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An HIV epidemic fuelled by drugs, guns and underdevelopment

An HIV epidemic fuelled by drugs, guns and underdevelopment Manipur's 2.4
million population grapples with an HIV/AIDS epidemic that stems from heroin
addiction directly related to poppy cultivation in the area. It can take two
days for people to reach a government hospital for treatment and more time and
money to access the ART centre in Imphal. Underdevelopment and decades-old
insurgency compound the problem, reports Dilnaz Boga

India’s north-eastern state of Manipur is paying a high price for its proximity
to the notorious Golden Triangle, the region incorporating mountainous areas in
Myanmar, Laos and Thailand and one of Asia’s two main illicit opium-producing
areas. With a land area of approximately 22,327 sq km, Manipur state shares its
border with Myanmar (fomerly Burma). Its population of 2.4 million grapples with
an HIV/AIDS epidemic that stems from heroin addiction that is directly related
to poppy cultivation in the area.

Opium extracted from poppies is used directly or refined into heroin which can
be smoked or injected. While both products are illegal and highly addictive, the
sharing of infected heroin injecting equipment is also responsible for HIV
transmission.

The prevalence of HIV in Manipur is among the highest in India.

The National Aids Control Organisation (NACO) reveals that 0.75% of pregnant
women in the state are infected by HIV (according to 2007 estimates), more than
twice the national average of 0.36%. Andhra Pradesh tops the list with 1% and
Manipur and Mizoram share second ranking with 0.75%.

Three per cent of pregnant women in Chandel and Churachandpur districts and an
alarming six per cent of pregnant women in Ukhrul district are HIV-positive.

Government neglect: The office of the chief medical officer is often shut. The
local administration has turned a blind eye to the drug and AIDS problem in
Manipur

When the HIV prevalence among pregnant women in a district is more than one per
cent, it indicates that HIV has moved from groups at high risk to the general
population in that district.

Almost 18% of injecting drug users in Manipur are HIV-positive. Some 16.4% of
men having sex with men and 13.1% of female sex workers are HIV-positive. The
high prevalence in all three groups is considered a matter of great concern.

More than 43% of the state’s people living with HIV are aged between 21 and 30.

“Most problems stem from poverty and insurgency, so easy money is always
welcome,” says Brigadier Balbir Singh, Commander, 26 Sector of the Assam Rifles,
a paramilitary unit of the Indian Army. He says that the Underground Groups (UG)
seeking independence from India resort to poppy cultivation and extortion to
fund their terrorist activities. “Youngsters have more material expectations and
ambitions, and their resistance to the lure of money is also weak, so they get
sucked into these problems. Poor economic structures are the best breeding
ground for resistance movements,” he says.

The youth of the state have to contend with unemployment and lack of
opportunities. “Despite the fact that our children are qualified, they are asked
to give a bribe of Rs 7-10 lakh to officials to get a teacher’s job in a
government-run school here,” says B S Agnes (48) of Lamphoupasa village, 1.5 km
from Chandel town. Such high levels of corruption have made matters worse,
pushing young men towards militancy or drugs.

“This is a complex problem. It is difficult for us to keep track of every part
of the jungle – the areas are remote and the terrain is treacherous. The
insurgent groups use the money from poppy cultivation to buy arms from Myanmar
and Bangladesh. The border can be infiltrated despite the presence of security
forces,” says Colonel Neeraj Shukla, also of the Assam Rifles.

Manipuris grapple with HIV/AIDS as well as the closely-related, spiralling
heroin problem. A major cause for the high incidence of HIV cases is the sharing
of injecting equipment by heroin users. “Intravenous drug users constitute 70%
of the HIV-positive population here,” says T Issac Zou, secretary of the Network
of Chandel Positive People (NCP+), a non-governmental organisation in Chandel
district in South Manipur, one of the remotest and poorest districts in the
state.

“Authorities are turning a blind eye to this problem. Villages like Joupi,
Khaimi and Churachandpur are notorious for poppy cultivation. Official agencies
operating in the area take cuts from the drug cultivators. So who will bell the
cat?”

Despite the alarming HIV/AIDS statistics, in June 2008, NACO stopped funds to
the Manipur AIDS Control Society (MACS) following reports that funds were being
embezzled. Three accountants were booked under the National Securities Act.

These reports were confirmed by the director general of NACO, Sujatha Rao. “Yes,
it’s true. Their accounts are not in shape, so we didn’t provide funds.” Shortly
after Rao gave this telephone interview, NACO released funds to MACS.

Despite such restrictions, many HIV-positive people have taken it upon
themselves to educate people and encourage them to fight the virus with the help
of care and treatment. Some of them, like Zou, do not restrict themselves to the
budget provided to their organisation; they even spend from their own pockets to
visit far-flung villages and spread awareness about the virus, and hope for
those living with it.

Despite the odds against them, and despite their own limitations, the people who
work for NCP+ have managed to rope in many others like them. Says Zou proudly,
“It gives me a chance to do something good for my people, in my own capacity.
Who else will help my people? Day by day, many more are joining our struggle to
spread the message.”

Zou predicts that “if the rate of spread of the virus is not stopped, there will
be few people left between 30 and 40 years of age in Manipur.”

“Out of the 3,300 people targeted for anti-retroviral treatment (ART), only 200
visit Chandel district’s only hospital,” says Nungchandai, a 28-year-old
counsellor at the ART centre in the hospital. According to the president of
NCP+, Donny Ngoni, the reason for this is that people expect more financial
support from NGOs and when they don’t get this support they don’t come back.

“When people have to go back empty-handed, they won’t listen to us. We need more
financial assistance. We don’t even have a proper office; we won’t be able to
sustain our project beyond 2010.”

Poor facilities compound the problem. The x-ray machine at the Chandel district
hospital doesn’t always work. The CD4 machine also often does not work, a source
reveals. Then people have to go to Imphal, which is 65 km away, for treatment.

It takes them a day to get there and it costs money to travel, says another
social worker. In addition, no one wants to be posted in this remote district –
they reach the hospital by 11 am and leave by 1 pm as they have to make it back
to Imphal before dark.

Manipuris follow the matriarchal system, yet it is the women who suffer the
most. Many have lost their husbands to drugs, militancy and AIDS. To make
matters worse, condoms are not encouraged by local churches; the state has a
large Christian population.

In Aigajana, a village 25 km from the Myanmar border, people have to depend on
the security forces for medical care, and even water. Headman Onkhothang Haokip
(70), who has lived there for 60 years, says: “We have to carry ill people on
foot as there is no mode of transport.” And those with HIV have no choice but to
trudge over mountains before making it to the hospital. Zou of NCP+, who
frequents these remote districts to counsel HIV-positive people, confirms this:
“It takes two days for people to reach the district hospital.”

Such a situation is fertile recruiting ground for some parties, enabling them to
take advantage of marginalised groups. The underground groups have trapped
minors into working for the cross-border arms and drug trade. “They kidnap
villagers and force them to ferry arms or drugs across the border,” says a
member of the security forces.

United Kuki Liberation Front (UKLF) general secretary, T L Jacob Thadou, a
political science graduate, denies the involvement of his cadres (approximately
300) in the drug trade and agrees that the heroin problem is destroying his
people. He says his aim is to unify all the factions of his Kuki tribe who are
fighting to control territories in different parts of the state. He claims, “We
banned poppy cultivation in 2006. It is cultivated in the more backward
districts, where access is difficult.” But the cross-border drug trade thrives.

The Indian security agencies continue to seize drugs and weapons that are being
smuggled to Myanmar on a regular basis. On February 16, 2009, the 20 Assam
Rifles seized Actifed-DM tablets (a medicine for colds that is abused; it has
the effect of brown sugar and is a synthetic opioid substance) worth Rs 4 lakh
in the Indian market and four times more in the international market, from a
vehicle check post at Byongyang. On January 2, 2009, the same paramilitary unit
had seized 98 kg of opium from four individuals travelling on a bus plying
between Imphal and Moreh. Each kilo of opium is worth Rs 1 lakh.

Villagers allege that the UKLF runs poppy plantations in the district along the
border. Incidentally, the group is also holding tripartite talks with the state
and the central governments. As a result, the armed struggle has been suspended
since 2005 and the security forces have been advised not to use harsh methods
under the ceasefire mandate. But Thadou retorts, “Developmental schemes don’t
reach the villagers because the money is siphoned off. The government is using
politics to divide our tribes, which is why we want our own Kuki nation.”

This cycle of drugs, poverty, terror and HIV/AIDS will continue to wreak havoc
in the lives of the Manipuris until such time as the state and the central
government decide to address these issues effectively through policies that
benefit the people. Despite the emotional turmoil of living in a volatile
conflict zone, and with little or no help from the national media to highlight
their problems and the injustice meted out to them over the years, the people of
Manipur have not only survived but continue to raise their voice to demand their
basic right to life.

(Dilnaz Boga is a freelance journalist based in Mumbai)
InfoChange News & Features, May 2009

http://www.hivaidsonline.in/index.php/Living-with-HIV/an-hiv-epidemic-fuelled-by\
-drugs-guns-and-underdevelopment.html
____________________________

We welcome comments and contributions to all sections of the website. Please 
write to me at sandhya_srinivasan@...

Best,

Sandhya Srinivasan
www.infochangeindia.org
www.hivaidsonline.in
www.ipsnews.net
www.ijme.in
www.cser.in
8 Seadoll, 54 Chimbai Road
Bandra (W), Mumbai 400 050
INDIA
Cell: (91) 98204 10849

Dear FORUM,

Re: http://health.groups.yahoo.com/group/AIDS-INDIA/message/10276

The strategy is called out-out testing, and is volunatry as one still has a
right to refuse the test.

I am advocating with the Human  rights law network in India to take up the issue
that while upsacling the right to acess to HIV
C & T; no test is to be carried out without the three C- consent
confidentiality and counselling.

Near universal testing also removes the stigma associated with the test, as is
in present day, and may improve access to treatment (first line). We dont
utilise what opportunities we have and pine for others. The coverage on and
PPTMTCT and ART in India in far from satisfactory presently; only when is
normalised more people can come forward to get tested. Testing is also an
opportunity for acceptance of risk and step towards changing risk behaviours,
getting condoms and counselling support.

When we aim at universal coverage, we will actually achieve at soemwhwere near
half way mark, and know better about the status of the disease, as well as
increase access to testing, definitely not at cost of human rights, but as a a
matter of right to access to Testing.

I have found treatment adherence to be good as people have a difficult
access, high tolearbility in our setting, and the PLHIV value it as a
sanjeevani.

RK Sood

Rajesh Sood
e-mail: <drrksood@...>

Rajashtan: Need for holistic care home for children orphened by AIDS.

Dear FORUM,

One life  many   dreams.... Global Fund PACT programmes and partnered efforts
are proved worth while and its impact is tremendous in Rajasthan which brings
responsibilities ahead, that need to be tackled beyond our limitations either by
PLWHA groups themselves or Public, private community participation.

HOwever, iIt is tragic that nearly three thousand children both infected and
affected in Rajasthan are in unsafe situation. Among them nearly thousand are
infected and majority of them are in painful living atmosphere.
 
There is no substitute for real issues like this .Meaningful contributions ,
associations , and partnership are important to support children and their
family members . Since we don’t have policy and separate programmes for
children such frame work will help to promote investments which further benefit
in facilitate or mange the issues of children comfortably.
 
Our recent strategic planning meeting for care and support aspect of children
has prioritized the list of children under three categories like :
 
Need care and support but they can survive in their target areas
Need extra care and support separately because their life is painful and
threaten

Need extreme extra care and support, but they need further medical assistance
and critical observation?
 
To pass the time and  hang on  promises will not provide a solution .

Group themselves to move ahead with confidence and try to optimum utilize the
resourses around .  So that RNP+ board and all the district partners has
decided to start a care home.
 
What prompted RNP+  to write or take some strategic planning to protect the life
of children all because the ground work allowed and undertaken with the support
of GF.

Since GF has no provision for the children’s infected and affected to those
who are living In such panic condition without any hope & help.
 
Since last One year RNP+ & Positive Mother's Association looked in to it and
taken up very serousely and their own running a holistic care home for 30
children orphened by AIDS.
 
Therefore we are seeking your invaluable support for this noble cause ..
 
Brijesh Dubey
 
PresidentRajasthan Network for People Living With HIV/AIDS
64, Mahadev Nagar, Chittrakoot,
Vaishali Nagar, Jaipur-302021 (Rajasthan)
Phone: 0141- 2353469, 4030861
Fax : 0141- 2353469
e-mail:  <rnpplus@...>

Dear Forum

Re: http://health.groups.yahoo.com/group/AIDS-INDIA/message/10277

I think that Mr S. Vijayakumar has tried to capture various shades of
issuesrelated to the recruitment processes in the civil society organisations.
He has also highlighted various limitations that the recruiters have to
continually face in the sector.

All of us would agree that both the employers and the employees display certain
idiosyncracies. While we often talk of the institutional practices, we seldom
talk about behaviour of potential employees.

I am reminded of a recent case when a person was selected after the due
recruitment process. She was handed over the offer letter  and she confirmed a
joining date after mutual discussion. On the day of the joining, the person did
not turn up.

Our HR person tried contacting the person but in vain. The same evening our
office received a curt mail expressing inability to join without citing
plausible or compelling reasons. You cxan imagine the months of painstyaking
labour that went in vain and forcing us to restart the process all over again.

I am willing to concede that this may be an abberation rather than a rule but
there are different examples that suggest that potential employees do add to the
complexity.

Best

Pankaj Anand
e-mail: <anandpankaj@...>

Maximum HIV+ drug addicts in Amritsar

Chitleen K Sethi
Tribune News Service/ Chandigarh, May 29

Amritsar district now has the highest number of HIV positive intravenous drug
users (IDUs) in the country. According to the latest figures released by the
National AIDS Control Organisation (NACO), Amritsar has overshot Churchandpur
district of Manipur in this regard.

IDUs are among the high-risk groups contracting HIV. According to Sentinel
Surveillance and Estimation Report 2007, released recently by NACO, the national
average of HIV prevalence among IDUs is about 7.23 per cent, while in Amritsar
this has been found to be as high as 30.4 per cent. In Churchandpur it is about
28 per cent followed by Chennai (27.2 per cent) and Mumbai suburban (24.4 per
cent).

The revelation has rung alarm bells in the state, and officials of the Punjab
State AIDS Control Society are learnt to have briefed Minister of Health Laxmi
Kanta Chawla about the situation. Chawla is an MLA from Amritsar.

The incidence of IDUs in Amritsar is high mainly because of the easy
availability of injectable drugs in the border districts of Amritsar, Tarn Taran
and Gurdaspur.

Amritsar also has the highest incidence of HIV positive persons in the state.
Over 5,400 persons here have tested HIV positive. At Patiala, over 2,000 persons
are HIV positive and in Jalandhar the number is over 1,700. Ludhiana has almost
a 1,000 persons who are HIV positive followed by Gurdaspur, where over 600
persons have been found to be HIV positive.

According to the state AIDS Control Society, Punjab has over 15,000 HIV positive
persons (till April 2009). In all India perspective, this is over 11 per cent of
the total HIV positive population in the country.

"The figures, which we provide NACO for the compilation of data, do not include
the number of HIV patients in the high-risk groups. That figure will be added to
the final count from next year. The number of HIV positive persons is likely to
be double than what the figures say right now," said Dr NM Sharma, additional
project director of the state AIDS Control Society.

According to the NACO report, the state-wise HIV prevalence among IDUs is
highest in Maharashtra at 24.4 per cent followed by Manipur (17.9 per cent),
Tamil Nadu (16.8 per cent), Punjab (13.8 per cent), Delhi (10.1 per cent) and
Chandigarh (8.6 per cent). Chandigarh the city has almost 450 registered HIV
positive persons.

Haryana is suspected to have over 42000 HIV positive persons with the disease
most prevalent among truckers, followed by commercial sex workers and
intravenous drug users.

http://www.tribuneindia.com/2009/20090530/main7.htm

Hi Arpita,

Re: http://health.groups.yahoo.com/group/AIDS-INDIA/message/10277

Dear forum, this is in response to Arpita's posting,

While no ones reply would be conclusive, yes there are issues involved and I, as
one hwo has been involved in the recruitment process recently, would like to
share my experience.

1.  While the ads are very clear about the qualifications and experiences, some
apply with out realising that the post does not suit them either due to
qualification and / or experience.  This results in huge pile of unqualified
applicants.

2.  Where the ad specifies that the envelope should be superscribed as, mention
the post name or email should bear the subject as that of the post name, many
times, people do not adhere to it.

3. When an agency is given the task of sorting or any staff is given the task,
most do a mechanical job, thus good applicants, because of the above defect/s,
lose the opportunity of being short listed.

4. There is no hard and fast rule as to salary.  Normally a range is given in
most NGOs.  I do not consider that it is rude to ask for the same.  However it
is based on institutional policies and negotiation based on salary last drawn.

5.  While people from far off places do apply, they do not mention that they are
willing to relocte.  Simply applying for a post does not convey their
willingness to relocate. It has been my experience at the time of interview,
that they put too many conditions while relocating which hinders the process of
short listing and interviews.

6.  NGOs working on specific projects, time is the essence, due to which there
is not much time between advertisement, interviews and joining time.

7.  NGOs normally in most cases, are short of human resource, due to which the
philosophy followed in corporate sector of responding after the interview, is
very limited.

I think I have tried to put things in right perspective - it is yet not a
situation to despair, but every one needs to understand the otherside of the
table as well.

With best wishes

S. VIJAYAKUMAR
e-mail: <vijayakumar@...>

Hi There,

I am an Indian-immigrant been living in the UK for seven years now. I am
planning to relocate to India.
I have a PhD in Public Health (HIV/AIDS) from a renowned University but have
been struggling to find a job in India for various reasons.

1. When employers advertise the post(s) either on AIDS-INDIA or anywhere else,
the contact details, most of the times, are in-correct such as email address

2. No telephone number is provided to discuss the post or to have an informal
conversation and you never get a reply on your emails

3. Salary is never mentioned in the advert and if you do make an attempt to ask
then you never hear back - yes we are working towards a cause but do we not need
to see our personal growth, carrier wise and economy wise?

I was informed by a friend, working in a charity organization in India that it
is rude to ask salary scale in India. Is this true? and if it is then why is it
rude to ask how much you are going to get paid for the work you will be doing?

4. If you do apply for the post, you will never receive an acknowledgment of the
receipt

5. If your application has been unsuccessful, you never get
informed which I can understand, as at times the number of applications are high
so it gets difficult to inform each and every individual. However, if a
telephone is provided then people like me would really like to get the feedback
on our application(s).

I think these are the issues, which stops people from the rest of the world to
use/increase/share their skills in different countries. Do we not need people
from diverse experiences? Why put too many barriers?

Why not make the process friendly and easier instead of being too objective
about it. We are dealing with human lives here and no one knows this better than
us i.e. people involved in working for a cause. Why treat people in your sector
objectively?

I feel these are the issues that needed attention and if you think this
does/doesn't make any sense, I would like to hear from you in either case.

Thank you for reading this. I look forward to hearing from
you.


Regards

Arpita

arpita_2006aug@...

Dear FORUM,

I totally agree with Sreeram's points on this.
Firstly I do not think you can call universal testing 'vloluntary'.

I work in Papua New Guinea and their situation for treatment is similar to
India's,  they are doing well in getting a reasonal coverage of people who
need need to be on treatment - but still have a long way to go.  They also have
problems of adherance and do not have second line treatment available.

The issue of mathematical modelling is that is does not take into account that
we are dealing with people - not machine.
 
Cheryl Kelly
HIV and AIDS Adviser
PNG Law and Justice Partnership
E-MAIL: ckelly77@...

Dear Hari Singh,

Re: http://health.groups.yahoo.com/group/AIDS-INDIA/message/10264

ART is the only medicine that is given free of cost. No medicne for cancer /
hypertension / diabetes are avaialble unless a person has health insurance.

I suggest that i this person is BPL, facilitate his enrollment under RSBY, the
health insurance scheme which covers exisitng conditions too for the BPL upto
30k pa.

With intial CD4 counts as low as 72, it unlikely that hte first tests were 
discordant. However, there is an tendency to get re-tested - ART will improve
the clinical profile but not cure HIV.

I fail to understand the need for retest of HIV status!

What is perplexing that the results of repeat test were discordant. We need to
get more info on the kits used and results of EQAS, so that we can understand
what happend. please try to get this info.

RK Sood

Dr RK Sood
e-mail: drrksood@...
+91 9418064077, +91 9445157327

Dear Forum,

Re: http://health.groups.yahoo.com/group/AIDS-INDIA/message/10264

In reponse to Hari Singh's concerns I would like to state that  in this
particular case there can be two probabilities

1. Maybe Dinesh did get infected (greater probability) during the
blood transfusion and the results now show negative because of the following two
reasons

- There have been various studies on HIV antibody reversion where
individuals with effective control of viral replication for prolonged
periods may demonstrate negative HIV antibody test results (Hare et al, 2004 and
Levy et al, 2005). This does not suggest that the person is free from HIV
infection but it just suggests that the antibody tests are unable to detect the
same.

- Cancer and its treatment both can cause immunosupression which
probably resulted in the low CD4 counts and a negative antibody test.

Which is why, it is advisable that he continues the antiretroviral treatment.

2. Maybe he really was negative and the first test result was faulty
in which case, quality assurance measures have to be taken for all ICTCs.

Blood banks employ antibody tests to analyze blood samples before sending them
for transfusion but the failure of these tests during the window period is well
known.

Therefore, there definitely is a requirement of Qualitative PCRs as the norm in
Blood Banks and  ICTCs ( if not free, at least at subsidized rates; more so in
Blood banks where it has to be free).

Regards,

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@...
http://www.aidshealth.org

Dear Forum Members,

Re: http://health.groups.yahoo.com/group/AIDS-INDIA/message/10267

Universal Voluntary HIV testing is impractical in most of the third world
countries owing to issues of lack of awareness, low information accessibility,
almost non-existent treatment preparedness and high levels of stigma and
discrimination faced by PLHIVs.

Countries like ours (India) still face the stiff task of treatment adherence as
a major obstacle in the ARV rollout leading to drug resistant strains of the
virus. As a mathematical model what is propounded by the Researchers is simple
to understand - the reduction in viral load if ART is initiated immediately upon
knowing sero positive status of an individual lends to negligible or no
transmission of the virus. But implementing it is fraught with dangers of
releasing a drug resistant strain in the general population – leading to
higher mortality rates on the one hand and a heavier burden on the cost of
treatment, care & support. We must be aware of the high costs of second line
drugs.
 
I personally opine that this may not be the correct time to initiate this model.

We are still at the phase where we need to advocate strongly treatment
preparedness among PLHIVs with special stress on treatment adherence.

It would also be in context to state that we have not yet covered all PLHIVs
whose CD4 is under 200 with our present ARV rollout, hence encouraging people to
test so that they can be started on ART seems not only improbable but also
impractical.

The sole purpose of early detection should continue for the time being, to be
for people to change their lifestyles for prolonging life span before ART is
necessitated.
 
While continuing current prevention strategies is a welcome step, provision of
ART irrespective of the CD4 count coupled with the knowledge that viral load
will reduce significantly could very well provide a false sense of security and
compromise the condom program of the country.
 
WHO and the National Programmes in different countries need to consider the flip
side of this mathematical model before venturing on to a policy that may prove
more expensive in the long run both in terms of mortality rates and treatment
costs.

Maybe we just aren't ready for this yet, whatever its efficacy on paper or in
The Lancet.

Sincerely
Sreeram

Sreeram Varadadesikan
e-mail: <setlurs01@...>

Women in abusive relationships vulnerable to HIV
23 May 2009, 2014 hrs IST, IANS

TORONTO: Women trapped in physically abusive relationships are more vulnerable
to HIV infection, says a study led by an Indian-Canadian.

The study, involving about 14,000 women, shows that "intimate partner violence",
which is physical or sexual assault of a spouse or partner, has become a
significant public health concern around the
world.

While research on the problem has taken place in Africa and
India, the new study is the first to look at the issue among a large number of
women in the US.

Researchers led by Jitender Sareen, associate professor of psychiatry,
University of Manitoba (Canada), used data from the
National Epidemiologic Survey on Alcohol and Related Conditions, which conducted
interviews with women aged 20 and older from 2004 to 2005.

They analysed information from 13,928 women who reported being in a romantic
relationship during the last 12 months.

Researchers asked the women whether they had experienced physical or sexual
violence from their partner during the last year, and whether they had received
a diagnosis of HIV during the same time.

The results showed that women who experience violence from their partners were
more than three times as likely to have HIV infection
as women who do not, said a Manitoba release.

Besides, almost 12% of HIV infection among women was due to intimate partner
violence. "These numbers are solely due to forced sex on women from their
infected partners. It is a substantial percentage," said Sareen.

"This is a very large sample of people and, on methodology side, it's a decent
study, so people will need to pay attention to it," said Julia Heiman, director
of The Kinsey Institute for Research in Sex, Gender and Reproduction at Indiana
University.

http://timesofindia.indiatimes.com/articleshow/msid-4569943,prtpage-1.cms

Hello

Re: http://health.groups.yahoo.com/group/AIDS-INDIA/message/10264

Such thing does happen.

It could be due to validity of diagonostic kits.
It could be due to antigen variability  and non compatible antisera. antisera
kit not stored at right temp or cross reactivity
or Phased out sample storage  or human error in processing, or sample exchange,
wrong labelling.

Dr Deepti Dongaonkar
Dean Govt Medical college, Nagpur
e-mail: <ddongaonkar@...>

Editors' note: As traditional methods struggle to control the HIV, bold new
approaches are called for. In this modelling study, Reuben Granich and
colleagues from WHO propose annual universal testing of all people over the age
of 15 years for HIV, and starting antiretroviral treatment immediately,
regardless of CD4+ level, for those found to be HIV positive. Although initially
more expensive than present practice, the authors argue that such a scaled up
approach might actually lead to elimination of HIV and would
save money by 2050.

The Lancet, Volume 373, Issue
9657<http://www.thelancet.com/journals/lancet/issue/vol373no9657/PIIS0140-6736(0\
8)X6055-6>,
Pages 48 - 57, 3 January 2009
doi:10.1016/S0140-6736(08)61697-9<http://www.thelancet.com/popup?fileName=cite-u\
sing-doi>

Universal voluntary HIV testing with immediate antiretroviral therapy as a
strategy for elimination of HIV transmission: a mathematical model

Summary Background Roughly 3 million people worldwide were receiving
antiretroviral therapy (ART) at the end of 2007, but an estimated 6·7
million were still in need of treatment and a further 2·7 million became
infected with HIV in 2007. Prevention efforts might reduce HIV incidence but are
unlikely to eliminate this disease.

We investigated a theoretical strategy of universal voluntary HIV testing and
immediate treatment with ART, and examined the conditions under which the HIV
epidemic could be driven towards elimination.

Methods We used mathematical models to explore the effect on the case
reproduction number (stochastic model) and long-term dynamics of the HIV
epidemic (deterministic transmission model) of testing all people in our
test-case community (aged 15 years and older) for HIV every year and starting
people on ART immediately after they are diagnosed HIV positive.

We used data from South Africa as the test case for a generalised epidemic, and
assumed that all HIV transmission was heterosexual.

Findings The studied strategy could greatly accelerate the transition from the
present endemic phase, in which most adults living with HIV are not receiving
ART, to an elimination phase, in which most are on ART, within 5 years. It could
reduce HIV incidence and mortality to less than one case per 1000 people per
year by 2016, or within 10 years of full implementation of the strategy, and
reduce the prevalence of HIV to less than 1% within 50 years.

We estimate that in 2032, the yearly cost of the present strategy and
the theoretical strategy would both be US$1·7 billion; however, after this time,
the cost of the present strategy would continue to increase whereas that of the
theoretical strategy would decrease.

Interpretation Universal voluntary HIV testing and immediate ART, combined with
present prevention approaches, could have a major effect on severe generalised
HIV/AIDS epidemics. This approach merits further mathematical modelling,
research, and broad consultation.

--
Dr RK Sood
drrksood@...
+91 9418064077, +91 9445157327

United action needed to meet nutritional needs of Children infected and affected
by HIV

All agencies currently integrating nutrition in their HIV/AIDS programmes for
children in India should synergise and collaborate on related-research and
advocacy, was the consensus emerged out of an academic meeting on "understanding
the effects of nutrition on HIV infected and affected children in CHAHA", which
was organised by the India HIV/AIDS Alliance in New Delhi, India on 22 May 2009.

There are no India-specific guidelines on nutrition and HIV/AIDS (for specific
communities and contexts), not sufficient research-backed evidence on
nutritional interventions in India, and lack of coordinated advocacy on this
issue at all levels (from local to national), were some of the prominent
challenges emerged out of this meeting.

This academic meeting had brought together more than 50 different stakeholders
from across India, including and not limited to, government agencies dealing
with HIV/AIDS and also those with nutrition, non-governmental organizations that
are currently implementing nutritional interventions along with their HIV/AIDS
programmes, Research institutions, UN agencies and representatives from networks
of people living with HIV in India.

According to 2007 estimates from the National AIDS Control Organisation (NACO),
70,000 children below the age of 15 are living with HIV in India and 21,000
children are infected every year through parent-to-child transmission.

National AIDS Control Organization (NACO) needs to harmonise on meeting
nutritional needs of people living with HIV (PLHIV), particularly children, with
the Integrated Child Development Services (ICDS) of Ministry of Women and Child
Development (WCD). The ICDS was launched in 1975 seeking to provide an
integrated package of services in a convergent manner for the holistic
development of the child.

There are many initiatives that are addressing the nutritional needs of children
infected and affected by HIV and their families in India. This includes CHAHA
project, which is managed by the India HIV/AIDS Alliance in four states – Andhra
Pradesh, Tamil Nadu, Maharashtra and Manipur. Comprehensive package of services
are provided to children infected and affected by HIV including supplementary
nutrition through this project.TCHAHA project is supported by the grant from the
Round 6 of the Global Fund to Fight against AIDS, Tuberculosis and Malaria
(GFATM), of which the India HIV/AIDS Alliance is a civil society Principal
Recipient, and its consortium of 9 organisations are the Sub-Recipients.

Other initiatives that are addressing the nutritional needs of children infected
and affected by HIV and their families in India include the 'Balasahayoga',
implemented by a consortium – FHI, CARE and Clinton Foundation in Andhra
Pradesh. Psychological, safety net, nutrition, education and health are some of
the components of Balasahayoga aimed to improve the quality of life of children
and families infected and affected by HIV.

Among other similar initiatives, was the Tamil Nadu Family Care Continuum
programme (TNFCCP) which was initiated in the state of Tamil Nadu by Tamil Nadu
State AIDS Control Society with support from the Children's Investment Fund
Foundation (CIFF) in September 2005.

It had three key components: Clinical services component (setting was hospital,
and provided medical examination, CD4, lab test, psychological counseling,
referrals to clinical services like TB), nutrition component (nutritional
counseling, micro nutrient, macro nutrient) and Home-based care component (home
visits, focus on nutrition counseling and adherence to nutrition supplements).

There was a strong agreement amongst all attending stakeholders in this meeting
to unite for optimally using the resources and enhancing the impact of
interventions for the people living with HIV including children.

It was recommended by one of the participants that a regular follow-up
action-oriented meeting be held for sharing of experiences and lessons learnt
bringing together all the partners working on nutritional interventions for
children infected and affected by HIV and their families in India, to advance
the research agenda and unite for the advocacy at all levels.


Padma Buggineni
Programme Manager - Policy
India HIV/AIDS Alliance
pbuggineni@...

Dear All,

Re:http://health.groups.yahoo.com/group/AIDS-INDIA/message/10238

I went back through documentation related to hoax emails I have been
collecting over the years.

There are several types about HIV/AIDS

1) The same as mentioned earlier, that needles contaminated with HIV have been
placed where innocent victims will sit or stick themselves. There are also ones
dealing with being on the subway/elevated train/bus etc. and in the crowd
someone sticks you with a needle but you can't even know who did it, but you get
tested and have HIV.

2) "We had sex and I intentionally gave you HIV". Sometimes there is an added
incentive that the HIV+ hates men or became infected from a male so they hate
all men. This one always had the female infecting the male and leaving a card or
message or in lipstick on a mirror

3) much the same as the first one except in crowd situations for holiday or
sporting events and even one that threatened there were government agents
spreading HIV to kill everyone in a specific group: gays, lesbians,PLWHA, gay
supporters, etc. etc.

I also have what I consider as evil as the the previously mentioned.

The "Dissident" garbage. I was able to track down two separate groups,
find all pertinent info. Name, address etc. Unfortunately every one I
spoke with told me their was nothing they could do.

The "dissidents" attempted to create an educated and scientific
profile that would make them seem possibly believable to people who
desperately wanted to hear that everything was going to be okay.

People kept coming to me wanting a stop put to it. Freedom of speech
was a big part of the issue. I maintain that it is a Privilege, not a
Right to send someone an email. It is private and belongs to the group
or individual and that harassment in the guise of free speech was
absurd.

When I began to receive death threats law enforcement told me
to stop what I was doing. Well that is not going to happen. One way to
spot the "dissident' emails is that they usually bear a great
resemblance to computer virus hoaxes.

They have things in bold type, capitalized and underlines - anything
to make it look even more scary and often a plot is mentioned that has
a certain medical group/government/people who want to get rid of gays
and lesbians deliberately creating HIV to eliminate entire groups of
people. These are often similar in structure to many of the computer
virus hoax.

Since there is more than one type of email I'm wondering if it might
be more helpful to include information about all HIV hoax emails by
listing a hot line (one already in existence), or a campaign against
any misinformation somehow or sending/posting the sort of list of
hoaxes.

I apologize for this being so lengthy but I wanted to share what
little information I have. I am willing to do whatever possible to
stop hoax emails even though I am in the US. I receive twenty or so
daily emails from India not only that but it is imperative that as
many people as possible active in such a task.

Jeanne Hatfield
HIV/AIDS Education and Prevention Council
ravaids@...
406.961.5183  US

Dear Forum,
 
Dinesh (Name change) 12yr child was admited in GTB Govt.Hospital Delhi
Dated 24/01/07 for some problems.

There he was found  with cancer first time. Dinesh was admited there for eight
months for treatment in ward-12. For Dinesh,  Ward Incharge Doctar MM Paridi
& Doctar Pooja Diwan & Doctar Sunil Gomar arranged eight units of blood &
parents are arrange four units of blood from Blood Bank of  GTB Govt. Hospital
Delhi.

Doctars are started the cancer treatment under ward admission countinuesly.
 
1) Dated-24/12/08 Dinesh found HIV+ in ICTC GTB Govt.Hospital Delhi. 

2) After Dinesh report ICTC tested her father & mother  they found HIV Negative
there.

3)Dated-01/01/09 Dinesh registered in ART GTB Hospital ART No-07/03/242/1673/23
CR No-200918239352 & Child health card no-07/03/242/0091

4)Dinesh five CD4 test reports are-79,92,119,172,272.

5)Dated 01/01/09 Dinesh Countinue on ART treatment from ART GTB & also on Cancer
treatment from GTB Hospital.

6)Dated 21/05/09 Dinesh found HIV Negative in ICTC GTB Govt.Hospital.

7)Dinesh father was belong from BPL family.Mostly all medicines of Cancer he
self afford from Chemist shops.
 
My Questions to all Forum Members & Concern Deppartments.

1)Who is responsible in all that?
Blood Bank-Ward Doctars-ICTC-ART Clinic-DSACS-NACO-MS-Health Minister
of state-Health Minster of Govt.of India?

For any information regarding in this matter my welcome to all for feel free to
mail/call me.
 
Regards

Hari Singh
Counsellor
DIC-DSACS
Board Member(Dnp+)
Mob:+919891263535
email ID -haridnp@...

The USF-India AITRP Program in Adolescent HIV/AIDS Training is now
accepting applications for  "MASTERS IN PUBLIC HEALTH OR MASTER IN
SCIENCE" degrees and also for  'Certificate in Clinical Investigation'.

About Certificate Program:

This Certificate training program will begin in August 2009 and is
conducted entirely online over 4 semesters through distance learning
with the University of South Florida. Applications for certificate
course are due June 1, 2009. Phone interviews will be conducted in early June.
Applicants will be notified of decisions by June 15, 2009.

About MPH and MS

MPH is through College of Public Health and MS is through College of
Medicine. GRE and TOEFL are required for MPH but not for MS if candidate has a
medical degree. All the candidates have to meet minimum USF eligibility
criteria. There two positions available for Masters course.

Applications for MPH are due September 1, 2009.

Preference will be given to the candidates from the State of Gujarat.

For details please visit
http://health.usf.edu/research/aitrip/training.html
<https://webmail.health.usf.edu/owa/redir.aspx?C=1552bd3ea3274825aabbbd8\
f62c12755&URL=http%3a%2f%2fhealth.usf.edu%2fresearch%2faitrip%2f>

http://health.usf.edu/nocms/research/pahrt/home.html

For College of Public Health Details see:

http://health.usf.edu/publichealth/degreereqsadmissionreqmphmsphmha.html
http://health.usf.edu/publichealth/globalcommdismph.html
http://health.usf.edu/publichealth/homepage.html


Please forward this to others who may be interested in this training
opportunity.

Eknath Naik, MD, PhD

Co-Director
Program in Adolescent HIV/AIDS Research Training
Department of Pediatrics, Internal Medicine and Global Health
University of South Florida
12901 Bruce B. Downs Blvd. MDC 02
Tampa, FL 33612
Location (CMS 3052)
(813 ) 842-8560 Phone
(813 ) 974-5411 Fax
enaik@health. usf.edu

UNICEF invites applications for a Consultant

The consultant will work in close coordination with NACO and UNICEF and will be
supervised by the HIVAIDS Specialist in UNICEF

Location: New Delhi : (the consultant will work out of the NACO office and home)

Duration: Seven months

Purpose: Develop tools and formats to strengthen the monitoring and evaluation
of NACO¡¦s PPTCT program, which is technically supported by
UNICEF.

Major Duties and Responsibilities:

1. In consultation with National programme officers of NACO and other relevant
staff from SACS in high prevalence states develop new, and revise and update
existing, reporting formats and M & E tools at all levels for tracking positive
pregnant women and exposed children up to age group of 18 months as semester
cohorts.

2. Integrate these tools into existing operational guidelines for PPTCT

3. Update existing reporting formats to incorporate the newer aspects in the
field of PPTCT, including EID and exposed baby care.

4. Develop reporting formats and M & E tools for whole blood testing by ANM and
ASHA.

5. Integrate and update the training curriculum with newer M & E tools and
reporting formats

6. Develop appropriate job aids to facilitate the implementation of M & E tools

Minimum qualifications and experience required:

Master's degree or higher in statistics, public health or„« related fields More
than 5 years of experience in public health programs„« with increased level of
responsibility, preferably related to HIV.

Working„« experience monitoring public health programmes or projects
Knowledge on„« infrastructure and functioning of health systems in India, and
National HIV programs in particular ICTC/PPTCT.

Experience in development of M„« & E tools will be considered as an asset.

Applications should be addressed to the Chief, Human Resources, UNICEF, 73 Lodi
Estate, New Delhi 110 003, and sent by e-mail within seven days of publication
of this advertisement to kohli@...

Please clearly indicate the title of the vacancy applied for on the subject
line. Only applications of short listed candidates will be acknowledged.

UNICEF IS A SMOKE FREE ENVIRONMENT QUALIFIED WOMEN ARE ESPECIALLY ENCOURAGED TO
APPLY

Consultant (Gender and HIV) for HIV/AIDS Cell in Ministry of Women and Child
Development (MWCD)  Family Health International (FHI) and United Nations
Development Fund for Women (UNIFEM)

Location: New Delhi at MWCD
Last Date: June 5, 2009

Email: hr@...

Date of Issue: 19th May 2009 Closing Date: 5th June 2009

Post Title : Consultant (Gender and HIV) for HIV/AIDS Cell in Ministry of Women
and Child Development (MWCD)

Organization : Family Health International (FHI) and United Nations Development
Fund for Women (UNIFEM)
Location : New Delhi at MWCD
Duration : One year

FHI and UNIFEM is an equal opportunity employer. Qualified and experienced
people living with HIV/AIDS are encouraged to apply.

BACKGROUND:
In the light of the pronounced emphasis for convergence and for an effective
response to preventing HIV among women and girls, it is proposed to set up a HIV
cell in the Ministry of Women and Child Development (MWCD). The initiative will
be a joint collaboration between the MWCD, UNICEF, UNIFEM, FHI and USAID. The
position is for the placement of a Gender and HIV Consultant to mainstream
issues of HIV/AIDS as they relate to women and girls.

INTRODUCTION:

It is estimated that there are between 2-3 million People Living with HIV/AIDS
(PLHIV) in India and of this 40% are young women between the ages of 15-45
years, especially from the poorer sections of society. In HIV/AIDS the interplay
of social, cultural and economic factors which enhance gender inequality pose
threat to the women and young girls' access to health and other services, rights
for economic independence, equal access to land, property and employment, and to
a life free of stigma, violence and discrimination.

As the leader of the Positive Women's Network, India says, "being diagnosed with
HIV rewrites women's lives. Fear of rejection, stigma, discrimination and
harassment prevents them form disclosing their status and accessing the basic
services." Multiple fall outs take place. Gender based and sexual violence,
dispossession, being thrown out of the marital home, increased burdens of the
care of the sick are some of the implications faced by women and girls.

The response also acknowledges the importance for an integrated, gender
sensitive and rights based response that promotes among other things gender
equality with the aim of effective containment of the infection levels of
HIV/AIDS in the country.

SCOPE OF WORK:

The Gender and HIV Programme Consultant will facilitate the work of integrating
HIV, gender and women's empowerment perspective in the policy, programmes,
services and activities which are being planned or implemented by the MWCD for
the women and girls development and empowerment.

Under the overall guidance of the Joint Secretary, Women Development, the Gender
and HIV Programme officer will:

• Assist the concerned J.S and Directors/ D.S in MWCD with her/his technical
inputs for mainstreaming gender and HIV issues in the ongoing programmes,
actions and events of MWCD

• Support the MWCD to develop a Gender and HIV strategy to be incorporated in
the national response of HIV

• Strengthen the ministry's work on women and HIV/AIDS and develop a towards
operationalizing the strategy in the programmes, schemes and services of the
MWCD

• Provide support for coordination and collaboration between MWCD and NACO that
will result in a real multisectoral approach to the national HIV response.

The specific tasks to be undertaken by the Consultant, Gender and HIV will
include:

• Review of the existing programs and policies and compile all information and
resources as necessary and related to women and girls empowerment under the
ministry to identify entry points for HIV/AIDS mainstreaming

• Review of the existing training programs to integrate issues concerning women
and HIV awareness prevention and human rights perspective for the HIV positive
women and girls

• Provide technical inputs in the design of and in facilitation of the trainings
on basics of HIV/AIDS to integrate within the existing training plans under
various schemes of the Department of Women and Child and this includes effective
co-ordination with NIPCCD

• Provide technical inputs for linking the gender and HIV components in the
existing schemes of the ministry for women and girls such as Swayam Siddha
programme, ICDS, income generation and micro credit programs, destitute homes,
short stay homes , and remarriage for women living with or affected by HIV/AIDS
incorporating program indicators for MWCD

• Provide suggestions to enhance the use of the provisions under PWDVA for HIV
positive women

• Facilitate meetings between MWCD and other government agencies like NACO,
MOHFW, Planning commission, UN agencies and multilaterals on behalf of the MWCD
for effective coordination between the relevant stakeholders for a concerted
response to address women and girls vulnerability to HIV

• Facilitate intra ministerial efforts for better convergence between different
policy and programme initiatives for women, girls and children for instance,
recommend action points to integrate HIV prevention awareness into anti
trafficking initiatives

• Develop HIV/AIDS related gender guidance notes for effective mainstreaming of
gender and HIV in the existing programmes and schemes

• Provide support to the GRB cell in MWCD to ensure that the HIV and women and
girls perspective is addressed by the GRB cell.

• Provide support to the J.S and economic advisor in preparing the ministry's
response on women, girls and HIV related issues for different platforms,
meetings and reports

DELIVERABLES:

• Prepare monthly work plan and regular progress updates on the activities to
J.S, Women development and to the monitoring committee of FHI, USAID UNIFEM and
UNICEF

• Deliverables on the specific tasks mentioned above in the TOR which would
include- a review report on issues of women (both at the policy and program
level) related to HIV/AIDS which the MWCD could address/strengthen through its
on-going programs. The report should also clearly outline the process of
operationalizing the recommendations

• Prepare a consolidated annual training plan of NIPCCD incorporating relevant
sessions on HIV/AIDS

• Produce concept papers, presentations and collate/ adapt knowledge products
and tools

• Prepare Mission Reports

• Prepare a detailed and comprehensive narrative report of all activities (as
part of the report include anecdotes that capture the process, partnerships,
lessons learnt, photographs, press coverage, questionnaires, human interest
stories, lists of participants, key strategies and recommendations) in hard and
soft copy will be submitted at the end of the grant period

EXPERIENCE AND QUALIFICATION:

Minimum of ten years of experience in managing, developing and implementing
Health and HIV/AIDS program with focus on Gender and HIV at the national or
state level; experience required of working with government departments for
programming, managing programmes and providing technical support. Strong
training, monitoring, advocacy and research experience will be essential.
Networking skills and experience of interacting and working with the women's
machinery at the national and regional level will be desirable.

Master's degree in a social or health science or doctoral degree or equivalent;
excellent communication and computer skills; highly motivated with ability to
work independently and multi-tasking.

Please send your resume at hr@...

It is necessary to mention the post title in subject line while applying.

Selected candidates will be required to join within one month of selection. Only
shortlisted candidates will be notified.

Candidates should also complete the United Nation Personal History Form (Form
P11) available at (mirror.undp.org /angola/LinkRtf/p11.doc. Completed P11 form
and resume are to be submitted along with the application.

Govt hospital staff in UP identify HIV-positive patient, refuse aid
Vijay Pratap Singh

Posted: May 22, 2009 at 0345 hrs IST

Allahabad In open violation of the guidelines of National AIDS Control
Organization (NACO), the staff of state-owned Swaroop Rani Nehru hospital, a
part of Moti Lal Nehru Medical College, brazenly pasted an `HIV' sign on the
wall behind the bed of a patient and refused him treatment.

The HIV positive man from Pratappur block, suffering from acute infection, was
brought to the SRN hospital on Tuesday. The doctors initially refused to admit
him, said sources. They relented only after the Allahabad Network for People
Living with HIV Positive (ANP Plus) took up the matter with the district
magistrate and the hospital administration.

The next morning, the staff wrote "HIV" on a piece of paper and pasted it on the
wall behind his bed in surgical emergency ward.
When the attendants of patient objected and reported the matter to ANP Plus, the
sign was removed on the instruction of Dr Amitabh Upadhaya, anti-retroviral
officer of SRN hospital.

The staff then wrote ART (Anti-retroviral Therapy) on the wall and tied a red
ribbon, the monogram of NACO, on the drip stand, said the relatives of the
patient.

Further, the doctors allegedly refused to treat the patient, saying proper
medical kits were not available in the hospital.

The attendants of the patient and the members of NGO reported the matter to
District Magistrate Rajeev Agrawal and Chief Medical Officer Dr PK Sinha.

"We were asked to purchase gloves and other items from outside. We also had to
do the dressings of the patient," said Mangal Singh, the attendant.

On Thursday morning, fed up with the antipathy of the hospital staff and
doctors, the family got the patient discharged and decided to go to the All
India Institute of Medical Science (AIIMS), Delhi.

The Superintendent-in-Chief of SRN hospital, Dr Shradhha Dwivedi, said she has
ordered a departmental inquiry into the matter. She also said she had provided
five medical kits for the treatment of the patient.

Sanjit Kumar Sharma, an office-bearer of ANP Plus, said: "It is an offence to
refuse treatment to an HIV positive patient and it a more serious offence to
identify him as HIV positive. The behaviour of doctors and hospital staff was
uncalled for and strict action must be taken against those responsible."

http://www.expressindia.com/latest-news/govt-hospital-staff-in-up-identify-hivpo\
sitive-patient-refuse-aid/464119/

AIDS spreads to infants as most mothers fail to get treatments

By Marilyn Chase. BLOOMBERG NEWS

Tucson, Arizona | Published: 05.21.2009

Drugs that prevent HIV in infants don't get to two-thirds of infected expectant
mothers, leading the virus to spread to 370,000 newborns a year, a treatment
advocacy group said.

Only 33 percent of pregnant women with HIV, the human mmunodeficiency virus that
causes AIDS, receive antivirals, a strategy proven 15 years ago to block
mother-to-child transmission of the disease, said a report released today from
the International Treatment Preparedness Coalition. The group blamed governments
and global health groups for poor coordination, funding gaps and valuing
"wealthy women over poor," said Stephen Lewis, founder of AIDS-Free World and
co- author of the report's preface.

Approximately 33 million people in the world have HIV/AIDS and 2.7 million
people a year become infected, according to the United Nations. In the most
hard-hit countries, AIDS has shortened life expectancy by 20 years, plunged
households into poverty and left behind 12 million orphans, the UN said.

"Donors talk the talk, but don't walk the walk," said coalition leader Gregg
Gonsalves in an e-mail. "For millions of women, maternal and child health is
about HIV/AIDS and we have failed them."

A top AIDS official at the UN, a target of criticism in the report, agreed with
many of its findings.

"There has been some progress," said Michel Sidibe, executive director of the
Joint United Nations Program on HIV/AIDS, in an e-mail.

"Overall coverage is still very low for this proven, inexpensive and effective
intervention."

Least Expensive Treatment

Most women with access to prevention get the cheapest possible regimen for
themselves and their babies â€" a single pill of the Boehringer Ingelheim GmbH
drug nevirapine, according to the report. Nevirapine cuts transmission to babies
by 40 percent and may also spark the rise of drug-resistant strains of the AIDS
virus, the report said.

Boehringer provides the drug free for mother-to-child prevention in developing
countries, and sells the drug for as little as 60 cents a day to treat those in
poor nations who already have the disease, according to the German company's Web
site.

Triple-drug combination therapy that is more effective and less likely to cause
drug resistance costs less than $100 a year per patient, Gonsalves said. About 8
percent of women in developing countries now get it..

Lacking Preventive Drugs

In Uganda, for example, more than 700,000 women are living with HIV, and there
may be 27,300 babies born with HIV in 2009 for want of the preventive drugs, the
report said.

Affluent countries such as the U.S. commonly provide antiviral drugs to
HIV-positive women and their babies around the time of labor and delivery. The
practice has slashed HIV infection rates in newborns by more than 90 percent,
according to the U.S. Centers for Disease Control and Prevention.

"Today we estimate that less than 150 babies are born with HIV, down from a peak
of nearly 1,700 a year in 1991," the Atlanta-based CDC said in a statement.

The current treatment rate of 33 percent of infected pregnant women is a step
toward better care, said Nicholas Hellmann, executive vice president for medical
and scientific affairs at the Elizabeth Glaser Pediatric AIDS Foundation. The
organization runs prevention programs

in Africa, India and China using funds drawn largely from the President's
Emergency Plan for AIDS Relief.

"I like to look at the glass as one-third full," Hellmann said in an interview.
"We feel it's best to get women and infants on some regimen, with the intent to
scale up to triple drug combination."

More Services

Hellmann said comprehensive care is needed to reduce the rates of HIV infection
in pregnant women and their children.

"Prevention is more than the dose of a drug," he said. UNAIDS, the World Health
Organization and 20 international partners will convene this week in Nairobi,
Kenya, to launch the "Preventing Mother-to-Child Transmission Push" to improve
the situation, Sidibe said.

"We agree with the report that the combination of stigma, fragmented health
services, inadequate knowledge within the community and insufficient political
leadership are root causes of low coverage," Sidibe said in an e-mail.

http://www.bloomberg.com/apps/news?pid=20601081&sid=aoAkNzuc24Ho&refer=australia

Outputs and cost of HIV prevention programmes for truck drivers in Andhra
Pradesh, India

SG Prem Kumar  , Rakhi Dandona  , John A Schneider  , Yk Ramesh  and Lalit
Dandona

BMC Health Services Research 2009, 9:82doi:10.1186/1472-6963-9-82
Published: 21 May 2009

Background
HIV prevention programmes for truck drivers form part of the HIV control
efforts, but systematic data on the outputs and cost of providing such services
in India are not readily available for further planning and use of resources.

Methods
Detailed cost and output data were collected from written records and interviews
for 2005-2006 fiscal year using standardized methods at six sampled HIV
prevention programmes for truck drivers in the Indian state of Andhra Pradesh.
The total economic cost for these programmes was computed and the relation of
unit cost of services per truck driver with programme scale was assessed using
regression analysis.

Results
A total of 120,436 truck drivers were provided services by the six programmes of
which 55.9% were long distance truck drivers. The annual economic cost of
providing services to a truck driver varied between programmes from US$ 1.52 to
4.56 (mean US$ 2.49).

There was an inverse relation between unit economic cost of serving a truck
driver and scale of the programme (R2 = 0.63; p = 0.061). The variation between
programmes in the average number of contacts made by the programme staff with
truck drivers was 1.3 times versus 5.8 times for contacts by peer educators.

Only 1.7% of the truck drivers were referred by the programmes for counseling
and HIV testing.

Conclusion
These data provide information for further planning of HIV prevention programmes
for truck drivers and estimating the resources needed for such programmes. The
findings suggest the need to strengthen the role of peer educators and increase
referral of truck drivers for HIV testing.

[A pdf copy of the  article is available from the editor, AIDS INDIA e FORUM]

Patterns and Distribution of HIV among Adult Men and Women in India
Jessica M. Perkins1, Kashif T. Khan2, S. V. Subramanian3*

Abstract

Background
While the estimated prevalence of HIV in India experienced a downward revision
in 2007, the patterning and distribution of HIV in the population remains
unclear. We examined the individual and state-level socioeconomic patterning of
individual HIV status among adult men and women in India as well as the
patterning of other individual demographic and behavioral determinants of HIV
status.

Methodology/Principal Findings
We conducted logistic regression models accounting for the survey design using
nationally representative, cross-sectional data on 100,030 women and men from
the 2005–2006 India National Family Health survey which, for the first time,
provided objective assessments of HIV seroprevalence.

Although there was a weak relationship between household wealth and risk of
being HIV-positive, there was a clear negative relationship between individual
education attainment and risk of being HIV-positive among both men and women.

A 1000 Rupee change in the per capita net state domestic product was associated
with a 4% and 5% increase in the risk for positive HIV status among men and
women, respectively. State-level income inequality was associated with increased
risk of HIV for men. Marital status and selected sexual behavior indicators were
significant predictors of HIV status among women whereas the age effect was the
most dominant predictor of HIV infection among men.

Conclusions/Significance

Although the prevalence of HIV in India is low, the lack of strong wealth
patterning in the risk of HIV suggests a more generalized distribution of HIV
risk than some of India's high-risk group HIV prevention policies have assumed.

The positive association between state economic development and individual risk
for HIV is intriguing and requires further scrutiny.

Citation: Perkins JM, Khan KT, Subramanian SV (2009) Patterns and Distribution
of HIV among Adult Men and Women in India. PLoS ONE 4(5): e5648.
doi:10.1371/journal.pone.0005648

[A pdf copy of the full version of the  article is available from the editor,
AIDS INDIA e FORUM]

Dear Forum members,

‘One in every Twelve’ individuals suffer from the disease (either
chronic Hepatitis B or C). Together hepatitis B and C represent one of   the
major threats to global health. Hepatitis B and C are both silent viruses and
anyone could be infected for many years without knowing it.

Approximately 1 million people die every year from chronic viral
hepatitis B or C. The World Health Organization (WHO) recognizes that  
hepatitis B is one of the major diseases affecting humankind today.

Hepatitis B is one of the most common viral infections in the world
and the WHO estimates that 2 billion people has been infected with the  
hepatitis B virus and approximately 350 million people are living with  chronic
(lifelong) infections. The hepatitis B virus is highly  infectious and about
50-100 times more infectious than HIV.

In Manipur, various agencies estimate that Hepatitis C co-infection
among the Injecting drug users living with HIV is more than 90%
approx. For the last five years, Injecting drug users who are also
PLHIV (people living with HIV/AIDS) are dying from Hepatitis C but not  with
HIV.

With the lack of information, knowledge and treatment cost,
access to treatment is almost negligible hence Hepatitis C has become  a major
public health issue in the state of Manipur.

SASO (Social Awareness Service Organization) being a drug user
organization working among the drug user and PLHIV community, take
this issue as an emergent public health issue as these twin epidemic
of HCV and HIV is hardest hit in the state of Manipur for more than a  decade.

SASO observed and took this day an important day, for the last three
years SASO has been observing ‘The World Hepatitis Day’ as part of
awareness, Education and advocacy to get access to proper treatment
among the IDUs community and various stakeholders in the state.

And  this year this important global event ‘World Hepatitis Day’ was
observed on Tuesday, 19th of May, 2009 at SASO Head Office. The said
event is jointly organized by SASO and HIMALAYA HERBAL HEALTHCARE,
India during the event more than hundred personals were attended.

In Service,

Bangkim Chingsubam

SASO, Imphal
e-mail: <cbangkim@...>