July Round Up

If you’re reading this, you’re probably subscribed or receiving this news via Twitter or Facebook but just in case you’re a casual browser why not stay a while, subscribe or follow us on Twitter and read up on LASS and HIV/STI updates.  Here’s a brief roundup from July’s posts

Many people take for granted the luxury of being able to travel anywhere in the world, the BBC World Service recently ran an article looking if there are still health risks attached to HIV+ travellers.

It’s not only travellers who experience prejudice and discrimination, guidelines adopted by the Department of Health 20 years ago, and revised and republished in 2007, state that health workers who carry out certain procedures are banned from working as soon as they are diagnosed as HIV positive.  A dentist learned he was HIV Positive and he had to keep it secret so he could continue his profession but after his confidentiality was breached his contract termination was backdated to the day after his diagnosis resulting in no sick pay.  Sadly, the messages of Ryan White are not well publicised any more.

There’s been talk about serodiscordant couples choosing to replace condoms with antiretroviral therapy and there’s a very interesting article from a youth testing perspective about the rise of HIV among 16-24 year olds.

Gilead Sciences, who are the lead maker of HIV drugs are sharing the intellectual property rights on its medicines to reduce the cost of medicine and separate to this, research suggests that Anti-HIV pills can cost as little as fifteen pence!  Tobacco plants are also being used to reduce the cost of HIV medicine.  Drug using couples are reported to reduce their HIV risk using counselling and for the first time in over a decade, there has been a drop in the number of new sexually transmitted infections in England.

New vaccines are being developed and at the same time, countries struggle to reduce the incidence HIV even though some countries are having their entire population tested for HIV.

There’s a new exhibition at Leicester’s New Walk Museum showing AIDS Posters from Around the World and despite the level of research and the importance of HIV support services, HIV patients may even loose out because of funding cuts for specialist social workers!

Sadly, Amy Winehouse has passed away and has received much negative press in the media, speculating on the cause of her death; however we prefer to focus on her charity work which includes support for HIV causes.

Worldwide estimates in drug users show 11.3 million people have hepatitis  and only a fraction of those who could benefit are receiving antiviral drugs even though it’s reached epidemic levels in certain (localised) areas.  Find out more about Hepatitis in this video from doctor Charlton and if you’re interested in helping us identify the needs of individuals living with or co-infected with Hepatitis, you’re welcome to meet us next week in person.

If you’ve enjoyed catching up with these stories and want to stay updated, please consider subscribing or following us on twitter, if you have friends of family who like to receive this news, please spread the word – we’d like to reach as many people as possible.

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Swaziland to Test Its Entire Population for HIV but can it Afford ARV’s or the Food Which Must be Eaten with Them?

Authorities in Swaziland want to subject the entire Swazi population to a HIV/AIDS screening test. Those eventually found to be HIV positive would then receive antiretroviral drugs (ARVs). It is an ambitious project involving various donors including the Dutch organization, Stop Aids Now! But is it possible to test an entire population?

Nearly 200,000 of Swaziland’s 1.2 million inhabitants are HIV positive, which makes the southern African country the world record holder for HIV prevalence. Moreover, many Swazis have never been tested for HIV before. The number of people living with the virus that causes AIDS could thus be much higher.  HIV/ AIDS expert, Joep de Lange, from the University of Amsterdam, is among the supporters of the project.

According to him, the screening test could lower the prevalence of the pandemic to one percent of the Swazi population. But he remains cautious: “You cannot force people to use ARVs. Continuous monitoring is necessary. But it is a promising strategy in the fight against the pandemic”.

Is it really possible to conduct a screening test on such a scale? Swaziland is one of the smallest countries in Africa, stretching over 200km from North to South and 130km from East to West. Only people above the age of 15 will be tested. A monumental task indeed, but not an impossible one according to local authorities.

Dutchman Ton Vriend has been living in Swaziland since 1976. He has been involved in numerous health projects and is skeptical as regards the feasibility of such a campaign. “I don’t think it is possible to provide drugs to all patients. Moreover, a checkup will only be possible in cities, where the clinics are, and people living in rural areas cannot generally afford to get there”.

Swaziland has some experience when it comes to large scale screening tests. Part of the population has already been tested in various rural areas such as the areas around sugar cane plantations.

Unlike many other African countries, HIV/AIDS is no longer taboo in Swaziland. However, according to Vriend, a there is still a lot to be done with regard to protection measures against the virus.

Vriend: “In the cities, condoms are widely available. However, in remotes areas, people sometimes have to walk for several kilometers to acquire them and sometimes they are already used. People here have a different kind of sexuality”.

Swaziland would nevertheless make history, as no other country has ever subjected its entire population to an HIV screening test.

However, there are protests in Swaziland over shortage of drugs.  Hundreds of people have taken to the streets to protest against poor governance which has led to a shortage of essential medical supplies.  More than 500 people demonstrated in Mbabane, the capital, on Wednesday while nearly 1,000 protested in the western town of Siteki.

AIDS groups have warned of an imminent shortage of anti-retroviral drugs in a country where a quarter of the people between the ages of 15 and 49 are believed to carry HIV.

However, it’s not just a shortage of drugs which is causing problems.  Many are eating manure to make their medication work.  Too poor to afford food, those lucky enough to receive ARV’s have resorted to eating dung to fill their stomachs because the drugs don’t work on an empty stomach, so patients are mixing dung with water to help them digest it.

Aid workers are shocked to see how people have been forced to live, said Siyabonga Sithole, from the Swaziland Network of People Living with HIV and Aids.

“HIV patients are told their drugs will not work unless they have something in their stomachs – but many people are suffering an economic crisis, which means they are unable to buy food,” he told the Swazi Observer newspaper.

“I first saw two months ago residents drying cow dung and mixing it with water to eat before they take their pills. I was told three or four people were doing this but since then the number has grown. This is very disturbing and it’s an indication of how bad the situation has become,”

Eating cow manure is most common in the eastern Lubombo region, which has suffered a long stretch without rain, and where up to half of the population is HIV positive.

Hundreds of people are protesting in the southern African country, claiming that poor management by sub-Saharan Africa’s sole absolute monarch has caused a shortage of essential medical supplies and a failing economy.

Swaziland is one of the world’s HIV capitals – a quarter of adults among its 1.2million people are HIV positive. The virus has killed many workers and farmers and has created thousands of orphans. Many have been given antiretroviral drugs – but these could soon run out as the economy collapses. Aids groups have already warned that the country faces a shortage of anti-retroviral drugs.

About 70 per cent of people in Swaziland are so poor they live in abject poverty, earning less than £1.20 a day. At least one third of the one million population get some sort of food aid each year.

This article is a combination of three separate editorials from Radio Netherlands Worldwide, Aljazeera and SOS Children’s Villages.

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Today is World Hepatitis Day & Find Out What LASS is Doing To Help

Following the World Health Assembly in May 2010, it was agreed that World Hepatitis Day would be recognised annually on 28 July.

World Hepatitis Day is an annual event which provides international focus for patient groups and people living with hepatitis.  It is an opportunity where interested groups can raise awareness and influence real change in disease prevention and access to testing and treatment.

Since its inception back in 2008 thousands of events have taken place around the world, generating massive public and media interest.  The World Hepatitis Alliance has also received support from governments worldwide, high-profile Non-Governmental Organisations and supranational bodies, such as Médecins Sans Frontières.

LASS would like to invite you to an open day, to help identify the needs of individuals in Leicester, Leicestershire and Rutland living with Hepatitis or who are co-infected with HIV and Hepatitis.

We envision a support group where individuals can collaborate and share knowledge with the aim to manage the condition in a supportive environment.  Suggestions so far include telephone support, full access to Hepatitis reference materials and one on one home visits (provided we can secure appropriate funding).  

We’re meeting in Loughborough, on Wednesday 3rd August in the afternoon, if you like to come along, please contact Michael on 0116 2559995 or email him directly and we’ll be happy to send you more information.

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An Overview of Hepatitus C in 10 Minutes [Video]

Mayo Clinic Dr. Michael Charlton provides an overview of Hepatitis C, including information on diagnosis and treatment.

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World Health Organisation: Hepatitis Toll “In Millions”

Medical experts are calling for global action to tackle the viruses that cause the liver disease hepatitis.

The first worldwide estimates in drug users show 10 million have hepatitis C while 1.3 million have hepatitis B.  Writing in the Lancet, experts say only a fraction of those who could benefit are receiving antiviral drugs.

Only one in five infants around the world are vaccinated against hepatitis B at birth, they say.  The figures, published in the Lancet, show about 67% of injecting drug users in the world have been exposed to hepatitis C, while around 10% have come into contact with hepatitis B.

In the UK, around half of injecting drug users have been infected with the hepatitis C virus, while the rate for exposure to hepatitis B is 9% – the highest in western Europe.

“This study provides us with a first step and powerful data to draw attention to the problem of viral hepatitis in people who use drugs”

Dr Joseph Amon – Human Rights Watch

The research was led by Prof Louisa Degenhardt of the Centre for Population Health, Burnet Institute, Melbourne, Australia, and Paul Nelson from the National Drug and Alcohol Research Centre at the University of New South Wales.

They say: “The public-health response to blood-borne virus transmission in injecting drug users has mainly centred on HIV.  “Maintenance and strengthening of the response to HIV in injecting drug users remains crucial, but the significance of viral hepatitis needs to receive greater attention than it does at present.”

Commenting on the study in the Lancet, Dr Joseph Amon, of Human Rights Watch, New York City, US, said: “This study provides us with a first step and powerful data to draw attention to the problem of viral hepatitis in people who use drugs.

“The next step is to challenge governments to act, and hold them accountable for implementation of rights-respecting and evidence-based programmes.”
Hepatitis is caused by five main viruses – A, B and C, and, more rarely D and E.
Hepatitis B is the most common, and can be passed from mother to baby at birth or in early childhood as well as through contaminated injections or injected drug use.

Hepatitis C is also spread through using unsterile needles and less commonly through unsafe sex or sharing razors or toothbrushes. The E virus, caught from infected water or food, is a common cause of outbreaks of the disease in developing countries, said the World Health Organization.

Many of those carrying hepatitis are not aware they have it and can unknowingly transmit it to others.

Source: BBC

You can find more information about Hepatitis at NHS Choices

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Amy Winehouse’s Charity Work, Events and Causes

Best known for her albums Frank and Back To Black, Amy Winehouse shot to fame in 2003 with a series of amazing singles highlighting her unique talents, as well as her incomparable style.

In 2008, she appeared naked in Easy Living magazine to raise awareness of breast cancer, a cause she supported throughout her career. She performed her hits Rehab and Valerie later that year at Nelson Mandela’s 90th birthday concert in London.

In 2009, Winehouse expressed interest in helping young musicians in the Caribbean, where she lived for a period of time on the island of St Lucia. She supported the Hear The World campaign to raise awareness of the topic of hearing and hearing loss and to promote good hearing all over the world, and appeared on a CD with Cuban musicians to raise awareness of climate change.

In 2010, Amy offered the pro-bono use of her “Back to Black” song for a film, “Baby In The Sky” part of the Global Fund’s Born HIV Free campaign.

“Baby in the Sky” is a highly creative and imaginative animated film that conveys the beauty of life ahead for an unborn child. The film artistically portrays an imaginary journey in a world full of adventurous landscapes and fantastic creatures. It ends with a call from Carla Bruni-Sarkozy for an HIV-free generation in which she says “Life is a beautiful journey. Don’t let AIDS kill it.”

“It was a question of finding a true resonance with the images in the film created by Bonzoms”, says musician / producer Julien Civange, who conceived the Born HIV Free campaign, about the use of Winehouse’s music. “We wanted to find a piece that was modern but also well known, something that carried the same sensibility as the film. The magic came with the soundtrack by Amy Winehouse, an artist that Carla considers one of the greatest and most talented of her generation and who was generous enough to participate in the campaign.”

Amy Winehouse passed away on July 23, 2011.

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The Ryan White Story (Continued)

During the course of his short young life Ryan White changed the face of HIV and AIDS as we knew it, forever. He is, to this day, an inspiration and hero for many people living with HIV/AIDS. This is his story, part 6 of 10.

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Hepatitis C Is Transmitted by Unprotected Sex Between HIV-Infected Men: Ongoing Epidemic in New York City in HIV-Infected Men

Sexual transmission of hepatitis C virus (HCV) is considered rare. But a new study by researchers at Mount Sinai School of Medicine, working with the Centers for Disease Control and Prevention (CDC), provides substantial evidence that men with HIV who have sex with other men (MSM) are at increased risk for contracting HCV through sex.
The results of the study are published in the July 21 edition of the CDC’s Morbidity and Mortality Weekly Report.

HCV transmission primarily occurs through exposure to blood, and persons who inject drugs at greatest risk. But when Mount Sinai researchers observed a large increase in the number of new cases of HCV transmission among HIV-infected men who did not inject drugs, they took a closer look to examine the role of sexual transmission among these men.

The researchers identified 74 HIV-infected men between October 2005 and December 2010 who had documented new HCV infection and yet reported no other risk factor for HCV infection, including injection drug use. When they compared 22 of these men with a control group of 53 closely matched HIV-infected MSM who did not have HCV infection, they found that the men who had recently contracted HCV were 23 times more likely to have had unprotected anal sex with men. In addition, HCV genetic analysis suggested that HCV was transmitted within social networks of these men, consistent with the presence of a city-wide epidemic.

“While hepatitis C is rarely transmitted among stable heterosexual couples, this is clearly not the case among HIV-infected MSM in New York City,” said Dr. Daniel Fierer, Assistant Professor of Medicine and Infectious Diseases at Mount Sinai School of Medicine. “MSM, and to some extent their health care providers are generally not aware that having unprotected receptive sex can result in HCV infection. The good news is that the cure rate for new HCV infections is very high with early treatment, but without regular testing of the men at risk, these largely asymptomatic infections may be missed and this opportunity lost.”

“Our study suggests that HIV-infected MSM should take steps to protect themselves and others by using condoms. Also, health care providers should be screening these men for hepatitis C, and public education and outreach programs should include information about these risks,” Dr. Fierer concluded.

Via Science Daily

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HIV Patients Losing Out From Cuts To Specialist Social Workers

People with HIV are losing out on vital social care support due to cuts to specialist social worker roles and rising eligibility thresholds.

That was the warning from a report published yesterday by the National Aids Trust, based on a survey of 149 healthcare professionals involved in the care of HIV positive patients.

Over three-quarters of respondents said the social care received by their patients benefited them, with 74% citing social care’s valuable role in providing physical or personal care, 71% citing emotional support and 65% saying social care helped patients adhere to treatment.

Specialist social work support was the most valued intervention by healthcare staff, with 77% citing its benefits.

However, several respondents warned that such posts were being cut, creating problems of stigma for service users who did not feel comfortable approaching generic social work teams.

“The current move to a ‘generic’ approach to social work is very unhelpful for HIV-infected patients, who often have complex medical histories and complex needs – requiring someone with some appropriate HIV-related knowledge to address these,” said one respondent.

Almost half of respondents (45%) said their patients had trouble accessing social care support, due to high and rising eligibility thresholds, lack of capacity in teams or referral processes being too slow.

The report concluded:

“These findings suggest that HIV-specialist social care support should, wherever possible, be maintained (particularly in high prevalence areas). Innovative solutions should be considered such as a number of local authorities sharing some HIV specialist social care staff to whom complex cases can be referred and who can also act as trainers for generic social care providers.”

Funding for social care for people with HIV/AIDS has traditionally come through the aids support grant. This was rolled into councils’ overall formula grant this year, although the government made notional allocations to local authorities for this purpose.

“Local authorities should put arrangements in place to ensure these funds are spent as intended, whether through greater flexibility or eligibility thresholds, greater provision of lower-level one-to-one social care support or greater support for voluntary sector open-access tailored services.”

By Mithran Samuel from Community Care

If you would like to find out more about the AIDS Support Grant and HIV social care, including the history of the grant and the current situation, Andrew Pearmain, HIV Consultant Practitioner, has produced a comprehensive report entitled Feast to Famine: HIV Social Care and the AIDS Support Grant.

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HIV/AIDS Posters From Around The World [Exhibition]

There is a fascinating new exhibition at Leicester’s New Walk Museum, curated by Dr Sarah Graham from the School of English. It’s called ‘Spreading the Word: AIDS Posters from Around the World’ and draws on the Wellcome Collection’s massive archive.

This year marks two important anniversaries: it is 30 years since AIDS was identified as a new disease and 20 years since the red ribbon was adopted as a symbol of the fight against HIV and AIDS. Dr Graham is working on a research project called Vital Signs: Representing AIDS which explores the various ways in which HIV and AIDS have been represented in a range of media including fiction, poetry, drama, memoir, film and visual art. The exhibition is the first outcome from this project.

There are 24 posters in the exhibition from the UK, USA, Africa, India and Australia, mostly from the early 1990s. The range of messages they convey is broad: some express the dangers of the disease quite bluntly; some demonstrate protection measures; others make a plea for a supportive attitude towards HIV+ people.

Also evident is the range of organisations which have produced posters, from Government departments to charities such as ACT-UP and the Terrence Higgins Trust. And the approach ranges from deadly serious through informative to, well, Australian superhero Condoman.

Dr Graham originally contacted the Wellcome Trust at the end of 2009 about mounting an exhibition and the Trust has been very supportive of the project as part of their mission is to make materials from their massive collection accessible to the public. New Walk Museum has also been very helpful in providing public gallery space, ensuring that the exhibition is seen by as many visitors as possible.

Although some AIDS posters produced over the years have been quite graphic, Dr Graham has been careful in making her selection suitable for family viewing so visitors to the museum can be assured that they won’t see anything more ‘shocking’ than a condom or two men embracing.

The exhibition is free to visit and runs until Sunday 28 August 2011.

(Press release)

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