In this study, researchers investigated gender differences in treatment outcome during first line antiretroviral treatment (ART) in a hospital setting in Tanzania, assessing clinical, social demographic, virological and immunological factors. They used structured questionnaires and reviewed patients’ files, including a total of 234 patients about to start ART, and followed up one year later. Seventy percent of participants were females. After one year of standard ART, a higher proportion of females survived although this was not significant. They showed a worse CD4 cell increase than men, even though they had a higher BMI. Although women were starting treatment at a less advanced disease stage, they had a lower socio-economical status. After one year, both men and women had similar clinical and immunological conditions. It is not clear why women lose their immunological advantage over men despite a better virological treatment response.
Equity and HIV/AIDS
HIV and AIDS are significant and growing public health concerns in southern Africa. The majority of countries in the region have national adult HIV prevalence estimates exceeding 10 percent. The increasing availability of highly active antiretroviral therapy (HAART) has potential to mitigate the situation. There is however concern that women may experience more barriers in accessing treatment programs than men.
Even with increased commitment, funding, and coordination, U.S. AIDS treatment efforts will fall far short of what is needed to provide ARV treatment to those suffering from AIDS today, according to a document from the Centre for Health and Gender Equity. Given limited resources, choices will inevitably be made about who will be treated and when, raising the issues of equity in access to treatment for sub-groups of those infected. In turn, these considerations dramatically underscore the need to ensure that specific efforts be made to ensure that treatment programs reach those groups that already face a disproportionately higher risk of infection.
The layering of HIV-related stigma with stigmas associated with gender, race, and class poses a methodological challenge to those seeking to understand and, thereby, to minimise its negative effects. In this meta-study of 32 reports of studies of stigma conducted with HIV-positive women, the researchers found that gender was hardly addressed despite the all-female composition of samples. Neither sexual orientation nor social class received much notice. Race was the dominant category addressed, most notably in reports featuring women in only one race/ethnic group. The relative absence of attention to these categories as cultural performances suggests the recurring assumption that sample inclusiveness automatically implies the inclusion of gender, race, and class, which is itself a cultural performance.
South African generic AIDS drug manufacturer, Aspen Pharmacare, has become the first African firm to win approval from the US Food and Drug Administration (FDA) for its production plant. The FDA conducted a pre-operational review and close inspection to ascertain good manufacturing practice at Aspen's Port Elizabeth facility in September last year. As a result of this approval, funds from the US President's Emergency Plans for AIDS Relief (PEPFAR) can be used to purchase Aspen-manufactured drugs for use in countries where the local drug regulatory agency has approved them.
US officials attending a major conference on anti-AIDS drugs in Botswana this week have dismissed allegations that they want to use the meeting to question the quality and safety of more affordable generic fixed-dose combinations (FDCs) of antiretrovirals. "We want to see use of internationally accepted scientific principles that will be used in evaluation of Fixed Dose Combination drugs for HIV, tuberculosis and malaria. The concern is the risk of resistance, because good drugs are not good enough with this disease," said Dr Mark Dybul, head of the US government's President's Programme for AIDS Relief (PEPFAR).
Carrying placards that read, ‘Huwezi Die Uki Abstain’, Swahili slang for ‘You won't die if you abstain [from sex]’, more than 3,000 young people recently marched through Nairobi in an effort to re-energise the campaign to keep teens from having sex too early. But beyond the placard-waving and slogan-chanting, march organisers were also trying to give young people the skills to avoid being pushed into sex before they are ready. James Kabucho, programmes director at Life Skills Promoters, one of the non-governmental organisations that organised the march, explained that the campaign was teaching young people negotiation skills. By acting out real-life scenarios, writing essays, and engaging peer educators in question and answer sessions, young people were able to talk about their experiences and learn to say ‘No’ to unwanted sexual advances. Research shows that early sexual initiation is associated with increased risk of HIV infection, while adolescents who engage in sex at an early age are likely to have more sexual partners than those who delay their sexual debut. Girls who engage in sex in their teens may also face the challenges of teenage pregnancy, unsafe abortions and dropping out of high school.
The first global consultation led by people living with HIV to address their sexual and reproductive health (SRH) and rights took place in Amsterdam, The Netherlands, 5-7 December 2007. The international group of 65 HIV-positive women, men, young people, and transgender people articulated a vision statement to guide advocacy, policy, legal, programmatic and funding priorities that respect SRH and rights, and that underscores the need for health systems to do the same.
The Global Fund to Fight AIDS, Tuberculosis and Malaria has granted Zimbabwe US$37.9 million, resuming support after getting assurances from the new unity government that the money would not be misused. The head of the Global Fund's Africa Unit, Fareed Abdullah, said the money, previously managed by the state-appointed National Aids Council, would now be overseen by the United Nations Development Programme (UNDP) in Zimbabwe. ‘We're glad that today marks a turning point in the relationship between Zimbabwe and the Global Fund, after the troubled history of the past 18 months,’ Abdullah said. Last year, the Fund alleged that Zimbabwe's central bank had confiscated US$7.3 million in 2007 meant for health programmes – the bank has returned the money since then. ‘The reason behind getting the UNDP as the principal recipient is to do with that history, no doubt.’ Apart from helping in the fight against HIV and AIDS, the money would also be committed to tuberculosis and malaria programmes.
Organisations in the International HIV/AIDS Alliance have been awarded up to $83 million in the sixth round of grants from the Global Fund to Fight AIDS, Tuberculosis and Malaria. Proposals have been successful in Alliance countries including India, Morocco, Senegal and Ukraine, with Global Fund grants for these countries totalling $480 million.