INDIANA: In Indiana, Blacks Continue to Be at Higher Risk for HIV
Will Higgins
Indianapolis Star (11.06.09) - Friday, November 06, 2009
Indiana's health commissioner said Thursday that the state's African-American residents continue to be
disproportionately affected by HIV/AIDS.
"It's a substantial increase, and it's an area of real concern to us," Judith Monroe said at a news conference.
State figures show that blacks, who represent less than 10 percent of the population, accounted for more than
four of every 10 new cases in 2008, up from about three of every 10 in 2007. Almost half of the state's 513 new diagnoses in 2008 were made in
Indianapolis. Of the city's known 3,779 HIV/AIDS cases, 1,559 are African-American.
"This is a complex problem," Monroe said. "When we look at HIV, it has to do with sexual activity and drug use,
but also with domestic violence, incarceration, poverty, [and lack of] education. It's all these other areas - those issues tend to affect
communities of color at higher rates."
"Poverty can lead to risk-taking," said Mwangi James Murage, director of training and evaluation for the Indiana
Minority Health Coalition. He noted that while most people are "pretty much aware of the basics" of how HIV is transmitted, "there's a
difference between being aware and changing behavior."
UNITED STATES: AIDS Confab Highlights Progress, Needs in US
Seth Hemmelgarn
Bay Area Reporter (San Francisco) (11.05.09) - Friday, November 06, 2009
HIV/AIDS funding, treatment, care, and prevention were among topics discussed last week at the 2009 US Conference
on AIDS in San Francisco.
On Oct. 30, attendees applauded as they watched video of the White House ceremony in which President Barack Obama
signed the reauthorization of the Ryan White CARE Act and announced plans to end the 22-year-old ban on travel to the United States by non-
nationals with HIV.
Lifting the ban was "long, long overdue," said Jesse Fry of the Florida HIV/AIDS Advocacy Network. Taking the
step concurrently with renewing Ryan White "shows the White House's commitment to fighting HIV/AIDS in America," he said. Fry added, however,
that he would like to see the act funded "commensurate with the severity of the disease."
Kathy Pearson of the Syracuse Model Neighborhood Facility in New York also praised the president's actions but
said she would like to see more done to reduce anti-AIDS stigma so people "are more comfortable knowing about their HIV status."
At a plenary session entitled "New Frontiers in HIV: Issues for Today's Leaders," speakers included Derek
Spencer, director of the JACQUES Initiative at the University of Maryland School of Medicine's Institute of Human Virology. Spencer noted that
death rates have fallen dramatically since the epidemic's early years, and many patients are now living long enough to experience health
problems typical of advancing age. Therefore, he said, there is a need to address "truly living with HIV" by encouraging patients to take steps
such as eating healthy diets and not smoking.
The conference was sponsored by the National Minority AIDS Council.
INTERNATIONAL NEWS
GLOBAL: Medical Aid Group Warns of Waning Support for AIDS Treatment Scale-Up
Joe De Capua
Voice of America News (11.05.09) - Friday, November 06, 2009
In a new report, Doctors Without Borders (DWB) is warning of a "major funding deficit and a looming crisis" in
AIDS funding. On Thursday in Johannesburg, South Africa, the report's author spoke about the problem.
In 2005, leaders of the G-8 nations committed to supporting universal access to AIDS prevention, treatment, and
care for all persons in need by 2010. "Now what we're seeing is a backing off," said Sharonann Lynch, DWB's HIV policy advisor.
While acknowledging the burden of the global financial crisis, Lynch said, "There is also very much a political
[crisis]. I don't believe that the US, the Netherlands, the UK, France are backing off from some of the commitments that they've made because
of a financial crisis." Rather, she said, they are doing so "because it's expensive and because they think no one is watching."
Lynch said the directors of the Global Fund to Fight AIDS, TB and Malaria will meet next week in Addis Ababa,
Ethiopia, and are "going to be voting on a resolution to suspend new funding rounds in 2010 due to the lack of funds. We've also seen that the
Global Fund has been forced to make substantial cuts in grants for proposals that had already been approved."
Officials with the US President's Emergency Plan for AIDS Relief (PEPFAR) stress that while this year's funding
increase may be below that of years past, the Obama administration remains committed to fighting the epidemic. They say that PEPFAR, in
addition to helping 3 million people access antiretrovirals, also provides other assistance to more than 10 million people affected by AIDS and
"supports HIV counseling and testing for nearly 57 million people."
To access the DWB report, visit http://doctorswithoutborders.org/publications/reports/2009/MSF_HI V-AIDS-
Punishing-Success.pdf.
SOUTH AFRICA: South Africa Tries to Enlist Men in AIDS Battle
Charlotte Plantive
Agence France Presse (11.06.09) - Friday, November 06, 2009
To more effectively get the HIV prevention message to men, South Africa is expanding its efforts beyond the
nation's health centers, which traditionally are used predominately by women.
"There is nothing especially made for men. We need to do something to talk to men," said Mzi Lwana, head of the
Men and AIDS program at the HIV research unit at Witwatersrand University.
In the campaign, HIV educators are tackling head-on the traditional cherished image of the South African man as a
hard-drinking, risk-taking seducer. The initiative is launching campaigns at football matches, in bars, and in the hostels that are home to
male workers.
The "Brothers for Life" effort attempts to create a new ideal of the man who "makes no excuse for unprotected
sex" and "respects his woman," according to a campaign ad.
Special clinics just for men are being established by the Men and AIDS program at Witwatersrand University.
"It is hard to go to a clinic and acknowledge your vulnerability as a man," said Dean Peacock, coordinator at
Sonke Gender Justice Network, one of the groups involved in the outreach.
At the clinic, clients can meet with nurses, educators, and social workers, all males. "It is much easier to
explain to a man," said one of the patients in the office of nurse Luthando Qobo.
The education efforts also encourage male circumcision, which has been shown to reduce the risk of female-to-male
HIV transmission by 50 percent.
Campaign organizers say they are taking the initiative to target men in their education efforts in the absence of
any strong leadership from the national government.
"We have the support of the government, but it is not yet taking the lead," said Lauren Jankelowitz of the
research unit.
UNITED KINGDOM: Sex Education to Be Compulsory for Pupils Aged 15 to 16 Even if Parents Object
Jessica Shepherd
The Guardian (London) (11.06.09) - Friday, November 06, 2009
Changes set to take effect in September 2011 will make sex education class compulsory for children ages 15-16,
even if their parents object. Parents will still have the right to withdraw children under age 15 from the classes. Currently, parents of
youths up to age 19 can opt them out of sex education.
About 0.04 percent of pupils are excused from sex education under current provisions, according to government
officials.
Debate on the law exposed long-standing differences in Britain on the role of government in providing sex
education. The representative of a teaching union was disappointed to see the right to remove any student from the curriculum.
"Allowing parents to withdraw their child from sex and relationship lessons up to the age of 15 does not sit well
with a statutory entitlement. If it is important enough to be a statutory provision then it is important enough for every child to receive it,"
said Chris Keates, general secretary of the NASUWT teaching union.
Under the new law, primary and second schools will teach personal, social health, and economic education to
children from the age of the five. Currently, schools have taught only the fundamentals of reproduction, contraception, and puberty as part of
a science curriculum.
Faith-based schools are free to provide the education in the context of their "values" and "ethos." "It is open
to faith schools to teach what they believe, according to the tenets of their faith," Schools Secretary Ed Balls said.
Proponents of the new law expressed the hope it would reduce Britain's teenage pregnancy rate, one of the highest
in Europe.
"Evidence shows that sex and relationships education help young people to delay early sex and make healthy
choices when they eventually do become sexually active," said Gill Frances, chair of the Teenage Pregnancy Advisory Group.
MEDICAL NEWS
UNITED STATES: Many Doctors Overuse Pap Testing: Survey
Reuters Health (11.02.09) - Friday, November 06, 2009
Guidelines for Pap screening were substantially revised earlier this decade in response to research showing that
low-risk women age 30 and older did not need annual testing. However, a new study suggests that many US primary care doctors recommend Pap
screening more often than guidelines suggest.
Researchers surveyed a nationally representative sample of physicians during 2006-07, asking what their Pap
testing recommendations would be for four patient vignettes. Of 1,212 participants responding, just 22.3 percent made recommendations fully
consistent with major professional organizations' guidelines, including the American Cancer Society (ACS) and the American College of
Obstetricians and Gynecologists (ACOG). The proportion making guideline-consistent recommendations was 27.5 percent among internists, 21.1
percent among family and general practitioners, and 16.4 percent among obstetricians and gynecologists.
Half of respondents would not recommend Pap testing for a hypothetical 18-year-old woman with no sexual
experience, which is in line with guidelines. The other half recommended testing at least every three years. ACS, ACOG, and the US Preventive
Services Task Force generally counsel that women begin Pap testing at age 21 or within three years of sexual debut, whichever is earlier; then
screen yearly to age 30; and thereafter screen every two to three years if results for three consecutive tests are normal.
More than 40 percent said they would advise Pap testing for a 66-year old woman with lung cancer, and some
recommended annual testing, despite the fact that the guidelines say Pap testing would not be indicated for this patient.
Low-risk women ages 65-70 can stop Pap screening, the recommendations say. In addition, according to ACS
guidance, women who have had a total hysterectomy for a noncancerous condition or who have a serious disease limiting life expectancy can stop
Pap screening.
The researchers said doctors' reasons for disregarding the guidelines could include disagreement with them,
confusion about the recent changes, concerns over potential malpractice suits or financial incentives for testing more often.
The full report, "Specialty Differences in Primary Care Physician Reports of Papanicolaou Test Screening
Practices: A National Survey, 2006 to 2007," was published in Annals of Internal Medicine (2009;151(9):602-611).
NEWS BRIEFS
WISCONSIN: Assembly OKs Bill Requiring Teaching Birth Control
Associated Press (11.06.09) - Friday, November 06, 2009
By a vote of 48 to 43, the Wisconsin Assembly on Thursday gave final approval to a bill that would require
schools teaching sex education to include instruction on preventing pregnancy. The bill must pass the Senate before advancing to the desk of
Gov. Jim Doyle.
SOUTH AFRICA: AIDS Program May Be Reducing South Africa Deaths
Tamar Kahn
Business Day (South Africa) (11.05.09) - Friday, November 06, 2009
New figures showing a slight decline in the number of deaths in South Africa "might be a data problem," or "might
be good news," the Department of Health's deputy director-general for strategic health programs told Parliament on Wednesday. "We hope at least
part of it is the ARV [antiretroviral] program," Yogan Pillay said. The latest mortality figures, released Monday by Statistics SA, show
601,133 deaths recorded by the Department of Home Affairs in 2007, a 1.8 percent drop from 2006. After long delaying the rollout of ARVs, a
decision largely due to former President Thabo Mbeki's doubts about their safety and efficacy, South Africa began distributing the medications
in 2004. By April 2009, more than 700,000 people were receiving ARVs at state health facilities. Pillay said more research is needed to
determine whether the figures represent a sustained downward trend.
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