Beijing, February 20: China will come up with a special HIV/AIDS prevention policy this year to combat the rising incidence of the infection in the gay population of the country, the ministry of health said here Wednesday.
The policy will incorporate detailed HIV/AIDS prevention measures for gays, including extending the use of condoms, according to the ministry's work plan for disease prevention and control in 2008.
China has decided to intensify its AIDS intervention campaign on gays by carrying out AIDS prevention training among the gay population nationwide as well as conducting consultation, HIV/AIDS tests, venereal disease treatment in some areas, the ministry said.
According to an appraisal report jointly prepared by the Ministry of Health, the World Health Organization (WHO) and UNAIDS, among the 700,000 people living with HIV/AIDS in China by the end of 2007, 40.6 percent contracted the virus through heterosexual transmission, 11.1 percent through same sex intercourse.
'Sex has become the main channel of contracting the HIV virus,' the report said.
China's health department estimated that the country has 5 million to 10 million gays. Most of them are in middle and large cities in China.
According to recent research on gays, prevalence of HIV/AIDS among this group in China is getting serious with the infection rate reaching 2.5 percent to 6.5 percent.
The Chinese government will expand its coverage of replacement therapy for drug addicts, using methadone, a synthesised narcotic, and continue to improve its policy of offering AIDS patients various free services, such as counselling, testing, anti-viral medicine and education for orphans of AIDS patients, the ministry said.
Clinics providing the therapy have been built in 503 communities in 23 provinces, autonomous regions and municipalities, figures from the Chinese Center for Disease Control and Prevention (CDC) showed.
HIV/AIDS policies and programmes disregard the sexual needs of people living with the virus, claim a number of HIV-positive women who attended the third Africa Conference on Sexual Health and Rights -- held this week in Nigeria.
The initiatives focus on prevention and treatment, they add, ignoring the fact that people living with HIV/AIDS who are conducting normal lives still want to experience sexual pleasure, and have children.
"The epidemic has evolved. HIV-infected people are not dying; we are living and we are having sex," noted Beatrice Were, an activist in Uganda for the Global AIDS Alliance, a non-profit based in Washington.
She said health care providers and others are shocked when they discover that a person living with HIV/AIDS is either interested in or having sex, viewing this as irresponsible -- even though condoms have been shown to be highly effective in preventing transmission of the HI virus, and re-infection of a person who has already tested positive.
"We are looked upon as patients who need to be pitied, patients who must be told what to do -- and this includes to abstain from sex, and not to fall pregnant," added Were, who has been HIV-positive for 16 years. "We are treated with bias, even though we are capable of enjoying sexual pleasure without passing on the disease."
Furthermore, noted Belinda Tima -- board co-chair of the International Community of Women Living with HIV/AIDS (ICW), a charity headquartered in London -- sexual pleasure need not be limited to penetrative sex, but can take a variety of forms.
Even the staunchest advocate of condom use cannot claim that the prophylactics are completely effective, however. Is there perhaps a sense among health workers that even the small risk of someone contracting the virus during protected sex with an HIV-positive person is too great?
"Condoms are not 100 percent safe -- we refer to it as 'safer sex' -- but the risk of infection in minimal," responded Anne Ntombela, the ICW's programme director for South Africa. "If you understand the nature of HIV and how it is transmitted you will know that it is not as easy as people think. It needs exposure for a sufficient period of time under the right conditions, and it needs an exit and entry point," she added, in reference to cuts, sores and the like.
The larger issue at play is a moral one, Ntombela said. "Health care workers try to force their moral values on other people, but in reality people will not stop having sex. They would be better served if they were told how to have safer sex, rather than not to engage in sex at all."
In addition, countries should create "...an environment that supports access to services. We need prevention tools like female condoms...and we need more co-operative research on living with HIV and AIDS, and policies and programmes that take cognisance of this."
Pregnancy prevention
Concerns about the sexual activity of HIV-positive people extend to the matter of pregnancy.
HIV-positive women may pass on the virus to children during pregnancy, labour or while breastfeeding. ARVs can reduce the risk of transmission to under two percent, according to AVERT, a global charity that helps combat the pandemic. However, research has indicated persistent fears about mother-to-child transmission of HIV, and that mothers who are HIV-positive could die -- leaving behind orphans who may receive insufficient care.
"When I chose to have a baby 15 months ago people demanded to know why I took the risk of infecting my child. There was a 98 percent probability of not infecting my baby -- but people...demanded to know why I took that two percent risk," said Rolake Odetoyinbo, executive director of Positive Action for Positive Treatment, a non-governmental group in Nigeria. She has lived with HIV/AIDS for a decade.
A number of delegates at the conference claimed that certain clinics administer contraceptive injections when providing AIDS treatment to women, without receiving the consent of these women or counseling them. There are also reports of health workers acting judgmentally towards HIV-positive women in search of reproductive health care, and even denying them assistance. Indications are that women with the virus may be pressed into having an abortion where this option is available, or into being sterilised.
But even in the face of these difficulties, an array of factors prompt women living with HIV/AIDS to become pregnant or remain so, notes a 2002 report by Ipas, 'Reproductive choice and women living with HIV/AIDS'. Ipas is an international organisation for the advancement of women's sexual and reproductive rights.
It states that "...often younger women appear to be most motivated by a desire for motherhood and the idea that having a child will give them more hope. In a few cases, personal convictions that abortion is wrong may prevent them from seeking terminations, so that they end up having children 'by default'."
Social expectations as concerns family size, the stigma surrounding childlessness and unsuccessful attempts to terminate pregnancy also play a role. In addition, childbearing can be seen as "...a means of obtaining or ensuring economic support from partners".
Noted the ICW's Ntombela, diagnosed with HIV 17 years ago, "All pregnancy is risky. Telling an HIV-infected woman not to have a child is the same as telling all women not to have a child in case it is born with a defect, in case it has Down's syndrome."
"There are worse complications than HIV for a child HIV-infected children can experience a healthy life style -- it's not like 10 years ago."
Restrictive abortion laws
Another issue that came under discussion at the Third Africa Conference on Sexual Health and Rights, held Feb. 4-7 in the Nigerian capital of Abuja, was the failure of most nations on the continent to ensure legal and safe voluntary abortions.
Several speakers at the biennial meeting called for the liberalisation of abortion laws in Africa. "Annually there are 5.5 million unsafe abortions performed in Africa, resulting in 36,000 unnecessary deaths," said Elizabeth Maguire, president of Ipas.
The conference was organised by various groups, including Ipas and the World Health Organisation, under the theme 'Sexuality, Poverty and Accountability in Africa'. About 400 people from 32 countries were present at the event.
Labels: Africa, Health, HIV/AIDS, World News
Washington, January 9; Danish researchers have revealed that staying active, and drinking moderately can lower the risk of death from heart disease and other causes.
The study led by Professor Morten Gronbaek, Director of Research of the National Institute of Public Health at the University of Southern Denmark in Copenhagen, and Professor Berit Heitmann, Director for Research of the Institute of Preventive Medicine at Copenhagen University Hospitals disclosed that people who neither drink alcohol nor exercise have a 30-49 per cent higher risk of heart disease than those who either drink, exercise or both.
The researchers examined the data of 11,914 Danish men and women aged 20 or older taking part in the larger Copenhagen City Heart Study and a 20-year follow up showed that there were 1,242 cases of fatal ischaemic heart disease (IHD) and 5,901 deaths from all causes.
"Our study shows that being both physically active and drinking a moderate amount of alcohol is important for lowering the risk of both fatal IHD and death from all causes," said Gronbaek.
"For both men and women, being physically active was associated with a significantly lower risk for both fatal IHD and all-cause mortality than being physically inactive; and drinking alcohol was associated with a lower risk of fatal IHD than abstaining," he added.
A weekly moderate alcohol intake reduced the risk of all-cause mortality among both men and women, whereas the risk among heavy drinkers was similar to non-drinkers.
The researchers divided physical activities into three categories: Physically inactive less than two hours of light physical activity a week, low level of activity that is light physical activity for two to four hours and moderate to high level of physical activity, a light physical activity for more than four hours a week or more vigorous activity for two to four hours a week.
And alcohol intake was total weekly intake. Non-drinkers consumed less than one drink a week, moderate drinkers had between 1-14 drinks a week, and heavy drinkers drank 15 or more a week.
The findings revealed that within each level of physical activity the risk of IHD was 30-31 per cent high among non-drinkers as compared to moderate drinkers.
Non-drinkers who had a moderate or high level of physical activity had a reduced risk at 31 and 33 per cent respectively compared to physically inactive non-drinkers.
People who drank at least one drink a week and were physically active had a 44-50 per cent lower risk of IHD compared to physically inactive non-drinkers.
"An important finding from our research for people who have reasons for alcohol abstention such as religious beliefs, previous alcoholism or pregnancy, is that physical activity can reverse some of the adverse health effects associated with alcohol abstention."
"People who did not drink but whose physical activity was moderate or high, had a lower risk of IHD than the inactive non-drinkers," said Jane Ostergaard Pedersen, the lead author and research assistant at the National Institute of Public Health.
They also found physically active people had 23 per lower risk of deaths from all causes as compared to physically inactive non-drinkers and those who are physically active and drinking at least one drink a week had 12-33 per cent lower risk of death.
"The lowest risk of death from all causes was observed among the physically active moderate drinkers and the highest risk among the physically inactive non- and heavy drinkers," said Ostergaard.
"Neither physical activity alone nor alcohol intake can completely reverse the increased risk associated with alcohol abstention and lack of physical activity. Thus, both moderate to high levels of physical activity and a moderate alcohol intake are important for lowering the risk of fatal IHD and deaths from all causes," she added.
The findings appear in the European Heart Journal.
Australia's near neighbour East Timor has a birth rate of 8.5 per woman and a maternal death rate 20 times that of Australia. It is hardly an unusual case: around the world one woman dies in childbirth every minute. Another 68,000 women die every year as a result of unsafe abortion, which also leaves about 5 million women permanently injured or diseased.
These are horrifying statistics. The fact that Australia is partly responsible for them should shame and anger us all.
The AusAID family planning guidelines, instituted in 1996 by a Coalition government desperate for the support of the ultra-conservative Senator Brian Harradine, forbade any organisation that accepts Australian aid dollars from providing, recommending or even supplying information on abortion - even when to do so may save the woman's life.
Funded organisations are also restricted as to the types and methods of contraceptives they can suggest. Harradine retired in 2005 and had not held the balance of power for some years before that - but the AusAid restrictions remain.
In May the All-Party Parliamentary Group on Population and Development published a paper demanding that the family planning guidelines be abolished. The report argued that worldwide access to contraception and safe pregnancy terminations would reduce maternal deaths by up to 35 per cent and child deaths by 20 per cent.
'I'm a doctor and I don't like abortion any more than [Harradine] does,' the group's chairman, the Liberal MP Mal Washer, told ABC radio at the time. "But we have got to be realistic. What Australia condones in its aid policies is that if you have an unwanted pregnancy then you do not get any help in the way of a safe termination … After you've had an illegal or unsafe termination then we'll treat you. Well that's good, if you don't die."
Preventing tens of thousands of deaths is, of course, sufficient reason to remove the ban, but there are other benefits to ensuring that women, wherever they live, have access to the full range of family planning options.
The ability to decide on the timing of pregnancy and childbirth is fundamental to a woman's ability to make decisions and act autonomously in every other area of her life.
Universal access to affordable, reliable contraception is a good start. However, in many strongly patriarchal cultures, women are often unable to refuse unwanted sex or insist on safer sex practices. In these cases, a drawer full of condoms and all the will in the world will not protect a woman from disease or unwanted pregnancy.
As the appalling statistics on abortion-related deaths indicate, many women will risk their lives to prevent the birth of a baby they do not want or cannot support. As the appalling death in childbirth statistics indicate, continuing with a pregnancy can mean taking the risk your new baby, and any previous children, will be left motherless.
Family planning services, such as those banned by AusAID, save women's lives, improve their ability to contribute to society, help to reduce overpopulation and infant mortality, and slow the spread of diseases including HIV/AIDS. All of these things, in turn, work to reduce poverty and raise the life expectancy and health outcomes of the community as a whole.
The foreign affairs minister has the power to change the AusAID conditions. There is no need for new or altered legislation and no need to take it to Parliament. When the All-Party Parliamentary Group on Population and Development presented its report in May, the then foreign affairs minister, Alexander Downer, said he would "consider the recommendation with an open mind". As nothing was done and nothing more said, we can assume that he decided the lives of non-Australian women were not a pre-election priority.
Now the matter is out of Downer's hands. As the new Foreign Affairs Minister, Stephen Smith, works to get on top of his portfolio, there are no doubt a thousand matters, small and large, vying for his attention. Let's hope Smith's ministerial colleague Tanya Plibersek, who was a member of the parliamentary group, shares with him her belief that "these guidelines … have contributed to the death of women in poor countries". Let's hope Smith realises the inherited policy is morally reprehensible and easily fixed.
Although Smith has yet to comment publicly on the AusAID guidelines, his remarks during last year's RU486 debate indicate that he supports reproductive rights. "My starting point is that abortion is a matter of conscience for the individual," he said then. "I also strongly believe that as a matter of conscience we should not seek to impose any one view on anyone else."
If Smith's belief in the right of individuals to make reproductive choices extends to non-Australians, he will move to overturn these murderous restrictions immediately. And if the Prime Minister, Kevin Rudd, is committed to ending poverty and injustice, he will unreservedly support his Foreign Minister.
People who have HIV and Aids and who are on anti-retroviral treatment (ART) tend to take greater sexual risks than those who are positive but who are not on treatment.
That's according to a recent study by the Human Sciences Research Council (HSRC) into perceptions and behavioural risk relating to people who are HIV-positive.
The study's findings indicate that HIV-positive people on treatment tend to practise safe sex less frequently compared to those who are not on treatment.
They appear not to view the disease as a threat.
The study was conducted by Vuyiswa Mathambo, a research manager in the Child, Youth, Family and Social Development research programme.
The research was conducted by sampling a group of 104 HIV-positive men and women who had been receiving ART for more than six months and 111 HIV-positive men and women who were not receiving ART at the time of the study.
Most of those surveyed were women aged 26 to 30, unmarried, with a secondary level qualification and unemployed.
People in both groups were asked about their perceptions of the impact of HIV and Aids on the frequency with which they practised safe sex.
The report is published in the HSRC Review.
In terms of the statistics, more people who were in the treatment group viewed Aids as a disease that was no longer life-threatening and reported practising safe sex less often since starting treatment.
Of those interviewed, 84 percent of those in the treatment group said Aids was no longer a threat compared to 76 percent in the non-treatment group.
Sixty-three percent of those in the treatment group practised safe sex compared to 51 percent of those in the non-treatment group.
Mathambo writes that the study's findings showed a need to communicate appropriate HIV-prevention messages to those on treatment as it was still important to practise safe sex.
"ART is known to reduce viral loads, Aids-related illnesses and death and to improve the quality of life of those taking this treatment but concerns have been raised about the perceptions of risk as well as the behaviour of those receiving ART...
"While acknowledging the difficulty of linking risk perception and sexual practices, it was notable that some respondents had sought treatment for STIs (sexually transmitted infections) in both groups in the past two to three months," she says.
Mathambo adds that the study site was located within a hospital founded on a Catholic ethos, meaning that condoms may not have been as readily available.
Meanwhile, a comprehensive study by the Institute of Security Studies says that the politicisation of HIV and Aids has impacted on corruption and accountability.
The study, A Lethal Cocktail by Collette Schulz-Herzenberg, explores the impact of corruption on HIV and Aids prevention and treatment efforts in South Africa.
"It (politicisation) appears to relate indirectly to instances of abuse and corruption on the part of public officials and other individuals by affording a degree of protection."
