Selected Topics - HIV/AIDS
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HIV/AIDS at UNSW
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Global policies and related documents
- UNAIDS Program
UNAIDS is the joint United Nation's programme on HIV/AIDS. It is an advocate for global action on HIV/AIDS, leading, strengthening and supporting an expanded response to the epidemic.
Reports, guidelines and projects
- 2008 Report on the global AIDS epidemic
"The [July 2008] report documents considerable progress in many countries in addressing their national epidemics. A six fold increase in financing for HIV programmes in low- and middle-income countries 2001–2007 is beginning to bear fruit, as gains in lowering the number of AIDS deaths and preventing new infections are apparent in many countries. Progress remains uneven, however, and the epidemic’s future is still uncertain, underscoring the need for intensified action to move towards universal access to HIV prevention, treatment, care and support. Reports by 147 countries on national progress in implementing the 2001 Declaration of Commitment on HIV/AIDS provide the most comprehensive global assessment ever undertaken of the HIV response."
- 2010 Report on the global AIDS epidemic
Based on the latest data from 182 countries, this global reference book provides comprehensive analysis on the AIDS epidemic and response. The 2010 edition of the UNAIDS Report on the global AIDS epidemic includes new country by country scorecards on key issues facing the AIDS response. Based on the latest data from 182 countries, this global reference book provides comprehensive analysis on the AIDS epidemic and response. For the first time the report includes trend data on incidence from more than 60 countries. [publication overview] [UNAIDS, 2010]
- AIDS Epidemic Update 2006
This report published by UNAIDS examines global HIV/AIDS trends. "The global AIDS epidemic continues to grow and there is concerning evidence that some countries are seeing a resurgence in new HIV infection rates which were previously stable or declining. However, declines in infection rates are also being observed in some countries, as well as positive trends in young people's sexual behaviours."
- AIDS Vaccines: The Next Frontiers AVAC Report 2006
Founded in 1995, the non-profit AIDS Vaccine Advocacy Coalition (AVAC) seeks to create a favourable policy and social environment for accelerated ethical research and eventual global delivery of AIDS vaccines as part of a comprehensive response to the pandemic. This annual report analyses progress toward the development of an HIV/AIDS vaccine and makes recommendations for actions in the coming year.
- Behavior Change and HIV Prevention: (Re)Considerations for the 21st Century
This August 2008 report by the Global HIV Prevention Working Group "focuses specifically on behavioral HIV prevention. The report surveys what we know about the effectiveness of behavior change strategies, what we still need to learn, and what we need to do to advance such efforts in coming years. Based on a comprehensive review of hundreds of studies of behavior change for HIV prevention, we find that the evidence base for behavioral HIV prevention is robust, with multiple studies documenting the effectiveness of interventions in numerous settings, among diverse populations, and throughout the course of the epidemic. Our review also indicates that the evidence base is not yet complete, and that important gaps and limitations remain in our knowledge about what works. Maximizing the effectiveness of prevention efforts requires that these limitations be acknowledged and addressed."
- Blood Services in Central Asian Health Systems: A Clear and Present Danger of Spreading HIV/AIDS and Other Infectious Diseases
"The [World Bank] report discusses inter-related parts of blood transfusions systems, and presents an overview of the parts that need to be strengthened in Central Asia. Numerous parts are in serious need of organizational restructuring, new investment and increased budgetary support for operation and maintenance… Evaluating communicable diseases rates in blood donors is essential for monitoring the safety of the blood supply and donor screening effectiveness. This assessment found that the current screening for blood borne pathogens of donated blood in Central Asia may be providing a false sense of security -- the risk of receiving an infected blood unit and acquiring a transfusion transmitted infection in the countries of the region is real. More ominous is the fact that some health facilities in Central Asia do not test blood donations at all. This means that the transmission risks indicated in this study may be conservative estimates, as they are based on a sample that excludes the blood that never reaches the existing screening system."
- Bulgaria Country Report: EU partnerships to reduce HIV & public halth [sic] vulnerabilities associated with population mobility
"The free movement of people, goods and services is perceived to be a pillar of the sustained development of the European Union. At the same time Europe is facing continuous ageing of the population, and increased immigration flows over the last decade, which have become driving forces for the demographic changes, especially in EU. Furthermore, population mobility naturally entails challenges from the common strategy and policy, legislation, human rights and public health. Migration increases vulnerability to infectious diseases, and in particular HIV and Tuberculosis. Therefore, HIV and migration should be brought to EU agendas as part of broader public health and social policies. Bulgaria, as a new member state and external EU border, also faces these challenges as it is expected that mobility will increase in two directions – internal (within the EU, mainly by young people emigrating from Bulgaria) and external (people from third countries immigrating to Bulgaria)." [International Organization for Migration, August 2007]
- Canada Communicable Disease Report
Canada Communicable Disease Report (CCDR) distributes current information on infectious diseases in Canada to public-health professionals, both nationally and internationally. It specialises in surveillance of infectious diseases, outbreak investigations, immunisation, infection control, and tropical health and quarantine information, and other disease control activities.
- Caring for Children affected by HIV and AIDS
"…Explores the options for the care of children in communities affected by the AIDS pandemic. Beginning with the premise that the parent-child bond is the basic building block of child development and that the family is the basic unit of society, the report first looks at ways to keep parents alive and the family together as long as possible. It then explores alternative care arrangements beyond the immediate family. Settings range from care by the extended family, through different forms of fostering in the community, to adoption and placement in residential institutions. The report highlights ways in which actors from outside the immediate community can help to sustain and improve the capacity of households and communities to care for the children left behind…".
- Civil Society Perspectives on TB/HIV: Highlights from a joint initiative to promote community-led advocacy
"Over the past two decades, the HIV epidemic has contributed to a global resurgence of tuberculosis (TB). HIV weakens the immune system, greatly reducing an individual’s ability to fi ght off serious coinfections such as TB, as well as many opportunistic infections. In some high HIV-burden African countries, up to 50 percent of HIV-positive people develop active TB, and TB is now among the most common causes of death by infectious disease among people living with HIV. It makes little sense from any perspective—public health, human rights, social or legal—to confront the two diseases separately. Yet there have been too few collaborative responses from HIV/AIDS and TB programs. In many countries, national TB and HIV/AIDS programs and policies are designed and implemented independently of each other. Lack of coordination greatly reduces access to comprehensive treatment and prevention services for people living with HIV and/or TB. In recognition of these limitations, the World Health Organization (WHO) adopted its Interim Policy on Collaborative TB/HIV Activities in 2004. The TB/HIV Policy provides guidelines on measures that can be coordinated jointly by national HIV/AIDS programs and national TB programs to reduce the burden of TB among people with HIV and the burden of HIV among TB patients. It emphasizes the importance of building upon existing programs, systems, and resources, and of involving governments, health care providers, patients, and communities in designing and implementing a collective response to the dual epidemic. The TB/HIV Policy explicitly recognizes community-led monitoring and advocacy as an important way to promote and increase public demand for accelerated and improved TB/HIV services." [Public Health Watch & Treatment Action Group, New York, 2006]
- Conducting a Participatory Situation Analysis of Orphans and Vulnerable Children Affected by HIV/AIDS: Guidelines and Tools
This document by Renee DeMarco explains how to gather and analyse information to guide planning and action. It offers sample consent forms, baseline surveys, and interview guides, which can be adapted for local use. It also discusses the ethical considerations related to gathering information about children.
- Costs of HIV Prevention among Out-of-Treatment Drug-Using Women: Results of a Randomized Controlled Trial
Objectives: We developed a micro-costing methodology to estimate the real resource costs consumed by delivery of the National Institute on Drug Abuse (NIDA) Cooperative Agreement Standard Intervention (SI) for human immunodeficiency virus (HIV) prevention, plus two enhanced modules, in a three-arm randomized controlled trial (RCT) among drug-using women. To our knowledge, this is the first micro-costing study of the SI and enhanced modules and the first of its kind targeting drug-using women. Methods: We conducted a micro-costing study alongside a three-arm RCT to estimate costs of (1) the modified NIDA SI; (2) the SI and a well woman exam (SI1WWE); and (3) the SI, WWE, and four educational sessions (SI1WWE14ES) to prevent HIV and sexually transmitted diseases in at-risk, drug-using women in St. Louis, Missouri. Results: The cost of the SI that all 501 participants received was approximately $227 per person. The additional costs for the WWE and 4ES were approximately [US]$145 and $942 per person, respectively. Total program costs for the SI (n5501) were $113,869; additional costs for the SI1WWE (n5342) were $49,403 and for the SI1WWE14ES (n5170) were $160,189. The main cost component for the SI (64% of total costs) was testing costs, whereas building and facilities costs were the main cost component for the SI1WWE14ES (75% of total costs). Conclusions: This study provides accurate estimates of the real costs for standard and enhanced HIV interventions for policy makers seeking to implement targeted HIV-prevention programs with scarce resources. [author abstract] [Public Health Reports, 2010, Supplement 1, Volume 125, pp.83-94]
- Courage and hope: Stories from teachers living with HIV in sub-Saharan Africa
"It is estimated that there are currently around 122,000 teachers in sub-Saharan Africa who are living with Human Immunodeficiency Virus (HIV), the vast majority of whom have not sought testing and do not know their HIV status. Stigma remains the greatest challenge and the major barrier to accessing and providing assistance to these teachers. The idea of collecting stories from teachers living with HIV evolved between the Association for the Development of Education in Africa (ADEA) Biennial meeting in Libreville, Gabon in March 2006, and the positive teachers consultation held by the ADEA working group on the teaching profession in Nairobi, in May 2006. In order to emphasize the human dimension of these stories, this activity was undertaken by journalists rather than researchers. The stories documented here [in this World Bank report of 1 December 2008] give voice to the real life experiences of 12 HIV-positive teachers, five of whom are women, from Burkina Faso, Cameroon, Ghana, Kenya, Mozambique, Rwanda, Senegal, Tanzania (both Mainland and Zanzibar) and Zambia. The teachers recount their experiences of discovering their HIV-positive status and how this has affected them in their families, their communities, and their professional lives."
- Current HIV/AIDS end-of-life care in sub-Saharan Africa: a survey of models, services, challenges and priorities
Background: In response to increased global public health funding initiatives to HIV/AIDS care in Africa, this study aimed to describe practice models, strategies and challenges to delivering end-of life care in sub-Saharan Africa. Methods: A survey end-of-life care programs was conducted, addressing the domains of service aims and configuration, barriers to pain control, governmental endorsement and strategies, funding, monitoring and evaluation, and research. Both closed and qualitative responses were sought. Results: Despite great structural challenges, data from 48 programs in 14 countries with a mean annual funding of US $374,884 demonstrated integrated care delivery across diverse settings. Care was commonly integrated with all advanced disease care (67%) and disease stages (65% offering care from diagnosis). The majority (98%) provided home-based care for a mean of 301 patients. Ninety-four percent reported challenges in pain control (including availability, lack of trained providers, stigma and legal restrictions), and 77% addressed the effects of poverty on disease progression and management. Although 85% of programs reported Government endorsement, end-of-life and palliative care National strategies were largely absent. Conclusions: The interdependent tasks of expanding pain control, balancing quality and coverage of care, providing technical assistance in monitoring and evaluation, collaborating between donor agencies and governments, and educating policy makers and program directors of end-of-life care are all necessary if resources are to reach their goals. [author abstract] [BMC Public Health 2003, 3: 33]
- Experience of a pediatric HIV clinic in Guatemala City
Objectives: To describe the clinical experience of a Guatemalan pediatric HIV clinic and referral center, and fill the gap in literature available on pediatric HIV in Guatemala, a country facing a growing HIV epidemic. Methods: Analyses were performed on data available from the clinical databases maintained by the Clínica Familiar Luis Ángel García within the Hospital General San Juan de Dios in Guatemala City, Guatemala. Results: From January 1997–June 2006, a total of 536 children (individuals under 13 years of age) were registered at the clinic, 54% of them female. At the initial visit, 241 were known to be HIV infected, while 295 were known to have been exposed to HIV, but were of undetermined infection status. Of the 295 with undetermined status, serostatus was determined in 173, and 57 (33%) were HIV positive. The patients came from all 24 departments of Guatemala, but the majority (64%) was from Guatemala City. Most had perinatal exposure; three patients had been sexually exposed to HIV (all male); and the mode of infection could not be determined for six children. In the cohort of children whose infection status was initially undetermined, the provision of antiretroviral (ARV) medication (both pre- and neonatal), in addition to Cesarean section, was associated with an odds ratio of 0.06 for HIV infection (P < 0.001) when compared to children who had no interventions. Highly active antiretroviral therapy (HAART) was administered to 167 HIV-infected children. There were 44 known deaths in this cohort; no deaths occurred among the children who were not infected. Conclusions: Pediatric HIV/AIDS is present in all parts of Guatemala. Programs to prevent mother to child transmission and to provide appropriate treatment to families living with HIV/AIDS must be a public health priority. [author abstract] [Rev Panam Salud Publica 2009; 25(1): 51–55]
- Faith in Action: Examining the Role of Faith Based Organizations in Addressing HIV/AIDS
"This report, commissioned by the Catholic Medical Mission Board and conducted by the Global Health Council examines opinions surrounding the involvement of faith-based organizations (FBOs) in addressing the AIDS pandemic in some of the world's hardest-hit nations. Faith in Action examines perceptions of FBO contributions and actions in Haiti, India, Kenya, South Africa, Thailand and Uganda through the eyes of both secular and faith-based HIV/AIDS experts."
- Financial Resources Required to Achieve Universal Access to HIV Prevention, Treatment, Care and Support
UNAIDS has released a new report on the estimated financial resources required for the AIDS response. The report, puts forward three different approaches to financing the AIDS response including: (a) Scaling-up at current rates - This approach would require between US$ 14 to US$ 18 billion and would provide treatment for 8 million people by 2015; (b) Universal Access by 2010 - This approach envisages significant increases in available resources and an urgent and dramatic scale-up of coverage in all countries. The approach would provide treatment for 14 million people by 2010 and would require between US$ 32 to US$51 billion. In 2015 the approach would require between US$ 45 and US$63 billion; and (c) Phased scale-up to 2015 - This approach assumes different rates of scale-up for each country based on current service coverage and capacity, with the achievement of different programmatic targets at different times and the achievement of universal access by all countries by 2015. The approach would require between US$ 41 and US$ 58 billion in 2015. All the estimates provided in the report, developed for 132 low- and middle-income countries, were based on the type of epidemic and nationally established targets using the latest available data.
- From the Global AIDS Response towards Global Health?
"…Global Health’ has recently become a fashionable term. New Global Health institutes have been created, and new Global Health trainings organised. But what does the term Global Health really mean? Perhaps it is best defined by the World Health Organization (WHO)’s mandate: “health is a shared responsibility, involving equitable access to essential care and collective defence against transnational threats”. There are two ‘global’ elements in this description: a globally shared responsibility for the health of all people, and global threats posed by infectious diseases. However, these two global elements of an emerging Global Health paradigm are not mutually exclusive. The fact that viruses do not respect national borders contributes to an awareness of global responsibility for the health of all people. Further, the risk of uncontrolled epidemics proliferating from low-income to middle- and high-income countries motivates the more wealthy to help poor people because the more wealthy do not want to get poor people’s diseases. It is probably not a coincidence that Official Development Assistance (ODA) for health seems to focus on infectious diseases disproportionately. However, a global responsibility for the health of all people should extend beyond a willingness to tackle the global threats posed by infectious diseases and ensure that there is equal attention and solidarity for non-infectious diseases. In this discussion paper, [the author] will examine the emerging Global Health paradigm as one that addresses a global responsibility for the health of all people…".
- Globalization and Infectious Diseases in Women
United Nations Children's Fund, New York, New York, USA; Emerging Infectious Diseases, Vol. 10, No. 11, Nov 2004 - “Women have an enhanced vulnerability to disease, especially if they are poor.The health hazards of being female are widely underestimated. Economic and cultural factors can limit women's access to clinics and health workers. The World Health Organization (WHO) reports that less is spent on health care for women and girls worldwide than for men and boys. " This report addresses these issues.
- HIV/AIDS and work: global estimates, impacts on children and youth and response, 2006
This report, released by the International Labor Office examines the impact that the HIV/AIDS is having on economic and employment growth in countries hit hardest by the epidemic. " The report's focus on children and youth reflects the severe impact HIV/AIDS is having on the future global labour force. Often the epidemic propels children into work too early because their parents are sick or have died and a means of income is needed. Child labour puts children at risk, robs them of education and can lead to work that makes them more vulnerable to acquiring the virus themselves. Yet a range of rights-based legal instruments have seen widespread ratification that would eliminate the worst forms of child labour if vigorously enforced, and limit access to underage children for purposes of work in order to keep them in compulsory education...".
- HIV/AIDS in Bhutan
This World Bank publication of August 2006 discusses the state of the epidemic; risk factors; the national response to HIV/AIDS; issues, challenges and priority areas; and the World Bank response.
- HIV and AIDS Treatment Education: A Critical Component of Efforts to Ensure Universal Access to Prevention, Treatment and Care
This paper explores some of the main issues contained within the definition of treatment education, signalling ways that the education sector can play a role along with others engaged in efforts to achieve universal access to prevention, treatment, and care. The paper considers some key strategies, including how to effectively engage and prepare communities and how to involve key constituencies and in particular people with HIV and those on treatment."
- HIV and Global Health: global inequality of life expectancy due to HIV/AIDS
This paper deals with the growth in global health inequality, particularly in the light of the enormous impact of HIV/AIDS in Africa, asserting that this trend is not inevitable and can be reduced.
- HIV and National Security: Where are the links?
This report, by Laurie Garrett, a Senior Fellow for Global Health at the Council for Foreign Relations, discusses the effect of the HIV/AIDS pandemic on state security throughout the world. It emphasises the way in which the pandemic is weakening economies, government structures, military and police forces and social structures and in so doing the state of security in many countries.
- HIV Genetic Diversity: Biological and Public Health Consequences
The devastating consequences of AIDS pandemic will probably only be controlled when a vaccine is developed that is safe, effective, affordable, and simple enough to permit implementation in developing countries where the impact of AIDS is most severe. However, the major obstacle for the control of the spread of AIDS lies in the diversity of HIV and its enormous evolutionary potential. Numerous HIV forms contribute to the AIDS pandemic. Two viral types (HIV-1 and HIV-2), numerous groups (M, N and O for HIV-1 and A through H for HIV-2) and numerous subtypes, sub-subtypes and circulating recombinant forms (CRF) have emerged during the last 50 years. At least nine different genetic HIV-1 subtypes and over 20 CRFs were defined within group M, which accounts for the majority of cases in the AIDS pandemic. Even though HIV-1 subtype C and A predominate globally, the other viral forms co-circulate all over the world and may have a major impact for the strategies of pandemic control. Here we discuss the distribution of these divergent viral forms worldwide and the potential consequences of such a tremendous viral diversity for diagnostic, monitoring, treatment and the development of an effective vaccine. [author abstract] [Current HIV Research, 2007, 5, 23-45]
- Implementing Freirean Perspectives in HIV-AIDS Education among Preliterate Guatemalan Maya Immigrants
"The focus of this study was on a HIV-AIDS education project undertaken as a facet of a broader Family Literacy Program (FLP), implemented within a Guatemalan Maya immigrant community in south Florida. Project participants had typically experienced between 0-3 years of formal education in their home countries, had limited reading and writing skills in any language, and lived in an area designated by Public Health Agencies as an HIV-AIDS 'hot zone' where the spread of the disease was unusually high. The Maya were typically not included in County Public Health statistics, which were limited to the categories of White, Black, and Latino, thereby making the Maya publicly invisible in this crisis, even though they were, perhaps, the most vulnerable population. This article is based on two years of action research conducted in the context of the HIV-AIDS education project… The project, still in operation, consists of a series of instructional sessions developed from American Red Cross materials but adapted, through extensive research, to address the cultural backgrounds of the diverse audiences which, in the first two years, totaled 1,424 participants. This is the first of multiple studies surrounding this program. As such, it was guided by the following questions that were intentionally broad-based, exploratory and descriptive in nature. (1) What were the unique challenges of implementing an HIVAIDS education project within this community? (2) How were those challenges addressed? (3) To what extent did a Freirean perspective on education contribute to the project’s effectiveness?" [Journal of Thought, Spring-Summer 2008, pp.41-54]
- Improving HIV data comparability in migrant populations and ethnic minorities in EU/EEA/EFTA countries: findings from a literature review and expert panel
"This report presents the findings and recommendations of a review of HIV-related data on migrant and ethnic minority populations in European Union (EU), European Economic Area (EEA) and European Free Trade Association (EFTA) countries. The review was intended to: (i) provide an overview of the current situation with respect to data on HIV in migrant and ethnic minority populations; (ii) identify gaps and methodological challenges; and (iii) propose ways in which data, and data comparability, might be improved in Europe. Aimed at policymakers, programme managers, epidemiologists, researchers and others involved in migrant health, this report is intended to inform future policy, research and practice." [ECDC European Centre for Disease Prevention and Control, Stockholm, August 2011]
- Integrating TB and HIV Care in Mozambique: Lessons from an HIV Clinic in Beira
Mozambique ranks among the top ten nations in the world in terms of the number of people living with HIV/AIDS, with an estimated 1,300,000 people infected with HIV in 2003. The overall estimated sero-prevalence of HIV among adults aged 15–29 years was estimated at 12%, with the central region being the most affected area in the country with an estimated seroprevalence of 17%. Sofala Province, in central Mozambique, has the highest sero-prevalence of any province at 27%, with some prenatal care sites in Beira city (Sofala’s largest city and provincial capital) registering HIV-positive rates as high as 35%. Mozambique also ranks among the 20 highest tuberculosis (TB) burden countries in the world, with an estimated 81,000 cases and an incidence rate of 436 per 100,000 people in 2002. The incidence of TB has been steadily growing over the last 10 years largely due to the high prevalence of HIV; an estimated 47% of adult TB cases are estimated to be HIV-positive. In 2003 and 2004 in Beira city, approximately 3,200 new cases of TB were registered per year, which corresponds to an incidence rate of 566 per 100,000 people. The pathophysiological links between TB and HIV are well recognized, as co-infection with HIV significantly increases the chance of developing active TB.1 In sub-Saharan Africa, TB is felt to be the most commonly diagnosed opportunistic infection, and it is also the most frequent cause of death among those infected with HIV. The immune stimulation caused by TB may also increase the HIV viral load, rate of HIV disease progression, and mortality, particularly among those with higher CD4 counts. Because of the large number of patients with both TB and HIV, the World Health Organization (WHO) has encouraged efforts to increase the linkages between TB and HIV programs in sub-Saharan Africa. These linkages could facilitate quick and efficient diagnosis of dual TB-HIV infection, provide beneficial interventions such as prophylactic cotrimoxazole that could reduce mortality among dually infected HIV-TB patients, and coordinate the complex treatment issues that may arise with concomitant administration of TB treatment and HAART, where available. This paper describes one strategy of integrating TB and HIV care during the development of a new MOH HIV treatment center in Beira city, Mozambique.
- Intellectual Property and Public Health: copying of HIV/Aids drugs by Brazilian public and private pharmaceutical laboratories - This article, written by Maurice Cassier and Marilena Correa, and published in the Electronic Journal of Communication, Information and Innovation in Health (vol.1, no.1, pp. 83-90 (2007)), examines how “Brazilian public and private laboratories’ experience in copying ARVs since 1993 has been a technological learning process that in some cases has produced innovations. Reproducing drugs and synthesizing their active principles involves the combination of information available in patent documents and the partial rediscovery of certain know-how through laboratory manipulations. Chemists have to reconstruct the numerous “cat leaps” in patent documents, and in so doing often improve on the published processes or formulae. Generics laboratories are also able to use this knowledge base to invent new formulae, combinations of existing molecules, or to discover new molecules. Since 2000 the five laboratories studied have filed about ten patents on ARVs. We pieced together this technological learning process by interviewing chemists at generics laboratories, using the methods of the sociology of science.” [authors’ abstract]. Also published in Portuguese.
- Legal Aspects of HIV/AIDS - A Guide for Policy and Law Reform
This report, by Lance Gable, Katharina Gamharter, Lawrence O. Gostin, James G. Hodge, Jr., Rudolf V. Van Puymbroeck, states that "...Dealing successfully with HIV/AIDS cuts across almost all areas of government responsibility, and as the breadth of the 65 topics included in the Guide shows, there are many ways in which laws and regulations can either underpin or undermine good public health programs and responsible personal behaviors. The Guide indicates that statutes relating to many areas of human endeavor — from intimate private conduct to international travel — can contribute to stigma, discrimination, and exclusion or, contrariwise, can avoid and help remedy these inequities. Thus, in order to create a supportive legal framework it is important that governments identify and address effectively any gaps or other problematic aspects of their legislation and regulatory systems...".
- Male circumcision: Evidence and implications
"This [World Bank Working Paper of August 2008] report summarizes the evidence linking male circumcision and HIV infection, and assesses the implications for HIV prevention programs. The practical implications are especially pertinent in countries with very high HIV prevalence and low circumcision rates - including South Africa, Botswana, Lesotho, Swaziland and Namibia."
- Men and women living heterosexually with HIV: The Straightpoz study, Volume 1
This monograph (2/2006) by Asha Persson, David Barton and Wendy Richards, published by the (Australian) National Centre in HIV Social Research, Faculty of Arts and Social Sciences, University of New South Wales, discusses how "people living heterosexually with HIV develop a range of strategies for building normality within a small, sheltered world of trusted people and within a wider world of indifference to and ignorance about HIV. They often feel like ‘cultural outsiders’ in the HIV sector and are generally disconnected from other positive people and from communal forms of dialogue and support around HIV."
- Migratory Routes from Haiti to the Dominican Republic: Implications for the Epidemic and the Human Rights of People Living with HIV/AIDS
The presented study analyzes the possibility of a relationship between the migratory flow from Haiti toward the Dominican Republic and the spread of HIV/AIDS, as well as implications for the human rights of immigrants living with the infection. Its purpose is to identify possible areas of intervention and research in order to increase the participation of this population and its organizations in HIV/AIDS awareness and prevention efforts. The current study was carried out in three main phases: 1) review of existing documentation on the relationship between Haitian immigration, HIV/AIDS, and the human rights of infected people; 2) semi-structured interviews with key informants, authorities, and experts in the areas of concern; and, 3) eight case studies of Haitian immigrants living with HIV/AIDS in agricultural bateyes in the Dominican Republic. Results evidence the stigmatizing scenarios that immigrants living with HIV/AIDS face. [publication abstract] [Revista Interamericana de Psicología/Interamerican Journal of Psychology - 2007, Vol. 41, Num. 1, pp. 7-16]
- Monitoring Equity in Access to AIDS treatment programmes: A review of concepts, models, methods and indicators
"Strong health systems are essential for equitable and sustainable HIV/AIDS – related programmes. Health systems need to be accessible and responsive to the specific needs of excluded groups, such as under-served rural and low-income communities. Against a background of wider inequities in health and health care, the expansion of HIV/AIDS treatment and care should tap any opportunities to strengthen equity in the provision of good quality health services. At the same time, we need to take care not to aggravate inequities by inappropriately withdrawing resources from other interventions or other parts of the system. As antiretroviral therapy (ART) is rolled out in the region, it is important to have a comprehensive framework to monitor and evaluate equity in access to HIV / AIDS treatment programmes and to gauge the strength of health systems. The World Health Organization (WHO) and the Regional Network for Equity in Health in east and southern Africa (EQUINET) through REACH Trust Malawi and Training and Research Support Centre (TARSC) developed this review. It provides a practical resource for programme managers, health planning departments, evaluation experts and civil society organizations working on health systems and HIV / AIDS programmes at sub-national, national and regional levels in east and southern Africa." [Commissioned by the World Health Organization (Department of Ethics, Equity, Trade and Human Rights - Social Determinants of Health) and the Regional Network for Equity in Health in East and Southern Africa (EQUINET) through REACH Trust and Training and Research Support Centre (TARSC) – 2010]
- National AIDS Treatment Advocacy Project (USA)
This site provides the latest in HIV and AIDS drug development, research, and treatment information (on topics such as protease inhibitors, nucleosides, non-nucleosides, and double protease combinations).
- Progress on Global Access to HIV Antiretroviral Therapy: An Update on "3 by 5" June 2005
The "3 by 5" strategy for ensuring treatment for 3 million people living with HIV/AIDS in low and middle income countries by the end of 2005 was launched by WHO and UNAIDS in late 2003. This report examines the progress being made towards that goal as well as highlighting a number of the major obstacles to scaling up retroviral treatment and accelerating HIV/AIDS prevention efforts.
- The Africa Multi-Country AIDS Program, 2000-2006: results of the World Bank’s response to a development crisis
This 2007 study, commissioned by the World Bank and written by Marelize Görgens-Albino, Nadeem Mohammad, David Blankhart and Oluwole Odutolu, answers the question: “What are the results of the World Bank’s Multi-Country HIV/AIDS Program (MAP) for Africa, so far? It documents the contributions of the MAP over the past five years, drawing on countries’ survey and program data that are not usually captured in routine World Bank reporting systems. It also proposes a new Results Scorecard and Generic Results Framework to better measure and report future results of HIV/AIDS programs in Africa that the World Bank helps to support.”
- The association of TB with HIV infection in Oromia Regional National State, Ethiopia in 2006/7
Background: Infection with Human Immunodeficiency Virus (HIV) is an established risk factor for tuberculosis infection. Population-based data on associations between HIV and tuberculosis (TB) can provide an epidemiological assessment of the impact of HIV infection on TB in environments where individual based data are difficult to collect. Method: We used an ecological study to assess the association between infection with HIV and tuberculosis in Oromia Region National State, Ethiopia in 2006/7. Result: The prevalence of HIV infection was significantly associated with the incidence of TB across the areas in Oromia region (r=0.69, p<0.01). Similar associations were also seen for the prevalence of HIV infection with the incidence of smear positive tuberculosis, smear negative tuberculosis and extra-pulmonary tuberculosis. Conclusion: Ecological association between HIV and TB is strong in Oromia Regional state. Therefore, in areas where there are high TB case notification rates, it is important to consider the possibility that the prevalence of HIV may also be increasing, and take appropriate public health measures to assess and address these issues. [Ethiop.J.Health Dev. 2009;23(1):63-67]
- The Criminalisation of HIV/AIDS in the Pacific Islands: Why using the criminal law to fight HIV/AIDS is not the answer - "Why do we think that the criminal law, and specifically the creation of an HIV/AIDS related offence, will protect us from infection? Since HIV/AIDS prevalence remains low in the region, our primary concern must be to prevent the spread of infection. So does such an offence actually contribute to this goal? Moreover, is the creation of such an offence an effective policy response to the HIV/AIDS epidemic in the Pacific region? This discussion paper is an excerpt from a larger paper which examines existing criminal code provisions in the Pacific and their suitability for use in cases of wilful, reckless or negligent transmission of HIV. This particular portion of that paper focuses on the pragmatic and principled reasons for why creating a HIV/AIDS specific offence, or – for that matter - relying on the criminal law at all, is not an appropriate course of action for Pacific Island countries to take." [AIDSLEX (the AIDS and Law Exchange), 2008]
- The Global Threat of New and Re-emerging Infectious Diseases: Reconciling U.S. National Security and Public Health Policy
This study offers a comprehensive analysis of the security implications of the spread of infectious diseases. The study examines the impact of the HIV/AIDS epidemic in South Africa, highlighting this particular crisis as a graphic example of the devastating effects that infectious disease can have on virtually every aspect of a state's functioning viability.
- Toward Universal Access to HIV Prevention, Care and Treatment - the 3 by 5 Report for the Americas
"The 3 by 5 Initiative launched by the World Health Organization (WHO) in 2003 aimed to provide antiretroviral therapy to an additional three million people requiring treatment globally. In the Region of the Americas, the Pan American Health Organization (PAHO) included prevention of HIV within 3 by 5 in order to promote a comprehensive care model. During 2004 and 2005, countries initiated a variety of activities to scale up prevention, care, and treatment with technical and financial support from 3 by 5. Most of the resources were used to strengthen health system infrastructure, including human resource capacity and expansion of services. Significant advances were also made in prevention, access to medicines, and strengthening the collection and management of strategic information..."
- Towards Universal Access: Scaling up priority HIV/AIDS interventions in the health sector
"The end of 2007 marks an important step in the history of the HIV epidemic. According to the WHO, UNAIDS and UNICEF report Towards Universal Access: Scaling up Priority HIV/AIDS Interventions in the Health Sector, nearly a million more people (950,000) were receiving treatment with antiretroviral therapy (ART) in low- and middle-income countries by year’s end, bringing the total number of recipients to close to 3 million — a more than seven-fold increase over four years… Nevertheless, countries are still far from meeting universal access goals. An estimated 2.5 million people were newly infected with HIV in 2007, and overall, ART coverage still remains low — only 31% of people estimated to be in need of treatment in low- and middle-income countries were receiving it in 2007. Moreover, weak health systems and, in particular, a critical shortage of health-care personnel and a lack of long-term sustained funding threaten efforts to achieve universal access to HIV prevention, treatment and care. At the end of 2007, the gap between required and available funding was estimated to be US$ 8.1 billion. To meet universal access targets, funding will have to more than quadruple to US$ 35 billion in 2010 and to US$ 41 billion in 2015." Also available in French.
- UNAIDS Best Practice Collection
"This site provides links to hundreds of UNAIDS publications documenting successful approaches to particular HIV/AIDS problems and issues."
- What is the Impact of HIV on Families
This Health Evidence Network (HEN) evidence report examines how HIV influences family lives and how families deal with the HIV/AIDS.In the context of an increasing number of HIV positive people in Europe. The report highlights several policy considerations including promotion of primary and secondary HIV prevention with specific efforts directed at the group of people below 30 years of age; environmental changes likely to reduce the risk of HIV, such as the reduction poverty; and the establishment of family-based services, possibly integrated into family planning, antenatal care and obstetric and child health services, aimed at the specific needs of living with HIV.
- World Disasters Report 2008
"The AIDS epidemic is a disaster on many levels. In the most affected countries in sub-Saharan Africa, where prevalence rates reach 20 per cent, development gains are reversed and life expectancy may be halved. For specific groups of marginalized people – injecting drug users, sex workers and men who have sex with men – across the world, HIV rates are on the increase. Yet they often face stigma, criminalization and little, if any, access to HIV prevention and treatment services. As this report explains, HIV is a challenge to the humanitarian world whose task is to improve the lives of vulnerable people and to support them in strengthening their capacities and resilience. Disasters, man-made and ‘natural’, exacerbate other drivers of the epidemic and can also increase people’s vulnerability to infection."
- Why is There No AIDS Vaccine?
The authors of this 2004 paper (Michael Kremer and Christopher M. Snyder) argue that differences in timing of drug and vaccine consumption will lead firms to be biased against developing vaccines. Vaccines are sold before consumers are infected, when they still have private information regarding their infection risk, whereas drugs are sold after consumers are infected, when those with positive valuation have no private information on infection risk. Given that antiretroviral drugs are difficult to deliver in the poor countries where most people infected with HIV/AIDS live, biases against developing a vaccine raise enormous public health concerns.
- Young people’s HIV/AIDS & reproductive health needs and utilization of services in selected regions of Ethiopia
"This report summarizes important work into the sexual and reproductive health needs of young Ethiopians. The generation of young people now in their late teens and early twenties is faced by unprecedented choice, but also daunting challenges. The combined effects of rapid urbanization and loosening cultural ties influence these young men and women at the same time that the impact of HIV/AIDS is being felt throughout Ethiopian society. The central findings of this study are that young people lack understanding of reproductive health issues, experience significant problems related to their sexual and reproductive health, and yet are reluctant to seek help for these problems. If available at all, the reproductive services provided in most regions are not designed with young people in mind and so may appear unwelcoming or unattractive. Health personnel are often ill-equipped to provide management and advice tailored to the needs of young people. However, there are positive elements to the study findings. The mould-breaking Model Youth Centers of the Family Guidance Association of Ethiopia demonstrate that it is possible to achieve accessible, attractive centers in which young peoples’ sexual and reproductive needs are tended to in the context of the wellbeing of the whole individual."
Educational resources
- AIDS Economics Homepage
World Bank AIDS Economics is part of the International AIDS Economics Network (IAEN). The IAEN offers data, tools, and analysis for compassionate, cost-effective responses to the global HIV/AIDS epidemic. New information is added regularly. The page includes access to a free IAEN newsletter.
- AIDSinfo
AIDSinfo is a U.S. Department of Health and Human Services (DHHS) project that offers the latest federally approved information on HIV/AIDS clinical research, treatment and prevention, and medical practice guidelines for people living with HIV/AIDS, their families and friends, health care providers, scientists, and researchers.
- The Body
The Body website provides a comprehensive selection of HIV/AIDS information collected from leading organisations and experts. Its aim is to use the web to lower barriers between patients and clinicians; demystify HIV/AIDS and its treatment; improve patients' quality of life and foster community through human connection.
- HIV, Health and Your Community
Published by the Hesperian Foundation this guide provides comprehensive advise on fighting HIV at a community level. Designed for people confronting HIV in places with few medical resources, it is easily accessible to those without advanced technical knowledge and without prior training in the care of people with AIDS or in the prevention of HIV. Interventions and treatments emphasised are available to the majority of the people in the world who have HIV, and focus on community-based solutions that are possible in poor communities.
- HIV InSite
This site provides comprehensive, up-to-date information on HIV/AIDS treatment, prevention and policy from the University of California, San Francisco School of Medicine.
- Johns Hopkins AIDS Service
The Johns Hopkins AIDS Service is provided as a resource for physicians and other health care professionals in providing care and treatment to patients with HIV/AIDS. The site includes an expert Q&A, publications, links to resources, a literature review, guidelines as well as epidemiology, prevention and treatment information.
- NAMES Project AIDS Memorial Quilt
In June of 1987, a small group of strangers gathered in a San Francisco storefront to document the lives they feared history would neglect. Their goal was to create a memorial for those who had died of AIDS, and to thereby help people understand the devastating impact of the disease. This meeting served as the foundation of the NAMES Project AIDS Memorial Quilt. Today, the Quilt is a powerful visual reminder of the AIDS pandemic.
- Research Matters in Governance Equity and Health Videos
This page provides access to videos produced by International Development Research Centre, Canada's Research Matters in Governance, Equity and Health. The first video 'Does Research Matter?' was filmed at the 2004 Global Forum for Health Research. "Making Research Matter" and "Researching the Rollout" examine the project " Public Sector Anti-Retroviral Therapy" currently underway in the Free State, South Africa.
- Synergising HIV/AIDS and Sexual and Reproductive Health and Rights - A Manual for NGOs
Published by Aidsnet, the Danish NGO network on Aids and Development this manual provides guidance to NGOs and their partners in low income countries on how NGOs can integrate HIV/AIDS related issues with those of sexual and reproductive health and human rights. It includes concrete examples and cases of good practices or common approaches, and links to more information and other user-friendly resources and tools, including websites, existing guides and training manuals.
- UNHCR: The Displaced and HIV/AIDS
This webpage, from the United Nations High Commissioner for Refugees, provides refugee-related HIV articles, guidelines and educational materials.
- WWW Virtual Library: Epidemiology
Organisations and Networks
UN and multinational
- Population Council: Horizons
HIV/AIDS poses a grave threat to families, societies, and economies worldwide. Nowhere is this truer than in developing countries, where more than 90 percent of all HIV infections have occurred. Since 1997, the Population Council has implemented Horizons under a cooperative agreement with the United States Agency for International Development (USAID). Horizons is one component of a larger USAID initiative to reduce HIV transmission and mitigate its effects in developing countries. Horizons also partners with other international organisations as well as national and community groups in countries around the world.
Government
- CDC National Prevention Information Network
A service of the CDC National Center for HIV, STD and TB Prevention in the United States this site includes links to Organisations, Materials, News, Conferences and Funding opportunities relevant to HIV, STD and TB .
Non Government
- AIDS Institute
The AIDS Institute is a leading national public policy research, advocacy, and education agency with offices in Miami, Tallahassee, Tampa, and Washington, DC. Affiliated with the Division of Infectious Diseases and Tropical Medicine at the University of South Florida College of Medicine, The AIDS Institute, while focused on HIV/AIDS incorporates work on related healthcare issues such as Hepatitis, as well as other infectious and chronic diseases.
- Asian Harm Reduction Network
AHRN is a global information and support network, created to link and support the people and programmes working throughout Asia to stop HIV among injecting drug users. AHRN is involved in five key activities Networking, Information sharing, Advocacy and support for harm reduction enabling policies, Programme and policy development and Training which has been translated into a range of services, i.e., strategic partnerships with international organisations and representation at key events, a resource centre (clearinghouse), a newsletter and special reports.
- EuroHIV
EuroHIV coordinates the surveillance of HIV/AIDS in the WHO European Region since 1984. Its mission is to understand, improve and share European HIV/AIDS surveillance data in order to better inform disease prevention, control and care
- Hong Kong AIDS Information Network
This site is developed and maintained by the Community Research Programme on AIDS, The Chinese University of Hong Kong and funded by the Council for AIDS Trust Fund. It provides comprehensive information on HIV/AIDS in Hong Kong and beyond.
- International Council on AIDS Services Organisations
ICASO is the International Council of AIDS Service Organisations, a global network of non-governmental and community-based organisations. ICASO was formed in 1991 with secretariats in five geographic regions, and a central secretariat based in Canada. It is a non-governmental organisation accredited to the United Nations Economic and Social Council (ECOSOC).
- International AIDS Economics Network
The International AIDS Economic Network provides data, tools and analysis on the economics of HIV/AIDS prevention and treatment in developing countries, for compassionate, cost-effective responses to the global epidemic.
- International AIDS Vaccine Initiative
IAVI is a global not-for-profit organisation working to speed the search for a vaccine to prevent HIV infection and AIDS. Founded in 1996 and operational in 23 countries, IAVI and its network of partners research and develop vaccine candidates. IAVI also advocates for a vaccine to be a global priority and works to assure that a future vaccine will be accessible to all who need it.
- San Francisco AIDS Foundation
Founded in 1982 in San Francisco's Castro district as an emergency response to a quickly emerging health crisis. Its primary purpose was simply to assemble and disseminate critical information to gay men who were being diagnosed with a rare and frightening cancer. Building upon its original mission to educate, the AIDS Foundation has added comprehensive services for people living with HIV disease and AIDS and an aggressive public policy component to compel federal and state governments to address the epidemic.
Academic Institutions with particular focus in this area
Key Conferences, conference and workshop reports
Coming conferences
Conference reports
Journals, Newsletters, Forums
- AIDS Clinical Care
AIDS Clinical Care is monthly newsletter providing "Information on the prevention, diagnosis, and treatment of HIV/AIDS."
- Bulletin of Experimental Treatment for AIDS
“BETA, the Bulletin of Experimental Treatments for AIDS, covers new developments in AIDS treatment research. BETA includes in-depth articles on treatment for HIV infection and AIDS-related illnesses for HIV positive individuals and their caregivers. It is published biannually by the San Francisco AIDS Foundation.”
- Newsletter of the National Association on HIV Over Fifty
Bi-annual newsletter for persons over the age of 50 infected with HIV and their caregivers.
Bibliographies, Libraries
Public health bookshops
Original website founded Lucien E. Schlosser and Eberhard Wenzel, 1997.
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