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Archive for the ‘circumcision’ Category

Dr. Robert Hecht is Principal and Managing Director at Results for Development Institute, a Washington, D.C.-based nonprofit that works on health, development, and education issues.

Dr. Robert Hecht is Principal and Managing Director at Results for Development Institute, a Washington, D.C.-based nonprofit that works on health, development, and education issues. He is editor of the just-published “Costs and Choices: Financing the Long-Term Fight Against AIDS,” an aids2031 project.

Hecht spoke with John Donnelly about the recent UNAIDS report that showed HIV prevalence declined by at least 25 percent in 22 countries in sub Saharan Africa over the last decade.

Q: What do these findings tell you?

A: It tells me that the rate of new infections is starting to come down in a number of countries from frightening high levels in the past. It means that some of the things we are doing in prevention are starting to have an impact. At the same time, looking at the other side of the coin, looking at infections that continue to accrue, it suggests a lot more needs to be done to go further in order to have significant HIV reduction. What it means is, until we make a further dent on the prevention side and stopping people from becoming infected, we are setting up a situation in the future where we are adding to the numbers of the people who need to be cared for and who need to be put on treatment. Those numbers of people continue to grow.

Q: What’s working in prevention that would account for the 25 percent drop? (more…)

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Male circumcision (MC) was a recurring theme throughout our congressional study tour, since the intervention has been shown to provide up to 60 percent protection for men from HIV infection from a female partner. There is also evidence that it reduces the chance of the female partner contracting some genital infections that could lead to cancer of the cervix.

Access to MC is being scaled up across many parts of Africa. It is particularly important given the significant proportion of discordant couples in which the man is HIV negative and the woman is HIV positive (about 40 percent in Kenya, for instance).

Zambia has a circumcision rate of about 13 percent.  In only one area of the country, the northwest, the practice is a normal part of male initiation ceremonies.

A young man waits in line to be circumcised at the Livingstone General Hospital male circumcision unit. "It's good for my health and my parents want me to get it done," he said.

A recent study by the U.S. Agency for International Development found that a rapidly scaled up MC effort in Zambia would avert 28 percent of HIV infections, with an enormous cost savings in the long term.  The study found similar results for many other countries.

At our hotel in Livingstone, in southern Zambia, we asked some of the young male workers about the experience with circumcision, and they were not shy about the topic.  (more…)

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Many themes emerged during the 18th International AIDS Conference last week in Vienna. Here is our list of the top five:

Universal Access to HIV Treatment and Prevention Remains Elusive Goal

From comments by Bill Gates to the many activist demonstrations, a main theme at IAS 2010 was fear over dwindling funds dedicated to the HIV/AIDS pandemic. The Obama administration took significant heat for recent budget proposals for FY2011 that indicate a retreat from the promise to fund global AIDS at $50 billion over the next five years. Austria also faced targeted criticism for not committing funds to the Global Fund, despite its role as the host country for IAS 2010.  Various speakers and activist actions also called out Canada, Germany and France for back-peddling on their commitment to global AIDS and the Global Fund, while African activists challenged their own leaders to honor the Abuja Declaration and to commit 15 percent of their respective budgets to health.

Also of note was the grave concern expressed by activists from Eastern Europe and citizens of the former Soviet Republics about changes in Global Fund eligibility criteria that may put their proposals at a disadvantage.  Numerous stories and presentations highlighted the failure of many of these governments to put resources into harm reduction and into treatment programs serving the highly stigmatized populations of injection drug users (IDU), commercial sex workers and prisoners who represent the major HIV-affected populations in the region.

Keeping Step with PrEP

There are many trials testing the ability of antiretrovirals (ARV) to prevent acquisition of HIV infection underway, and the results of two such trials gained quite a bit of attention at IAS 2010. (more…)

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The Center for Global Health Policy staff will be hosting five congressional staff on a trip to Zambia to visit U.S. government funded programs to address HIV and TB in mid- August.  In addition to visiting life-saving HIV treatment programs for adults and children, staff will have the opportunity to see a male circumcision program providing this HIV prevention intervention to men in the community.  Congressional staff visitors to Zambia will have the opportunity to meet with Zambian AIDS and TB activists, some of whom are benefiting from HIV treatment funded by the PEPFAR program.

Stay tuned to ScienceSpeaks in August for live blogging from the trip.

In related news, HBO and the (RED) campaign released “The Lazarus Effect” in May — a wonderful, 30-minute video on HIV/AIDS in Zambia directed by Lance Bangs and executive produced by Spike Jonze and Susan Smith Ellis. 

The 30-minute documentary reveals how antiretroviral drugs can bring people from near death back to productivity, and shows the effect this life-saving transformation can have on the Zambian people, their families and communities.

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This post is by the Global Center’s Christine Lubinski, reporting from the International AIDS Conference in Vienna. This is a summary of a report released at a session on Thursday by E. Odoyo-June and colleagues.

Kisumu is the third largest city in Kenya and was the site of one of the three critical clinical trials that demonstrated the efficacy of male circumcision (MC) to prevent acquisition of HIV infection in men.  The trial results were widely reported in the community and triggered a national committee to scale up circumcision.

The results of a random household survey on male circumcision and HIV in men and women 15-49 years old found that 32 percent of the men had been circumcised, but 59 percent of the men who were not circumcised expressed an interest in being circumcised.  The uncircumcised men who were interested in circumcision did believe it would provide them with some protection from HIV, but 25 percent also thought it would make condom use less necessary.  Only 15 percent of the circumcised men thought condom use was less necessary.  These findings demonstrate the importance of the prevention counseling accompanying circumcision.

Seventy-three percent of women surveyed indicated a preference for a circumcised partner. Kenya’s comprehensive Voluntary Medical Male Circumcision (VMMC) program, launched in 2008

The government of Kenya launched the Voluntary Medical Male Circumcision program in 2008, which is committed to circumcising 860,000 men over the next four years. (more…)

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