"Swine Flu Could Threaten Millions with Other Diseases"

Reuters     (04.29.09):: Laura MacInnis

In countries other than Mexico with confirmed outbreaks, the H1N1 or swine flu
strain has caused mainly minor symptoms. However, epidemiologists are warning it
could be especially dangerous to people already fighting other infections like
HIV or TB.

H1N1 has killed up to 160 people, including a 23-month-old child in Texas - the
first death from the flu strain outside Mexico. In Mexico, the outbreak has
raised alarm among health officials due to its lethal effect on young adults, a
population normally more resilient to influenza than infants and the elderly.

Of the deaths in Mexico, World Health Organization (WHO) spokesperson Gregory
Hartl said, "Maybe people were infected with other illnesses too that made their
illness more severe. Maybe they were immunologically suppressed."

An estimated 33 million people have HIV/AIDS worldwide, and another 9 million
are diagnosed with TB each year, according to WHO. If H1N1 spreads to these
communities and infiltrates densely populated and impoverished urban slums,
health experts believe the outbreak could rapidly worsen.

WHO officials are urging governments to ensure that HIV and TB patients get the
treatment they need to remain healthy, and to enhance access to care in poor
areas.

"Many of the world's poorest people are particularly vulnerable to lethal
airborne diseases," noted Glenn Thomas of the Stop TB Partnership. "With health
resources already stretched in low-income countries, a new disease pandemic
could jeopardize effective TB control and other health programs."

http://www.cdcnpin.org/scripts/listserv/prevention_news.asp.

Adherence to anti-retroviral therapy among HIV patients in Bangalore, India

Introduction Human Immunodeficiency Virus (HIV) has an estimated prevalence of
0.9% in India (5.2 million). Anti-retroviral drugs (ARV) are the treatments of
choice and non-adherence is an important factor in treatment failure and
development of resistance, as well as being a powerful predictor of survival.

This study assesses adherence to ARV in HIV positive patients in Bangalore,
India, a country where only 10% of those who need therapy are receiving it.

Methods:

A cross-sectional anonymous questionnaire survey of 60 HIV antibody positive
patients was carried out with patients attending HIV outpatient services at two
centres: The Chest and Maternity Centre, Rajajinagar, and Wockhardt Hospital and
Heart Institute, Bangalore. Consent was obtained.

Translation was done by a translator and doctors where required. Data was
analysed using SPSS statistical analysis.

Results:

A response rate of 88% (53/60) was achieved.

The mean patient age was 39.98 years, with 50% aged 30-40, and 73.6% of
participants being male. Mean family size was 4.8 (1-13).

21% lived less than 50 kms and 21% greater than 400 kms from clinic. 60%
reported they were fully adherent.

Adherence was statistically significantly linked to regular follow-up attendance
(70.5%, p=0.002). No other results were statistically significant but trends
were found.

"100% adherence" trends were seen in older patients, male gender, those from
larger families, those who had a previous AIDS defining illness, those taking
fewer tablets, and without food restrictions. Commonest side-effects causing
non-adherence were metabolic reasons (66%) and GI symptoms (50%).

No trends were seen for education level, family income, distance travelled to
clinic, time since diagnosis, or time on ART.

Conclusions:

Regular attendance for follow up was statistically significant for 100% lifetime
adherence. Positive trends were seen in those in larger families, older, those
who had AIDS defining illness, simple regimes, and without side-effects.

Education, income, distance travelled and length of time diagnosed or treated
had no effect on adherence.

Author: M B Cauldbeck, C O'Connor, M B O'Connor, J A Saunders, B Rao, G V
Mallesh, K N Praveenkumar, D Mamtha, C McGoldrick, Rbs Laing and K S Satish

Credits/Source: AIDS Research and Therapy 2009, 6:7

http://7thspace.com/headlines/307934/adherence_to_anti_retroviral_therapy_among_\
hiv_patients_in_bangalore_india.htm

NARI set for monitoring trends and levels of HIV epidemic

Anuradha Mascarenhas.

Pune: Even as the surveys in 2006 and 2007 reported a decline in HIV, the annual
exercise of tapping the trends for prevalence of the virus will now begin on
April 15. City-based National AIDS Research Institute (NARI) will commence the
exercise for eight states from Wednesday.

Dr R S Paranjape, director, NARI said that the core team of epidemiologists is
located at the institute and has been involved in training the trainers on how
to conduct the survey. National AIDS Control Organisation (NACO) conducts this
annual exercise all over the country with the help of National Institute of
Health and Family Welfare and National Institute of Medical Statistics since
1998.

This surveillance monitors the trends and levels of HIV epidemic among different
population groups in the country. It was estimated in 2007 that there are 2.31
million people living with HIV/AIDS in India with an estimated adult HIV
prevalence of 0.34 per cent. An overall decline in HIV prevalence was also found
among ante natal care clinic attendees.

Dr Sanjay Mehendale, deputy director, senior grade, NARI who is coordinating the
HIV sentinel surveillance programme said that NARI has been entrusted the task
since 2006 for seven states of Maharashtra, Rajasthan, Madhya Pradesh, Goa,
Gujarat, Dadra and Nagar Haveli and Diu and Daman and for Mumbai as a separate
location.

A total of 97 sites in Maharashtra, 54 in Madhya Pradesh, 46 in Rajasthan, 50 in
Gujarat, 8 in Goa, 17 in Mumbai, two in Diu and Daman and one in Dadra and Nagar
Haveli have been identified to conduct the surveillance. "NARI is responsible
for the training, monitoring, supervision and improving the quality of the
programme since 2006," says Mehendale.

The sample size of pregnant women at ANC sites will be 400, while 250 patients
will be selected at the identified sexually transmitted infection sites in each
state. A sample size of 250 people will be identified among the groups for
targeted interventions like men having sex with men, female sex workers,
injecting drug users, truck drivers and migrant workers.

The surveillance programme will involve collection of blood samples. "This time
the team will collect dried blood smears," Mehendale said. NARI has also been
involved in quality control measures , selection of new testing laboratories,
data analysis and provide suggestion for improvement of future round of surveys

http://www.indianexpress.com/news/nari-set-for-monitoring-trends-and-levels-of-h\
iv-epidemic/446791/2

Training in Management of Pediatric HIV

Greetings from Prayas Health Group!
 
PRAYAS Health Group announces a comprehensive training program in clinical
management of pediatric HIV for pediatricians and other physicians from
Maharashtra. This will include two contact workshops (of 4 and 2 days
respectively), and in-between several discussions through internet and
telephonic conversations.

As you are aware Pediatric HIV is an emerging epidemic. The efforts to control
this epidemic through expansion of prevention of mother-to-child transmission
(PMTCT) are going on. Even then, till such time that these programs will be
functional to such a level that pediatric HIV will be virtually eliminated; it
is understood that maternal transmission of HIV to their children will continue.

We also need to continue providing care to children already infected with HIV.
Management of Pediatric HIV differs from that of adult HIV patients in many
aspects. Along with the routine ART and TMP/SMX prophylaxis, they require
comprehensive care and vigilance over growth, development, immunization,
nutrition and complementary support for education and recreation.
 
The government and other agencies are already striving to tackle this issue..
Given the complexity of our health services there is an urgent need by the
private health sector to compliment the efforts by developing and enhancing
pediatric HIV care and support services. As our commitment, PRAYAS Health group
too wishes to contribute to this cause.
 
Prayas health group has been working on HIV-AIDS since its inception (1994). The
array of our activities includes clinical and counseling care, intervention
programs, research and training. At Prayas clinic, children living with HIV are
being treated and taken care of in our Special Pediatric OPD. We have been
conducting training programs and workshops for doctors and other health care
providers on various aspects of HIV. From our experience we gather that
Pediatric HIV cases exist in almost all districts of Maharashtra, but
unfortunately quality services are not yet available everywhere.

Since last two years we are implementing a program- Setting up model Pediatric
HIV Care. Under this program, we are announcing a comprehensive training course
in pediatric HIV management.

It begins with the first contact workshop of 4 days, from 27th June afternoon
till 1st July (afternoon) 2009. The workshop will be conducted at Pune. This
will be followed by multiple on line discussions and end with a contact workshop
of 2 days again at Pune.

The total duration of this training will be of 6 months.
 
As the number of participants will be limited to 20, we are presently
restricting the course admissions only to those from Maharashtra.

Thus the process will be selective. We invite applications from pediatricians.
Physicians who are already working with HIV infected children are also eligible.

Interested doctors are requested to send the applications in following format:
 
Contact Details: Name, Address, Tel. number, Mobile number, and Email ID.
Qualifications
Experience of Clinical Practice
Scope of HIV Practice
Existing HIV practice with special reference to pediatric cases.
Type of practice (Private/NGO/Trust/Government)
Area of practice (Urban/Rural)
Association with any organization
Future plans in the field of clinical HIV
Expectations from training

Please write I feel that Pediatric HIV is an important issue because†(In
approximately in 150-200 words)
Recommendation letter/s or references if any

Selected participants will get travel expenses (economy class air/ 2nd class
AC), accommodation and a reasonable per diem during the period of the contact
training workshops along with required training material.
 
Last date of application: 25th May 2009
Do not hesitate to contact us if you have any question.
 
Please mail or post your applications to:
 
Director,
PRAYAS Health Group, Amrita Clinic, Sambhaji Bridge Corner, Karve Road , Pune-
411004.
Tel: 020 25441230, 020 25420337, 020 65615726
E-mail: prayashealth@...

(For more information about PRAYAS you may visit www.prayaspune.org )
 
PRAYAS Health Group
Amrita Clinic, Karve Road
Deccan Gymkhana
Pune 411004 (India)
Tel: +91 20 25441230, 25420337
prayashealth@...
www.prayaspune.org

SAATHI trains AIDS trainers

The Imphal Free Press

Imphal, Apr 29: A team of doctors along with some of the resource persons went
on a visit to one of the Community Health Centre in Imphal west. This visit was
a part of the programme of the facilitators` workshop (training of trainees) as
organised by Solidarity and Action against the HIV infection in India (SAATHI)
in collaboration with Manipur State Aids Control Society (MACS) and NRHM, Imphal
west.

In the three days training programme 27-29 April 2009 both the Medical and
Para-Medical Staffs were  trained so that they could in turn become trainers and
train the other staff - doctors, nurses and other paramedics. They emphasised
more on the decentralisation of HIV services.

Through this programme the trainees are being trained on the issue of HIV/AIDS.
Group discussion, role play, group interaction were some of the tools used in
the training programme. They are trained on how to recognise the situation of
the patients so that they can provide first aid and direct them for further
treatment to the proper places. The trainees are made to understand and get
familiar with the various types of drugs to be provided to the patients like ART
and such.

Dr. Meera Ramanathan from Bangalore currently working in Coimbatore as Public
Health Specialist in HIV Medicine - who has been working as HIV consultant for
the past 11 years and been training the trainees is one of the resource persons
of the training programme.

The problem of HIV has become a major issue in the North-East and more
particularly in Manipur due to the intravenous use of drugs. So the need for
spreading more awareness/information on HIV to the masses has become a must -
like how to deal with the issue, how to treat the infected and affected people,
what type of medications to be provided, what type of counselling to be given,
how to take care of pregnant women, how to lessen the risk of transmission of
HIV from the pregnant mother to her unborn child. All  these have become a must
and hence the training to provide trainers and spread the awareness.

Anu Somasundaran, social worker from Chennai who was also a part of the trainees
discussed the stigma and discrimination faced by the people infected and
affected with HIV. According to her, many people cannot come out for treatment
and counselling due to the huge barrier created by the stigma and
discrimination. So through more awareness programmes particularly on the
knowledge of HIV/AIDS - how it is spread, what are those things that do not
spread it etc. Then more people will come forth for treatment and the issue of
stigma and discrimination will also be  lessened, she said.

Dr. Moses Christian, from St John`s Research Institute, Bangalore was also one
of the trainees who trained the doctors so that the trained doctors in turn
could train other doctors and students.

Altogether 13 doctors and 14 paramedical staffs participated in the 3-day
training programme.

http://www.kanglaonline.com/index.php?template=headline&newsid=46481&typeid=1

Dear Forum,

Re: http://health.groups.yahoo.com/group/AIDS-INDIA/message/10172

Dr. Rewari's and Mr. Kumar's statements are both valid in their own way but
there are a few things that I believe need more attention

1.  Quality Enhancement of ICTC services - In support of Dr. Rewari's
statements, when a policy decision is taken it is done considering a larger
population into account and so individual issues might not make much impact in
these decisions hence some stiffness in the criterion e.g., presence of ICTC
results for ART registration.

It might be an inconvenience for most people but this process decreases some
amount of discrepancy among all the results that are received by the ART center.
Imagine an ART center receiving positive results from those private labs that do
not even test the samples and make up results. So an ICTC result is definitely
the way to go but then, as suggested by Kumar, these ICTC centers have to stay
open and have adequate amount of kits.

It is a known fact in the field that many people do not visit ICTCs because they
have themselves been or have known people who have been denied a test due to
lack of kits. This is where quality enhancement of services is required.

2. Flexibility of ART registration - There is a requirement of some amount of
flexibility in the system of registration as Kumar has suggested especially for
the mobile population in our country since now we are talking about a larger
population.

Take the trucker population for example; even if they have an address proof,
will they be able to access ART from the registered centre every month?
Shouldn't there be some system in place which allows them to collect their
medications from the nearest place wherever they are located with a week's time
in hand instead of being told that they come at the end of the month with the
empty bottles in the place of registration?

Not everyone can stick to that schedule. Now, one can say that in order to
access life saving medicines they have to make such an effort but look at the
flip side of the story - they have to earn to stay alive too and not only their
lives, their family also depends on that earning and that is their immediate
requirement.

3. Flexibility of Interregional ART policies - In India, most people have
travelling jobs and they shift jobs - a majority of the working population,
especially the young population (those at higher risk of contracting HIV) is now
mobile. So, the condition and issues of access to ART is not limited to the
Truckers and Migrant workers (traditionally considered amongst the lower
economic strata) per se.

Now it is a much larger population and involves the young and working PLHA group
- does not matter which community or economic strata they belong to. So, the
need of the hour is building of policies that hold the flexibility that an ART
card, no matter from which government center, be enough to collect medications
from any center across the country although steps have to be taken to avoid
duplication of the provision of ARVs.

LFU rates should not be a hindrance in keeping the promise of ' Universal access
to treatment'. LFU rates can be dropped by better counseling and outreach
techniques and who is to say that this flexibility will not further decrease the
LFU rate? Theoretically it can because there is an increase in accessibility and
therefore a policy should be considered for the same.

Dr. Nochiketa Mohanty

Country Project Coordinator
AHF India Cares
S 345 Panchsheel Park
New Delhi 110017
Phone +91 11 46866800
Fax     +91 11 46866813
Cell    +91 9958262277
nochiketa.mohanty@...
www.aidshealth.org

The first case of HIV infection in Orissa was reported in 1992 in the District
of Nayagarh and the first reported death due to AIDS was in 1993 and was
reported from Ganjam. Since then a cumulative total of 1036 AIDS cases have been
reported while the estimated numbers of HIV cases are 11,436. (OSACS, Nov 2008).
4900 people have been registered for treatment at ART centres of Cuttack and
Berhampur. The number of death cases reported is 803.

However these figures may not be a true reflection of the HIV status in Orissa
as:

- No comprehensive study has been conducted to assess the magnitude of the
problem.

- Although ICTC/VCCTC facilities are available, there are intermittent gaps in
procurement and distribution of essentials such as testing kits.

- No stringent adherence to disease surveillance guidelines as a result many a
times in many of the district level data seems to be either inflated or there is
underreporting.

In the district of Ganjam the epidemic, which was initially concentrated in
certain localities and certain subpopulation, has now spilled over into the
wider population. Ganjam also accounts for 43% of all AIDS Cases reported from
Orissa. On the national level, Ganjam district is ranked as eighth of the 14
most HIV-affected districts, and has been given a Grade �A’, since more than
1 % of the population is now affected by AIDS. As per the latest figures,
available from the Behaviour Surveillance Survey Report 2006, Orissa has a
prevalence rate of 0.22 % among adult population.

Among the districts, Ganjam was at the top with 3.25% followed by Angul with
1.75%, Bolangir 1.25% and Bhadrak 1%.

Despite this grim scenario in Ganjam, only 4 Targeted Intervention Programme are
currently being implemented through three NGOs. Aruna which is implementing two
of the TIs, GPSS one and a new organization Janasadhana has been working since
the past one month.

The population covered through these TIs is hardly 50,000. What is worrying is
that though all the 22 Blocks have reported positive cases with Aska and
Hinjilikat leading, the TIs are only being implemented in two of the Blocks.

Many National/International Organizations have come to Ganjam and expressed
their concern about the situation in Ganjam; however they have rarely spent
their resources. Many National/International organizations have access to
resources to be spent on HIV&AIDS in Orissa, however majority of the money is
not spent on community level initiatives or strengthening the capacity of local
NGOs/CBOs (who will be very effective in prevention initiatives) but on
establishing structures of their own, and that too not in Ganjam but in
Bhubaneswar.

The need of the hour is not establish layers and layers within one's own
organization but to build the capacity of local CBOs and NGOs to tackle
migration and HIV&AIDS and create a sustainable initiative.

I sincerely do hope that NGOs and CBOs and other civil society organizations
come together and along with the Government act as pressure groups for
national/international organizations and plan which are the priority areas in
Orissa where resources should be poured in and who should be the major
beneficiaries of these resources.

Published: livingwithdignity-ritu.blogspot.com

UNAIDS Second Independet Evaluation- Web Based Survey

Dear Colleagues,

The Evaluation Team conducting the Second Independent Evaluation of UNAIDS is
carrying out two web-based surveys. The surveys provide stakeholders with an
additional opportunity to give their views on the performance of UNAIDS.

These data will supplement information gathered from interviews with
stakeholders and document reviews.

The first survey was completed in March and covered the role and performance of
the PCB and Committee of Cosponsoring Organisations (CCM).

We would appreciate your input on the current survey which is based on the main
evaluation questions and covers the performance of UNAIDS as a whole, including
both the secretariat and the cosponsors.

Your participation will help the evaluation team to develop recommendations for
UNAIDS for the next five years. The greater the response we get, the more
confidence we will have in the results reflecting the views of stakeholders
accurately.

The survey will take about 20 minutes to complete. Click on the link below to be
taken to the survey. Your responses to this survey are completely anonymous.

Link to the survey:

http://www.surveymonkey.com/s.aspx?sm=4ofeK0ZhGhKYkof7vX8H6w_3d_3d

If you have received more than one invitation to complete this survey,
please only respond once. The address lists have been compiled from UNAIDS,
associated organizations and evaluators conducting country and regional visits.

We are keen to be inclusive at the risk of duplication. Sorry for
any confusion caused.

Daisy MacDonald,
E-mail: <Daisy.Macdonald@...>

Sex education: Why India should go all the way

26 Apr 2009, 0049 hrs IST, Insiya Amir, TNN

The lesson that Indian leaders seem to take from sex education: Prevention is
better than cure. But this may not be the best formula for a country  with a
high incidence of child marriages and teenage pregnancies.

Experts say that the case for sex education in India is quite different from in
the West because it is `legitimate' here for young people to have sex. According
to the National Family Health Survey conducted by the International Institute
for Population Sciences (IIPS) and Macro International in 2005-06, 12% women
aged between 15-19 years are mothers.

The survey said that one in six Indian women aged 15-19 starts to have children.
Dr Sunil Mehra, director of the MAMTA Health Institute for Mother and Child,
says, "Youth in India needs sex education more than in any other country since
child marriage ensures that you not only have sex at a young age, you also have
teenage pregnancy."

Contrast this with the received wisdom of our politicians. The Committee on
Petitions headed by the BJP's Venkaiah Naidu is a cross-party group up of nine
Rajya Sabha members. The Committee has said there should be no sex education in
schools because it promotes promiscuity and India's "social and cultural ethos
are such that sex education has absolutely no place in it."

The Committee directed its outrage at the human resource development ministry's
(HRD) Adult Education Programme (AEP). Launched in 2005 and backed by the
National Aids Control Organization (NACO), the AEP's focus is safer sex, as well
as the physical and mental development of 14-18-year-olds. But the Committee
said that it was "highly embarrassed" by the HRD ministry's curriculum and
insisted that pre-marital sex, together with sex outside marriage, is "immoral,
unethical and unhealthy". It also said that consensual sex before the age of 16
"amounts to rape".

But Mehra is one of many who point to the facts. Child marriage means huge
numbers of adolescent Indians indulge in "legal" sexual activity. The IIPS says
that 47.4% of all women aged 20 to 24 are married by the time they are 18. About
18% are married by the time they are 15. Mehra says politicians have long
promoted regressive policy on the pretext of culture. "It is due to this
so-called culture that many young girls are forced into marriage and sex and
early pregnancy," he says.

Sex education can also help with India's fight against Aids. Government
statistics indicate that 40% of new sexually transmitted infections are in the
15-29 age group. More than 31% of all reported Aids cases occur in this age
group, which indicates that young Indians are a high-risk demographic.

But all is not lost. A four-year study by MAMTA underlines the difference good
sex education classes can make. The study was conducted in four schools in
Haryana from 2004. Two schools were in urban Rewari; the other two in rural
Bawal. Five-hundred students participated. Sex education classes led 78% of the
rural schoolgirls and 33% of the urban to declare they would decline sex without
a condom. It was a startling rise in condom-awareness. Before the classes, just
5% of the rural schoolgirls and 10% of the urban knew about the need for a
condom.

Ranjana Kumari, director of the Centre for Social Research says sex education
achieves many goals missed by a blinkered Parliamentary Committee. Not least
sexual abuse. A nationwide study by the Department of Women and Child
Development says that 53.2% children have faced one or more forms of sexual
abuse and at least half the perpetrators were known to the child. "We have to
educate youth so they can protect themselves," says Kumari.

http://timesofindia.indiatimes.com/Sex-education-Why-India-should-go-all-the-way\
/articleshow/4449680.cms

Telling our secrets

Sex between men is illegal in India, putting them at high risk of contracting
HIV

Sylvia Rowley. The Guardian

Venkatesh Routh lives with his wife and two-year-old son in Mancherial, a small
city in the Indian state of Andhra Pradesh. Three nights a week he says goodbye
to his wife, who is nine months pregnant, and goes to the railway station. But
instead of getting on a train he walks to the end of the brightly lit platform,
past the chai-wallah selling hot sweet tea, to the point where the floodlights
go no further. Here he steps into a maze of dirt paths and thorny bushes. There
are no women, and the men have all come for the same reason: to have sex with
other men.

"I come here in secret," says Venkatesh, standing in the dark. A train clatters
past, horn blaring. "I am a kothi [effeminate homosexual]. I didn't want to get
married, but my family members pressured me. Every day for three years they kept
asking, 'Why don't you marry?'"

"When I started coming here for sex I'd heard the word 'Aids', but I didn't know
how you get it. I didn't know how to use a condom," he says. "Now I show other
people how to use them properly."

As 29-year-old Venkatesh fills up the condom box bolted to a crumbling wall
among the bushes, he is taking part in what looks to be one of the most
promising HIV prevention efforts in the developing world in recent years. All
over Andhra Pradesh, men who have sex with other men - who may or may not think
of themselves as gay or bisexual and who are often married with families - are
forming community groups and helping each other to solve their own problems.
Venkatesh is one of them.

One in seven men who have sex with men in Andhra Pradesh is HIV positive
according to the state government. They are almost 20 times more likely to be
infected with HIV than the average Indian adult (the national adult prevalence
rate is 0.36%). This is because unprotected anal sex with multiple partners
carries a high risk of HIV, and because discrimination drives men who have sex
with men underground.

Homosexuality is illegal in India under the notorious section 377 of the Indian
penal code and is a social taboo. There is incredible pressure for men who are
attracted to men to hide their sexuality.

Sex between men is often limited to brief liaisons at so-called "hotspots"
behind a train station or by the side of a highway. "We wear a mask, the
masculine mask," says Krishna, founder of a network for men who have sex with
men in Andhra Pradesh. "We drop our voices, change our walk. That is drama, you
have to act."

Because men who have sex with men are so well hidden, it is almost impossible
for government Aids agencies or HIV/Aids charities to reach them. "The
Government people can't walk around looking for hotspots," Krishna says,
laughing at the thought. "They can't find them!"

Men such as Krishna, however, do know where to look. In Andhra Pradesh,
community-based organisations (CBOs) made up of men who have sex with men can
now be found in every district. Outreach workers at the CBOs map all of the sex
hotspots in their area and visit them daily, armed with an HIV education
flipbook, a stash of condoms, lubricant, and a plastic model of a penis. Each
CBO is supported by a local non-governmental organisation (NGO) which provides a
drop-in centre and sexual health clinic, and a state level NGO, the Alliance for
AIDS Action, a partner of the International HIV/Aids Alliance, which coordinates
the programmes and provides training to the community groups.

CBO members also work with police, doctors and parents to tackle the wider
discrimination that puts men like them at risk of HIV. "I tried to go to the
government hospital because of an anal infection, but the doctor called me a
kojja [derogatory word for transsexual] and refused to see me," says Venkatesh.
"I felt so bad I wanted to commit suicide," he says, "but now we do workshops
with the doctors to make them understand us better." This work is crucial as
untreated sexually transmitted infections increase men's vulnerability to HIV.

If the sessions fail then Venkatesh will try other means - one doctor who
constantly refused to treat men who have sex with men was sacked recently after
CBO members talked to the hospital authorities.

Most groups also try to improve relations with the police because, as one man
says, they "harrass us like hell". I was told about police at hotspots demanding
bribes ("they will pocket whatever we have"), and arresting, beating and raping
men. In response to this and violence by local thugs, CBOs have formed Rapid
Action Teams - if a man is in trouble he can ring for help and a group of his
peers will quickly come to the scene and challenge the attacker. CBOs also do
"sex and sexuality" training to build a rapport and understanding with the
police.

The results for these projects are staggering. An evaluation in 2007 showed that
96% of men who have sex with men reported using a condom with their last male
partner, up from 55% in 2003. The prevalence of syphilis, which is used as an
indicator for HIV, more than halved in the same period. This is a cause for
celebration not just for men who have sex with men, but also for their wives.
Roughly eight out of 10 men who have sex with men in Andhra Pradesh are married
and if they become HIV positive it is very likely that their wives will too. The
state Aids prevention body estimates that 96% of men who have sex with men in
Andhra Pradesh (that they know of) are now being reached by this type of
programme.

The Alliance for Aids Action hopes that by empowering men who have sex with men
to solve their own problems, these changes can be made to last. "How long can a
third party run a programme?" asks Narendra Nath, a senior programme officer at
the alliance. "When this project finishes [in about five years] we hope that the
CBOs will be able to keep doing the HIV prevention work."

Back in the maze of bushes by Mancherial train station a group of three kothis
who have come here in search of "someone beautiful" crowd around. The mood is
jovial and they joke that one man in our group is "looking very smart!"

"I don't tell my wife I come here because she'll feel bad," one says. But I use
a condom - I don't want to make her suffer."

http://www.guardian.co.uk/journalismcompetition/amateur-finalists-hiv-infection

Job title: Administration Officer – Coalition Based Advocacy Project (Job code
–CAL-AO -0409)

Employing organization: Solidarity and Action Against The HIV Infection in India
(SAATHII), India

Location: Kolkata, India

Date of Issue: April 28, 2009

Closing Date: May 8, 2009

About SAATHII:
SAATHII, a non-government organization founded in 2000, works to strengthen the
capacities of individuals and organizations working on HIV/AIDS in India through
information dissemination, networking, advocacy, research and technical
assistance services.
It is known for innovative and multi-sectoral initiatives in the HIV/AIDS field.
SAATHII is registered as a tax-exempt charitable trust with offices in Chennai
(Head Office), Kolkata, Hyderabad, Karur, Bhubaneswar and Jaipur.

Job Description:

SAATHII is looking for a suitable individual for its Administration Officer –
Coalition Based Advocacy Project position under a long-term project titled
“Building the Capacity of People Living with HIV and Sexual Minorities in
Orissa and West Bengal to Advance their Health and Rights”. The project seeks
to build and facilitate coalitions of these communities to conduct joint
advocacy, play a watchdog role and engage with government agencies in effective
implementation of crucial health programmes. The project is a collaborative
venture of SAATHII and Interact Worldwide, London, with funding support from
Department for International Development – Civil Society Challenge Fund,
Glasgow.  This position requires a broad knowledge of day-to-day NGO
administrative and accounting functions and a basic idea of current health
sector issues, with special emphasis on HIV/AIDS and related issues.

The principal role of the Administration Officer – Coalition Based Advocacy
Project will be to maintain daily accounts (including cash management),
logistics management, writing financial / administrative reports, helping the
Project Manager in making short term financial plans, and also to perform other
duties like correspondence and filing as stipulated by the Administration
Manager, Kolkata Office and the Project Manager.

Skills and Qualifications Required:

At least five years of experience in financial management, accounting and
administrative work in the social development sector.
Ability to prepare financial plans, forecasts and reports.

Graduation or higher degree from a recognized university in commerce or
financial management. Candidates with Post Graduate Degree in Commerce or MBA in
Finance will be preferred.

Sound skills in computer usage - including use of latest version of Tally and
Microsoft Office softwares and the Internet.

Good command over English, particularly in writing technical reports and
correspondence.

Fluency in spoken English and Bengali languages.

Basic knowledge of current health and development sector issues, particularly
HIV/AIDS, gender, sexuality, human rights and reproductive health issues.

Ability to work independently and as a team player in a complex, multicultural
environment, with demonstrated leadership, communication, networking and
presentation capabilities.
People living with HIV, women candidates and candidates from gender or sexuality
minority sections are encouraged to apply.

Monthly pay amount: Rs.10,000/- per month .

To apply:
Please submit a comprehensive CV in English with a supporting cover letter,
including the names of three referees (preferably one should be a current or
previous employer), as well as last salary earned, and whether able to join
immediately or not.

Applications should be sent by e-mail / courier to the following address, and be
clearly marked: “Application for Administration Officer – Coalition Based
Advocacy Project”.

Contact information:

Director, Kolkata Office
Solidarity and Action Against The HIV Infection in India (SAATHII)
229, Kalitala Main Road, Purbachal (North), Kolkata 700 078

E-mail: saathii.jobs@...

CVs sent to any other e-mail ID will not be entertained) 
Website: www.saathii.org

Closing date for applications: May 8, 2009Likely interview and written
examination date and venue for short listed candidates will be intimated over
phone.

Dear Forum,

Greetings from CNP+,

The APAC has recently initiated the toll free new help line is
18004191800. If we call we can get the correct messages on HIV/AIDS like
Govt.ICTCS, DICs, TI NGOs etc,. I request the forum to try to call the
above mumber and get the accurate referal & Linkages in Tamilnadu and
Andhra pradesh also.

With thanks& Regards

M.SOMESH

PRESIDENT
Coimbatore Network for Positive People (CNP+)
454, SBA complex, Kamarajar Road,
Near Manis theatre,
Hopes College, Peelamedu,
Coimbatore - 641 004.
Tamilnadu. INDIA
Tele Fax : 0422 2596855  Cell: 09443281947/09486191682
Email: cnpplusnet@...

INP+ launches �Positive Journey Through Life’, a photo exhibition to promote
Social Acceptance of People Living with HIV/AIDS.


India is one of the largest and most populated countries in the world, with over
one billion population. Of this number, it is estimated that around 2..4 million
Indians are currently living with HIV.

What is even more shocking is the fact that just 6 high prevalence states
contribute to more than 60% of the total population of people living with
HIV/AIDS. In one of the latest reports it was recorded that even today 87%
acquired AIDS through the sexual route.

In a country like India where poverty, illiteracy and poor health are
predominant, the spread of HIV/AIDS presents an intimidating challenge. At this
point, INP+ seeks to improve the quality of life and also to develop a positive
image of people living with HIV.

In April 2004 the government started the ART Programme to provide free access to
Antiretroviral Therapy (ART). Today 177,808 adults and 12,116 children receive
free ART through 179 centers spread across 31 states. Their aim is to be able to
provide free treatment to 300,000 adults and 40,000 children by 2012 by adding
another 250 ART Centers and 650 link ART centers by 2011.

INP+ compliments these government initiatives by conducting outreach programmes,
peer counselling and advice and providing care and support.

INP+ strives to reduce the stigma and discrimination in the healthcare,
workplace and community settings by addressing issues for the Marginalized
communities through the forums for Women & Children, Injecting Drug Users (IDU),
Female Sex Workers (FSW), Men who have Sex with Men and Transgender.

To realize this goal INP+ together with Family Health International (FHI) and
Avahan AIDS Initiative has launched a project �Positive Journey Through Life to
strengthen National, State and District Level Networks to reduce stigma and
discrimination at all levels of society.

Strengthening People Living with HIV/AIDS (PLHA) Networks is the permanent
solution to reduce stigma and discrimination faced by PLHA in India. This
exhibition will boost the self esteem of PLHA in the country and encourage more
people to be open about their status said K.K.Abraham, President, INP+

A passionate Indian photographer who has spent over 20 years behind the lens
freezing everything that moves the human spirit - colours, emotions, beauty
After 10 years of working with a leading publication in the city he decided to
launch out on his own as a film/documentary maker and photo-journalist. For
Shaju, photography is not merely a vocation or a hobby, but art and life itself.

Mr. Shaju John who traveled across the country and was able to capture and
document the changes and social and emotional impact of the HIV and AIDS
epidemic in India, highlighting the varied positive human responses in the
workplace, healthcare, family and community settings.

This project has been one of my most fulfilling projects. To have seen people
living such fruitful happy lives even with HIV was such an eye opener for me.”
– Shaju John

These photographs show the extraordinary insights into the lives of individuals,
families and communities who are affected by HIV. The photo exhibition will be
hosted at

The Park , Chennai on April 29, 2009 from 10:30AM to 9:30PM

Following which it would be taken to other cities across the country.

This exhibition and campaign aims to complement the current national AIDS
program and will promote a positive image of responsible people living with HIV.
The campaign acknowledges that there is a long healthy life after HIV infection,
people living with HIV are active just like anyone else and places prevention as
part of a continuum of care. INP+ will also publish a book �Positive Journey
Through Life’ with 100 PLHIV in the month of May 09.

Join us in this initiative

For more information contact:

Indian Network for People Living with HIV/AIDS (INP+)
New No 41 (Old No 42/3), Second Main Road,
Kalaimagal Nagar, Ekadduthangal, Chennai - 600 097
Ph: + 91 44 22254671/72/ 73/74
Fax: + 91 44 22254670
Email: inp@inpplus. net
Website: www.inpplus. net

Dear all,

Thank you for the OVERWHELMING RESPONSE TO CHATPAP!

We acknowledge with gratitude to all our partners in the region who have
endorsed CHATPAP in totality. This is a consortium that has evolved to explore,
identify gaps and address continuum of HIV treatment, co- related issues,
strengthen networks of treatment providers, scale up efficiency, build capacity
and establish newer innovative models for universal treatment and care and
support access in the Asia Pacific region.

We are pleased and emboldened by the overwhelming response on the launch of
Consortium of HIVAIDS Treatment Providers in Asia Pacific (CHATPAP) from every
constituents cutting across sectors, focal areas and communities.

We are continuing to receive membership requests from Pakistan, Bangladesh,
India, China, Cambodia, Thailand, Vietnam, Nepal and other parts of the region.

CHATPAP aims to create a dynamic forum of doers/providers to connect, network,
understand and share their experiences in providing HIV treatment and critical
care issues related to basic access, availability, and affordability of drugs,
generic drugs and diagnostics, procurement issues, varied delivery of services,
innovative and high end technology for testing scale up, to address revival of
creative prevention strategies, identify gaps and to advocate for increase
treatment access for marginalized populations such as IVDUS, CSW, MSM, Migrants
and refugees working in tandem with government and UN agencies in the region.

Kindly Contact us at:

CHATPAP
AHF Asia Pacific Bureau Secretariat
S345, Panchsheel Park,
New Delhi – 110 017
Tel:                 +91 11 46866800
Fax: +91 11 46866813
Email: chinkholal.thangsing@...
For enquiries and coordination contact
Email: mahesh.ganesan@...
______________________

CHATPAP Membership is still open

Activities of CHATPAP

1.  Consortium of HIVAIDS Treatment Providers in Asia Pacific (CHATPAP) shall
immediately accept applications for membership from various NGOs in the present
countries and within the next year expands to other countries in the region.

2.  To promote CHATPAP in the lines of other existing regional networks and have
its first joint assembly during the 9th ICAAP.

3.  To advocate for universal access to treatment, care and support services
which is our fort and to consolidate through this consortium and expand our
reach to new partners and strengthen existing partners.

4.  To showcase our presence as a single largest consortium in six countries and
working in tandem with different stakeholders at national, regional and global
level.

5.  To share experiences, challenges, lessons learnt to better HIVAIDS treatment
delivery and enhance program effectiveness.

6. To exchange key strategies and strengthen treatment providers network.

7.  To give an equal participation and equal voice to members of the consortium
to address or share their problems and solutions.

8.  To set up a database of treatment providers and generate a directory of
treatment services providers in the Asia Pacific region.

9.  To liaise with UN bodies, WHO and provide critical field experience based
data to create needful changes in HIVAIDS care and treatment policy.

10. To jointly participate and or conduct simple analysis of programs,
activities and gather relevant demographic data/profiles.

11. To advocate Universal Access to ART including second line drugs.

12. To organize regional treatment providers workshop, meetings in conjunction
with regional programs, workshop, conferences.

13. To influence policy makers for positive and effective changes.

14.  To advocate for affordable second line/third line drugs and newer
molecules.

15.   To establish initially and later to assert through this consortium the
following demands:

a)   Active participation in the decision making process in regional bodies

b)   Co-sponsor international and regional conference such as ICAAP

c)   Have a say in the nomination of members to the highest decision/policy
making bodies such as UNITAID, GFATM, PEPFAR etc.

d)  Influence and seek mandate from other regional exclusive groups to support
our global campaigns

e)  Represent our demands through this consortium to various multilateral
organizations including UN bodies

Membership to CHATPAP is free and registration can be done by providing basic
information about your organisation. Personal information submitted to CHATPAP
will be kept strictly confidential and used only for the purposes of
dissemination of CHATPAP activities.

Membership Application Form

I hereby submit this application duly filled on behalf of my organisation as my
application to be a member organisation of Consortium of HIVAIDS treatment
provider in Asia Pacific (CHATPAP).

My details are as follows:

Name:
Organisation:
Designation:
Address:
Contact Details: (Phone/Fax/Email/Skype ID Etc.)
Major areas of work:
Country:
The above details are true to the best of my knowledge.
Signature: (Authorised Signatory)
Date:

*Submit by email to: Chinkholal.thangsing@...
For Official Use only:
Membership No.
Acceptance Date:
Country Code:

Category Code:

1. ART Treatment
2. Counselling services.
3. Testing Services.
4. IEC Services
5. Community Outreach
6. Care and Support
7. Advocacy for Treatment care and support.
8. Drug procurement 9.High technology on HIV diagnostics etc.
10: Other HIV care services

Dear Dr Sharma and the forum,

Re: http://health.groups.yahoo.com/group/AIDS-INDIA/message/10170

My idea was not to malign anyone (individual or institution) and if
some one is hurt ,my unconditional apologies.

In the same breath let me have an oppurtunity to inform that my
credentials can be checked at any time by anyone,although I do not
have to prove anything to anyone.

Regarding patient being asymtomatic when admitted with me-the records
of the hospital (EMC3, Amritsar-where she was admitted )can be
checked,yes the viral load was not done because of affordability.

Aluvia ,I know is not availabnle with you sir,but the combination was
same. And also I did not confuse duovir with Zidovudine--still if that
is the issue and Dr. sharma thinks so,then I become wiser.

Dr.Sharma, with all regards to you,we always point fingers at
others,who are qualified(BTW-I stand qualified to be called an
HIVspecialist by the defination, please check the following by American academy
of HIV medicine What Makes an HIV Specialist?

Being an HIV specialist is not just a matter of a physician calling
him or herself a specialist. There are guidelines and requirements
that have to be met in order to be considered an HIV specialist.

The American Academy of HIV Medicine (AAHIVM) has established a definition of
the HIV specialist that includes three standard criteria for HIV knowledge
measurement. They include:

Experience

The doctor must maintain state licensure and provide direct, on-going,
continuous care for at least 20 HIV patients over the past two years.
This requirement has to be documented every two years and if the
doctor fails to document this requirement, the doctor is no longer
considered an HIV specialist.

Education

The doctor must complete at least 30 credits of HIV related continuing
medical education (CME) every two years or must have completed an
HIV-related internship or fellowship in the last two years.

External Validation

A doctor must be recognized by an external credentialing entity such
as the AAHIVM. This is accomplished by passing an HIV Medicine

Credentialing Exam.

When looking for an HIV doctor, make sure he or she meets these three
criteria. If so, your doctor can be considered an HIV specialist. Now
that you know what an HIV specialist is, let's tell you why having one
is a must.

Dr.Sharma-I fulfill all these criteria.

Finally, whatevevr I have been doing for more than a decade is for the
benefit of patients---my patients are my proof.

Regards Dr.Aman

Dr.Bharti
 

--
Rakesh Bharti
MD,AAHIVS,
BDC Research center,
27-D,Sant Avenue,The Mall,Amritsar.
Punjab,INDIA143001.
TEl-91-183-2277822;E-MAIL:
E-MAIL: <rakesh.bharti1@...>

Dear AIDS INDIA FORUM Members,

The latest epidemiological trends in India show that more and more
women are becoming HIV positive in India in the recent years.  As per
the sentinel surveillance findings of 2005, 38.4% of the infected
persons were women.

The male to female ratio of HIV prevalence among STD clinic attendees shows a
shift from 55/100 males in 2001 to 60/100 males in 2005. The ICTC data of 2005
also indicate that more than 40% of the people tested positive are women. All
these data indicate increasing feminization of the epidemic in India.

NACP-III PIP aims at increasing access to women and girls (15-49
years) to accurate and comprehensive information about HIV prevention.

Effective approach to HIV prevention includes risk reduction coupled
with strategic approaches that address contextual factors that foster
vulnerability.  While there is sufficient documentation on the
effectiveness of risk reduction strategies in preventing HIV
transmission (provision of information and education, service delivery
including HIV testing, needle and syringe exchange, condoms and
lubricants, safe blood and blood products) in India, there is a gap in
information as to how effective the strategies to reduce the
vulnerabilities to people involved in high risk behaviour.

With increasing HIV infection among women, it is important to review the
interventions that use a variety of strategies to reduce the
vulnerability of women to HIV. With support from UNIFEM, ICRW in
partnership with Population Council is undertaking a desk review of
the state of the current interventions strategies on reducing the
vulnerabilities of women to HIV infection. In this connection, we
would like to know from the members about:

1. Details of the programmes that adequately address the vulnerability
of the women to HIV infection.

2. The category of women that these programmes address.

3. The vulnerability reduction approach (not risk reduction approach)
adopted in these interventions and;

4. The outcomes of these interventions.

We would appreciate if you can share your experience including
research studies, evaluation reports, project descriptions or any
other useful resources related to reduction of vulnerability to be
included in the review study.

You may send the materials, links etc to

<sherryjoseph@...>

Thanking you in anticipation,

Yours sincerely,

Sherry Joseph
Independent Consultant
Mobile: 09818277842
e-mail: <sherryjoseph@...>

*Children consultation in Goa*

A three day consultation was organized for children in Goa.  This programme was
organized by World Vision India in partnership with Zindagi Goa. The technical
support was provided by Buds of Christ, Chennai.

The workshop had about 50 children from different parts of the state.

This was the first workshop of it’s kind in Goa, in educating children on
various topics related to health. One of the major topic included HIV and AIDS
too.

The three day workshop was participatory involving singing, drawing, role plays,
games and learning sessions in groups.

From the workshop it was realized that children above 13 years, had very less
information about reproductive health and the risk factors to HIV and AIDS.
There was a general fear about the transmission of HIV and common myth like
mosquitoes as one mode of transmission and avoiding eating food prepared by
people living with HIV were also assessed from the group.

In the same age, boys had more exposure to information through internet, which
was mostly pornographic pictures and not information around reproductive health
nor sexuality. With regard to girls they had very poor knowledge on the
reproductive function of female organs.

Stigma and fear of being discriminated was felt and well understood among
children, and there was an unanimous expression of care and support towards
people living with HIV and children affected by HIV and AIDS.

For most of the children, though they have all come from a background where
either one member in their family is affected by HIV and AIDS, the information
about infection is very less, as parents themselves have not been able to share
information and their status due to pressures from the care takers, especially
their close relatives.

The workshop has been able to provide information around HIV and AIDS,
stigma associated with it in the society and the love, affection, care and
support to be provided for people living with HIV AIDS, but more encouragement
for parents and care takers need to be done on issues surrounding disclosure.

In solidarity

Jpaul
Buds of Christ
# 305, M.I.G 6th Cross St., Mugapair, Chennai 600 037.
TN - India
e-mail: <jpaul@...>

Dear Forum,
 
Ms.Bindu needs to be thanked for articulating her angst and concerns.
 
Until we share the same with sincere and like-minded people and
organiztions (with varying stands and perspectives we all are perfectly
justified to take and pursue) we will not be in position to partner and forge
very strong alliance which are needed to fight the humungous challenge.

We must see the intentions of the gestures even if they have not been able to
bring about the desired outcome in the initial stages.
 
In a national meeting of the GIPA coordinators we all agreed to the point that
even a tokenist participation may be the very first step towards a meanigful
partnerships with full synergy and earnest sincerity.
 
We all decided that :-
 
GIP coordinators must ensure for themselves and the PLHIV
Meaningful Roles,
Active Participation in and
Proactive facilitation of the entire continuum of activities for prevention,
care, support and treatment under all the components of the National AIDS
Control Programme-Phase III including (but not limited to):-
Prevention of new infection (TIs, ICTC,STD clinics, Blood Safety etc..)
Care, support and treatment (ART,OI, Psycho-social Support, legal support,
income generation programmes )
Surveillance, studies, Operations Research etc.
Monitoring and Evaluation/Strategic Information Management
Active contribution in Policy formulation/revision and all the planning
activities.
Zero tolerance for stigma and discrimination faced by the PLHIV and/or core
population
Facilitation of myriad activities in accordance with the NACO guidelines and
directives.

I would like to make to make a personal appeal to Bindu not to be disheartend by
any incident not in accordance with her expectations in the past.Most of us are
committed to the cause of the containment of dual epidemics and are working in
all fesible ways to ensure that at all quarters.We all are with you.
 
GIPA is there (though in very early infancy),GIPA is gaining momentum and GIPA
will definitely emerge stronger with the fullest support from ALL of us in the
letter and the spirit.
 
I am pretty cofident and optimistic about it.
 
Best wishes,
 
Rajesh Gopal.

Dr. Rajesh  Gopal,MD
Joint  Director,
Gujarat  State  AIDS  Control  Society (GSACS),
O/1 Block, New  Mental Hospital  Complex,
Meghaninagar,Ahmedabad, Gujarat.
PIN 380016 Phone (O) 079-22680211--12--13,22685210 Fax 079-22680214
e-mail: <dr_rajeshg@...>

The Other Side: ‘Sai Sandhya’ for MSM.

Behind make-up, style, fashion & sexuality there lies an unmasked face, a lonely
heart, ridiculed, abused and depressed longing for love and acceptance.

While most ‘Kothies’ and Transgender have a spiritual side and very secular in
faith, it was observed that many are believers of ‘Sai Baba’ cutting across
personal faith and religions.

Working on HIV prevention with MSM & TG we tend to forget that the so called
‘HRGs’ are more than our targets whose needs are much more than STIs and HIV
prevention related services. While we like to mainstream our projects/programmes
with various ministries and departments, we also need to put some extra efforts
towards reducing phobia and further marginalization of our ‘target population’
and mainstream them with the general society.

Keeping this in mind a ‘Sai Sandhya’ with Sufi Qawalli was organized by SPACE
organization at its DIC to mobilize the MSM community and bring about Behaviour
Change in the context of health and wellbeing through spirituality, moving away
a little bit from HIV and AIDS that stigmatize the community so often.

Many were surprised, some were shocked, some raised eyebrows and many felt happy
and highly appreciated that such initiatives can be taken by NGOs that mostly
speak about HIV & AIDS & Condoms etc.

It was an innovative concept and for the first time that such a spirituality
based event was organized by any organization working with MSM and Transgender
individuals on HIV/AIDS.

The response was tremendous and surpassed all expectations. Hundreds of MSM of
all typology cutting across personal faith, conflicts and  breaking all power
structures gathered at the ‘Sai Sandhya’ and listened to Sufi Qawallis with an
utter devotion never seen before.

Tears welled up in many eyes and some started dancing and clapping in ecstasy on
songs and ‘Bhajans’ that spoke of love and attachment with the almighty.

Just at the end of the programme, a short talk was delivered by the organizers
on health and general well being.
Each had millions of thanks on their lips while leaving and had their Prasada
with much devotion.
SPACE sincerely thanks the Delhi State AIDS Control Society for supporting the
initiative.

SPACE-
Society for People’s Awareness, Care & Empowerment
Project – ‘Delhi Dost’
E-31, Majnu Ka Tila, Civil Lines
Delhi-54
spaceorganisation@...
# 23811714, 9818227105

Dear Dr Rewari

Re: http://health.groups.yahoo.com/group/AIDS-INDIA/message/10147

That was a fantastic response and it is great to notice NACO'a planning,
preparedness and approach to the care and treatment program.
In fact the numbers speak for themselves.

Can I take this opportunity to request for a centewise list of patients regd for
ART at the 197 centres?

Regards

Dr Sanjay Sarin

National Manager (Global Health)
BD India
e-mail: <ssarin_2000@...>

Dear Dr.B.B.Rewari,

Re: http://health.groups.yahoo.com/group/AIDS-INDIA/message/10152

This is in regard to the 2nd line ARV, in our state we have approximately 7000
PLHAs registered and there 3800 ARV 1st lineand there are only 5 on 2nd line at
the Government ART Center, we as a Forum Based in Bangalore have come accrose
there are some people those who are taking 2nd line ARV drugs from NGO supported
by some Donors.

Presently they are finding it difficult to maintain as the donated amount
differs from tha actual cost and some donors have told them they cannot sponsor
as the Government ART center is giving free 2nd line ARV drugs.

As i understand as per the Naco guidelines only registered PLHAs acn be given
2nd line ARV drugs,refering to your previous mail you said any such problems
mail to me for help.

Now let me know what we can do for those who are not getting 2nd line ARV drugs
when they are not registered in the ART center and how can you and we can help
the needy PLHAs

Awaiting your speedy respopnse

Thanks and regards

P. William Christopher
Member BHAF (Bangalore HIV and Aids Forum)
e-mail: <williamwvi@...>

[Editor's note follows the main text of this message]

Dear FORUM,

Re: http://health.groups.yahoo.com/group/AIDS-INDIA/message/10152

As the nodal officer of the COE at PGIMER, I would like to apprise the readers
in general and Dr Bharti in particular that as per the NACO gudelines the two
recommended second line regime is
Lpv/r , tenofovir, lamivudine with or without Zidovudine depending upon Hb.

As the full name of the patient is not provided, We have on our record one
patient from Amritsar with name as Ms C. K (full name of this patient is removed
by the ediotr) who was also started on the Zidovudine based NACO regime. We have
records to substantiate the same. (just for records ALUVIA is not the brand
available with us).

If Dr bharti is confusing Zidovudine with duovir then the quantum of error is
self explanatory and if he has done it intentionally then it is liable for
defamation suit.

Further to apprise the kind of practices some men do, this was a patient who was
doing well and was on NACO  first line regime and was doing fine, due to some
mishap at home she went to some private practitioner (whether it was Dr Bharti
or someone else can be confirmed when she come for follow up) while she was
clinically asymptomatic, all her previous CD4 could were way above 250. CD4
count was asked and single time report of 10 was obtained, without confirming
such drastic fall in a patient who was asymptomatic and without doing viral load
she was started on second line drugs.

As she could not afford these when she learnt that the same are now being
provided at PGI 4-5 months after she was already on second line, she wanted free
second line drugs from PGI.

As she had already taken drugs for a long time, she was started on second line
NACO ART regime whih is available free of cost as per rules.

It is ironical that in this country, those people who are not even trained to
manage life threatening conditions like Cryptococcal meningitis,
PCP,Toxoplasmosis and AIDS dementia complex are managing all such issues, taking
therapeutic decisions like the ones highlighted in this particular case where we
end up clearing the mess created by them (although reluctantly but without
making any noise)  and then take the altruistic approach and use the medium for
only their advertisement.

Just for record we have documentary proof of wrong prescriptions from AMRITSAR
which can be put on any forum. We generally do not tell the patient as to what
our colleagues have been doing. But from this case it seems that we should not
do that.

Whether at least an apology is warranted from DR BHARTI, I leave to the
judgement of the readers.

The academic points have been very well highlighted by Dr Murugan from Tamil
Nadu for which I am thankful personally.

Best wishes to all the readers,

Dr Aman Sharma,

Nodal Officer, COE, PGIMER, Chandigarh
e-mail: <amansharma74@...>

[The name of the patient supplied by Dr Aman Sharma is with held by the editor.
It is disappointing to see Dr Sharma, is willing to discuss the health condition
of a patient apparently without the permission of the patient on a public FORUM
like this. Please note, this is not a clinical discussion forum. Clinical issues
are discussed, only when it has wider health policy implications. In this case,
the question under discussion has implication on quality of care provided by ART
centres.  Editor AIDS INDIA].

The Female Health Company / HLL Lifecare Limited Receive National AIDS Control
Organization of India Order for 1.5 Million FC2 Female Condoms

Thursday April 23, 2009, 8:30 am EDT
CHICAGO, April 23 /PRNewswire-FirstCall/ -- The Female Health Company (NYSE
Alternext: FHC) which manufactures and markets the FC1 and FC2 Female Condoms®,
today announces that its technical collaboration with HLL Lifecare Limited (HLL)
(formerly Hindustan Latex Limited) has been successful in winning another order
from the National AIDS Control Organization of India.

The order, for one and a half million (1,500,000) female condoms, will be
manufactured in HLL's factory in Kochi, India. The female condom will be "FC2",
the Nitrile polymer version of FHC's female condom. (The technical collaboration
between the FHC and HLL has been partly funded by the British Government's
Department for International Development through the Business Linkages Challenge
Fund.

The fund shares costs and risk with business partnerships for improved
competitiveness, increased market access and to benefit the poor in Africa, Asia
and the Caribbean.
 
O.B. Parrish, Chairman and C.E.O. said that, "This order is the result of HLL's
and Hindustan Latex Family Planning Promotion Trust's (HLFPPT) continuing
commitment to make the female condom accessible to the men and women of India.
We are pleased to see the program's continuing growth and especially proud to
have enabled production to commence in India for the Indian market. This is the
first initiative of its kind."

Mr. M. Ayyappan, Chairman and Managing Director, HLL Lifecare Limited stated,
"This NACO led FC Social Marketing initiative will enable millions of vulnerable
women to stay protected from HIV and other sexually transmitted infections. We
are extremely happy to supply the Female Condoms for the NACO supported program
from our commercial manufacturing facility set up at Kochi in collaboration with
FHC."

About HLL Lifecare Limited

HLL Lifecare Limited (HLL) (www.lifecarehll.com), a government of India
enterprise, was incorporated in 1966 to make superior quality male condoms
widely available in India. Today, HLL is one of the world's largest
manufacturers of male condoms with an annual production capacity of over 1.3
billion pieces. HLL also manufactures oral contraceptive pills, intra-uterine
devices, blood transfusion bags, surgical sutures and rapid diagnostic kits.

Headquartered in Trivandrum, Kerala in South India, HLL has manufacturing
facilities with the ISO 9001:2000, ISO 13485:2003 and environmental management
system certifications. HLL has the FDA 510(K) registration, CE Mark, KITE mark
an, SABS mark for Male condoms. Today, HLL is the leading social marketing
organization in the country in the area of contraceptives - with a market share
of over 65 percent in the rural and semi urban markets.

HLL had recently tied up with the New York-based philanthropic venture Acumen
Fund to set up a chain of low-cost high quality hospitals under 'Lifespring'
brand in rural India. HLL's brand today reach over 500,000 retail outlets in
India and are being exported to over 115 countries today.

About The Female Health Company

The Female Health Company, based in Chicago, Illinois, manufactures and markets
the FC Female Condom® (FC1) and the FC2 Female Condom (FC2), which are primarily
distributed by public health organizations and donor groups in over 90
developing countries around the world.

Globally, the Female Condoms are available in various programs in 116 countries.
The Company owns certain worldwide rights to the FC Female Condom®, including
patents that have been issued in the United States, United Kingdom, Japan,
France, Italy, Germany, Spain, the European Patent Convention, the People's
Republic of China, Canada, South Korea and Australia.

FC1 and FC2 Female Condoms® are the only available FDA-approved products
controlled by a woman that offer dual protection against sexually transmitted
diseases, including HIV/AIDS, and unintended pregnancy.
 
http://finance.yahoo.com/news/The-Female-Health-Company-HLL-prnews-15009571..htm\
l?.v=1

Dear forum,

Re: http://health.groups.yahoo.com/group/AIDS-INDIA/message/10137

Point is well taken and Govt. needs to strengthen the health system.

At the same time Mr. Karurnanidhi should initiate a rapid assessment of the CCC
funded by TANSACS and should address the following issues across many community
care centers in Tamilnadu.

1. non - availability of part time doctors
2. Proper fund utilization and functioning as per NACO guideline.

Even in the case of this poor girl Sneha, Opportunistic infections could have
been managed by the doctors at the CCC. Why there was a lapse there?

It is the responsibility of the network to assess the service provision at all
CCC and advocate with TANSACS.

Dr. Raman.


Suresh Raman
e-mail: <tenthplanet@...>

Condoms 'too big' for Indian men By Damian Grammaticus BBC News, Delhi

There is a "lack of awareness" over condom sizes A survey of more than 1,000 men
in India has concluded that condoms made according to international sizes are
too large for a majority of Indian men.

The study found that more than half of the men measured had penises that were
shorter than international standards for condoms.

It has led to a call for condoms of mixed sizes to be made more widely available
in India.

The two-year study was carried out by the Indian Council of Medical Research.

Over 1,200 volunteers from the length and breadth of the country had their
penises measured precisely, down to the last millimetre.

The scientists even checked their sample was representative of India as a whole
in terms of class, religion and urban and rural dwellers.

It's not size, it's what you do with it that matters

Sunil Mehra The conclusion of all this scientific endeavour is that about 60% of
Indian men have penises which are between three and five centimetres shorter
than international standards used in condom manufacture.

Doctor Chander Puri, a specialist in reproductive health at the Indian Council
of Medical Research, told the BBC there was an obvious need in India for
custom-made condoms, as most of those currently on sale are too large.

The issue is serious because about one in every five times a condom is used in
India it either falls off or tears, an extremely high failure rate.

And the country already has the highest number of HIV infections of any nation.

'Not a problem'

Mr Puri said that since Indians would be embarrassed about going to a chemist to
ask for smaller condoms there should be vending machines dispensing different
sizes all around the country.

"Smaller condoms are on sale in India. But there is a lack of awareness that
different sizes are available. There is anxiety talking about the issue. And
normally one feels shy to go to a chemist's shop and ask for a smaller size
condom."

But Indian men need not be concerned about measuring up internationally
according to Sunil Mehra, the former editor of the Indian version of the men's
magazine Maxim.

"It's not size, it's what you do with it that matters," he said.

"From our population, the evidence is Indians are doing pretty well.

"With apologies to the poet Alexander Pope, you could say, for inches and
centimetres, let fools contend."

http://news.bbc.co.uk/2/hi/south_asia/6161691.stm

Job title:

1. Stakeholder Analysis, Policy Research and Advocacy Strategy Development
Consultant – West Bengal (Job code KOL-COA-SPAC-0409)

2. Stakeholder Analysis, Policy Research and Advocacy Strategy Development
Consultant – Orissa (Job code BBSR-COA-SPAC-0409)

3. Project and Administration Assistant – Kolkata Office (Job code KOL-PAA
-0409)

Employing organization: Solidarity and Action Against The HIV Infection in India
(SAATHII), India

Location:

For vacancy 1 and 2 – Kolkata and Bhubaneswar, India
For vacancy 3 – Kolkata
Date of Issue: April 22, 2009
Closing Date: April 30, 2009

About SAATHII:
SAATHII, a non-government organization founded in 2000, works to strengthen the
capacities of individuals and organizations working on HIV/AIDS in India through
information dissemination, networking, advocacy, research and technical
assistance services. It is known for innovative and multi-sectoral initiatives
in the field of HIV/AIDS. SAATHII is registered as a tax-exempt charitable trust
with offices in Chennai (Head Office), Kolkata, Hyderabad, Karur, Bhubaneswar
and Jaipur.

Job Descriptions:

Vacancy 1 and 2:
SAATHII is looking for two suitable individuals as Stakeholder Analysis, Policy
Research and Advocacy Strategy Development (SPA) Consultants for West Bengal and
Orissa under the project titled “Building the Capacity of People Living with
HIV and Sexual Minorities in Orissa and West Bengal to Advance their Health and
Rights”. The project seeks to build and facilitate coalitions of these
communities to conduct joint advocacy, play a watchdog role and engage with
government agencies in effective implementation of crucial health programmes.
The project is a collaborative venture of SAATHII and Interact Worldwide,
London, with funding support from the Department for International Development
– Civil Society Challenge Fund, Glasgow.

Both the SPA Consultants will be required to work closely with the project teams
and representatives of the members agencies of the state level coalitions of
West Bengal and Orissa. Consultants will need to conduct stakeholder analysis
and policy research, and accordingly assist in developing strategies for
advocacy activities. Consultants will need to submit a good quality report, and
will report to respective Training and Coalition Coordinators of West Bengal and
Orissa.

Skills and Qualifications Required:

1. Strong knowledge base in health and development issues particularly HIV/AIDS,
gender, sexuality, human rights and reproductive health issues.

2. Research and analytical skills, documentation skills, with at least two to
three years of experience in conducting policy research studies in the field of
health and social development.

3. Good command over English, Hindi and Bengali is needed (written and spoken).
Translation skills will be considered as an advantage.

4. At least a graduation degree or equivalent diploma from a reputed university
or institute, preferably in social sciences.

5. Sound computer skills (including use of Internet and Microsoft Office
software).

6. Experience in working / liaising with GOs, NGOs, CBOs.

7. Willingness to travel within West Bengal and Orissa.

8. Ability to work independently and as a team player in a complex,
multicultural environment, with demonstrated leadership, communication,
networking and presentation capabilities.
Consultancy fee amount: Commensurate with skills and experience .
Consultancy period: May to September 2009
 
Vacancy 3:
SAATHII seeks to fill the position of Project and Administration Assistant –
Kolkata Office for a WHO-supported short-term project for development of HIV
Treatment Literacy Modules for Men Who Have Sex with Men (MSM) and
Male-to-Female Transgender (TG) people.  This position requires knowledge and
experience of basics of data collection and documentation regarding HIV/AIDS and
related issues along with day-to-day NGO administrative and accounting functions
and logistic

The Project and Administration Assistant – Kolkata Office, will report to the
Programme Manager of MSM / TG Treatment Literacy Project and Administration
Officer, Kolkata Office.
Skills and Qualifications Required:

At least two years of experience in data collection (conducting GDs and FGDs)
and documentation in relation to HIV and/or other health issues.

At least two to three years of experience in accounting and administrative work
in any eminent organization. Candidates with experience in social development
sector will be given added preference.

Basic knowledge of current health and development sector issues, particularly
HIV/AIDS and associated issues.

Graduation or higher degree from a recognized university in social sciences,
commerce or business administration.

Good command over English and Bengali, particularly in writing technical reports
and correspondence.

Sound skills in computer usage - including use of Tally, Microsoft Office
softwares and Internet.

Ability to work independently and as a team player in a complex, multicultural
environment, with demonstrated leadership, communication, networking and
presentation capabilities.

Monthly pay amount: Rs. 8,000/- per month . An initial four-month contract will
be offered, renewable as per further negotiation.
People living with HIV, women candidates and candidates from gender or sexuality
minority sections are encouraged to apply.
 
To apply:
Please submit a comprehensive CV in English with a supporting cover letter,
including the names of three referees.

Applications should be sent by courier or e-mail to the following contact
address, and be clearly marked:

1. Stakeholder Analysis, Policy Research and Advocacy Strategy Development
Consultant – West Bengal (Job code KOL-COA-SPAC-0409)

2. Stakeholder Analysis, Policy Research and Advocacy Strategy Development
Consultant – Orissa (Job code BBSR-COA-SPAC-0409)
Please mention expected remuneration.

3. Project and Administration Assistant – Kolkata Office (Job code KOL-PAA
-0409)

Contact address:

Director, Kolkata Office
Solidarity and Action Against The HIV Infection in India (SAATHII)
229, Kalitala Main Road, Purbachal (North), Kolkata 700 078
E-mail: saathii.jobs@... (CVs sent to any other e-mail ID will not be
entertained)

Website: www.saathii.org

Closing date for applications: April 30, 2009
Likely interview and written examination date and venue for short listed
candidates will be intimated over phone.
----------

Subhadip Roy
Training and Coalition Coordinator (West Bengal) - Coalition Based Advocacy
Project
Solidarity and Action Against The HIV Infection in India (SAATHII), Kolkata
Office
229 Kalitala Main Road, Purbachal (North)
Kolkata 700 078, West Bengal, India
033 2484 5002, 0 98303 15269
saathii@... / subhadip_roy_04@...
subhadiproy.04
www.saathii.org

Nosocomial transmission

Ganczak M, Barss P. Nosocomial HIV infection: epidemiology and prevention-a
global perspective. AIDS Rev. 2008;10(1):47-61.

Because, globally, HIV is transmitted mainly by sexual practices and injection
drug use and because of a long asymptomatic period, healthcare-associated HIV
transmission receives little attention even though an estimated 5.4% of global
HIV infections result from contaminated injections alone.

It is an important personal issue for healthcare workers, especially those who
work with unsafe equipment or have insufficient training. They may acquire HIV
occupationally or find themselves before courts, facing severe penalties for
causing HIV infections.

Prevention of blood-borne nosocomial infections such as HIV differs from
traditional infection control measures such as hand washing and isolation and
requires a multidisciplinary approach.

Since there has not been a review of healthcare-associated HIV contrasting
circumstances in poor and rich regions of the world, the aim of this article is
to review and compare the epidemiology of HIV in healthcare facilities in such
settings, followed by a consideration of general approaches to prevention,
specific countermeasures, and a synthesis of approaches used in infection
control, injury prevention, and occupational safety.

These actions concentrated on identifying research on specific modes of
healthcare-associated HIV transmission and on methods of prevention. Searches
included studies in English and Russian cited in PubMed and citations in Google
Scholar in any language.

Medical Subject Headings (MeSH) keywords such as nosocomial, hospital-acquired,
iatrogenic, healthcare associated, occupationally acquired infection and HIV
were used together with mode of transmission, such as “HIV and
haemodialysis”. References of relevant articles were also reviewed.

The evidence indicates that while occasional incidents of healthcare-related HIV
infection in high-income countries continue to be reported, the situation in
many low-income countries is alarming, with transmission ranging from frequent
to endemic.

Viral transmission in health facilities occurs by unexpected and unusual as well
as more frequent modes.

HIV can be transmitted to patients and to donors of blood products by specific
vehicles and vectors during blood transfusion, plasma donation, and artificial
insemination, by improperly sterilized sharps, by medical equipment during
activities such as dialysis and organ transplantation, and by healthcare workers
infected by occupational exposure to hazards such as blood-contaminated sharps.

Personal, equipment, and environmental factors predispose to acquisition of
nosocomial HIV and all are pertinent for prevention.

For infection and injury control, poverty is often an underlying determinant.
While sophisticated new tests offer improved HIV detection, increasingly higher
marginal costs limit their feasibility in many settings. Modest investment in
safer equipment and appropriate integrated training in infection control, injury
prevention, and occupational safety should provide greater benefit.

Editors’ note: Nosocomial (from the Greek nosos [disease] and komein [to care
for] and later from the Latin for hospital nosocomium) infections are those that
occur more than 48 to 72 hours after a patient is admitted and were not present
or incubating at entry.

This exhaustive review, the first in 15 years, is essential reading for policy
makers, health personnel, and the public alike. The detailed descriptions of
modes of health care-associated HIV transmission and of virtually all the
documented cases from around the world set the stage for recommended
interventions to eliminate/reduce risk for all countries, with special
priorities for low-income countries. Arguing that prevention begins when
everyone accepts that nosocomial infections are truly avoidable, the authors
call for international action to develop and implement appropriate and efficient
safety equipment, training, and surveillance that are feasible for even remote
areas of low-incomecountries.

http://hivthisweek.unaids.net/2009/04/17/nosocomial-transmission/