continues to be, the largest commitment by any country to combat HIV/AIDS. The first $350 million was authorized the next year.

The US, the UN, the G8, international projects such as the Global Fund to Fight AIDS, Tuberculosis, and Malaria, countless other organizations, have continued to fight for HIV/AIDS prevention and treatment, and as the 31st year of AIDS begins there is a renewed energy to this battle.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Bloomberg Editorial: Treatment has Grown, Prevention Has Languished

via Bloomberg

AIDS has been with us, officially, for 30 years, since the U.S. Centers for Disease Control and Prevention reported the first cases. This unhappy anniversary is perhaps as good a time as any to spell out why the global response to AIDS is in need of serious adjustment.

Annual spending on AIDS worldwide has risen to $15.9 billion. The bulk of this money goes to the treatment and care of indigent people who are HIV-positive. Without question, the investment in anti-retroviral therapy, or ART, has saved lives. Today, the treatment is provided to about 36 percent of those in the developing world who qualify for it under World Health Organization guidelines.

United Nations member states have pledged to raise that to almost 100 percent. Universal treatment has become the principal mission of many AIDS organizations around the world; governments and philanthropies have followed their lead.

The idea of treating everyone who has the human immunodeficiency virus, regardless of ability to pay, is laudable. The problem is, the laudable runs the risk of crowding out both the practical and the doable. As programs for treatment have grown, those focused on prevention have languished or gotten short-shrift.

Read the rest.


[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Countdown to 30 Years: Up in Arms

by Aldona Martinka, IRMA intern

As the thirtieth anniversary of the very beginning of the AIDS crisis draws near, IRMA will be counting down the last five days with a short series on AIDS history. It will explore where we began, where we are now, and where we are going as we continue to battle this disease with hope and determination. This is part two of five.

When the eighties came to a close the world was still reeling from the devastation of a new, terrible disease. In the past few years strides had been made to de-stigmatize HIV and its victims, but they were still misunderstood and underrepresented in the media and in the government. This really began to change in the nineties as the government, technology, and pop culture finally took up arms on a large scale.

Ryan White died in April of 1990, and four months later the first Ryan White CARE (Comprehensive AIDS Resources Emergency) Act was enacted, marking the largest piece of AIDS-related legislation to date, allocating $220.5 million in federal funds for HIV care and treatment. Since then it has been reauthorized three times. In the next years, congress would pass several more pieces of legislation that would give funds, housing, and (most importantly) legitimacy and support to AIDS victims and advocates. In 1991 the ubiquitous symbol of AIDS support and awareness, the red ribbon, is launched. Right after AIDS became the number one cause of death for males 25-44, the FDA approved a 10-minute HIV test which would change testing for and diagnosis of HIV in the United States. The female condom is approved in 1993. AIDS is the number one cause of death for women 25-44 as well in 1994. Months later AZT is approved to help prevent vertical transmission of the virus. Clinton’s Conference on HIV/AIDS in 1995 comes the year that the number of US HIV cases crosses the 500,000 line.

The nineties were not just a decade of political advocacy and technological advances; celebrities began to follow in the footsteps of Elizabeth Taylor and others supporting the fight against AIDS. “Magic” Johnson announced his HIV-positive status in 1991. Rock and roll fans everywhere mourned when icon Freddie Mercury of Queen died from AIDS-related pneumonia. Tom Hanks starred in the film “Philadelphia” as a lawyer with AIDS, bringing his repute and acting talent to the first major Hollywood film about AIDS. Athletes, artists, and other celebrities come forward throughout the decade, each one helping to reduce stigma just a little.

Finally, in 1996, the United States collectively heaves a sigh when the number of new diagnoses of AIDS drops for the first time since the start of the epidemic due mostly to the advent of Highly Active Anti-Retrorviral Therapy (HAART.) Really for the first time there are drugs that can suppress the virus.  AIDS is no longer the cause for most 25-44 year olds, but remains so for African-Americans. The next year the CDC reports a 47% decline in AIDS deaths from the last year. With such significant improvements, even though AIDS continues to be a vicious disease in the US (especially among minorities), eyes turn to AIDS in the rest of the world as the crisis becomes a global issue. In the new millennium the United States continues to battle HIV at home, but also sends support overseas where victims of the disease in the third world are ravaged by its effects.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Annual HIV Testing May Not Suffice for MSM

Via CDC Morbidity and Mortality Weekly Report.

The findings from this analysis suggest that adherence to annual HIV testing recommendations for MSM is low and that even among MSM who reported being tested during the past 12 months, a substantial proportion were newly infected. Because persons often reduce their risk behaviors when they receive a diagnosis of HIV infection and persons who do not know they are infected are estimated to account for more than half of sexually transmitted HIV infections, increasing the frequency of HIV testing for MSM can reduce the time from HIV infection to diagnosis and reduce HIV transmission.

Current CDC guidelines identify MSM who should be tested more frequently according to their risk behaviors. However, among MSM in this analysis, those who had high-risk behaviors were not more likely to be newly infected than those without high-risk behaviors, suggesting that self-reported risk behaviors might not determine which MSM should be tested more frequently. The 7% prevalence of new HIV infection detected through NHBS among MSM who had been tested for HIV during the past year and the similar prevalence of new HIV infection among MSM with and without high-risk behaviors suggests that more frequent testing, perhaps as often as every 3 to 6 months, might be warranted among all sexually active MSM, regardless of their risk behaviors. In considering revising guidelines regarding frequency of testing among MSM, public health officials also should weigh other factors, including the acceptability and cost effectiveness of testing MSM more frequently and the sensitivity of tests in the early stages of infection.

Read the full report here.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Meet Paul Semugoma - a Friendly Rectal Microbicide Advocate

via IRMA

 For the populations that I have been working with, MSM/GB men, unprotected anal sex may be the single most important reason they are so vulnerable to HIV. So, getting a way and means of decreasing the spread of HIV in this way is something that should have been a priority from the beginning of the pandemic. - Paul Semugoma

Paul Semugoma is a medical doctor in Kampala, Uganda and is a member of the Global Forum on MSM and HIV Steering Committee. Paul first heard of rectal microbicides at International Conference on AIDS and STIs in Africa in Nigeria while he was involved in other projects. Later, he revisited rectal microbicides when he realized that anal sex is perhaps the most significant means of HIV transmission, yet interventions in that area have been very limited.

Paul's current work as an advocate includes encouraging research, interest, and discussion within his community. He is also part of the Project ARM - Africa for Rectal Microbicides working group.

Paul is an introspective man in his free time, reading and writing poetry when not hard at work.

Read about other friendly rectal microbicides advocates.
Newly featured advocates include Margaret Onah, Brian Kanyemba, and Ian Lemieux.

Want to join the best e-mail discussion list on new prevention technologies on the planet? Send a note to IRMA here - rectalmicro@gmail.com - and we will get you signed up.Joining the list makes you an automatic IRMA member too!

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Lancet: Towards an improved investment approach for an effective response to HIV/AIDS

via The Lancet

Summary

Substantial changes are needed to achieve a more targeted and strategic approach to investment in the response to the HIV/AIDS epidemic that will yield long-term dividends. Until now, advocacy for resources has been done on the basis of a commodity approach that encouraged scaling up of numerous strategies in parallel, irrespective of their relative effects. We propose a strategic investment framework that is intended to support better management of national and international HIV/AIDS responses than exists with the present system. Our framework incorporates major efficiency gains through community mobilisation, synergies between programme elements, and benefits of the extension of antiretroviral therapy for prevention of HIV transmission. It proposes three categories of investment, consisting of six basic programmatic activities, interventions that create an enabling environment to achieve maximum effectiveness, and programmatic efforts in other health and development sectors related to HIV/AIDS. The yearly cost of achievement of universal access to HIV prevention, treatment, care, and support by 2015 is estimated at no less than US$22 billion. Implementation of the new investment framework would avert 12·2 million new HIV infections and 7·4 million deaths from AIDS between 2011 and 2020 compared with continuation of present approaches, and result in 29·4 million life-years gained. The framework is cost effective at $1060 per life-year gained, and the additional investment proposed would be largely offset from savings in treatment costs alone.

Click here for full text, free (just need to register.)

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

The Economist: The end of AIDS?

Thirty years on, it looks as though the plague can now be beaten, if the world has the will to do so...

via The Economist

Excerpt:

If AIDS is defeated, it will be thanks to an alliance of science, activism and altruism. The science has come from the world’s pharmaceutical companies, which leapt on the problem. In 1996 a batch of similar drugs, all of them inhibiting the activity of one of the AIDS virus’s crucial enzymes, appeared almost simultaneously. The effect was miraculous, if you (or your government) could afford the $15,000 a year that those drugs cost when they first came on the market.

Much of the activism came from rich-world gays. Having badgered drug companies into creating the new medicines, the activists bullied them into dropping the price. That would have happened anyway, but activism made it happen faster.

The altruism was aroused as it became clear by the mid-1990s that AIDS was not just a rich-world disease. Three-quarters of those affected were—and still are—in Africa. Unlike most infections, which strike children and the elderly, AIDS hits the most productive members of society: businessmen, civil servants, engineers, teachers, doctors, nurses. Thanks to an enormous effort by Western philanthropists and some politicians (this is one area where even the left should give credit to George Bush junior), a series of programmes has brought drugs to those infected.

The result is patchy. Not enough people—some 6.6m of the 16m who would most quickly benefit—are getting the drugs. And the pills are not a cure. Stop taking them, and the virus bounces back. But it is a huge step forward from ten years ago.

What can science offer now? A few people’s immune systems control the disease naturally (which suggests a vaccine might be possible) and antibodies have been discovered that neutralise the virus (and might thus form the basis of AIDS-clearing drugs). But a cure still seems a long way off. Prevention is, for the moment, the better bet.

There are various ways to stop people getting the disease in the first place. Nagging them to use condoms and to sleep around less does have some effect. Circumcision helps to protect men. A vaginal microbicide (none exists, but at least one trial has gone well) could protect women. The new hope centres on the idea of combining treatment with prevention.

Read the rest.
 


[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

IRMA ALC Presents on PrEP and Rectal Microbicides for Lima's Gay Community

by Steve Miralles

On May 11th, IRMA ALC (América Latina y el Caribe), based at Epicentro Gay Men’s Community Center in Lima, Peru, hosted a presentation on PrEP and rectal microbicides.

More than 15 men attended the presentation that was facilitated by IRMA-ALC leaders Steve Miralles and Jerome Galea.

The 15 community members included doctors, lawyers, psychologists and others participated in an open discussion/dialogue about these HIV prevention interventions under investigation and information was shared on the current state of the field of rectal microbicides and the inclusion of Lima in a RM study hopefully in 2012. 

Also, the results of the PrEP study (iPrEx) which took place in Lima was discussed along with the study’s results and how PrEP could change the HIV panorama.

Participants received IRMA's Spanish edition of the report “From Promise to Product” (De la Promesa al Producto: Avanzando en la Investigación y Promoción de los Microbicidas Rectales) AVAC fact sheets on iPrEx and other information and resources available in Spanish thanks to the IRMA-ALC team.

Now underway is the preparation of a radio program about rectal microbicides and iPrex to be aired in July on Epicentro's weekly program Espacio Común and an article for the next edition of Epicentro's magazine La Antena.

Visit IRMA ALC on Facebook. And check out the IRMA ALC page on the IRMA website to see some of those Spanish resources.

Also available in Spanish are IRMA's documents on lube safety:

Safety of lubricants for rectal use: A fact sheet for HIV educators and advocates

Safety of lubricants for rectal use: Questions & Answers for HIV educators and advocates

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

What's preventing prevention?

How national AIDS responses are failing in prevention efforts for key populations – an analysis of available data

via International HIV/AIDS Alliance

Several decades after the start of the global AIDS pandemic, data confirms that most low- and middle-income countries still do not adequately focus their HIV prevention efforts on the key populations of sex workers, men who have sex with me, transgender people, and people who use drugs.

Of all low- and middle-income countries that report standard information to the United Nations on their AIDS responses, more than half fail to include timely data concerning these key populations.

According to the International HIV/AIDS Alliance, which has conducted a review of 132 country reports, this is a strong indicator of the current level of national AIDS efforts devoted to reaching populations that are most affected by HIV.

Read more.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Meet Margaret Onah - a Friendly Rectal Microbicide Advocate

via IRMA

 Margaret Onah believes that rectal microbicides are an important priority among new HIV prevention technologies because so many people, both males and females, engage in anal sex and the society pretends that it is not real, and so do not want to be associated with it.

An advocate from Calabar, Nigeria, Margaret is the Director for Safe Havens International and is a member of IRMA and IRMA Nigeria. She provides support services to vulnerable women and girls (female sex workers, teenage mothers and widows) and communities by educating and informing them on issues of sexual & reproductive health rights. Her mission as an advocate for human rights and health issues is to enhance the well-being of her community and its most vulnerable members with a participatory approach.

Margaret was introduced to IRMA when she became a member of the Global Campaign for Microbicides and the New HIV Vaccine and Microbicides Advocacy Society (NHVMAS), the "steering wheel" for microbicide advocacy in Nigeria. She began her advocacy with IRMA because she is concerned about the stigma and discrimination associated with anal sex, which she knows prevent people from seeking diagnosis and treatment, further compounding the problem. "If we are soliciting for vaginal microbicides, we should do the same for rectal microbicides because sex is sex no matter what form."

When she's not working Margaret enjoys reading biographies, dancing, and Christian books and music.

Read about other friendly rectal microbicides advocates.
Newly featured advocates include Brian Kanyemba, Paul Semugoma, and Ian Lemieux.

Want to join the best e-mail discussion list on new prevention technologies on the planet? Send a note to IRMA here - rectalmicro@gmail.com - and we will get you signed up. Joining the list makes you an automatic IRMA member too!

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]