Tag Archives: who

World Health Organisation Advocates for HIV Self-Testing

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The first legally approved HIV self testing kits only became available in the UK last year.

Forty percent of the people with HIV globally are unaware they are infected, the World Health Organisation (WHO) said in a statement yesterday (Tues 29th Nov) , two days ahead of World AIDS Day.

The WHO is advocating for broader access to self-testing kits to make it easier for those at risk to determine whether they are infected.

“HIV self-testing should open the door for many more people to know their HIV status and find out how to get treatment and access prevention services,” said WHO Director-General Dr. Margaret Chan.

The report cited studies which found that providing self-testing kits nearly doubles the chances of men who have sex with men getting tested.

Late Diagnosis in Leicester

Late HIV diagnosis in Leicester is 13.8% higher than the average for England.  HIV testing is a scary prospect to some and no one takes that for granted, but by taking the chance to be tested, you could be buying yourself years of life.

Do you know your HIV status? – The only way to know if you have HIV or not is to get a HIV test.  You can do this for free at your doctor, free at an NHS clinic, free with charities like LASS and now you can even do a HIV test at home, at your convenience.

For more information on HIV Testing, please visit our website where you can find information about testing with us or other places in Leicester/shire and around the UK.

You can also apply for a FREE home sampling HIV kit or you can purchase your own self test kit.  An explanation on the differences between testing methods is available in our HIV Testing Pages.

Self-testing would be particularly beneficial to populations that face a wide variety of barriers to testing centers; however, many of the financial constraints which prevent access to testing and treatment may similarly impede access to self-testing kits.

Still, the WHO noted significant improvements in HIV awareness and treatment in the past decade. In 2005, just 12 percent of those infected with HIV knew they had the AIDS virus. Last year, the number climbed to 60 percent. Additionally, 80 percent of those who know they are HIV-positive are currently receiving antiretroviral therapy (ART).

Wide-scale implementation of self-testing remains limited, but 23 countries currently have policies in place supporting it, and many other nations are developing similar policies.

You can read the full statement by the World Health Organisation here: http://www.who.int/mediacentre/news/releases/2016/world-aids-day/en/

Want to know how a HIV test works? – See this video featuring Dr Christian on loose women .

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HIV effort let down by test shortages, says WHO

The Most Revd Ephraim S Fajutagana, Supreme Bishop of the Philippine Independent Church, undergoes an HIV test as part of the National Council of Churches in the Philippines public campaign to remove the stigma associated with HIV/Aids.

The Most Revd Ephraim S Fajutagana, Supreme Bishop of the Philippine Independent Church, undergoes an HIV test as part of the National Council of Churches in the Philippines public campaign to remove the stigma associated with HIV/Aids.

A shortage of HIV testing could undermine global efforts to diagnose and treat people with the infection, warn experts from the World Health Organization.  They looked at responses to annual surveys that the WHO had sent to 127 countries between 2012 and 2014 asking about capacity and usage of blood tests that check HIV status and health.

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They found worrying gaps in provision. They warn that United Nation targets for HIV could be missed as a result.

The targets say that by 2020, 90% of all people living with HIV should know their HIV status, 90% of those diagnosed should receive antiretroviral therapy and 90% of these treated patients should have “durable viral suppression” (a measure of effective treatment).

Laboratory testing is vital to meet and monitor these aims.

But Vincent Habiyambere and his colleagues say in the journal PLoS Medicine that some low and middle-income countries, including African countries where the HIV burden is high, are not yet geared up for the challenge.

The surveys were sent to:

  • all 47 countries in the WHO African Region
  • 33 countries in the WHO Region of the Americas
  • all 21 countries in the WHO Eastern Mediterranean Region
  • eight high-burden HIV countries in the WHO European Region
  • all 11 countries in the WHO South-East Asia Region
  • seven high-burden HIV countries in the WHO Western Pacific Region

Over the three survey years, 55 (43%) countries responded to all three surveys, 35 (28%) to two surveys, 25 (20%) to one survey, and nine (7%) responded to none of the three surveys.

Testing provision did improve over the years, but shortfalls remained in some parts of the world.

Worrying gaps

Reasons for the gaps in provision included lack of reagents, equipment not being installed or maintained properly and inadequate or absent staff training. In some laboratories, machines were not serviced regularly. In others, machines broke down and were not covered by contracts to be serviced or fixed.

Dr Habiyambere and his team say: “A national laboratory strategic plan to strengthen services must be developed, implemented, and monitored by governments and their national and international partners.

“The focus of the international community, to ensure optimal use of laboratory technologies, should be on those countries where interventions for scaling up access to HIV diagnostic technologies are most needed.”

They acknowledge that they did not look at private sector testing and that some countries might rely more heavily on this than others.

In an accompanying editorial, HIV experts Peter Kilmarx and Raiva Simbi say the findings show some programmes may have been “overly focused” on buying equipment without planning for how it would be used and maintained.

In Zimbabwe, for example, only 5.6% of HIV patients on drug treatment in 2015 received regular blood checks to monitor their viral load – far fewer than the goal of 21%.  This was largely down to problems with resource mobilisation and specimen transport as well as equipment procurement, they say.

“Strong leadership, resources, planning, and management are needed to scale up laboratory services,” they conclude.

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World Health Organisation records highest-ever number of new HIV cases in Europe

by Tom Robson

The World Health Organisation (WHO) said yesterday that in 2014 it had recorded the highest number of new HIV cases in its European Region, which also includes Central Asia, since the start of reporting in the 1980s.

Story via Reuters
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WHO and the European Centre for Disease Prevention and Control (ECDC) said in a statement that more than 142,000 people in WHO’s European Region were diagnosed with HIV last year with the increase coming from its eastern sector which comprises 15 countries including Russia, Ukraine and Central Asia.

The statement followed publication on Tuesday of findings by the United Nations AIDS programme which showed that new HIV infections overall had fallen by 35 percent since the peak of the three-decade-old pandemic in 2000.

“Heterosexual transmission is responsible for the increase in eastern Europe, and transmission through drug injection remains substantial,” the joint statement by the WHO and ECDC said.

ECDC spokeswoman Caroline Daamen said “eastern Europe” referred to the eastern part of WHO’s European Region, where the organisations said the number of new HIV cases had more than doubled in the past decade.

Apart from Russia, Ukraine and Central Asia, this region also includes countries of the Transcaucasus.

“In the EU and the EEA, sex between men is the predominant mode of HIV transmission. Two in three new HIV infections are among native-born Europeans,” the organisations said.

In the European Union generally, the number of people diagnosed with HIV was roughly unchanged over the past decade, ECDC’s Daamen said.

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Women living with HIV: a matter of safety and respect

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Last month the results of a global survey on women living with HIV were published. The survey was designed and conducted by women, and commissioned by the World Health Organisation. Will the findings be acted upon?

In 2014 the World Health Organisation commissioned the largest international survey to date on the sexual and reproductive health and human rights of women living with HIV. The survey was designed, led and conducted by women living with HIV.  Last month the global survey was published: Building A Safe House On Firm Ground.

I live in Canada in a small rural setting, and I have been living with HIV for many years. The survey calls for “safety, support and respect for all women at all times”.  It is my hope that readers examine the survey in its entirety.

A total of 832 women from 94 countries, aged 15-72, with another 113 women in focus groups from 7 countries took part in the survey. Violeta Ross (Bolivia) expressed how “This consultation means for me, the opportunity to learn from one and other. Women living with HIV are the best positioned for the design of sexual and reproductive health policies“.

The single most prominent finding of the survey was how women living with HIV experience high rates of violence, on a continuum throughout the life cycle: 89% of the respondents reported experiencing or fearing gender-based violence, before, during and/or after HIV diagnosis.

Violence was described as physical, psychological and/or financial, with an HIV diagnosis or disclosure acting as a trigger for violence at times. Over 80% of respondents reported experiences of depression, shame and feelings of rejection. Over 75% reported insomnia and difficulty sleeping, self-blame, very low self-esteem, loneliness, body image issues, or anxiety, fear and panic attacks, whether before, or as a direct result of, or after diagnosis.

Poverty ties in with violence, along with gender inequality. Many women with HIV come from diverse backgrounds, such as drug use, sex work, being lesbian or transgender. Women are often in relationships where they do not have the financial means to leave and are reliant on their partners, placing them in an unequal power dynamic and open to further abuse and blackmail.

The survey reveals the way in which the lack of human rights-based approaches to women’s services contributes to mental health issues, lack of satisfying sex lives, and lack of sexual and reproductive rights. All women with HIV have the right to achieving their sexual and reproductive rights as a fundamental part of being human. The survey also highlights the importance of women needing to achieve their own rights in all these areas in order for them adequately to support their children and partners – which women with HIV are very much wanting to do.

The report strongly recommends the meaningful involvement of women living with HIV as active participants in all plans and research which affects them.

As Sophie Strachan of the UNAIDS Dialogue Platform and the Global Coalition of Women and AIDS explained, “The main importance of this consultation is that WHO hear and take up our recommendations, listen to our voices (as experts) to hear the needs of women living with HIV and include peer led support/services in their guidelines. We need gender specific policies to ensure the rights of women in all our diversities are met.”

Gender-based violence against women living with HIV is a world-wide phenomenon. In a Canadian context it takes place on a continuum from polite rejections, discrimination and regular experiences of being stigmatized, to more overt forms of violence including physical assault, threats of violence during disclosure of their HIV status or with partners who use the secret of “shame” of their HIV status to control women and keep them from leaving a relationship.

Women living with HIV in Canada often have children and cannot find adequate child care. So they cannot spend time furthering their education and are therefore trapped in a poverty cycle which is often impossible to break. This further exacerbates the potential for abuse and violence.

Indigenous women in Canada represent a small percentage of the overall population, but are over-represented in the number of women living with HIV in Canada, as are women of colour who have emigrated from other regions of theworld. Women living with HIV in Canada often live in isolation, keeping their HIV status private for fear of backlash from the community and to protect their children from stigma and discrimination.  Living in isolation leads to decisions to not seek treatment, not seek care and support to deal with stress and anxiety, and not take prescribed medication on a regular basis, if at all.

It may come as a surprise to learn that Canada has one of the highest rates of criminalization of HIV for non-disclosure in the world. This needs to be addressed to alleviate fear and silence about HIV. Canada demands that other countries adhere to basic human rights practices, yet at home we do not. Fortunately we have a strong organization, the Canadian HIV/AIDS Legal Network, which lobbies for de-criminalization of HIV and changes in our government’s position on this topic. Criminalization of HIV in fact serves to increase HIV transmission. With the onus on the HIV positive person to disclose their status to sex partners or risk prosecution, individuals assume and expect that everyone living with HIV will disclose, and they rely on this and do not ask questions, do not insist on the use of condoms or any safe sex practices. This causes a false sense of security for people on the dating scene, and indirectly creates a situation where people living with HIV are used as part of screening mechanisms for safe sex practices, with the rationale that a person can rely on prosecution if and when a person does not disclose their status. It places the burden of disclosure on the person living with HIV, and does not emphasize the need for each individual to take responsibility for their own sexual health and well being. Laws will not protect people from contracting HIV, personal responsibity for oneself will.

Two recent court rulings in 2013 and 2014 against women in Canada for non-disclosure of their HIV status highlight how the law lags far behind science in relation to the virtual impossibility of transmitting HIV if one has an undetectable viral load. There is a critical need to decriminalize HIV; there is also a need for everyone to take responsibility for their own sexual health.

Services to support women living with HIV in Canada exist in a splintered fashion and vary from province to province.  In Quebec I have had many conversations with women living with HIV, but there seems to be no clear or definitive answers about why women are so reluctant to engage in services. Service providers do not have the solutions around engaging women in services either. From my own point of view I would like to see more concrete and  practical services which will enable us to learn new job skills to integrate back into the work place.

A human rights focus is needed as much in Canada as it is in the so-called “developing” world. The many components on the continuum of violence towards women living with HIV need to be addressed, including financial inequality, need for adequate housing, job security and human rights-based approaches to employment and care.

There is an obvious need for a national cohesive voice for women living with HIV in Canada. What needs to take place here in Canada, as everywhere, is a serious attempt to practice the meaningful involvement of women living with HIV in the full cycle of all aspects of planning, programme implementation and evaluation. We are the experts, and we alone can identify what our needs are and how they can be addressed. This was clearly demonstrated in the Salamander Trust survey, which has produced the most meaningful and authentic results I have read to date.

World Health Organisation (WHO) guidelines now need to be updated to reflect both the findings of the report, and to reflect recent political and biomedical aspects of the HIV response.

via OpenDemocracy

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Ebola, polio, HIV: it’s dangerous to mix healthcare and foreign policy

A polio worker brings vaccine drops to children in Peshawar, Pakistan. Using health initiatives as a cover for foreign policy can create suspicion of aid workers. Photograph: Fayaz Aziz/Reuters

A polio worker brings vaccine drops to children in Peshawar, Pakistan. Using health initiatives as a cover for foreign policy can create suspicion of aid workers. Photograph: Fayaz Aziz/Reuters

There are reasons to be fearful of the Ebola crisis gripping parts of west Africa: death; the risk of contagion; overburdened health infrastructure; and concern as neighbouring countries worry about what the WHO now admits is an international health emergency.

These difficulties are exacerbated by the population’s fear not just of the virus itself, but also of the health workers there to help.

While this fear is primarily related to contagion, there are other, more deeply rooted factors at play. Mistrust of outsiders, particularly western health workers, is bound up in the history of Africa and colonial medicine. When much of the continent was under colonial rule, great powers used these outposts of their empires as laboratories, and Africans as their test subjects.

Much work has been done through the years to counter this negative legacy: decentralised health systems, collaborations with local partners, training for African health workers, and partnerships between government, civil society and international donors.

The Ebola outbreak underlines how quickly such progress can unravel in times of crisis, and how the legacy of past mistakes by western powers can resurface to speed up that unravelling, to the detriment of health and security locally and globally. Frequently, particularly in the developing world, past failures re-emerge, complicating efforts at crisis management.

In this context, recent revelations from Cuba – where it was revealed that the US Agency for International Development (USAid) had used HIV prevention work as a smokescreen for fomenting political opposition – should ignite a debate about the necessity of keeping the work of public health agencies, security services and foreign policy separate. Where they converge, trust is squandered. And, as we are witnessing in west Africa, mistrust in times of emergency hampers the necessary work and efforts of foreign aid workers hugely.

The so-called “securitisation” of healthcare is not new. The outbreak of HIV set a precedent as the first health issue to be recognised by the UN security council as an explicit threat to international security. While HIV was a genuine global crisis, there have been recent examples in which foreign policy objectives have been cloaked by apparently innocuous public health activities.

In Pakistan, CIA operatives masqueraded as polio vaccinators to gain greater access to Osama bin Laden’s compound. Though the charade fulfilled its security intent, it later resulted in very damaging reversals in local efforts to eradicate the disease. The motive was disguised and trust was spent. Ultimately, the populace – and healthcare workers – suffered.

The ability of western governments and agencies to act as emergency providers of healthcare, and as honest brokers, will be increasingly reduced unless we agree that the provision of healthcare should be sacrosanct and protected from motives best realised by other means.

The “blue water” between global health and international security continues to narrow, as the UK foreign and commonwealth office encroaches further on the Department for International Development. Meanwhile, the US state department continues to treat USAid as an extension of its operations. Health has traditionally been housed in the international development agencies of western governments. However, as with the role and function of aid and international development, global health is increasingly seen as a part of wider international security strategies for protecting populations from threats such as bioterrorism and infectious diseases such as drug-resistant tuberculosis.

Tactical security objectives – however “successful” – should remain separate from international efforts to improve and protect public health. The Ebola crisis has posed incredible difficulties for health workers in west Africa – imagine how difficult it would be to deal with an outbreak where trust was absent at the outset. We are drifting towards a dangerous convergence of health and security policy, one that makes populations less secure and crisis management immeasurably more difficult.

Story via The Guardian

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