Meet Stephen McGill, A Friendly Rectal Microbicide Advocate

Find out a little about Stephen McGill in his mini-bio, the latest in IRMA's "Meet a Friendly Rectal Microbicide Advocate" series on the IRMA website here.  Stephen is one of five new bios posted in the past week.

 

Stephen McGill

Monrovia, Liberia 

Stephen McGill, with an extensive background in public health, HIV/AIDS prevention, and human rights advocacy, first came into contact with rectal microbicide advocacy when he joined the highly-active IRMA listserv through the help of ACT UP Philadelphia and Health GAP. As an active member on the listserv, Stephen is able to engage with experts, researchers, and activists on the potential of rectal microbicide research in combating HIV/AIDS in sub-Saharan Africa, notably his native Liberia.

Stephen is founder of Stop AIDS in Liberia (SAIL), one of three organizations that received small Global Lube Access Mobilisation (GLAM) grants to advocate for improved access to safe, condom- compatible lubricant So far, Stephen and SAIL have organized stakeholders meetings to promote condom compatible lubricants with other local organizations in Liberia, Sierra  Leone, Guinea, Gambia, and Cote d'Ivoire. In Liberia, Stephen has met with many organizations and media outlets including the Ministry of Gender and Development and the Ministry of Justice.

Stephen would also like to tell IRMA's followers to keep up the great work promoting diversity in advocacy, policy, and research. We are all looking forward to hearing more about Stephen and SAIL's advocacy efforts to improve lube access.

Thanks Stephen! 

 

------------------- *Join IRMA's robust, highly-active. moderated, global listserv addressing rectal microbicide research and advocacy as well as other interesting new HIV prevention technologies by contacting us at rectalmicro@gmail.com. Joining our listserv automatically makes you a member of IRMA - a network of more than 1,100 advocates, scientists, policy makers and funders from all over the world.

*Please look for us on Facebook: www.facebook.com/InternationalRectalMicrobicideAdvocates, and you can follow us on Twitter: @rectalmicro.

*Also, please note that shared news items from other sources posted on this blog do not necessarily mean IRMA has taken any position on the article's content. -------------------

South Africa: Aids Response Must Be Guided By Human Rights and Justice

via allAfrica, by Festus Mogae and Stephen Lewis

In South Africa and across Africa, HIV continues to prey on women, sex workers and men who have sex with men. It is clear that to end the HIV epidemic, we must protect and support these groups.

Archaic laws and customs make women and girls more vulnerable to HIV. Legally condoned violence and oppression-including genital mutilation, sexual violence, denial of property rights and early marriage- undermine the ability of women to protect themselves. Laws urgently need to protect women, who are often the ones left to care for the sick, tend to the family and till the fields.

Laws across the continent also criminalize homosexuality. Yet, punishing men who have sex with men force them into secrecy. They are unable to access counseling and testing, making it almost impossible for HIV prevention and treatment interventions to reach them. In 2008, when the Senegalese government jailed nine gay HIV outreach workers under a law prohibiting "acts against nature," health workers went into hiding, advocacy groups disbanded and HIV treatment sites were shut down.

The time has come for African leaders to take action against bad laws that stifle our HIV response. We must challenge societal values rooted in fear and prejudice and implement laws based on human rights and sound public health.

Read the rest.



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*Join IRMA's robust, highly-active. moderated, global listserv addressing rectal microbicide research and advocacy as well as other interesting new HIV prevention technologies by contacting us at rectalmicro@gmail.com. Joining our listserv automatically makes you a member of IRMA - a network of more than 1,100 advocates, scientists, policy makers and funders from all over the world.

*Please look for us on Facebook: www.facebook.com/InternationalRectalMicrobicideAdvocates, and you can follow us on Twitter: @rectalmicro.

*Also, please note that shared news items from other sources posted on this blog do not necessarily mean IRMA has taken any position on the article's content.
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PrEP Provides New Hope for HIV Prevention in Nigeria

via Leadership, by Winifred Ogbebo
*Mentions IRMA advocate Morenike Ukpong!*

Like a breath of fresh air, the news that a combination prevention drug would soon hit the Nigerian market is definitely something to cheer about, given Nigeria’s high prevalence of HIV rate, which is said to be second only to South Africa in the African continent. WINIFRED OGBEBO reports.

It is like Sunday-Sunday malaria drugs. But in this case, you take HIV drug to prevent HIV and HIV negative people, says the Director-General, National Agency for the Control of AIDS (NACA), Prof John Idoko, explaining the new prevention treatment drug, pre- exposure Prophylaxis.

“From what we learnt from malaria for example, he explains further, “if we give the drugs to somebody who doesn’t have HIV, and the person has sexual relationship with an HIV positive partner, it can prevent transmission from the positive person to the person. That is why it’s called a pre- exposure prophylaxis because before exposure, the person has taken the drugs and because he has the drugs in him, the virus cannot infect him or her.”

Also, Idoko says, “ If you take this sero-discordant couples; one is positive and the other is negative, instead of giving the drug to the negative person before the sexual relationship, just put the positive one on drug as soon as you know. It doesn’t matter what his CD-4 count is even if it’s 500, just give him the drugs. It has shown clearly one of the best study results that we have seen, as 96 per cent chance of the person transmitting HIV is blocked. So we call that treatment as prevention. So you can now imagine that if you go to a community, and they are using this method, your chances of blocking transmission are very high. We believe that these are the two things we need to put together as part of our combination prevention method.”

The pre-exposure prophylaxis is the newest HIV prevention tool that has been developed. It involves the use of Truvada, an antiretroviral to prevent HIV infection. A few studies have shown the ability of this drug to prevent HIV infection in sero-discordant couples, MSMs, transgenders and in men and women.

Read the Rest.



------------------- *Join IRMA's robust, highly-active. moderated, global listserv addressing rectal microbicide research and advocacy as well as other interesting new HIV prevention technologies by contacting us at rectalmicro@gmail.com. Joining our listserv automatically makes you a member of IRMA - a network of more than 1,100 advocates, scientists, policy makers and funders from all over the world. *Please look for us on Facebook: www.facebook.com/InternationalRectalMicrobicideAdvocates, and you can follow us on Twitter: @rectalmicro. *Also, please note that shared news items from other sources posted on this blog do not necessarily mean IRMA has taken any position on the article's content. -------------------

World Delegates Fight to Protect Homosexuals and Prostitutes in Uganda

via AllAfrica.com, by Gloria Nakiyimba

World politicians meeting in the Ugandan capital, Kampala, have agreed on the need to repeal laws discriminating against HIV/Aids which they say have contributed to an increase in the rate of new infections.

MP's at the Inter Parliamentary Union assembly said laws that criminalize transmission of HIV, laws against sexual workers and those discriminating against sexual minorities need to be repealed.

Speaking during a panel discussion, Professor Sheila Tlou, UNAIDS Regional Director for Eastern and Southern Africa, said "there is a fear that a still highly stigmatized condition such as Aids can, and will, fall out of the agenda of national and global leaders".

Tlou said early signs of a decreasing commitment to Aids in the form of reduced funding for HIV prevention, treatment, care and support were worrying especially since the epidemic is far from being over.

She said where the law deepens social fractures and inequality, denies access to services and criminalizes those who need these services it becomes an obstacle to the Aids response.

In Uganda, the HIV and Aids Prevention and Control Bill 2010 was aimed at criminalising attempted transmission of HIV. The anti-homosexuality bill which remains on the shelves of parliament was identified as discriminatory and hampering the fight against HIV/Aids.

MP's called for zero discrimination against people living with Aids if the new campaign for zero new HIV infections and zero Aids related deaths is to be successful.

Tlou said UNAIDS was working with countries to introduce a programme to eliminate mother-to-child transmission to ensure that no child is born with the disease.

In 2009, the World Health Organization estimated there are 33.4 million people worldwide living with HIV/Aids, with 2.7 million new HIV infections per year and two million annual deaths due to Aids.

Ugandan MP Doctor Elioda Tumwesigy said 7,000 people are infected every day worldwide - half the number are women and girls in sub-Saharan Africa.

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.]

Ugandan Gay Rights Activists Fight Against Anti-Homosexuality Bill

via Chicago Sun Times, by Frank Mugisha

The world listened last week as Liberian President Ellen Johnson Sirleaf defended her country’s laws that discriminate against its lesbian, gay, bisexual, transgender and intersex population. In an interview with the Guardian newspaper, she spoke of preserving Liberia’s “traditional values” and said in part, “We like ourselves the way we are.”

It’s a sad sentiment I hear in my own country of Uganda: the idea that homosexuality is somehow un-African and foreign to our culture, an import of the West that must be stopped. But it is not African to restrict another’s freedom. It is not African to spread lies and dissent and urge brutality against others. And it is certainly not African to deny fellow citizens basic human rights. No, these are ideas introduced and fostered by our colonizers, not by our ancestors.

My organization, Sexual Minorities Uganda, works against these forces of hate and division, and we live every day under the threats of violence that keep so many LGBTI Ugandans from coming forward. In 2010, a local newspaper published photographs and addresses of many of us under the headline “Hang Them.”

But still we work, because there is so much work to be done: gay men to be rescued from jail after arbitrary arrests and beatings. Lesbian women who need to be sheltered after curative rape assaults. Friends to be healed after being denied medical care.

The anti–gay groups call this struggle a campaign for gay rights. But there is nothing gay or straight about the right to worship, to assemble publicly or to live without fear of sanctioned brutality.

In Uganda today, bosses routinely fire employees suspected of being gay. We can be expelled from school or denied medical attention. Our friends and neighbors can be persecuted just for being seen with us.
The Ugandan Parliament is pushing a bill that is inspired by hateful ideas brought to us, not from within Africa, but by anti-gay activists like Scott Lively from the United States. The new law would equate gay people with pedophiles and call on the LGBTI population to stop “promoting homosexuality.”


The original version of the legislation even called for applying the death penalty to gay couples, and although it may be revoked from the final bill, even the more “palatable” version seeks to silence our voices, criminalize anyone who speaks on our behalf and encourage the wrongheaded stigmas that increase our nation’s rising HIV prevalence.
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.]

High HIV Prevalence Found Among Ugandan Sex Workers

via New Vision, by Joyce Nyakato

New research published in The Lancet, an international medical journal, has revealed that commercial sex workers in Uganda have one of the highest rates of HIV infections in the world.

Some 99,878 female sex workers in 50 countries (14 in Asia, four in Eastern Europe, 11 in Latin America and the Caribbean, one in the Middle East and 20 in Africa), were subjects in the study conducted between January 1, 2007 and June 25, 2011. Results of the study, which was led by Dr. Stefan Baral of the US-based John Hopkins School of Public Health, were released on Thursday.

The study, which assessed the burden of HIV compared to that of other women of reproductive age, found that the burden is disproportionately high and concluded that there is an urgent need to scale up access to quality HIV prevention programs for sex workers.

State minister for ethics and integrity Fr. Simon Lokodo agrees that like all Ugandans, sex workers have a right to HIV treatment and attention.

“However, giving them the leeway to operate as a business is too much to ask from the Government,” he said.

The four-year survey funded by the World Bank and the United Nations Population Fund ranked Uganda as one of the countries where sex workers had a higher HIV prevalence than other women.

Women who sell sex came sixth among the 20 African countries after Malawi, Zimbabwe, South Africa, Kenya and Benin.

An average of four sex workers in ten will have HIV.

This rate is about five times more than other women of reproductive age, who have 7.7% prevalence, according to the recent AIDS indicator survey released by the Ministry of Health last week.

In addition, the likelihood of new HIV infections among sex workers stands at 15%.

“These findings suggest an urgent need to scale up access to quality HIV prevention services among female sex workers because of their heightened burden of disease and the likelihood of onward transmission through the high number of sexual partners as clients,” Stefan wrote.

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.]

Increase in HIV Prevalence Causes Concern in Uganda

via PlusNews Global

Uganda's HIV/AIDS prevalence rate has risen from 6.4 percent to 6.7 percent, according to a recently released national AIDS Indicator Survey.

The population-based HIV serological survey showed that 6.7 percent of adults aged between 15 and 49 were HIV-positive, while at least 500,000 people have been infected with the virus in the past five years.

Uganda's HIV prevalence fell from a high of 18 percent in 1992 to 6.1 percent in 2002; this rate later stabilized and then stagnated at about 6.4 percent in 2004, when the last such survey was conducted.

Some 7.7 percent of women are positive, compared to 5.6 percent of men, according to the 25-page preliminary report launched by Health Minister Christine Ondoa on 15 March in the capital, Kampala. The full report is due for release in June 2012.

Government officials have played down the higher prevalence. "The increase is not much… because of the population growth; there are new people entering into the age bracket of 15 to 19," said Dr Zainab Akol, programme manager for HIV in the Ministry of Health.

However, activists are concerned that the new statistics are the result of gaps in the government's HIV prevention programmes.

"I don't agree that the rise is merely as a result of an age shift - prevention efforts do not match the needs of the population... it is not uncommon to run out of basic [HIV prevention] supplies like condoms," said Milly Katana, long-term activist and one of the inaugural board members of the Global Fund to fight HIV, Tuberculosis and Malaria.

"We are becoming increasingly concerned about risk compensation as a result of failing HIV prevention messages," she added. "People, especially the elites in cities, have a false sense of safety... we did work 10 years ago but it is not enough; behaviour change is not sustainable without regular doses of information."

Despite years of condom promotion, the survey found that just 28.1 percent of women and 31.4 percent of men aged between 15 and 19 used a condom during their last sexual encounter, dropping to 6.7 percent and 12.2 percent respectively among 30- to 39-year-olds.

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.]

Ugandan Gay Rights Activists Take Action

via New York Times, by Laurie Goodstein

A Ugandan gay rights group filed suit against an American evangelist, Scott Lively, in federal court in Massachusetts on Wednesday, accusing him of violating international law by inciting the persecution of gay men and lesbians in Uganda.

The lawsuit maintains that beginning in 2002, Mr. Lively conspired with religious and political leaders in Uganda to whip up anti-gay hysteria with warnings that gay people would sodomize African children and corrupt their culture.

The Ugandan legislature considered a bill in 2009, proposed by one of Mr. Lively’s Ugandan contacts, that would have imposed the death sentence for the “offense of homosexuality.” That bill languished after an outcry from the United States and European nations that are among major aid donors to Uganda, but was reintroduced last month.

Mr. Lively is being sued by the organization Sexual Minorities Uganda under the alien tort statute, which allows foreigners to sue in American courts in situations asserting the violation of international law. The suit says that Mr. Lively’s actions resulted in the persecution, arrest, torture and murder of gay men and lesbians in Uganda.

Reached by telephone in Springfield, Mass., where he runs Holy Grounds Coffee House, a storefront mission and shop, Mr. Lively said he did not know about the lawsuit. Nevertheless, he said: “That’s about as ridiculous as it gets. I’ve never done anything in Uganda except preach the Gospel and speak my opinion about the homosexual issue.”

Mr. Lively is the founder and president of Abiding Truth Ministries. He is also the author of “The Pink Swastika: Homosexuality in the Nazi Party,” which says that Nazism was a movement inspired by homosexuals, and “Seven Steps to Recruit-Proof Your Child,” a guide to prevent what he calls “pro-homosexual indoctrination.”

He has traveled to Uganda, Latvia and Moldova to warn Christian clergy members to defend their countries against what he says is an onslaught by gay rights advocates based in the West.

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.]

FEM PrEP Study Releases Trial Results

via MedPage Today, by Ed Susman

Pre-exposure prophylaxis with antiretroviral drugs failed to prevent women in Africa from becoming infected with human immunodeficiency virus (HIV) – apparently because more than half the women failed to take their medication.

The incidence of HIV infection among previously uninfected women treated with a co-formulation of emtricitabine and tenofovir (Truvada) was 4.7 per 1,000 person-years compared with a rate of 5 per 1,000 patient-years among women in the placebo group (P=0.81), said Lut Van Damme, MD, PhD, senior scientist at FHI 360, in Durham, N.C.

In a press briefing here at the Conference on Retroviruses and Opportunistic infections, Van Damme said it was likely that lack of adherence resulted in the failure to show a difference between those women on the active antiretrovirals and those who received placebo.

"The women in the study seriously overestimated adherence," she said. The participants told researchers that they took their assigned medicine 95% of the time. Pill counts indicated that 85% of the pills were not returned at regular points in the trial. But tests for emtricitabine/tenofovir in the blood of patients showed that only about 40% of the women had levels of the drug that would indicate the pills had been ingested within 48 hours of the tests.

The study was stopped early when an interim analysis showed that it was unlikely to prove positive.

The so-called FEM-PrEP was a randomized, double-blinded, placebo-controlled trial of once-daily oral emtricitabine/tenofovir. The primary effectiveness endpoint was incident HIV infection during 52 weeks of follow-up.

Participants attended screening, enrollment, and follow-up visits monthly. HIV seroconverters were taken off the product and followed for an additional 52 weeks

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.]

UNAIDS Director Michel Sidibé Uses Charm in Diplomacy to Fight AIDS

via NY Times, by Donald G. McNeil, Jr.

Shortly after Michel Sidibé became executive director of the United Nations’ AIDS prevention agency, a court in Senegal sentenced nine gay men, all AIDS educators, to eight years in prison for “unnatural acts.”

In one of his first moves as the new chief of U.N.AIDS, Mr. Sidibe flew to Senegal to ask its aging president, Abdoulaye Wade, to pardon the men.

Mr. Sidibé, the son of a Muslim politician from Mali and a white French Catholic, asked the president — who is married to a white Frenchwoman — if he had ever suffered discrimination.

“Oh, Sidibé, you have no idea,” came the reply. “And for not marrying a Muslim.”

“Then, Uncle,” Mr. Sidibé said, using the African way to politely address an older man, “why do you accept that men here are put in jail for eight years just for being gay?”

Mr. Wade thought about it and promised to call his justice minister. Shortly afterward, the charges were dropped.

Asked if his predecessor — Dr. Peter Piot, a Belgian and one of the discoverers of the Ebola virus — could have gotten the same results, Mr. Sidibé said, “Without doubt, it would have been more difficult. It would be very automatically perceived as ‘the white people moralizing to us again.’ Since I’m African, I can raise it in a way that is less confrontational.”

Asked about that, Dr. Piot laughed and agreed, saying he sometimes thought his African missions, like those of the U2 singer Bono, “felt like a junior Tanzanian economist and Hugh Masekela coming to Washington to scold Congress for its budget deficit” — with Congress having to grin and bear it because it needed Tanzania’s cash.

Mr. Sidibé, 59, is a former relief worker, rather than a physician, and, along with English and French, he speaks West African Mandingo, the Tamashek of the Tuaregs and other languages.

With a combination of bonhomie and persistence, he has delivered difficult messages to African presidents very persuasively in his three years in office: Convince your men to get circumcised. Tell your teenage girls not to sleep with older men for money. Shelve your squeamishness and talk about condoms. Help prostitutes instead of jailing them. Ask your preachers to stop railing against homosexuals and order your police forces to stop beating them. Let Western scientists test new drugs and vaccines, despite the inevitable rumors that Africans are being used as guinea pigs.

“You can’t say ‘no’ to Michel,” said Dr. Piot, who hired him away from Unicef. “I was at a conference in Ethiopia in December, and for the first time, I felt I was hearing ‘ownership’ of AIDS by African countries. They weren’t talking so much about the donors, but about it as their own problem. I think he had a lot to do with that.”

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.]

An interview with South African Constitutional Court Judge Edwin Cameron discussing homophobia in Africa

via BBC HARDtalk, Interview with Edwin Cameron

Living as an openly gay man in socially conservative Africa is hard enough, but Edwin Cameron went even further. He was the first public official in South Africa to reveal his HIV positive status. Nelson Mandela appointed him a judge and he now serves on South Africa's Constitutional Court. There remains high levels of homophobia on the continent - why are gay activists like Cameron losing the argument?



Watch Part 2 of the video 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.]

No time to give up on microbicides

via allAfrica.com, by Julie Frederikse

Africans tracking the worldwide HIV epidemic have not found much to celebrate since Aids began ravaging the continent 30 years ago, but researchers are optimistic that they are learning as much from their failures as their successes.

Sub-Saharan Africa still carries the biggest burden of HIV worldwide, and while there has been a significant improvement in access to antiretroviral treatment in recent years, scientists searching for a gel or vaccine that can prevent HIV infection ride a rollercoaster of hope and disappointment.

Take the case of a husband and wife team from the University of KwaZulu-Natal in South Africa. Professors Salim Karim and Quarraisha Abdool Karim head up a research unit that has been at the forefront of clinical trials to find a safe and effective microbicide to protect women from HIV.

In July 2010, delegates at the last World Aids conference gave the couple a standing ovation when they announced the results of one of the most promising studies on HIV prevention to date. Their team at the Centre for the Aids Program of Research in South Africa (Caprisa), showed that a vaginal gel called tenofovir was able to reduce sexual transmission of the virus by 39 percent overall and 54 percent in women who used it consistently.
But the euphoria over this breakthrough has dissolved into disappointment, with the unexpected finding of a wider sub-Saharan African study that the microbicidal gel, when prescribed daily, does not prevent HIV infections. This has led to the suspension of tenofovir in the Vaginal and Oral Interventions to Control the Epidemic (Voice) trial.

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.]

Meet Thomas Muyunga: Another New Friendly Rectal Microbicide Advocate!

“When one goes to fish, they go to the water body for fish. With the net one catches all sorts of fish and other debris. Sorting out the fish from debris is part of fishing. Same applies to HIV work. Talk about HIV, engage in activities around mobilising beneficiaries and challenge them to participate fully- make it enjoyable. Show the whole list of HIV fuels. Show how stigma, discrimination and abuse fuel HIV in communities.”

Thomas Muyunga is an IRMA Advocate from Kampala, Uganda. There he is CEO of MARPS (Most At Risk Populations’ Society) In Uganda, an umbrella organization committed to “lasting, enduring, and durable solutions against poverty.” Their work focuses on “PLEASE” - Protection, Lasting sexual-reproductive health practices, Empowerment, Attitude change, Social integration and Education. Thomas loves to mobilize communities and prepare and empower them to fight poverty, discrimination, and HIV.

Thomas has worked in HIV Services Provision since 1993 when he was a student volunteer at Rotary International. He first became aware of microbicides at an STD/STI Clinic at the National Referral Hospital in Uganda. He has since dedicated much time and effort to learning about and advocating for the development of successful microbicides. He will join IRMA as a Project ARM (Africa for Rectal Microbicides) scholarship grantee in Addis Ababa, Ethiopia prior to ICASA 2011 to be part of a working meeting to develop an African rectal microbicide agenda!

He believes rectal microbicides are very important because they bring more attention to anal intercourse and help to create conversation about it. He hopes this will also stimulate talk about the power dynamics of anal intercourse.

His advice for others wanting to become IRMA advocates is to first focus on learning as much as possible about HIV prevention, care and treatment so that you can teach others about these issues. Education will also prepare you to inform planning, programming and policy. We can only move forward if we are educated.

Read more Friendly Rectal Microbicide Advocate bios.



[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 Amadou Moreau: Another New Friendly Rectal Microbicide Advocate!

“Advocating for the cause of minority groups in general is on my everyday to do list.”

Amadou Moreau is an IRMA advocate from Dakar, Senegal. There he is also a sociologist and demographer and Vice President of Global Initiatives at the Global Research and Advocacy Group (GRAG) - and he loves his job. HIV related matters are among key issues GRAG advocates for, as well as youth education across the developing world and gender-based violence.

He stays up to date on IRMA through the listserv and is hoping to become more involved through greater collaboration between IRMA and GRAG. He believes this relationship could be an asset to “enhance education and advocacy initiatives” and that IRMA collaboration with other groups, like GRAG, could do the same.

To Amadou, rectal microbicides are important among new HIV prevention technologies because they could be easy and safe to use and could add an important element to prevention packages. He has learned that across the developing world, and particularly in sub-Saharan Africa, it is not easy to advocate for rectal microbicides. However, he believes that with commitment and creativity IRMA advocates can succeed. He is excited to work with IRMA to bring more positive change to those who need it most.

Read more Friendly Rectal Microbicide Advocate bios.


[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.]

‘Confront legal and policy barriers to HIV’: Sub-Saharan Africa Regional Dialogue on HIV and the Law

Via UNAIDS.

In Sub-Saharan Africa, the region most heavily affected by HIV, legal, policy and social barriers, including stigma, discrimination, gender inequality and the criminalization of key populations at higher risk of HIV infection, continue to make people vulnerable to HIV and hamper the ability of individuals, communities and states to respond to the epidemic. This was the conclusion of the Regional Dialogue for sub-Saharan Africa, part of the Global Commission on HIV and the Law, held at the beginning of August in Pretoria, South Africa.

No taboo should be left unchallenged

A significant breakthrough came from the pledge of participants to highlight and discuss all aspects of the legal environment relating to HIV, including laws and practices related to stigma and discrimination, access to affordable treatment, children and adolescents, women’s rights and gender-based violence.

“This regional dialogue is a great opportunity for us, as Africans, to confront the difficult issues including discriminatory and punitive laws that target sex workers and men who have sex with men, and other populations vulnerable to HIV,” said Bience Gawanas, African Union Commissioner for Social Affairs.

The criminalization of drug use, sex work and same-sex sexual relations was also confronted by the participants in a bid to challenge all taboos. This is remarkable as recent punitive legal and policy developments in a number of countries in sub-Saharan Africa relating to the situation of members of key populations has raised concerns about the readiness of stakeholders in the region to confront this issue. Some 31 countries in the region criminalize sex work, and same-sex sexual relations constitute a criminal offence in at least 30 countries.

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.]

Risk factors for HIV vary between African cities, need tailored responses

Via AIDSMap, by Carole Leach-Lemens.

A comparative study in three large cities in southern Africa has found big differences in risk factors for acquisition of HIV infection, emphasising the importance of locally tailored HIV prevention strategies and up-to-date information on local risk factors.

The study looked at behavioural risk factors associated with acquiring HIV infection in 5000 sexually active women in Harare, Durban and Johannesburg who took part in a large trial of an HIV prevention method based on use of the diaphgram.

Sue Napierala Mavedsnege and colleagues report the findings of their prospective cohort analysis in the advance online edition of the Journal of Acquired Immune Deficiency Syndromes.

A total of 309 incident HIV infections were identified. Durban reported the highest incidence rate, followed by Johannesburg and then Harare (6.75 per 100 person years, 95% CI: 5.74-7.93; 3.33 per 100 person years, 95% CI: 2.51-4.44; 2.72 per 100 person years CI: 2.26-3.26, respectively).

Having more than one partner in the last three months was the only common factor associated with HIV incidence.

The majority of the estimated 35 million people living with HIV live in sub-Saharan Africa where 70% of all new infections occur. Women represent over 60% of all infections. Southern Africa, with the highest regional prevalence, reflects different phases of the epidemic.

In Zimbabwe, with an estimated prevalence of 14.3%, the epidemic began early, peaked in 1998 with a subsequent decline in incidence and prevalence.

From 1990-1998 South Africa had an exponential increase followed by a moderate increase until 2004 when apparent stabilisation began. In 2008 estimated provincial prevalence rates ranged from 5.3% to 25.8%.

In Gauteng province, with Johannesburg its largest city, prevalence appears to have peaked in 2002 at 20.3% and declined to 15.2% in 2008. In contrast, Kwa Zulu Natal province where Durban is the largest city, estimated prevalence rose from 15.7% in 2002 to 25.8% in 2008.

While cross-sectional studies looking at risk factors associated with HIV have taken place in Zimbabwe and South Africa, few have looked at risk factors for HIV incidence in women. A better understanding of these factors within local contexts will help develop targeted interventions so reducing transmission.

The authors looked at factors associated with differences of HIV incidence among women in Harare, Johannesburg and Durban enrolled between September 2003 and September 2005 in the Methods for Improvement of Reproductive Health (MIRA) study, a randomised clinical trial to look at the effect of the diaphragm plus lubricant gel for the prevention of HIV. The intervention did not reduce HIV incidence.

The authors undertook a prospective cohort analysis of trial participants who were followed for a median of 21 months (12-24 months).

Socio-demographic, biological and behavioural data were collected at baseline and at quarterly visits. Testing for HIV and STIs were conducted at each quarterly visit.

Each location had distinct characteristics as well as different patterns of individual risk factors.

In Harare women were more likely to live with their partner, be employed and not use alcohol or drugs but more likely to wipe inside their vagina. While they had a later sexual debut and fewer partners than in Durban or Johannesburg there was more transactional sex (for money, food, drugs or shelter) within the last three months.

Early sexual debut was more common in Durban, while in Johannesburg consumption of alcohol within the last three months, multiple sexual partners and sex under the influence of drugs or alcohol were more likely.

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.]

“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.

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[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: Counselling, not alarm device, had best effect on ART adherence

Via aidsmap, by Carole Leach-Lemens

Patients in Nairobi, Kenya getting intensive early adherence counselling when starting antiretroviral therapy were 29% less likely to have poor adherence and 59% less likely to have virological failure compared to those getting no counselling Michael H Chung and colleagues reported in a randomised, controlled trial published in the March issue of PLoS Medicine.

The positive effects of counselling on adherence were seen immediately after starting antiretroviral therapy and maintained throughout the18 month follow-up period. Use of an alarm device had no effect on adherence or virological outcomes. Public health concerns that scale-up of antiretroviral treatment in sub-Saharan Africa would lead to poor adherence and widespread drug resistance have been proven wrong, note the authors.

The authors conclude “as antiretroviral treatment clinics expand to meet an increasing demand for HIV care in sub-Saharan Africa, adherence counselling should be implemented to decrease the development of treatment failure and spread of resistant HIV.”

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[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.]

African Girls Getting World Bank Cash Deters Sex With 'Sugar Daddies'

Via Bloomberg, by Simon Clark

Young women in sub-Saharan Africa have HIV infection rates up to three times higher than their male peers, largely because of relationships with older "sugar daddies" who give them money in exchange for sex.

The phenomenon contributes significantly to HIV's spread, said Ester Etkin of loveLife, South Africa's largest anti-AIDS group.

A World Bank study in Malawi examined cash incentives among approximately 3,800 females ages 13-22. One group received roughly $10 a month and payment for school fees if they regularly attended class, while the control received no incentives. HIV infection rates at 18-month follow-up were 60 percent lower among girls who were given cash: 1.2 percent, compared with 3 percent. The study also showed a delay in the start of sexual activity among beneficiaries and a decline in the number of partners among those who were sexually active.

Though the study's results are being assessed by a peer-reviewed journal, plans are underway to repeat the experiment elsewhere in Africa, said Mayra Buvinic, director of gender and development at the World Bank. "The potential could be huge to reduce HIV rates in teenage girls," she said.

But some experts question whether cash payouts are an appropriate strategy. "We could end up creating an environment of dependency that cannot be sustained," warned Peter Lamptey, a Family Health International physician practicing in Ghana. "Paying people to influence their sexual behavior won't solve the wider problems of abuse, esteem, neglect and inequality that cause them to get HIV," said Sophie Harman, a senior lecturer at London's City University who has studied World Bank AIDS policies.

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[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.]