WHO and UNAIDS have issued new guidance on informed, voluntary HIV testing and counselling in the world's health facilities, with a view to significantly increasing access to HIV treatment, care, support and prevention services. The new guidance focuses on provider-initiated HIV testing and counselling (recommended by health care providers in health facilities), essential to promoting earlier diagnosis of HIV infection, which in turn can maximize the potential benefits of life-extending treatment and care, and allow people with HIV to receive information and tools to prevent HIV transmission to others.
Equity and HIV/AIDS
WHO and UNAIDS issue new guidance on HIV testing and counselling in health facilities
World Health Organisation and UNAIDS, 30 May 2007
Who are the male partners of adolescent girls and young women in Swaziland? Analysis of survey data from community venues across 19 DREAMS districts
Reynolds Z; Gottert A; Luben E; et al: PLOS One, doi: https://doi.org/10.1371/journal.pone.0203208, 2017
Adolescent girls and young women (AGYW, ages 15–24) are at high risk of HIV in Swaziland and understanding more about their male sexual partners can inform HIV prevention efforts for both. Using the PLACE methodology across all 19 DREAMS implementation districts, 843 men ages 20–34 were surveyed between December 2016-February 2017. Surveys were conducted at 182 venues identified by community informants as places where AGYW and men meet/socialize. In multivariate analyses, men who reported three or more AGYW partners in the last year were more likely to be HIV-positive. Men were also less likely to disclose their HIV status to adolescent versus older partners and partners more than 5 years younger than themselves. Results also revealed relatively high unemployment and mobility, substantial financial responsibilities, and periodic homelessness. Most men identified through community venues reported relationships with AGYW, and these relationships demonstrated substantial HIV risk. Challenging life circumstances suggest structural factors may underlie some risk behaviours. Engaging men in HIV prevention and targeted health services is argued to be critical, and informant-identified community venues are suggested to be promising intervention sites to reach high-risk male partners of AGYW.
Who is accessing antiretroviral therapy in Malawi? Study in the Southern Region on the occupation category “other”
Teferra TB, Hochgesang M, Makombe SD, Kamoto K and Harries AD: Malawi Medical Journal 19(4):138-139, 2007
As part of quarterly national reports on the scale up of antiretroviral therapy (ART), demographic and clinical characteristics are recorded including data on occupation. The largest occupational category is that of “other”. As there is no information on the composition of the different occupations of patients placed in this category, a formal study was therefore conducted in six representative public sector facilities in the Southeastern Region of Malawi. Between January to June 2006, there were 126 adult patients recorded as “other” in the occupation column. A great variety of different occupations was recorded including no employment 30%, administration jobs 24%, general labourers 11%, builders 10%, tailors 9% and drivers 7%. A wide range of people with different jobs are accessing ART, and this should help in improving the economy of the patients as well as the country at large.
WHO report says 9.7 million at risk of death from AIDS today; AHF renews call for US Congress to commit to scale up treatment to save seven million lives
AIDS Healthcare Foundation, 4 June 2008
This World Health Organisation/UNAIDS/UNICEF report documents appreciable global progress in the effort to deliver lifesaving antiretroviral treatment (ARVs) to people living with HIV/AIDS in developing countries; however, it also underscores the crucial need to maintain a focus on scaling up and providing lifesaving antiretroviral treatment in programs like PEPFAR (the President’s Emergency Plan for AIDS Relief) notes AIDS Healthcare Foundation (AHF). The report claimed that three million people were on treatment in 2007 (a goal that World Health Organization officials had initially hoped to reach in 2005 in its ambitious ‘3x5’ treatment plan), but it also revealed a more ominous trend that AHF and other advocates believe calls for a renewed and stepped up commitment to delivering care and antiretroviral treatment—more than 9.7 million people with HIV/AIDS around the world are in critical need of antiretroviral treatment (those who would otherwise die within two years) than at the end of 2006; 2.6 million more are in need today than one year ago.
WHO/UNAIDS: Expanded Testing Guidelines should recognise reality
Human Rights Watch, 30 May 2007
Expanding access to HIV testing is critical in the fight against AIDS, but new WHO/UNAIDS guidelines pay only lip service to the conditions that will make testing successful, Human Rights Watch said today. Human Rights Watch was responding to the release of new WHO/UNAIDS guidelines on provider-initiated HIV testing and counseling. The guidelines appropriately rule out mandatory or coercive testing and call for expanded, health facility-based testing in countries with an “enabling environment” in place and with “adequate resources” available for HIV prevention, treatment and care. But Human Rights Watch warned that few of the most affected countries have such resources and environments in place.
Will 2005 be a year of action on HIV/AIDS?
Commentators are beginning to raise other fundamental questions about the Tsunami disaster, reports the latest edition of the Africa Focus Bulletin. "Most significantly, can the response to the tsunami be carried over to even more devastating crises that are less photogenic, such as AIDS, global health, conflict, and poverty? Or will the effect be to reduce resources for implementing programs that have not been scaled up for lack of political will and resources? " Despite significant expansion of programs in the last two years, only four percent of the estimated 3.8 million people in need of such treatment in Africa now have access. Global spending on HIV/AIDS in low and middle-income countries was estimated at $6.1 billion in 2004, with the need projected at $12 billion for 2005.
Will we end the HIV epidemic? The impact of HIV treatment on HIV prevention and implications for the 2010 replenishment of the Global Fund to Fight AIDS, TB and Malaria
International AIDS Society: March 2010
According to this article, since the 2005 commitment by G8 leaders – and thereafter all United Nations Member States – to work towards universal access to HIV treatment, prevention and care by 2010, many resource-limited countries have been highly successful in decreasing AIDS-related morbidity and mortality and slowing down the spread of HIV. The efforts to achieve this scale up have been driven by governments and civil society in these countries, with much of the resources provided by external partners, in particular the United States' PEPFAR2 and the Global Fund to Fight AIDS, TB and Malaria. Since its inception in 2002, the investments made through the Global Fund are estimated to have saved five million lives, including through the provision of HIV treatment to 2.5 million people. This article poses a question to donors to the Global Fund: How many more lives they are prepared to save in the next three years? And will they make the bold investments required to make a real change to the future course of the HIV epidemic?
Women's rights and women's health during HIV/AIDS epidemics: The experience of women in sub-Saharan Africa
Dugassa BF: Health Care for Women International 30(8): 690–706, August 2009
It is becoming clear that HIV/AIDS spreads most rapidly among poor, marginalised, women, colonised and disempowered groups of people more than others. The HIV/AIDS epidemic is exacerbated by the social, economic, political, and cultural conditions of societies such as gender, racial, class, and other forms of inequalities. Sub-Saharan African countries are severely hit by HIV/AIDS. For these countries the pandemic of HIV/AIDS requires them to go the extra mile in their efforts. The objective of this paper is to promote the need to go beyond the biomedical model of ‘technical fixes’ and the traditional public health education tools, and come up with innovative ideas and strategic thinking to contain the epidemic. It argues that containing the HIV/AIDS epidemic and improving family and community health requires giving appropriate attention to the social illnesses that are responsible for exacerbating biological disorders.
Women, HIV and AIDS, and violence
Minter W (Ed): Africafocus, 28 April 2008
Based on interviews in two South African provinces and extensive consultation with South African agencies involved with the issue, this report provides a detailed portrait of the situation of rural women, and the interaction among violence, poverty, and the risk of HIV/AIDS. The overview has a concise survey of the development of the AIDS epidemic in South Africa including the debates about government policy and the active role of civil society.
Womens rights and HIV/AIDS
Agenda Feminist Media Project
Fifty four women from 21 African countries representing 41 national, regional and international women’s organizations in Africa; comprising of HIV and AIDS organizations, feminist associations and human rights institutions, meeting in Johannesburg, South Africa between April 6 and 7, 2006 to formulate advocacy positions on women’s rights in the context of HIV and AIDS expressed outrage at the conduct of the defence lawyers, the media, the courts and the police in the rape trial of the deputy President of the African National Congress, ANC, Jacob Zuma; concern at the twin epidemics of Violence Against Women and HIV and AIDS; and solidarity with Khwezi for bravely reporting her experience; and for showing respect for the mechanisms that exist in South Africa to report and resolve crimes.