[Delhi Dynamos] Lanre Onigbogi of Ibadan, Nigeria

More Grease to Your Elbows!
Proud Member of IRMA Puts Rectal Microbicides
on the African Map

Correspondence from IRMA advocates

by way of India

M2008 memories and the path forward

by Lanre Onigbogi

I had always wondered what it would be like visiting the Asian continent and M2008 provided that opportunity. As a rectal microbicide advocate and an IRMA scholarship recipient, the challenge could not be bigger because there was so much to look forward to about the conference. The excitement was further heightened by the fact that my exposure to rectal microbicide sessions at M2006 had generated my venturing into research related to rectal microbicides. I wondered whether my exposure to the rectal microbicides sessions in this meeting will heighten my curiosity about the subject or totally dampan my enthusiasm. In summary, I was not disappointed and could not have wished for a better conference. 

The apprehension about how the rectal microbicide sessions and how to combine that with the volunteer efforts at the advocate corner was too overwhelming to be hidden from colleagues who were also participants at the meeting. This was heightened by the fact that I had made up my mind to talk to some Nigerian delegates about the International Rectal Microbicide Advocates (IRMA), an area that was hitherto novel to many of my colleagues.

Anecdotal reports put it that many who came without ever hearing about rectal microbicides ended up signing up to be advocates.

The M2008 conference itself was a great success. If we can learn from this conference and support the development of research on microbicides and convince investors to invest more in these, it would be a great achievement. There were also many youths, especially really dynamic ones from Africa who I believe will grow up to become great advocates. Simply put, youths are the best investment in the future of our nations, as they are healthy and fresh workers. The rectal microbicide agenda was also a greater success. Anecdotal reports put it that many who came without ever hearing about rectal microbicides ended up signing up to be advocates. Quite an achievement bearing in mind the stigma that is still associated with homosexual relationships in many parts of the world.

We need to look at the research agenda of the conference so that African universities can do operations research and evaluate their rectal microbicide programs. I look forward to a cohort of researchers and advocates who will come out of Africa and will collaborate to get funding for rectal microbicide research and advocacy. 

Since coming back from Delhi, I have picked up the responsibility of editing the Quarterly Newsletter of the Nigeria HIV Vaccine and Microbicides Advocacy Group (NHVMAG) called the NHVMAG Echoes. We are in the final stages of producing the newsletter that will highlight activities at M2008, and the success of advocacy efforts by IRMA will be showcased. I also look forward to participating in the rectal microbicide sesions of the AIDS 2008 conference in Mexico City later in the year as well as further involvement in rectal microbicide research and advocacy.

My heartfelt gratitude goes to the steering committee of IRMA and the indefatigable Jim Pickett for working tirelessly to put the rectal microbicide agenda on the main table, thereby potentially saving many valuable lives of African women and men.

More grease to your elbows!

I am proud to belong to IRMA and will forever be grateful for this wonderful opportunity to attend M2008 and look forward to seeing you all in Pittsburgh!

Read other Delhi Dynamo entries.

Check out IRMA's photo set from the M2008 conference here.

Did you attend M2008 and want to add your photos to our growing collection? Send Jim Pickett of IRMA a note with your photos attached and they will be included.

The unspoken truths about Aids

[Via Great Britain's The Sunday Times Online, epidemiologist Elizabeth Pisani says political correctness over criticising sexual practices such as multiple partners in Africa has prevented us finding an effective strategy to fight HIV. Check out Elizabeth's controversiall blog - The Wisdom of Whores]

After researching HIV for over a decade, I know that we now have the information, the tools and the money required to eradicate Aids in most of the world. But we’re not doing it – and that makes me very angry.

To be fair, Britain has been a world leader in sensible HIV prevention. Under Margaret Thatcher, we were the first country to fund clean needles for drug injectors at a national level, and to make methadone widely available so that heroin addicts could stop injecting. The result: fewer than one in 75 drug injectors in Britain is infected with HIV, compared with one in two in Indonesia, for example.

For all its sensible policies, though, Britain won’t give out needles in prison. Yet two-thirds of all injectors in Britain have been to prison at some point; and nearly a quarter of all male injectors in prison say they’ve shot up while inside. Meanwhile, taxpayers fund needle-exchange programmes in prisons in other countries through the Department for International Development. But in Britain, the Home Office dictates what happens in prison, and denial rules.

I call it the Three Monkeys approach to HIV: we close our eyes to people injecting drugs, to people buying and selling sex, to people getting plastered and getting laid. We close our eyes, in short, to all the things that do the most to spread HIV.

Yet we can’t close our eyes to the fact that nearly 60m people have been infected with a preventable, fatal disease. About 25m of those are already in their graves. It’s also hard to ignore the fact that two-thirds of people with HIV in the world are Africans. Yet few people ask why.

HIV is largely a sexually transmitted infection, so there must be something different about sex in Africa. Yet you can’t say that without appearing to be racist. So campaigners have come up with other reasons that HIV is worse in Africa: poverty, ignorance, men having more power than women. All politically correct, but not epidemiologically correct.

Read the rest.

A Spade is a Spade - "Anal Sex is a Public Health Risk"

[IRMA received permission to re-print this e-mail correspondence from Dr. Ruben F. del Prado, the UNAIDS Country Coordinator for Guyana and Suriname (left), calling on his global colleagues to address unprotected anal sex as a public health risk.]

Dear UNAIDS colleagues, members of the Global Forum on MSM and HIV, The Johns Hopkins Bloomberg School of Public Health, and The Royal Tropical Institute colleagues… fellow workers towards universal access for all,

Seizing the opportunity to reiterate my appeal to ‘call a spade a spade,’ please check this out.

More than ever before, UNAIDS and its partners must strongly advocate for establishing unprotected anal sex as high risk behaviour and a public health risk, and not as conduct that typifies ‘marginalised’ groups and ‘sexual minorities.’ This would make good public health sense, and immensely benefit HIV prevention through broader community prevention messages that might more usefully fit overall HIV prevention objectives.

By continuing to use euphemisms in the HIV arena such as ‘MSM’ and ‘gender’ we actually undermine gay and transgender rights activism by further stereotyping men who have sex with men and transgender people.

There continues to be an urgent need for activism, for instance by demanding medical and nursing training colleges and HIV counseling and prevention programmes to address sexual health related pathology and psychology of sexual minorities in their curriculums and training programmes. There is no doubt about that!

I hold and intensify my firm stand on the importance of identifying unprotected anal sex as a public health risk.

It is not without reason and common sense that extensive consultations throughout India have resulted in the key recommendation to address male-to-male sexual transmission of HIV by "Mainstreaming ‘unprotected anal sex’ as a public health risk: As a key public health measure, advocate for and put emphasis on unprotected anal sex as a mode of HIV transmission in all relevant health programmes; not just those for MSM or Hijras but also for other populations."

[Click here for the full report, organized by NACO, supported by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the Resource Centre for Sexual Health and HIV/AIDS (RCSHA), June 21st – July 5th 2006]

I am an advocate and international civil servant working towards HIV prevention, treatment care and support for all, but first and foremost I am a public health professional. If we want to make an impact in our time and be seen by the next generation as successfully establishing solid HIV prevention practice, we must address unprotected anal sex head on with full force as a public health and sexual health issue of great concern. Religious, cultural and societal dogma notwithstanding, we can and we must.

Regards,
r
Uniting the world against AIDS
Dr. Ruben F. del Prado
UNAIDS Country Coordinator for Guyana and Suriname

HIV prevention studies in Africa: it's important to ask about anal sex

[originally published on aidsmap, april 10, 2008]

Individuals enrolled on HIV prevention trials in Africa should be asked if they have had anal sex, suggest investigators in a article published in the online edition of Sexually Transmitted Infections. Their study found that 18% of women enrolled in their study had recently had receptive anal sex and that undiagnosed anal sexually transmitted infections were present in many of these individuals.

Studies into sexual behaviour in Africa have often neglected to enquire about anal sex, and sex between men. There has either been an assumption that such behaviour was not prevalent, or a sensitivity to cultural taboos and prejudices means that investigators are reluctant to enquire about such behaviour. But studies are now suggesting that anal intercourse is common in Africa in both heterosexual and homosexual contexts and is an important mode of HIV transmission.

The study also showed that relying on patient report of symptoms will lead to many sexually transmitted infections remaining undiagnosed, and that simple microscope examinations of genital and anal swabs can lead to more infections being diagnosed.

Read the rest on aidsmap.

For related analysis, read IRMA's new report - "Less Silence, More Science" here.

[Delhi Dynamos] Shaleena Theophilus of Ottawa, Canada

Renegade Daughter and Microbicide DIVA
Makes Subcontinental Advocacy Magic

Proves You CAN Go Home
And Walk the Talk

Correspondence from IRMA advocates

by way of India
M2008 memories and the path forward

by Shaleena Theophilus

Thanks to the generous funding by IRMA through the John Shaw Memorial Scholarship, I was able to attend the Microbicides 2008 conference that was held in New Delhi. For me, these conferences are so amazing because you not only get to attend sessions on the latest in the field of microbicides research, you also get to genuinely interact with people from all sectors invested in microbicides advocacy from around the globe. How amazing is that!

I did my usual conference routine of trying to attend at least one session from every track. I had to stretch my mind a bit for the basic and clinical sciences, but overall, the information that I brought back was useful and informative for the work that I will be doing here in Canada.

Now, being an Indo-Canadian, this conference held an added importance to me. I had not been back to India for 13 years (as my family who still live there reminded on every occasion possible) and seeing how it has changed and the impact that this disease has had was something that I find hard to describe. In Canada, there are a handful of us -- South Asians working in this field. I found it inspiring to be surrounded by other Indians who are not only committed to the cause, but who also have an interest in microbicides.

Heading off after the conference, I had wished that more delegates could have seen Delhi beyond the confines of the conference, and experienced India in all of its intensity. I left to visit the plethora of aunties and uncles in the south, and I found that attending Microbicides 2008 afforded me the opportunity to talk with many of my relatives about these issues. I secretly chuckle when I think of my mother finding out that I talked about sex to her childhood classmate. However, I guess it is the smallest things that can have the biggest impact, whether that be giving a renegade daughter a secret pleasure or changing a person’s perception and actions around this disease.

Back in Canada, I have already had the opportunity to share what I had learned with the Canadian Microbicides Action Plan steering committee, as well as the Microbicides Advocacy Network Group. I will also be incorporating this information into upcoming presentations, the next of which will be held for community members in Nova Scotia at their regional skills building conference.

I look forward to the next conference in Pittsburgh. More importantly, I look forward to one day showing community members what a microbicide looks like and how to use it both vaginally and rectally as the newest prevention option available to them!

Read other Delhi Dynamo entries.

Check out IRMA's photo set from the M2008 conference here.

Did you attend M2008 and want to add your photos to our growing collection? Send Jim Pickett of IRMA a note with your photos attached and they will be included.