Monthly Archives: May 2012

HIV treatment breaks lead to drug resistance in the female genital tract

Antiretroviral treatment interruptions of 48 hours or more are associated with the emergence of resistant strains of HIV in the female genital tract, investigators report in the online edition of the Journal of Acquired Immune Deficiency Syndromes.

The study included 102 women in Kenya who started first-line antiretroviral therapy based on a non-nucleoside reverse transcriptase inhibitor (NNRTI). Drug-resistant virus was detected in the genital tract of five women in the twelve months after treatment was started. Treatment interruptions were the most important risk factor for this outcome.

“We found that ART [antiretroviral therapy] adherence was a key determinant of genital tract resistance and that treatment interruptions of whatever cause lead to a substantial increase in the hazard of detecting genotypic resistance to antiretrovirals in female genital tract secretions,” write the authors. “Efforts to prevent treatment interruptions by improving program effectiveness, promoting adherence and timely refills, and avoiding the use of more toxic antiretroviral agents could therefore play an important role in reducing transmitted drug resistance.”

First-line HIV therapy often comprises two nucleoside reverse transcriptase inhibitors (NRTIs) combined with an NNRTI. This treatment can have a powerful and durable anti-HIV effect. However, it requires high levels of adherence. Drug-resistant strains of HIV can emerge with poorer adherence. Older drugs in the NNRTI class, nevirapine (Viramune) and efavirenz (Sustiva or Stocrin), have a low barrier to resistance.

Little is currently known about the emergence of drug-resistant virus in the genital tract of women treated with NNRTI-based therapy. This is an important gap in knowledge as drug-resistant virus is potentially transmissible.

Investigators therefore designed a prospective study involving women who started first-line HIV treatment in Mombasa between 2005 and 2008. During the first twelve months after starting therapy viral load was monitored at three-monthly intervals in both plasma and the genital tract. Samples with viral load above 1000 copies/ml were sent for resistance testing. The investigators conducted analysis to see which factors were associated with the emergence of drug-resistant virus in the genital tract.

Overall, the women had high levels of adherence to their antiretroviral therapy. Assessed by pill count, median adherence was 97%. However, there were 40 treatment interruptions. Their median duration was four days. Median pill-count adherence following treatment interruptions was just 83%.

Drug-resistant virus was detected in the blood of nine women (incidence, 10 per 100 person-years) and in the genital secretions of five individuals (incidence, 5.5 per 100 person-years). All five women with resistant HIV in their genital secretions also had resistant virus in their blood.

The investigators’ first set of analysis showed that a number of factors were associated with genital tract resistance. These included treatment interruptions (p = 0.006), pill-count adherence (p = 0.001) and a higher baseline viral load (p = 0.04).

But only treatment interruptions remained significant after controlling for potentially confounding factors. Interruptions were associated with a more than 14-fold increase in the risk of genital tract resistance (aHR = 14.2; 95% CI, 1.3-158.4; p = 0.03).

“The reasons for treatment interruption in this study included both unavoidable discontinuations due to drug toxicity or systemic illness and avoidable interruptions due to late refills, when it is likely that consecutive doses were missed,” note the investigators. “Despite a comprehensive program of adherence support including pre-ART counseling, directly administered therapy during the first month of treatment, a support group, pill boxes and transportation reimbursements, we were unable to prevent these events.”

Transport problems and pharmacy stock-outs have emerged as major barriers to adherence in resource-limited settings. The investigators are concerned that “such barriers may lead to the development of genital tract resistance due to treatment interruptions, suggesting an increased risk for transmission of drug-resistant virus”.

The Aids Library of Philadelphia FIGHT has a video on YouTube which explore the subject of HIV which is resistant to anti-HIV medications. Further information can be found on their website.

Original Article via NAM and Philadelphia Fight’s YouTube Channel

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A History of HIV & AIDS – 1997

As we prepare to enter our 25th year, we are reflecting on the global HIVevents from the last three decades.  HIV has swept across the globe touching communities on every continent.  Here’s an introduction to some of the key moments in the early global history of HIV.  Catch up on the story using the ‘Recent Posts’ link to the right.

For the first time since the AIDS epidemic became visible in 1981, the number of deaths from AIDS had dropped substantially in the developed world due to the advances of anti HIV medicine and combination therapy.  Within two years, death rates due to AIDS will have plummeted in the developed world. (See 1996 for why)

In New York City the decline was even more dramatic, with the number of people dying from AIDS falling by about 50 per cent compared to the previous year. The number of babies being born HIV positive had also declined dramatically.

In May, President Clinton set a target for the USA to find an AIDS vaccine within ten years.

In August UNAIDS estimated HIV/AIDS cases in India, Myanmar (Burma), Bangladesh and Nepal at 3 million, 350,000, 20,000, and 15,000 respectively.

Worldwide, 1 in 100 adults in the 15-49 age group were thought to be infected with HIV, and only 1 in 10 infected people were aware of their infection. It was estimated that by the year 2000 the number of people living with HIV/AIDS would have grown to 40 million.

September 2, “The most recent estimate of the number of Americans infected (with HIV), 750,000, is only half the total that government officials used to cite over a decade ago, at a time when experts believed that as many as 1.5 million people carried the virus.” article in the Washington Post.

Based on the Bangui definition the WHO’s cumulative number of reported AIDS cases from 1980 through 1997 for all of Africa is 620,000. For comparison, the cumulative total of AIDS cases in the USA through 1997 is 641,087.

December 7, “French President Jacques Chirac addressed Africa’s top AIDS conference and called on the world’s richest nations to create an AIDS therapy support fund to help Africa. According to Chirac, Africa struggles to care for two-thirds of the world’s persons with AIDS without the benefit of expensive AIDS therapies. Chirac invited other countries, especially European nations, to create a fund that would help increase the number of AIDS studies and experiments. AIDS workers welcomed Chirac’s speech and said they hoped France would promote the idea to the Group of Eight summit of the world’s richest nations.”

At the end of the year, UNAIDS reported that worldwide the HIV epidemic was far worse than had previously been thought. More accurate estimates suggested that 30 million people were infected with HIV. The previous year’s estimate had been 22 million infected people with an estimated 3.2 million cases of new HIV infections.

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A History of HIV & AIDS – 1996

As we prepare to enter our 25th year, we are reflecting on the global HIV events from the last three decades.  HIV has swept across the globe touching communities on every continent.  Here’s an introduction to some of the key moments in the early global history of HIV.  Catch up on the story using the ‘Recent Posts’ link to the right.

UNAIDS and the World Health Organization (WHO) estimated in 1996 that more than 4.6 million people had died from AIDS since the beginning of the epidemic and that over 20.1 million were then living with the virus that leads to AIDS. The majority of those infected (over 15 million) lived in sub-Saharan Africa, followed by more than 31.8 million in Asia, 1 million in Latin America and the Caribbean and about 1.5 million in North America and Western and Central Europe.

On 1 January 1996, The UN aids agency, UNAids, is established.  UNAids – the Joint United Nations Programme on HIV/AIDS opened for business. This was 15 years after the first published report of AIDS cases, 15 years during which most of the world’s leaders, in all sectors of society, had displayed a staggering indifference to the growing challenge of this new epidemic.

Tommy Morrison in February, 2007

In February, the heavyweight boxer Tommy Morrison was identified as HIV positive after being tested prior to a fight.  A few days before a scheduled fight against Arthur Weathers, Morrison tested positive on a mandatory HIV test performed by the Nevada Athletic Commission.  Morrison’s personal physician administered a confirmatory test, which was also positive.  Nevada cancelled the fight and placed Morrison on indefinite suspension.

At a news conference, a “reflective” Morrison said that he had contracted HIV because of a “very permissive, fast, reckless lifestyle’ that involved unprotected sex with multiple partners.”  Morrison also said that he once thought HIV was a danger only to drug addicts and homosexuals, but that his infection was evidence that HIV “does not discriminate.”  Morrison stated that he would never fight again but later in 1996, he announced that he wished to make a comeback with one more bout, the proceeds of which would benefit his newly created KnockOut Aids Foundation.

To treat his HIV infection, Morrison told the New York Daily News in 2001, he took antiretroviral medication, which reduced his viral load to low levels and according to his promoter, saved his life.

Beginning in 2006, Morrison launched a comeback bid, alleging that his positive HIV tests had been false positives or that he was a victim of a plot by a rival boxer.  The Nevada boxing commission’s medical advisory board reviewed Morrison’s status and concluded that the HIV positive results were “ironclad and unequivocal.”  The commission’s Keith Kizer stated, “I hope he’s HIV negative, I really do, but it doesn’t seem likely…We’ll wait and see what happens. He said he’s been tested several times in recent years, but (we’ll ask) what happened from 1996 and 2002, the years he won’t talk about.”  Morrison said he tried to get a copy of the original test results. “We’ve asked, but they can’t come up with it,” he said. “I don’t think it ever existed.”  USA Today reported that “Goodman said that’s nonsense: ‘All Mr. Morrison has to do is contact the laboratory, and they would immediately release the results to him.’

It’s very interesting reading, for more on Tommy Morrison, follow these links:

In May the US Food and Drug Administration (FDA) approved the first ‘home sampling’ system of HIV testing.

Meanwhile in China it was estimated that the number of AIDS cases could be as high as 100,000. Two thirds of the reported AIDS cases had occurred in the southern province of Yunnan, where the use of heroin and the sharing of needles had helped the spread of HIV.

In the USA there had been a cumulative total of 81,500 AIDS cases in New York.

New outbreaks of HIV infection were erupting in Eastern Europe, the former Soviet Union, India, Vietnam, Cambodia, China and elsewhere.

The International Aids Vaccine Initiative set up to jumpstart the search for an effective vaccine.

BREAKTHROUGH IN HIV / AIDS TREATMENT

The first major breakthrough in the treatment of HIV comes in 1996, with the introduction of protease inhibitors as part of antiretroviral combination therapies.

Protease Inhibitors stop HIV replication by preventing the enzyme protease from cutting the virus into the shorter pieces that it needs to make copies of itself. Incomplete, defective copies are formed which can’t infect cells.

This new class of medicine means that viral loads drop, t-cells rise, and death rates plummet, even as it becomes clear that the new medications cannot “eradicate” HIV from the body and thus fall short of being a cure.  Alongside these tremendous advances, new HIV infections remain undiminished, and the drugs also prove difficult to take, cause serious side effects, and don’t work for everyone.

Robert Gallo, an American biomedical researcher, best known for his role in the discovery of HIV published his discovery that chemokines, a class of naturally occurring compounds, can block HIV and halt the progression of AIDS. This was heralded by Sciencemagazine as one of the top scientific breakthroughs within the same year of his publication.  The role chemokines play in controlling the progression of HIV infection has influenced thinking on how AIDS works against the human immune system and led to a class of drugs used to treat HIV, the chemokine antagonists or entry inhibitors.

Gallo’s team at the Institute of Human Virology maintain an ongoing program of scientific research and clinical care and treatment for people living with HIV/AIDS, treating more than 4,000 patients in Baltimore and 200,000 patients at institute-supported clinics in Africa and the Caribbean.  In July 2007, Gallo and his team were awarded a $15 million grant from the Bill and Melinda Gates Foundation for research into a preventive vaccine for HIV/AIDS.


Just 12 months earlier, AIDS was considered a death sentence, and those seeking to treat it seldom uttered the words “AIDS” and “hope” in the same sentence.  However, in 1996 those terms have become inextricably linked in the minds and hearts of researchers and patients alike and while the new optimism must be tempered with numerous caveats, 1996 had ushered in a series of stunning breakthroughs, both in AIDS treatment and in basic research on HIV.

Protease inhibitors can now dramatically reduce HIV levels in the blood when taken with other antiviral compounds. At the same time, natural weapons in the immune system’s defences, polypeptide molecules called chemokine’s, have been unveiled as potent foes of HIV. This work offered new insight into the pathogenesis of HIV and may one day blossom into new treatments or even vaccines.

Read This: AIDS Research: New Hope in HIV Disease

These major breakthroughs resulted in a steep decline in the number of AIDS cases and deaths reported each year which gave hope to the many millions of people with HIV.  Less and less people with HIV were dying however, the number of infections continues to rise, and peaks at a new high from 2000, due in part to living healthy with HIV but also due to decreased education and awareness.

At the 11th International Aids Conference in Vancouver, excitement over the development of combination drug therapies is tempered by their extreme cost – estimated at $20,000 a year per patient.

Brazil introduces free combination therapy for HIV-positive citizens

At the end of the year UNAIDS estimated that during 1996 some three million people, mostly under the age of 25, had become newly infected with HIV, bringing to nearly 23 million the total number of infected people. In addition an estimated 6.4 million people – 5 million adults and 1.4 million children – had already died.

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A History of HIV & AIDS – 1995

As we prepare to enter our 25th year, we are reflecting on the global HIVevents from the last three decades.  HIV has swept across the globe touching communities on every continent.  Here’s an introduction to some of the key moments in the early global history of HIV.  Catch up on the story using the ‘Recent Posts’ link to the right.

By 1st January 1995, a cumulative total of a million cases of AIDS had been reported to the World Health Organisation Global Programme on AIDS.  Eighteen million adults and 1.5 million children were estimated to have been infected with HIV since the beginning of the epidemic.

AIDS had become the leading cause of death amongst all Americans aged 25 to 44.

Two research reports provided important new information about how HIV replicates in the body and how it affects the immune system.

The South African Ministry of Health announced that some 850,000 people – 2.1 percent of the 40 million population – were believed to be HIV positive. Among pregnant women the figure had reached 8 percent and was rising.

By the autumn of 1995, 7-8 million women of childbearing age were believed to have been infected with HIV.

By December 15th, the World Health Organisation had received reports of 1,291,810 cumulative cases of AIDS in adults and children from 193 countries or areas. The WHO estimated that the actual number of cases that had occurred was around 6 million. Eight countries in Africa had reported more than 20,000 cases.

Other organisations estimated that by the end of 1995, 9.2 million people worldwide had died from AIDS.

Worldwide during 1995, it was estimated that 4.7 million new HIV infections occurred. Of these, 2.5 million occurred in Southeast Asia and 1.9 million in sub-Saharan Africa. Approximately 500,000 children were born with HIV.

The WHO estimated that by the end of the century, 30 to 40 million people would have been affected by HIV.

British DJ and entertainer Kenny Everett dies from AIDS on 4 April 1995.

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Sex education: we should teach young people about more than the mechanics

Sex education: too much emphasis on the mechanics, says Doortje Braeken, who argues for more teaching about sexuality. Photograph: David Levene (The Guardian)

Sex education polarises opinion, sets legislators against parents and parents against schools and regularly inflames media opinion. Somewhere in the middle sit young people: ill-served, receiving confused messages and gaining their information from famously unreliable sources, such as peers or the internet.

Sex education, as all too many experience it, is like teaching people how to drive by telling them in detail what’s under the bonnet, how the bits work, how to maintain them safely to avoid accidents, what the controls do and when to go on the road. It’s all about the mechanics. And that’s it.

There’s a growing consensus that young people don’t need sex education, they need comprehensive sexuality education or CSE..  CSE is sex education plus: the mechanics, plus a lots more about sexuality.

That means not just teaching young people about the biology of sex, but also teaching them about the personal, emotional, societal and cultural forces which shape the way in which they choose to conduct their lives. Armed with this understanding, young people can make far more considered decisions.

This approach has the potential to unite the warring factions that bicker over the fundamental rights and wrongs of sex education: CSE equips young people with basic biological knowledge, but at the same time it equips them to question why they act in certain ways, and whether or not it is right, valuable or desirable to do so. CSE imparts information, and promotes responsibility.

CSE contains components which allow learners to explore and discuss gender, and the diverse spectrum of gender identities that exist within and between and beyond simple heterosexuality. It also contains components that examine the dynamics of power in relationships, and individual rights.

These are not taught as theoretical concepts. They have serious practical effects on the way in which young people interact with each other, both in the sexual and the wider social and educational spheres. Studies have shown that addressing such issues can have a marked impact both in school and the expansion of young people’s social networks.

CSE also engages with what some doubtless regard as difficult territory. Sexuality – however, individually, we choose to regard it – is a critical aspect of personal identity. The pleasure that we derive from sexuality, even if that pleasure is the pleasure of feeling that a reproductive duty is being fulfilled, is a vital part of our lives: it’s what makes us human. CSE views sexuality as a positive force.

CSE exploits a variety of teaching and learning techniques that are respectful of age, experience and cultural backgrounds, and which engage young people by enabling them to personalise the information they receive.

What is most telling is that a large number of studies have reached the clear conclusion that CSE does not lead to earlier sexual initiation or an increase in sexual activity. To paraphrase, traditional sex education seems to say: “If you’re going to do it, this is how everything works and you need to protect yourself in these ways to prevent this.” CSE says all that, but it also asks young people to ponder what exactly “it” is, and to deepen their perception of its implications.

In a political environment which is quantitatively driven, we measure the success of sex education in straightforward health behaviour indicators. These are easy to manage: numbers which build on existing health surveillance and measurement systems, and which are simple to understand from an objective point of view.

However, CSE is a far more nuanced discipline, and it will be necessary to include other measures of programme success: qualitative, subjective indicators which relate to gender equity, empowerment and critical thinking skills.

While governments have recognised young people’s right to CSE via various intergovernmental resolutions and conventions, the journey from recognition to delivery will be a long one. Even in the UK, there are notable differences, with England having a bare-bones biological approach “puberty, menstruation, contraception, abortion, safer sex, HIV/Aids and STIs should be covered”, while Wales and Scotland have curriculums which incline far more towards the CSE agenda.

The International Planned Parenthood Federation, the organisation I work for, and its 153 member associations around the world, has been instrumental in pressing for the adoption of international policy commitments to CSE. For many, it may seem like we are pushing 10 steps ahead of the agenda when the basic principle of young people’s right to even the most basic introduction to the biology of sex is still not universally accepted.

Our view is different: it is that CSE is what will secure widespread acceptance of sex education, because it is about more than the mechanics of sex. It is about helping young people, the world over, to become more healthy, more informed, more respectful and more active participants in the life of their community and their nation.

Doortje Braeken is the IPPF’s senior adviser on adolescents and young people, responsible for co-ordinating programmes in 26 countries implementing a rights-based approach to youth friendly services and comprehensive sexuality education. She will be among the panellists for a live discussion on sex and sexuality education, taking place on the SocietyGuardian site from noon to 2pm on Thursday 31 May

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A History of HIV & AIDS – 1994

As we prepare to enter our 25th year, we are reflecting on the global HIV events from the last three decades.  HIV has swept across the globe touching communities on every continent.  Here’s an introduction to some of the key moments in the early global history of HIV.  Catch up on the story using the ‘Recent Posts’ link to the right.

We focus on 1994 today, when The Centre for Disease Control (CDC) released 13 hard hitting AIDS advertisements which was a significant move from their more subdue approach. The prevention method was the use of condoms, which were rarely seen or even mentioned on television.

“One of the television ads, entitled Automatic, features a condom making its way from the top drawer of a dresser across the room and into bed with a couple about to make love. The voice-over says, ‘it would be nice if latex condoms were automatics. But since they’re not – using them should be. Simply because a latex condom, used consistently and correctly, will prevent the spread of HIV.’ (Library Reference)

In February, Secretary Shalala announced the eighteen members of the National Task Force on AIDS Drug Development, which includes experts in AIDS drug development issues from academia, industry, medicine, the HIV/AIDS-affected communities, and Government.  The Chairman of the Task Force is the Assistant Secretary for Health. The FDA (Food & Drug Administration in America) provides administrative and managerial support for the Task Force.

In March, the actor Tom Hanks won an Oscar for playing a gay man with AIDS in the film Philadelphia.

Philadelphia was was the first big-budget Hollywood film to tackle the medical, political, and social issues of AIDS.  Tom Hanks plays Andrew Beckett, a talented lawyer at a stodgy Philadelphia law firm. Andrew had contracted AIDS but fears informing his firm.  The firm’s senior partner, Charles Wheeler (Jason Robards), assigns Andrew a case involving their most important client. Andrew begins diligently working on the case, but soon the lesions associated with AIDS are visible on his face.

I won’t tell you more in case you’ve not seen it yet, (spoilers are never nice)! Suffice to say it’s all about prejudice and discrimination in legal setting in the early 90’s.  It’s nice to see that laws have since changed but today, 18 years on we still have a long, long way to go in order to stop the ignorance and stigma left behind!

On March 29, The FDA asked condom manufacturers to begin using the air-burst test on all brands of latex condoms. This new test measures a condom’s strength, and may be an indirect indicator of its resistance to breakage during use.

By July 1994 the number of AIDS cases reported to the WHO was 985,119. The WHO estimated that the total number of AIDS cases globally had risen by 60% in the past year from an estimated 2.5 million in July 1993 to 4 million in July 1994.

It was estimated that worldwide there were three men infected for every two women, and that by the year 2000 the number of new infections among women would be equal to that among men.

At the end of July, it was announced that the WHO’s Global programme on AIDS would be replaced. The UN Economic and Social Council approved the establishment of a new “joint and cosponsored UN programme on HIV/AIDS”.  The separate AIDS programmes of the UNDP, World Bank, UN Population Fund, UNICEF and UNESCO would have headquarters with the WHO in Geneva.  Later in the year it was announced that Dr. Peter Piot, the head of the research and intervention programme within the Global Programme on AIDS, would be the head of the new UN program.

Official statistics for Brazil, with a population of about 154 million, indicated that some 46,000 cases of AIDS had been recorded, but estimates put the actual number at anywhere between 450,000 and 3 million cases. Two thirds of the known cases were in Sao Paulo state where AIDS was the leading cause of death of women aged 20-35.

In early August 1994, the Tenth International Conference on AIDS was held in Yokohama, Japan. It was the first of the International Conferences to be held in Asia.  No major breakthroughs emerged, and it was announced that in future the international conference would be held every two years.

An exciting study, ACTG 076, showed that AZT reduced by two thirds the risk of HIV transmission from infected mothers to their babies.  It was the most stunning and important result in clinical acquired immunodeficiency syndrome research to date because it was the first indication that mother-to-child transmission of HIV can be at least decreased, if not prevented. And it will provide a real impetus for identifying more HIV-infected women during pregnancies so that they could consider the benefit of AZT treatment for themselves and their children.”

Meanwhile in the Russian Federation, deputies in the Russian Parliament, the Duma, voted at the end of October to adopt a law making HIV tests compulsory for all foreign residents, tourists, businessmen and even members of official delegations.

India by this time had around 1.6 million people living with HIV, up by 60% since 1993 (identical to the global figure). Local and state governments were accused of underusing and misusing HIV prevention funds.

In December, President Clinton asked Joycelyn Elders to resign from the post of US Surgeon General, following a remark during a World AIDS Day conference that children could be taught about masturbation.  She was asked whether it would be appropriate to promote masturbation as a means of preventing young people from engaging in riskier forms of sexual activity, and she replied, “I think that it is part of human sexuality, and perhaps it should be taught.”

This remark caused great controversy and resulted in Elders losing the support of the White House. White House chief of staff Leon Panetta remarked, “There have been too many areas where the President does not agree with her views. This is just one too many.”

Elders was fired by President Clinton as a result of the controversy in December 1994.

Perhaps this unfolds unhappy memories if you experienced this discrimination first hand but to our younger audience who may not have lived during these times, it’s important to understand that prejudice, stigma and discrimination remained significant obstacles for sex education, HIV prevention and AIDS awareness throughout the 1990s and into the new millennium.

In closing today, someone recently told me that Tim Radford (A freelance Journalist) wrote a special report “the progress being made in the fight against the cleverest and most malevolent virus scientists have ever seen”.  The report also examines issues of stigma, discrimination, and the effect HIV/AIDS has on families. – I’m afraid I can’t link to it, but if anyone has a copy, please get in touch!

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A History of HIV & AIDS – 1993

As we prepare to enter our 25th year, we are reflecting on the global HIV events from the last three decades.  HIV has swept across the globe touching communities on every continent.  Here’s an introduction to some of the key moments in the early global history of HIV.  Catch up on the story using the ‘Recent Posts’ link to the right.

We focus on 1993 today.  During January, 116 new cases of AIDS were reported in the UK, bringing the cumulative total to 7,045. One in six of these new cases were acquired through heterosexual intercourse.

In March, the House of Representatives in the USA voted overwhelmingly to retain the ban on the entry into the country of HIV positive people.

In early April the Ministers of Health and Finance from 39 countries met in Riga, Latvia, and launched an initiative to contain the spread of HIV in Central and Eastern European countries.

On 7th April all French television networks broadcast ‘Tous contre le Sida’ (All against AIDS) simultaneously, a special 4-hour programme designed to heighten awareness about HIV/AIDS and to raise money. The estimated audience for the programme was 33 million. Some 32,000 cases of AIDS had been recorded in France, with 15 deaths each day, and an estimated 150,000 people were thought to be infected.

In Romania, the number of children infected with HIV had increased. There were an estimated 98,000 infected orphans.

China had reported one thousand cases of HIV infection, mostly in injecting drug users, but it was believed that this greatly understated the scale of the country’s HIV epidemic.

In South Africa, the National Health Department reported that the number of recorded HIV infections had grown by 60 percent in the previous two years and was expected to double in 1993. A survey of women attending health clinics indicated that nationally some 322,000 people were infected.

In mid-1993, it had been realised that HIV was also spreading rapidly in the Asia and Pacific regions, home to more than half the world’s population, where more than 700,000 people were already believed to be infected.

Official statistics for Brazil indicated that some 46,000 cases of AIDS had been recorded, but estimates put the actual number at anywhere between 450,000 and 3 million cases.  Two thirds of the known cases were in Sao Paulo state where AIDS was the leading cause of death of women aged 20-35.

Despite the overwhelming evidence and more importantly, the need that safer sex campaigns were needed, in 1994 In the UK, the Department of Health vetoed an AIDS campaign promoting safer sex and condoms which was already developed at a cost of £2m on the grounds that it was too explicit!

The campaign was developed by the Health Education Authority (a government funded body) who later in the year were banned by the Department of Health from distributing the book, ‘Your Pocket Guide to Sex’. It was aimed at 16 to 25 year olds, giving advice on contraception, HIV and safe sex. The media reacted hysterically, saying that it was encouraging young people to have sex, and the government panicked. They pulped the book and threatened to stop all of their AIDS and sexual health education programmes.

However, this author has just researched Amazon and found it’s available to buy online, here’s the link if you’re interested!

The World Bank reviewed its HIV and AIDS activities in Africa, and decided that AIDS should not dominate its agenda on population, health and nutrition issues.

In the UK the radio DJ and comedian Kenny Everett announced that he was HIV positive, as did Holly Johnson, former lead singer with the group Frankie goes to Hollywood.

During the summer, the AIDS Prevention Agency in Brussels, in collaboration with the European Union, launched a campaign whose central image was ‘the flying condom’.

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On World AIDS Day, 1st December, Benetton in collaboration with ACT UP Paris placed a giant condom (22 metres high and 3.5 wide) on the obelisk in Place de la Concorde in Central Paris in an effort to waken the world to the reality of the disease. A symbolic monument to HIV prevention, it appeared on the covers of newspapers worldwide.

At the end of 1993 the estimated number of AIDS cases worldwide was 2.5 million.

But hope was on the horizon, if only for some, a large European study on mother-to-child transmission showed that Caesarean section halved the rate of HIV transmission, something of hope to expectant mothers and demonstrated that progress was being made in the field of HIV research.

Research indicated that Thailand had reduced its rate of HIV transmission. This was largely due to action by the government, which had distributed condoms to brothels and insisted that they were used consistently.

In face of opposition to HIV prevention programs it seemed that hope was near, in Leicester LASS moves to new premises, our current home.  The Michael Wood Centre and establishes a ‘company limited by Guarantee’, and gain charitable status.

Following the dissolution of Leicester Body Positive, a peer support development project is set up to develop opportunities for peer support, undertake and develop advocacy, and develop self-sustaining systems for people with HIV to influence the planning and provision of services in Leicestershire.

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