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[afro-nets] HIV/AIDS: Caribbean; Universal Treatment; South Africa

  • From: Leela McCullough <leela@healthnet.org>
  • Date: Fri, 08 Jul 2005 12:23:07 -0400

HIV/AIDS: Caribbean; Universal Treatment; South Africa

Reprinted with permission from http://www.kaisernetwork.org

HIV/AIDS Epidemic at 'Tipping Point' in Many Caribbean Coun-
tries, Opinion Piece Says

08 July 2005

HIV/AIDS has "taken a strong hold" on local populations of many
small Caribbean islands, and HIV/AIDS experts say the epidemic
is at a "tipping point" in the region, Loretta McLaughlin, a
senior fellow at the Harvard AIDS Institute, writes in a Boston
Globe opinion piece. According to data collected by the Carib-
bean Epidemiology Centre, HIV prevalence for 17 countries in the
region, excluding Haiti and Guyana, is between 1% and 2.5%, but
the rates are moving "relentlessly and seemingly inexorably up-
ward," McLaughlin, a former Globe editorial page editor, says.
Although the Clinton Foundation and the Global Fund To Fight
AIDS, Tuberculosis and Malaria have provided medical expertise
and millions of dollars for HIV/AIDS programs in the region,
those working to fight the disease know that understanding local
customs and practices is key to fighting the epidemic, she
writes. Sexual activity among young people, a low marriage rate,
a high teenage birth rate, and cultural and religious taboos re-
main challenges to HIV prevention, McLaughlin says. Although the
number of HIV-positive people seems "sparse because the general
populations are so small, the ramifications pose just as severe
economic and human consequences as anywhere else," McLaughlin
writes (McLaughlin, Boston Globe, 7/2).

Universal HIV/AIDS Treatment Access Would 'Keep Societies from
Disintegrating Into Chaos,' Opinion Piece Says

08 July 2005

The international community is "beginning to respond" to the
more than six million HIV-positive people in the developing
world who need immediate antiretroviral treatment, "but we can
and must do better," Jim Kim, director of the World Health Or-
ganization's HIV/AIDS Programme, writes in a Bangkok Post opin-
ion piece. Although the number of people with access to HIV/AIDS
treatment has more than tripled in Africa and Asia over the past
year, most of the three million annual AIDS-related deaths could
be prevented if universal treatment were provided, he says. How-
ever, reaching that goal requires more support from political
leaders, as well as the adoption of standardized, simplified,
quality treatment approaches, Kim writes. In addition, WHO and
other agencies "must do a better job" of training health care
workers, procuring medications, and creating health infrastruc-
ture that can support treatment for HIV and other diseases, Kim
says. Universal HIV/AIDS care also depends upon greater finan-
cial resources, which countries must pledge on a long-term basis
that encourages developing countries to match donor support by
investing money into health care "knowing that AIDS treatment
will not disappear when the international community takes up
other priorities," he writes. Providing HIV/AIDS treatment to
those in need would bring "renewed hope for the future" and
"strengthe[n] the pillars that keep societies from disintegrat-
ing into chaos," Kim says (Kim, Bangkok Post, 7/4).

Use of Unsterilized Blades in Ritual Circumcision Might Contrib-
ute to HIV Spread in S. Africa, Doctors Say

08 July 2005

Doctors are concerned that ritual circumcision practices per-
formed on adolescent boys as a rite of passage in South Africa
might be spreading HIV through the repeated use of unsterilized
blades, the Baltimore Sun reports. The practice, which is per-
formed by a traditional surgeon without anesthesia, is meant to
reinforce the belief that "real men can endure pain," but hun-
dreds of boys have died or been maimed by the procedure, leading
provincial health officials to criticize the tradition, the Sun
reports. "We can imagine in some communities about 20% of boys
going off to the bush [for circumcision] will be HIV-positive,"
Graeme Meintjes, an AIDS specialist in Cape Town, South Africa,
who has written a book on ritual circumcision, said, adding,
"It's an extremely high risk" (Calvert, Baltimore Sun, 7/6).

Possible Prevention Method?

However, the Wall Street Journal reported Tuesday that French
and South African researchers have found that circumcision, when
performed correctly, might reduce by 70% a man's risk of con-
tracting HIV through sexual intercourse with an HIV-positive
woman. Researchers hope circumcision can be an effective tool to
slow the spread of HIV in Africa, where 70% of males are circum-
cised at birth or during rite-of-passage ceremonies in adoles-
cence, the San Francisco Chronicle reports (Russell, San Fran-
cisco Chronicle, 7/6). "If male circumcision can reduce the rate
of HIV transmission, it gives us the potential for a very impor-
tant intervention in a lot of African cultures where circumci-
sion is not traditionally practiced," Ronald Gray, an AIDS re-
searcher at the Johns Hopkins Bloomberg School of Public Health,
said. Thabo Rangaka, the South African Medical Association's
spokesperson on circumcision, is pushing to have all boys un-
dergo circumcision at a clinic or hospital before going!
to rural areas to complete the rest of their ceremonial transi-
tion to manhood (Baltimore Sun, 7/6). Gray is conducting a con-
trolled clinical trial of male circumcision in Uganda, which is
scheduled to be completed in 2007. A similar trial in Kenya also
is set to finish in 2007, according to the National Institute of
Allergy and Infectious Diseases, which is sponsoring the trial
(San Francisco Chronicle, 7/6).

"Reprinted with permission from http://www.kaisernetwork.org.
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Leela McCullough, Ed.D.
Director of Information Services

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