By Kassim Mohamed

Holding the holy Quran in her right hand, Amina adjusts her veil. She appears like any other ordinary woman on the streets of Nairobi but Amina has had a recent past full of emotional turmoil.home hiv test, hiv self test, home hiv kit

“A gang of 12 men raped me in turns on January 15, 2008. I passed out. That’s a day I’ll never forget in my entire life,” Amina bitterly says adjusting her veil.

Amina was born and brought up in Mogadishu but moved to Kenya along with her husband and five months old son in 2005. When life became too hard to cope in Nairobi, they relocated to Narok, a small town 200 km west of Nairobi.home hiv test, hiv self test, home hiv kit

With the help of relatives living abroad, the young family started a business: money came in and life appeared rosy. Kenya became a safe heaven and they considered it a home away from home but just until Kenya’s disputed election results were announced. In front of her maid and three-year old son, Amina was gang raped.home hiv test, hiv self test, home hiv kit

“My husband was not around, he left just before the Kenyan election for Mogadishu to see the other two wives and children back there. After the incident I didn’t inform him about what happened. I was too scared; he might consider me as an infidel. He doesn’t know up to now”.

In July 2008, the family left for Mogadishu and settled there for a while. However, the constant violence in the Horn of Africa country saw them back to Nairobi, Kenya.home hiv test, hiv self test, home hiv kit

She went for an HIV test in October 2009 and tested positive and because of the high levels of stigma attached to HIV/AIDS in her community, this 26 year old has not revealed her status to anybody. According to her, the Kenyan elections turned her world upside down.

Medical authorities at Nairobi Women Hospital say more than 300 women were raped during the post-election violence.home hiv test, hiv self test, home hiv kit

When Radio Netherlands informed Amina about the presence of the Chief Prosecutor of The International Criminal Court (ICC), Luis Moreno Ocampo in Nairobi, Amina sighed in relief. But she was soon heartbroken to learn that Moreno Ocampo has categorically stated after his first press briefing on Saturday that he will deal only with the “big fish” – those who bear the most responsibility in fanning the violencehome hiv test, hiv self test, home hiv kit

“I am here in Kenya illegally because my country is unstable. If the International Court can not heal my wounds and bring those who raped me and other women to book, I have little hope that local courts in Kenya will deliver me justice”.home hiv test, hiv self test, home hiv kit

Mr Moreno Ocampo is viewed by many Kenyans as the only hope to see those responsible for the infamous post-election crisis in the country punished. Moreno Ocampo has assured the public that Kenya’s case will serve as an example. He further asked the government of Kenya to protect witnesses who agree to give evidence.

Meanwhile, Amina says she will rather go back to Mogadishu than stay in Kenya during the 2012 general election.home hiv test, hiv self test, home hiv kit

According to Johns Hopkins researcher Charlotte Gaydos, DrPH, participants had no trouble distinguishing between positive and negative results.

Nearly all participants said they would “definitely or probably recommend” self-testing to a friend and would “probably or definitely” perform a test at home if it were available, Dr. Gaydos remarked in an article on WebMD. With further study, she went on to say, home testing for HIV might one day be as routine as pregnancy testing.home hiv test, hiv self test, home hiv kit

“Rapid HIV testing works by detecting antibodies against HIV, just like the kits used by health care workers for routine HIV testing,” says Larry Siebert, CEO of Chembio Diagnostics. Siebert went on to note that rapid, point-of-care (POC) tests such as those his company develops are single test cartridges, similar to pregnancy tests, that use a small sample of oral fluid or whole blood and deliver a visual result in approximately 20 minutes–and one may serve as a viable at-home HIV test.home hiv test, hiv self test, home hiv kit

“The hope for this test is that it can help identify those HIV-positive individuals who are unaware of their status and motivate them to seek immediate medical attention and early treatment,” says Siebert.

The campaign launched to stop such practice must therefore be extremely commended. Unfortunately, there seems to be a paucity of alignment between the message aired out as portrayed in the radio adverts and the continuous reassurance given to persons found to be HIV positive during post-test counselling. home hiv test, hiv self test, home hiv kitFor instance, one of the campaign message aired out against sexual network is to the effect that; once one gets HIV, neither the patient nor the children can ever live a good life. It also expounds that; once either of the married couples (discordant couples put into consideration) or both become infected with HIV, then the children’s future is thwarted completely. First of all, isn’t this message undermining the counselling techniques used on people found to have acquired the virus?home hiv test, hiv self test, home hiv kit

The post-test counselling of a patient found to have the HIV virus is geared towards reassuring the victim that regardless of his/her HIV positive results, he/she can still live a good quality life, with good monitoring.

Secondly, have the proponents against sexual networks put into consideration the children who acquire the virus at birth? Are they aware that some of the children born with the virus in the 1990s are now adolescents, and some are young adults who require constant moral and psychological support? Describing HIV infection as an automatic avenue to hopelessness as portrayed in the aired messages in the media, may tantamount to stigmatisation of the HIV patients. In fact, such kind of message may be discriminatory in character, infringing on the patient’s constitutional right, not to be discriminated against as provided for by (Article 21 of the 1995 Constitution).home hiv test, hiv self test, home hiv kit

The campaign should come up with an appropriate message that strikes a balance between protecting the public health while preserving the human rights and dignity of people living with HIV. They should focus more on revitalising the marriage institution by encouraging couples to observe two major elements; one: Being available for one another and two: showing mutual respect for one another as husband and wife, since a big percentage of sexual networks do arise through search for new companionship.home hiv test, hiv self test, home hiv kit

With due respect to those behind the campaign against sexual networks, the message, as it is being aired out currently, to a great extent, stigmatises HIV patients and increases social rejection, self condemnation and self pity.home hiv test, hiv self test, home hiv kit

David was at the forefront of the barrage. Wide-eyed, young and naïve, I was mesmerized by his swagger and flamboyance. I vividly recall the butterflies in my stomach each time he, while tightly clasping my hand, marched me into queer night at La Luna or Saturday night at the City Nightclub.home hiv test, hiv self test, home hiv kit

Although roughly the same age, David was years ahead of me in terms of liberation and sophistication. One night, nestled on his old yellow couch, he insisted I sit through the history of gay cinema. After Tootsie and during The Rocky Horror Picture Show, he decided to talk numbers with me. His? 62.home hiv test, hiv self test, home hiv kit

At that point in my gay evolution, he may as well have told me he his number was infinite. Although I had certainly racked up a modest handful of bedpost notches, mentally I may as well have lived in a nunnery. I was stunned and horrified. I panicked, convinced we were riddled with STDs. I stopped returning David’s calls the next day.home hiv test, hiv self test, home hiv kit

The trepidation I felt then isn’t totally unlike the angst I feel now when I make mistakes of the sexual variety. Fear often drives us to—and through—our inevitable firsts. Soon after David’s declaration, I scheduled an appointment with my family doctor, thus beginning another major gay rite of passage.home hiv test, hiv self test, home hiv kit

It felt like I sat in my doctor’s waiting room for hours; its pale pastel walls and stale décor only intensified my discomfort. Loud children squirmed in parents’ laps; their sneezing and coughing worsened my paranoia. When I finally saw my doctor face to face and explained why I needed a test, he scolded me—berating me at length and encouraging me not to. The last thing I wanted, he argued, was insurance companies deeming me “high risk,” because they’d surely penalize me for it.home hiv test, hiv self test, home hiv kit

“Go home, I’m sure you’re fine,” he assured me.

After much pleading, he caved. I had blood drawn, went home, and my dreaded two-week wait began. It seemed like eight months before the nurse called to give me my result.home hiv test, hiv self test, home hiv kit

What a difference time makes.

A couple of weeks ago, a familiar uneasiness consumed me as a comrade and I sauntered down Stark Street to the Men’s Wellness Clinic to get our now frequent, regular tests. We approached the clinic in a deluge of pounding rain, nervously evaluating our risk levels, discussing interesting strategic choices we’d recently made. To lighten the mood, my friend introduced us to the staff as lovers.home hiv test, hiv self test, home hiv kit

“We’re desperately in love,” he said. “And we’re ready to take it to the next level.”

The dewy receptionist, incredibly friendly, played along.

“Really,” he insisted. “Look, we even dressed alike.” We had, albeit inadvertently.

After we procured our letters—you’re assigned letters (for rapid HIV tests) or numbers (full STD screenings), based on your testing preference—we examined the scene and took our seats on large leather couches in the back corner. Aside from a handful of new magazines, Garden State helped pass the time. Shockingly, my friend hadn’t ever seen it (“I only like blockbuster romantic comedies and porn!”), so the movie provided a nice distraction.home hiv test, hiv self test, home hiv kit

I looked around the room, noticing how it contrasted with my earliest experiences. No screaming children. No ghastly pastels or floral prints. Instead, CAP offered serene, queer-friendly ambiance.

As I was called back, my anxiety arose and, once inside the room with the testing liaison, abruptly subsided. I used the poor soul as a de facto counselor, spilling all, sharing every sordid sexual detail, hoping he was happy to listen. Yeah, I totally let him put it inside me, but I made him pull out. Doesn’t that count for something?home hiv test, hiv self test, home hiv kit

“Well, we call it strategic positioning,” he told me.

Perfect. I was all about strategic positioning. And strategic maneuvering.

I jest, of course—the safer the better, people. I told my de facto counselor about how my family doctor argued against testing. He seethed. We were about the same age, so we talked about the olden days when an excruciating two-week wait was customary. He told me how a slightly impatient younger generation balks at a twenty-minute wait. I imagined my younger self thrilled by it. As I received the good news, I marveled at how much things change—and don’t.home hiv test, hiv self test, home hiv kit

“I came here from North Kivu Province with my husband and our two children. When I got pregnant, the doctor asked me to do an HIV test. I thought it was not necessary. I was married for years, why would I be HIV-positive?

“When the results came a few days later I was shocked. I didn’t know much about HIV other than if you have it, you are going to die. I went back home and told my husband about my status. He was furious, we had a fight and after that he left. I have no idea where he is now.home hiv test, hiv self test, home hiv kit

“All I know is that I gave birth to our third child two days ago and he doesn’t even know about it. I wonder if he even cares. If he did, he would have looked for the other two children; he never has since the day he left us.

“Since finding out my HIV status, I enrolled in the counselling programme in the camp. I go there once a week. It helped, I think. At least now I know I am not the only person going through this and that I should not be ashamed of it.home hiv test, hiv self test, home hiv kit

“If you are HIV-positive you are stigmatised in your community. I lost many friends. People just don’t talk to me, and they don’t care that maybe it is not even my fault if I got sick. I am very angry as I still cannot understand how that could happen. My only partner was my husband.

“The doctors told me to follow the prevention of mother-to-child-transmission programme for my new-born. In six months, we will know if he is HIV-positive as well or not.home hiv test, hiv self test, home hiv kit

“This is the only thing I can do to maybe save my son’s life. I am taking [life-prolonging antiretroviral drugs] ARVs myself. I need to be as healthy as possible. If I were alone, I would probably let myself die, but I have to do this for my children.”home hiv test, hiv self test, home hiv kit

“Sixth Street is well-trafficked by many San Franciscans most vulnerable to HIV infection,” Barbara Kimport, interim CEO of SFAF, said in a statement. “By introducing HIV testing to places like 6th Street where HIV continues to be a major problem, we move one step closer to radically reducing new infections in San Francisco.”home hiv test, hiv self test, home hiv kit

HIV screening will be available each Friday at SFAF’s client services headquarters at 1 6th Street between 3 and 5 p.m. and at the agency’s needle exchange site at 117 6th Street between noon and 2 p.m.

New services on 6th Street include RNA and routine HIV antibody testing, as well as hepatitis C testing. As part of a comprehensive approach in neighborhoods with high HIV incidence, SFAF works collaboratively with local service providers including the South of Market Health Center, Tom Waddell Health Clinic, Tenderloin Health, and the ISIS Clinic at San Francisco General Hospital.home hiv test, hiv self test, home hiv kit

The new testing services are being promoted on a large billboard directly across the street from SFAF’s offices. That effort is a part of a new collaboration between the agency and the “Greater Than AIDS” campaign, a national movement to mobilize hard-hit communities in response to AIDS, with a focus on reaching African Americans.home hiv test, hiv self test, home hiv kit

For more information, visit www.sfaf.org.

Sisters’ video project seeks materials
The Sisters of Perpetual Indulgence are collecting video of Sister performances and appearances over the last 30 years and are seeking any archival material. The group is digitizing this material onto external hard drives for future preservation. So far, said Sister Vicious Power Hungry Bitch, the group has digitized approximately 50 hours of material from the 1980s and 1990s.home hiv test, hiv self test, home hiv kit

If people have any material, they are asked to contact Sister Vicious. The Sisters can accept VHS, Hi8, DVD, and other formats. Materials can be home movies of Sister events people may have attended or more professionally produced material. Originals will be returned to owners after the material is added to the Sisters’ library. The group has until the end of April to complete the project.home hiv test, hiv self test, home hiv kit

While more men than women have the disease, female numbers continue to grow.
“One in four people living with HIV are women,” said Holly Jordt, a nurse at Family Planning. “It’s time for women to get tested.”
Susan said she never expected to find herself as one of these statistics.home hiv test, hiv self test, home hiv kit

Her story begins in Montana where she grew up. Susan, now 42, said she left home at 18, fell in love, got married and had a baby. It had the makings of a feel-good Hallmark movie until the plot took a terrible turn.
Susan was alone at home with her 5-month-old baby when a knock at the door changed her life forever.
A representative from the health department told her that she had been exposed to HIV.home hiv test, hiv self test, home hiv kit

“I said, ‘What’s that?’” she recalls. “They said ‘That’s the virus that causes AIDS.’ I said, ‘You’ve got the wrong door.’ It took a lot of convincing for me to get tested.”
She argued that she wasn’t gay and didn’t do drugs. Women, especially those in a committed relationship, weren’t considered at risk in 1991 when she was 23.home hiv test, hiv self test, home hiv kit

Health department officials didn’t disclose who provided her name but her husband, who died in 1994, later told her that he was the person who sent the health officials to her door.
When she tested positive, Susan was terrified for her tiny daughter who had been born prematurely weighing just three pounds, 12 ounces. She had to wait two weeks for her daughter’s results.home hiv test, hiv self test, home hiv kit

“I thought I had killed her,” she said. “That was the longest two weeks of my life. I couldn’t even set her down.’”
Two weeks later, Susan got the results showing that her baby had a 90 percent chance of not being infected. She had to wait three more years to receive a clean bill of health for her child.
At the time, she was consumed with anger toward her husband. Susan had trusted him completely and now she faced a potential death sentence.home hiv test, hiv self test, home hiv kit

“I needed to blame someone,” she said.
Since then, Susan has come to realize that he did not knowingly infect her with the virus. Ignorance of the threat of the virus killed him and condemned Susan to a lifetime of battling to stay alive via an ever-changing cocktail of drugs.
“You’re responsible for your own health,” she said. “With education, I would have realized how susceptible I was as a woman.”home hiv test, hiv self test, home hiv kit

Just six months into her fight, she decided to risk her privacy in the interest of making a difference.
She talks to young people in many settings.
“If I can save one life, it’s worth it,” she said. “It’s easy to avoid.”
For her courage, Susan was honored with the Governor’s Award for HIV Awareness in 2008. She speaks simply but directly about how a person does and does not acquire the disease.home hiv test, hiv self test, home hiv kit

She delineates the four bodily fluids of HIV virus transmission — blood, semen, vaginal secretions and breast milk — and the routes into the body. Her audience learns that any activity that exposes a person to these fluids put them at risk for an HIV infection.
She underscores that saliva and urine do not transmit the disease.
Susan finds some people refuse to believe that they won’t become HIV-positive from casual contact. They also blame the victims for becoming infected.home hiv test, hiv self test, home hiv kit

“There’s a certain part of society that can’t be taught — they think you must have done something to have this,” Susan said. “My family is like that.”
Her partner of 13 years, who was a friend first, provides proof that protected sex works. She points out that he has not become positive from casual contact living in close quarters with her.
“He feels the stigma as much as I do,” she said. “It’s scary — they’re afraid of the unknown. I never knew what prejudice was until I got this disease.”home hiv test, hiv self test, home hiv kit

In spite of all the publicity about HIV in the last 18 years, Susan said she hasn’t seen the stigma decrease. She hopes at least that more people use condoms and both get tested, ideally before embarking on an intimate relationship.
After her talks, Susan said some confide in her that they had unprotected sex, often under the influence of alcohol, and ask her advice. She encourages them to get an HIV test and take command of their health and safety.
“For women and girls, it’s easy to avoid if you’re empowered,” she said. “If you can’t say no, make sure you use a condom.”home hiv test, hiv self test, home hiv kit

Judging from her own daughter and her friends, Susan said the young still feel invincible even from AIDS. She added that young and old alike disconnect from sexually transmitted diseases with permanent birth control in place.
“You can get pregnant a few days a month,” she said. “You can get a STD any day of the month.”
Statistics of risky behavior show many young people don’t practice abstinence or safe sex. A 2009 survey of Montana youths in grades 9 through 12 revealed an average of 48 percent had sex; 68 percent used a condom during their last encounter.home hiv test, hiv self test, home hiv kit

Since 1985, almost 600 people have been diagnosed with HIV in Montana. In 2009, another 31 Montanans got the devastating news that they were HIV-positive.
This number was almost 30 percent higher than 2008. Deaths since 1985 have numbered 382.
Susan has been fortunate in recent years to find a combination of five drugs that have kept her healthy enough to finish schooling and work at a job. It was much tougher in the earlier days when she took up to 25 pills a day with terrible side effects.home hiv test, hiv self test, home hiv kit

“Most of the ’90s, I wasn’t able to work,” she said.
She has fought off bouts of pneumonia, shingles, thrush and yeast infections. Her blood is tested every three months to monitor when the virus becomes resistant to her drugs.
When that happens, she starts a new combination that makes her violently ill during the first weeks. Susan always faces the temptation to stop the drugs since she feels better off them.home hiv test, hiv self test, home hiv kit

Still, she feels gratitude that she lived to raise her daughter and remains in relatively good health with improvements in therapy over the years.
“The meds have made leaps and bounds,” she said. “It’s amazing what they’ve done. I never thought I would live this long.”
Susan worries that her appearance of good health might diminish her impact with the students. She makes the point that AIDS remains a fatal disease.home hiv test, hiv self test, home hiv kit

“I don’t want them to think you just take a pill. Side effects can be very debilitating,” she said. “It’s a strict regime. If you miss a dose you risk mutation of the drug.”
The financial burden can be substantial. Susan’s drugs cost $2,500 a month and cause numerous side effects over time.
Some people get diabetes and clogged arteries or suffer body changes such as fat accumulating as a buffalo hump on men or around the middle on women.home hiv test, hiv self test, home hiv kit

“It’s a less-than-ideal way to live,” she said. “I hope they [students] go home and share this with their parents and it starts a conversation. Maybe they’ll think ‘I should get tested.’”home hiv test

Ms. George’s first child died at 13 months, likely due to HIV infection, and the Lesotho Ministry of Health is working to ensure that her second baby is not born with HIV as well.

In 2007, the Government, with help from UNICEF and other partners, initiated a massive effort to improve the country’s Prevention of Mother-to-Child Transmission (PMTCT) services. To succeed, they needed to ensure that every clinic in the country could provide HIV testing and treatment.home hiv test, hiv self test, home hiv kit

Lesotho leads the way

Lesotho became one of the first countries in the region to allow nurses to administer anti-retroviral (ARV) treatments, which greatly expanded access to these critical interventions in the remote areas of the country where fewer doctors are available.

But despite such efforts, major challenges remain, including the fact that many women, like Ms. George, are likely to make only one clinic visit. home hiv test, hiv self test, home hiv kit

This is a typical problem for many health systems in Africa. Though ARV drugs can increase the chances that a baby is born free of the virus, providing HIV-positive mothers with the treatment is not easy, especially in remote areas. The combination of distance, lack of transport and poverty prevents many women from making regular antenatal care visits. Such factors also lead many women to drop out of the PMTCT programmes, and to deliver their babies at home without the presence of trained medical professionals.home hiv test, hiv self test, home hiv kit

In a country such as Lesotho, where one in four people is living with HIV, that one antenatal visit has become all the more critical.

Keeping mother and child healthy

Innovative prevention methods are also making a huge difference. The Lesotho Government has designed a minimum package for expectant mothers like Ms. George that includes the most effective ARV drugs and antibiotics needed to keep them, and their children, healthy. When they leave the clinic, these women are also provided with clear instructions on what medicines they need to take – and when – and what medicines they need to give to their babies after their birth.home hiv test, hiv self test, home hiv kit

In an effort to expand this public health innovation ever further, UNICEF and WHO have created a colour-coded take-home box that will be rolled out to five countries in eastern and southern Africa, Lesotho included, by July. Instead of the nurses having to pack the medicines all in small pill bags, this new ‘Mother to Baby Pack’ clearly separates the ARV drugs and the antibiotics according to when they need to be taken. home hiv test, hiv self test, home hiv kit

“We had to take advantage of the first antenatal visit,” said UNICEF HIV and Maternal Health Expert Blandinah Motaung. “In case a woman delivers at home, she will have that package with her.”

A dramatic drop in infections

With the new regimen of ARV treatments, and the efforts to facilitate women in taking these medicines at home, health experts expect the number of babies born with HIV in Lesotho to drop dramatically. home hiv test, hiv self test, home hiv kit

“The expectation is that with better adherence to the treatment and more focus on helping mothers to exclusively breastfeed for six months, we can further reduce the transmission rate to less than five per cent,” said Ms. Motaung.

Take home medicine

After her check-up, Ms. George listened carefully to Marethabile Lelia, the clinic nurse, give instructions on the medicines that she would be carrying home, and a mother-to-mother counsellor reiterated the importance of sticking to her treatment.home hiv test, hiv self test, home hiv kit

Although Ms. George has another appointment scheduled at the clinic, Ms. Lelia doesn’t expect to see her until she returns with a six-week-old for the baby’s first round of immunizations and first HIV test – children are again tested at 12, and then 18 months.

As she prepared for her five-hour walk home, Ms. George clung to her medicines, understanding clearly they represented her best hope of ensuring that her baby would escape infection and grow up healthy.home hiv test, hiv self test, home hiv kit

Dessaix had planning to attend the Shanghai International Literary Festival and also had been invited to speak in Beijing and Chengdu.

China’s travel ban dates back to the 1980s when the HIV epidemic first emerged in the country. It now has one of the fastest growing HIV epidemics in the world. home hiv test, hiv self test, home hiv kit

Dessaix was reported to be “humiliated” and “insulted” by the refusal of the Chinese authorities to grant him entry.

Regulations state that all short-term visitors to the country must state that they are HIV-negative. Those planning stays of six months or longer in China are required to have an HIV test.

A temporary waiver was issued in 2008 to allow people with HIV to attend the Beijing Olympics. It was understood that the country’s health ministry aimed to fully repeal the ban in time for a trade exposition that opens in Shanghai on May 1st this year. home hiv test, hiv self test, home hiv kit

Over 90 Australian literary figures have signed an open letter protesting at the decision of the Chinese authorities to forbid Dessaix to enter the country because of his HIV infection.

Meanwhile, the announcement by the South Korean government that it has lifted its country’s restrictions on entry by HIV-positive foreign nationals has been described as an “empty gesture”. No legislation has been put in place to make the change legally binding. home hiv test, hiv self test, home hiv kit

Indeed, a bill is currently before the country’s national assembly which calls for the mandatory HIV testing of all foreigners hoping to work in the country. The draft legislation has its origins in anti-western feeling in South Korea promoted by the Spectrum group which has sought to portray foreigners as HIV-infected, child abusers and sexual predators. The preamble of the bill states: “”Nowadays, the number of foreigners working in Korea is increasing, but a good many have previous convictions for drug and sexual crimes or carry infectious diseases.”home hiv test, hiv self test, home hiv kit

Today, despite the progress made in research, about 60 per cent of HIV-infected patients are still not treated.

“I’m very furious,” said the 2008 Nobel Prize of Medicine winner. “I’m furious also to see that people are discriminated (against).”

The self-described “scientist-activist” also lamented that “we will not reach the (global) objective of universal access to treatment by 2010″.

In Singapore’s case, “the stigma, the fact that they (people) have to pay everything, it’s the worst condition for stimulating people to be tested and treated”, said Professor Barre-Sinoussi.home hiv test, hiv self test, home hiv kit

Free testing, free treatment

Prof Barre-Sinoussi, who was at the Biopolis last week to share her latest research findings on natural protection against Aids, said she was initially impressed with Singapore’s “wonderful facilities”. “Then, I rebalanced my positive view,” she said.

Singapore’s proportion of new HIV cases – there were 456 in 2008 and 423 in 2007 – to the general population is “a little more” compared to France, said the research director. Throw in “stigma and discrimination” – the No 1 barrier to tackling HIV/Aids – and the figures are probably under-reported, she said.home hiv test, hiv self test, home hiv kit

“Coming from a country (France) where everything is free, this is difficult to accept,” she added.

“HIV, like cancer, is a very severe deadly disease and should be considered as 100 per cent free for patients,” she stressed.

When contacted, the Ministry of Health (MOH) agreed that the stigma of HIV was “still prevalent” here.

It is working to encourage greater acceptance of people with HIV. home hiv test, hiv self test, home hiv kit

But MOH pointed out that unlike France, where the state-funded healthcare system “means a higher tax burden”, Singapore’s approach of “heavy Government subsidies and co-payment” allowed for affordable healthcare without heavy taxes.

“Like all other patients, HIV/Aids patients have access to subsidised … care,” said MOH. Patients here can use Medisave and Medifund.

HIV prevalance among Singapore residents is “similar” to other developed nations, said MOH. home hiv test, hiv self test, home hiv kit

It was about 0.1 to 0.2 per cent last year, while UNAIDS 2008 figures showed France’s HIV prevalence at 0.4 per cent.

MOH said it had “expected” that more HIV-infected people would be discovered as MOH encouraged testing. Over half of 2008’s new cases had late-stage HIV infection.

But what is the cost to the economy when young people who should be working die, asked Prof Barre-Sinoussi, suggesting that Singapore conduct studies to determine the cost. “The answer (in similar studies) was clearly in favour of access to free treatment,” she said.

Action for Aids’ executive director Lionel Lee said free treatment subjects the healthcare system to abuses and “may not translate to long-term economic benefits” because of the side effects of HIV medication.home hiv test, hiv self test, home hiv kit

Furthermore household members of index patients who tested HIV positive were 54% less likely to accept VCT (voluntary counselling and testing) than household members of patients who tested negative, and 78% less likely if the index patient had been tested at home.

The researchers suggest that this is not because HIV was explicitly discussed in households with an HIV-positive member, and people were afraid to test, but rather the opposite: the stigma of HIV meant that HIV testing was less likely to be discussed and normalised in households both where someone did have HIV, and in households where someone did not have HIV but feared they did.

The researchers conclude that “community-level interventions are needed to mitigate the effects of HIV stigma” in order to improve VCT rates and address a situation where the very people more likely to have HIV are those less likely to take a test.

Reference
Charlebois E et al. Impact of anticipated and actual HIV status on referral and acceptance of household testing in Kampala, Uganda. 17th Conference on Retroviruses and Opportunistic Infections, San Francisco, abstract 1008, 2010.

Source: Aidsmap

It also found that those who thought they had HIV were significantly less likely to refer members of their household for HIV testing than those who did not think so.

And it found that if a study member did test HIV-positive, members of their household were much less likely to accept the offer of an HIV test than members of households with no HIV-positive member.

The survey was jointly conducted by researchers from the University of California, San Francisco and Makerere University, Uganda.

The study enrolled 419 patients of unknown HIV status who presented for tuberculosis (TB) evaluation at the Uganda National TB and Leprosy Control Agency in Kampala, Uganda, because their household included someone with active TB. Further details of the study can be viewed on the Makerere University website here.

The patients were part of a study that randomised HIV testing of the patient and members of their household to on-site testing at the TB clinic or to home-based testing by mobile health workers.

Before receiving their test result (in either setting), index patients were asked what they anticipated the result would be and how willing they were to refer other household members for clinic-based or home-based testing.

After they received the result, other household members were asked how willing they were to accept an HIV test (regardless of whether the test result was disclosed).

Most participants were male (62%) and their mean age was 31. Just over 40% of participants were married, just under 40% never had been, and the remaining 20% were separated or widowed.

The first striking finding was that far more participants thought they had HIV than actually did. The actual HIV prevalence in the group was 19% (80 individuals), but fully two-thirds of the group (276 individuals) anticipated a positive result. In fact:

• 18% correctly assumed they were HIV-positive

• 33% correctly assumed they were HIV-negative

• Only 1.4% of the group thought they were HIV-negative when they in fact had HIV

• 48% of the group thought they were HIV-positive when they did not have HIV.

Source: Aidsmap

Facts – Screening Blood for HIV

    - On March 2, 1985, the U.S. Food and Drug Administration (FDA) approved
      the first-ever diagnostic test to screen blood donors for antibodies to
      HIV. This first test was developed by Abbott.
    - The first test to screen donors for exposure to the virus took nine
      months of around-the-clock work by dozens of Abbott scientists to
      develop.
    - U.S. Health and Human Services (HHS) Secretary Margaret Heckler
      announced FDA approval
      (http://www.fda.gov/ForConsumers/ByAudience/ForPatientAdvocates/HIVand
      AIDSActivities/ucm151074.htm) of the first test at a news conference
      in Washington, D.C. The screening test was immediately adopted by the.
      American Red Cross (http://www.redcross.org/) and other blood
      organizations.home hiv test, hiv self test, home hiv kit

Facts – HIV

    - In 1985, the virus was widely called HTLV-III
      (http://www.thebody.com/Forums/AIDS/SafeSex/Archive/origins/Q8777.html).
      The International Committee on Taxonomy of Viruses
      (http://www.ictvonline.org/index.asp?bhcp=1) changed the name to Human
      Immunodeficiency Virus (HIV) in May of 1986.home hiv test, hiv self test, home hiv kit
    - The Centers for Disease Control and Prevention (CDC)
      (http://www.cdc.gov/hiv/topics/surveillance/index.htm) estimates that
      there are 56,000 new cases of HIV in the United States annually, down
      from an estimated peak of 130,000 new cases in the mid-1980s.
    - In 2008, UNAIDS (http://www.unaids.org/en/default.asp) estimated
      that 2.7 million people throughout the world are newly infected with
      HIV each year, primarily in Sub-Saharan Africa.
    - Women account for 50 percent of adults living with HIV globally.home hiv test, hiv self test, home hiv kit

This is Regan Hofmann, who has been living with HIV for 14 years.

Hofmann grew up in Princeton, N.J., and graduated from the private, co-ed Princeton Day School and Trinity College in Hartford, CT. Soon after, she married and moved to Atlanta, GA, with her husband, where she was hoping to find a writing job. Then the marriage failed.home hiv test, hiv self test, home hiv kit

After her divorce at 28, Hofmann started dating a man.

“I had sex without a condom twice,” she says.

She never imagined her boyfriend was HIV positive.

“He seemed so clean and safe. He had a nice family. He sang to me and let me drive the boat, with his arms wrapped protectively around my shoulders, when we went waterskiing,” she said.home hiv test, hiv self test, home hiv kit

He was the kind of man she’d bring home to her family. She didn’t know that he had a sore on his leg that would not heal. He did not know the implications of his sore.

But Hofmann knew that shortly after unprotected sex – when she and her boyfriend were in the process of breaking up – she had a swollen lymph node in her upper leg. She went to the doctor, who gave her an HIV test.

He gave her the results with these words: “I don’t know how to tell you this, so I am just going to tell you. Your blood work shows that you are HIV-positive. I am so sorry.”home hiv test, hiv self test, home hiv kit

Back then, Hofmann considered HIV a death sentence. But instead of “planning for my impending death and a graceful demise with a service of song, dance, drink, and celebration,” she is now “completely and thankfully healthy.”

She estimates that she has consumed over 48,000 pills over the past 14 years – mostly protease-inhibitors, which have kept the virus at bay. Today, her regime is down to three pills a day.home hiv test, hiv self test, home hiv kit

She has never had a negative reaction to the drugs or suffered ill effects from HIV. She sums up her good health by saying, quite calmly, “You can have a normal life with HIV.”

Her ex-boyfriend died five years ago from complications of AIDS. Hofmann says he didn’t know he had the virus or that he was passing it along to her. She says he was not “a gift-giver” – a person who knowingly and intentionally passes along HIV.home hiv test, hiv self test, home hiv kit

Hofmann tells her story in an exceptionally well-written book, I Have Something to Tell You. It reads like a novel and is selling well. (”Even my plumber has read it,” she confides.)

She says that writing the book – and more importantly, telling the truth about life with HIV – was “a new beginning.” It led her to become an activist and gave her life a mission: “to tell everyone in the world willing to listen how to prevent getting HIV, how to get tested, how to get proper treatment in order to live, and how to change the insulting stigma so often associated with the disease.”home hiv test, hiv self test, home hiv kit

Hofmann fulfills her mission in several ways: She is editor-in-chief of POZ, a national magazine for people living with HIV and AIDS. And she recently joined the board of directors of AmfAR, The Foundation for AIDS research, by far the most important organization of its kind in the U.S.home hiv test, hiv self test, home hiv kit

Despite years of hard work, Hofmann worries she’s not doing enough. She’s deeply concerned about the current state of the pandemic.

“The world and America are suffering from ‘AIDS apathy,’ ” she says.

The numbers she reels off are proof that there is no reason for complacency: Every nine seconds, someone in the world is diagnosed with HIV; 33.4 million people are estimated to be living with the virus, and 25 million have died from AIDS to date. The numbers, she says, “make the HIV/AIDS pandemic far and away the worst medical catastrophe to have visited humankind since the Black Death struck Europe in the 14th century.”home hiv test, hiv self test, home hiv kit

Hofmann is concerned about the disease’s effect on women, particularly African-American women. AIDS is the number-one killer of women between the ages of 15 and 44 worldwide; in the U.S., 27 percent of people infected with HIV are female and disproportionately African-American (although the good news is that African-American men are more likely to get tested than other racial and ethnic groups).home hiv test, hiv self test, home hiv kit

“Women are not in a position of power when it comes to sex,” says Hofmann, when asked about the discrepancy in numbers. She talks of women she has seen in her travels who are caught up in the sex trade.

“They have sex to make money to buy food to feed their children. They make more money if they have sex without a condom – almost five times more than if they have sex with a man who uses one,” she says.home hiv test, hiv self test, home hiv kit

She sees the development and use of microbicides as one of the most promising preventive interventions to emerge over the past decade. She says they are an effective weapon against HIV/AIDS for young girls forced into early marriage in sub-Sahara Africa and other parts of the developing world. These young women are often infected by their older husbands, who have had unprotected sex with HIV-positive prostitutes.home hiv test, hiv self test, home hiv kit

Hofmann’s activist work has taken her as far away as Vietnam and as near as Greenwich, CT. She remembers a visit to a Greenwich middle school, when a supervisor warned her not to answer any questions about sex, and a 12-year-old male student asked her if it was safe to keep a condom in his wallet. Hoffman plowed ahead and answered him: “Just make sure that you check the expiration date on the condom and don’t use it if it has expired.” The student shot back: “Oh, I’ll get to it long before it expires.”home hiv test, hiv self test, home hiv kit

Hofmann is frustrated with Americans’ views about sexuality education. She quotes her mother: “Condoms are like Band-Aids and gardening gloves: they’re just a protective device.” She wishes that every parent and teacher would use this wise analogy.

She has wonderful ideas for HIV/AIDS prevention. She’d like to see HIV-prevention ads run during halftime of the 2011 Super Bowl.home hiv test, hiv self test, home hiv kit

“Why can’t we discuss how football and the leadership idolatry it creates be leveraged to help educate American youth about sexual health?” she asks. “Give us one cool player from each team mentioning the use of ‘safe sex,’ and maybe a cheerleader or two, and that should get the nation’s attention!”

She favors teaching young people decision-making skills in sex ed, so that in the heat of the moment, they will have the skills they need to discuss using condoms or not having sex.home hiv test, hiv self test, home hiv kit

“Courses have to be much more explicit than most presently are, and young people need to practice putting condoms over rubber penises in the classroom. They also need to learn to put them on in the dark,” says Hofmann.

“Sex isn’t just kissing or intercourse; it’s everything in between,” she adds.

For Regan Hofmann – whose story has given her a global vision and global work – preventing HIV is about self-esteem, human rights, and personal dignity. She will spend her life doing everything in her power to removing its stigma and stop the virus from infecting more women and men.home hiv test, hiv self test, home hiv kit

That is what Hofmann has to tell us.

Will we listen?