A more rational and scientific approach to AIDS is needed, says expert
A factor that helps optimize brain formation and function may also provide clues about whether patients suffering with schizophrenia are headed toward relapse, researchers say. Over the next two- and one-half years, they are regularly measuring levels of brain-derived neurotrophic factor, or BDNF, in the blood of patients with schizophrenia to see if the pattern
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The Secretariat of the Joint United Nations Programme on HIV/AIDS (UNAIDS) has lost valuable ground by ignoring for years the contribution of long-term concurrent relationships to Africa’s AIDS epidemic, claims an expert ahead of World AIDS Day on bmj.com.
UNAIDS may be “contributing to the mystification of AIDS in Africa by promoting a needlessly overcomplicated view of the epidemic”, says Helen Epstein, an independent consultant on public health in developing countries.
She argues that long term, overlapping, or “concurrent” partnerships provide at least a partial explanation for the staggeringly high infection rates in the general population in some African countries, and calls for UNAIDS to reassess its handling of scientific data.
Epstein speculates that UNAIDS’ tendency to emphasize only typical high risk behaviours such as casual sex and prostitution may have hindered prevention, promoted denial and stigma, and contributed to HIV associated domestic violence by implying that people with HIV are necessarily promiscuous.
In fact, African people do not seem to have more sexual partners than people in other countries, but they are more likely to have two or three long term “concurrent” partnerships at a time, and this creates a “virtual superhighway” for HIV.
Condom use is rare on this “superhighway” because long term relationships, even concurrent ones, are seldom perceived as risky. This may explain why reductions in sexual partners have been a crucial factor wherever infection rates have fallen in Africa, she says. For example, in Uganda, a 60% fall in casual partnerships coincided with a 70% fall in HIV prevalence during the 1990s. In addition, declines in HIV prevalence in the US gay community and Thailand were also accompanied by rapid declines in multiple partnerships.
According to Epstein, for years UNAIDS overlooked independent reports about the importance of partner reduction, and until 2006, did not mention long-term concurrency in its reports on sexual behaviour.
Concurrency does not imply a simple solution to the AIDS crisis in Africa, she says, but education about the “superhighway” could help motivate behavioural change, especially partner reduction, and should be integrated into all AIDS education programmes in Africa.
Epstein concludes by calling on the new UNAIDS director and its governing board to re-evaluate the agency’s political and scientific roles, and suggests that scientific issues be addressed through a more open process of research and peer review, rather than by one, largely unregulated UN agency.
In a second feature, Bob Roehr examines how institutionalised homophobia and the criminalisation of homosexual activity are aiding the spread of HIV and hindering efforts to provide treatment and prevention among men who have sex with men. According to Dr Peter Piot, director of UNAIDS, homophobia is one of the top five obstacles to stopping the epidemic.
With World AIDS Day on December 1, a leading expert is urging the Government to repeat the 1980s campaigns in order to deal with a new crisis of awareness and understanding of the AIDS threat in the UK. New research by Professor Hazel Barrett of Coventry University alongside a research student Betselot Mulugeta among African
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A study published in the British medical journal Lancet yesterday suggesting that testing all adults in Africa annually for HIV and immediately treating every person who tests positive could halt the AIDS epidemic in Africa within a decade has spurred the AIDS Healthcare Foundation (AHF) to renew its call for the massive scale up of,
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South Africa’s revitalised drive against AIDS has received a £15 million boost which could help save millions of lives and stop the spread of HIV across the country. International Development Minister Ivan Lewis travelled to Johannesburg ahead of World AIDS Day to offer the new South African Health Minister, Barbara Hogan, direct UK support as she
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Dr. Margaret Chan, WHO Director-General says a major milestone in the long struggle against HIV/AIDS has been reached. This year is the 20th anniversary of the emergence of the devastating disease and Dr. Chan says more than 3 million people in low and middle-income countries are now receiving life-prolonging antiretroviral therapy - an achievement which
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Addressing the discrimination against HIV-positive teachers in Africa is a key aim of a new documentary and accompanying book being launched in Senegal today by the Partnership for Child Development based at Imperial College London. An estimated 122,000 teachers in sub-Saharan Africa are living with HIV, most of whom have not sought testing and do
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