08 August 2008

Lowdown on Aids conference

HIV/Aids was in the headlines this week as new findings, old challenges and current issues were brought to light at the 17th International Aids Conference in Mexico City this week.

HIV/Aids was in the headlines this week as new findings, old challenges and current issues were brought to light at the 17th International Aids Conference in Mexico City this week.

At the conference, leaders in the fight against Aids have pleaded for the world to keep up its momentum against the disease and to step up funding for HIV treatment and prevention.

"We are entering into a new phase, with new challenges, challenges of sustainability," said Peter Piot, executive director of the UN agency UNAIDS at the opening of the six-day conference.

A surprising new finding that came out of the conference was that scientists suggested that HIV-positive patients who are on antiretroviral treatment (ART) don't have to use condoms when having sex with a non-infected partner.

The Swiss researchers suggested that discordant couples (couples in which one individual has HIV while the other one doesn't), need not use a condom provided the infected partner regularly followed antiretroviral therapy.

They reckon that an HIV-negative male would face a 0.22 percent risk of infection each year from an HIV-positive woman. The risk for an uninfected female from an infected male would be 0.43 percent annually. The risk in gay relationships would be far higher: in male-to-male anal transmission the probability of infection would be 4.3 percent per year.

Travel ban on HIV-positive people
During the conference it also came to light that several countries don't allow HIV-positive travellers into their countries. In fact, until very recently the United States had such a ban on HIV-positive travellers. However, only last week US President George Bush signed legislation repealing the rule that prevented HIV-infected immigrants, students and tourists from receiving US visas.

Seven nations still have an outright ban on entry for HIV-infected people, and more than 65 impose some travel restrictions on the estimated 33 million people worldwide who live with the virus.

Shortage of Aids doctors
Delegates at the Aids Conference also emphasised the need for more trained healthcare workers in the field of Aids to treat patients, especially in the developing world. A report by Reuters Health said: "many developing countries that are combating Aids are facing dire shortages of qualified doctors and nurses as healthcare workers leave for developed countries where they are paid many times more."

Other news that came out of the conference:

- Scientist said that there are no medical/technical breakthroughs, which may drastically reduce the number of HIV-infection, in sight. The most promising research, such as a vaccine or a virus-thwarting vaginal gel, both lie many years, or even decades away.

- Once considered a cultural or religious rite, male circumcision has also leapt into the HIV prevention arena. According to French researcher Bertran Auvert, who conducted a study in South Africa, circumcision could avert up to 3.8 million infections and half a million deaths in sub-Saharan Africa between 2006 and 2016, and up to 5.8 million deaths by 2026.

- Lastly, new research argues that hope is a powerful tool in the battle to stop the spread of HIV/Aids.

ESRC Professorial Fellow, Tony Barnett, from the London School of Economics, argues that people with hope for the future are less likely to engage in activities in the present that put them at risk of illness in the future. Those without hope for the future by contrast, place a low value on the future. For example, men who lack hope for the future may be unwilling to surrender immediate pleasure in return for a far-off future benefit by wearing a condom.

HIV/Aids can destroy hope, resulting in vicious spirals that damage societies and lead to further HIV infections. When life prospects are so poor, people have little incentive to save for the future and to educate children.

"Although there is not a great deal of experience in developing programmes to increase hope, policies such as cash support for children, microfinance for small businesses, women's education, reduced discriminations against sexual minorities and health system reform will improve the wider environment. And with more to live for, interventions that encourage individuals to change their behaviour are more likely to succeed," said Barnett.

- (Health24/Reuters Health, August 2008)

Read more:
No-condom-sex for those on ART?
SA Aids-pariah image in rehab


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Dr Sindisiwe van Zyl qualified at the University of Pretoria in 2005. She is a patients' rights activist and loves using social media to teach about HIV. She is in private practice in Johannesburg.

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