Archive for the ‘HIV & AIDS’ Category

June 25, 2013

HIV/AIDS Policy and Prevention Cannot Succeed if Sex Workers Are Stigmatized

by Anna Forbes

In a ruling praised by organizations working on HIV/AIDS policy and prevention, the U.S. Supreme Court last week struck down a decade-old law forcing groups that receive government money in a global anti-AIDS program to embrace a policy opposing prostitution.

By a vote of 6-2, the Court ruled that the Anti-Prostitution Pledge in the President’s Emergency Plan for AIDS (PEPFAR) violated the First Amendment rights of U.S.-based organizations and was therefore unconstitutional.

PEPFAR funding is allocated to implement the 2003 United States Leadership Act against HIV and AIDS, Tuberculosis, and Malaria. While a major step forward in terms of overall investment in global health (and particularly in the HIV/AIDS response), the Act contains some insidious provisions, one of which is the Anti-Prostitution Pledge (APP), which states that “no funds, “may be used to provide assistance to any group or organization that does not have a policy explicitly opposing prostitution and sex trafficking,” and that “[N]o funds…may be used to promote, support, or advocate the legalization or practice of prostitution.”

The APP required, as a condition of funding, that all PEPFAR grantees write and adopt an explicit agency policy condemning sex work. Under this policy, grantees could not use any of their funding (including money received from other sources) on activities in any way related to sex workers’ rights. This resulted in the reduction or complete elimination of HIV prevention and treatment services for sex workers in numerous countries — including the de-funding of USAID-identified best practices programs.

Legal challenges to the constitutionality of the APP were brought by the Alliance for Open Society International (AOSI) and Pathfinders International in 2004; InterAction and the Global Health Council later joined the case.

Chief Justice John G. Roberts wrote in the majority opinion: “This case is not about the government’s ability to enlist the assistance of those with whom it already agrees. It is about compelling a grant recipient to adopt a particular belief as a condition of funding. By demanding that funding recipients adopt — as their own — the Government’s view on an issue of public concern, the condition by its very nature affects ‘protected conduct outside the scope of the federally funded program.’”

He added that although the government has a legitimate interest in controlling how PEPFAR funds are spent, it cannot require grantees to “pledge allegiance to the government’s policy of eradicating prostitution.”

The majority opinion was supported by Justices Samuel Alito, Stephen G. Breyer, Ruth Bader Ginsberg, Anthony Kennedy, and Sonia Sotomayor, with Justices Antonin Scalia and Clarence Thomas dissenting. Justice Elena Kagen, who had worked on the case while Solicitor General, recused herself.

It remains to be seen whether the Supreme Court decision will enable funded organizations based outside of the United States to abandon compliance with the APP without risk. The Court’s decision affirmed that U.S.-based agencies are protected under the Constitution but was not clear on whether agencies based outside of the United States, without the Constitution’s First Amendment purview, were similarly protected.

Despite this ambiguity, the decision is a clear win for those who uphold the human rights of sex workers and support access to the peer-based programming that has been shown to effectively reduce their vulnerability to HIV, as well as other health risks and human right violations.

Globally, sex workers are identified by UNAIDS and others as one the three “most at risk populations” (MARPS). In its 2011 report “Guidance for the Prevention of Sexually Transmitted Infections,” USAID wrote that countries receiving PEPFAR funding “should take steps to ensure that scale-up of prevention programs for MARPs is accompanied by appropriate protections of their rights, including the review of policies and regulations that criminalize or deter MARPs seeking services and training for service providers to reduce stigma and discrimination.”

Grantees’ ability to follow this guidance, however, was directly impeded by the APP requirement that grantees not only adopt an anti-prostitution policy but also distance themselves from any “organization that engages in activities inconsistent with the recipient’s opposition to prostitution and sex trafficking.”

Rather than risk funding loss, many grantees simply eliminated any sex worker-related services they had been providing. In a survey of staff in PEPFAR-recipient agencies, the Center for Health and Gender Equity (CHANGE) found that “19 of the 31 people interviewed in the field reported that they censored themselves or their organizations as a result of the pledge. Almost all contracting agencies reported that they have cleared their websites of references to sex workers or rights.”

In Bangladesh, for example, a drop-in center program recognized as a UNAIDS “best practices” model was defunded (losing 16 of its 20 centers) after the international NGO funding them decided to err on the side of caution in compliance with the APP. These drop-in centers provided homeless street-based sex workers with sanitation facilities, a place to sleep, temporary safety, condom counselling and promotion, and skills-building opportunities to facilitate transitioning out of sex work for those wishing to do so.

Hazera Bagum, director of the Bangladesh program, told CHANGE, “They came in and rested, educated themselves and talked to each other about effective HIV prevention … The monthly condom distribution rate used to be very high, but since the closings, there is less access, so sex workers are not using as many condoms. They distribute fewer every month.”

It is impossible for the U.S. government, or any government, to stigmatize people on one hand and simultaneously help them to reduce their HIV risk on the other. Gay men know the truth of this, as do women, as do people of color, as do sex workers, as do we all.

Now, at least, the Supreme Court has stopped Congress from insisting that its U.S.-based grantees attempt the impossible in this particular case. We have a long way to go, but this is progress.

Plus: For a broader view of how this fits into advocacy for sex workers rights, particularly with regard to HIV, read “Solidarity with Sex Workers: On the Agenda or Under the Bus?

An advocate, organizer and writer, Anna Forbes has worked on HIV/AIDS policy since 1985 and on women’s health and rights since 1977. Now an independent consultant with an international client base, her work centers around women, HIV, gender, health and rights.


December 13, 2012

From Prevention to Palliative Care: Changing the Face of HIV/AIDS Outreach in Rural Nigeria

By Eyitemi Mogbeyiteren

In 2011, three members of our outreach team were kidnapped in the Delta State of Nigeria. We were held captive for several weeks, during which we were repeatedly raped, and only released after a ransom was paid to the kidnappers. Soon after, we learned that all three of us had tested positive for HIV.

My name is Eyitemi Mogbeyiteren, and I work with Women for Empowerment, Development and Gender Reform. Our goal is to ensure that poor grassroots women in the South-West region of rural Nigeria have information on their bodies and health, adapted from the trusted book Our Bodies, Ourselves, so they make choices that protect their reproductive and sexual needs and dignity.

HIV is rarely talked about in our community, and people living with the virus are inevitably discriminated against and cast out by their friends and family. Over the years, our organization has worked hard to unravel myths about the virus — its transmission, prevention and treatment — and fight the terrible stigma and isolation faced by those infected.

But as more people become ill, we continue to see families despair and grieve as their loved ones die without medicines, care and support. Drugs cost approximately $15,000 per person in my community — an amount that is beyond the grasp of many people!

After being diagnosed, I experienced a lot of the same discrimination and isolation. I was shunned in my community and my family stopped speaking to me for a long time. With my own health failing, there were many moments when I felt I could not live, could not stand people saying things about me.

It felt like the end of the road, until I decided to raise my voice and change the fear and shame into something positive.

We are now expanding our HIV/AIDS outreach to include palliative care — care that relieves not only the physical but also the emotional, spiritual and socially generated suffering faced by a person infected with the virus. It is one of the most valuable services that can be offered to someone with terminal illness and their family. Unfortunately, it’s availability in my community is zero!

Using Our Bodies, Ourselves as our tool yet again, our plan is to train ourselves on this holistic and critical model of care, and bring our services to our women via support groups and home visits. We will also develop a training manual for other caregivers, including family and community health workers, so they can comfort their loved ones and clients.

And, to get word out, we will organize an “itinerant exposition” on board a bus. This vehicle — our Anti-Rape, Anti-Kidnap and HIV/AIDS Bus — will carry 12 activists around the country for 18 months, unleashing our materials, our knowledge and our passion. It will allow us to serve women beyond our community, to empower them with information on HIV/AIDS and self-defense skills to protect them from rape and kidnap.

And if we are able to raise the funds, we will distribute the drugs needed to prolong life — drugs that are the right of every human being to access, drugs that are impossible to find in my community.

OBOS is assisting Eyitemi and her colleagues at WEDGR with strategies, promotion and in-kind donations, and by generating funds for this critical work. If you would like to help with this effort, contact Ayesha Chatterjee at ayesha AT bwhbc.org.

This article was originally published in the winter 2012/2013 Our Bodies Ourselves newsletter. View the full newsletter.


September 12, 2012

Today is Global Female Condom Day!

global female condome day 9/12/2012Today is the first ever Global Female Condom Day, intended to help raise awareness of the female condom as an option for pregnancy and HIV prevention. The female condom is the only available woman-initiated method available that offers dual protection.

You can get involved by reviewing and sharing talking points on female condoms, downloading and posting sheets that invite onlookers to share why female condoms are important, and joining the conversation online.

To find out more about what’s happening today and what you can do, check out the National Female Condom Coalition page and the Global Female Condom Day event on Facebook.  The National Female Condom Coalition is also tweeting and encouraging online participation using the hashtag #GlobalFCDay.

To learn more, check out our web content on female condoms and read our previous posts.


July 18, 2012

HIV and Black Women

PBS’s FRONTLINE recently aired “ENDGAME: AIDS in Black America,” which looks at disproportionate rates of HIV infection among Black Americans and related factors, addressing, among other issues, poverty, needle reuse and exchanges, policies that have harmed public health, churches and stigma.

In a related interview for NPR’s Fresh Air, “Endgame” director Renata Simone talks about delays in diagnosing women with AIDS, and how those delays affect women both physically and economically:

So the fact that we were not diagnosing women as having full blown AIDS when in fact their immune systems were crashing meant that they weren’t eligible for housing. Nor were the kids that they were trying to bring up. They weren’t eligible for a whole host of economic as well as treatment benefits that automatically come once an AIDS diagnosis has been reached.

A piece of companion content on the Frontline website talks about why some people with HIV *still* can’t get treatment, primarily because of the cost of drugs, including antiretrovirals and treatments for complications of HIV.

There is a lot of other discussion and content freely available on the FRONTLINE website, along with the full video of the program. The CDC has also recently launched a new “Act Against AIDS” campaign, especially focused on “reducing the risk of infection among the hardest-hit populations – gay and bisexual men, African Americans, Latinos, and other communities at increased risk.” It includes a “Take Charge. Take the Test.” initiative to encourage Black women to be tested.


June 21, 2012

Want to Help Make History? Join Us in Demanding Female Condoms!

by Anna Forbes

Sign for Female CondomsHave you ever been part of an attempt to set a new record in the “Guinness Book of World Records”? Want to help break an existing world record while also helping to increase access to HIV prevention tools?

If so, your message can be featured in what we hope will become the world’s longest chain of paper dolls.

Universal Access to Female Condoms Joint Programme (UAFC) is working with CHANGE, Our Bodies Ourselves, and dozens of other organizations around the world to collect 30,000 individually completed paper dolls to display in one massive chain at the International AIDS Conference, scheduled for July 22-27 in Washington, D.C.

To participate, just go to Sign4FemaleCondoms.org by July 27 and write a message about why you think female condoms are important. Your message and paper doll will be included in the chain. Together, we’ll break the world record.

This extraordinary visual statement will illustrate the broad-based, urgent demand for female condoms that exists all around the world. Right now, only 1 percent of all condoms used worldwide are female condoms (FC). Most people either don’t know about FCs or have never used them because they are poorly promoted, expensive and/or unavailable. Meanwhile, more than half of all people living with HIV worldwide are women.

Female condoms are just as effective as male condoms in preventing HIV and pregnancy—and they allow women to protect themselves when male condoms aren’t being used.

Participation is free, it’s fast, and you will contribute to a powerful visual statement urging policy-makers and funders to invest more in making the FC, an under-utilized, highly effective HIV prevention tool, accessible to all women and men who need it.

Learn more about this project by visiting Facebook.com/zawadi.smartlove. Thanks for taking part!

Anna Forbes is an advocate, organizer, and writer who has worked in HIV/AIDS since 1985 and on women’s health and rights since 1977.  Now an independent consultant with an international client base, her work centers around women, HIV, gender, health, and rights.


June 14, 2012

Upcoming Webinar on Reproductive and Sexual Health, Including HIV Initiatives

The following is an announcement for an upcoming webinar on reproductive and sexual health, especially as they relate to Healthy People 2020 goals for improving the nation’s health:

Join the U.S. Department of Health and Human Services for the Who’s Leading the Leading Health Indicators? Webinar on Thursday, June 21, from 12–12:45 p.m. ET. This month, we will address issues related to reproductive and sexual health.

To commemorate National HIV Testing Day on June 27, we’ll feature The Bronx Knows, an initiative that has seen success in identifying undiagnosed HIV-positive individuals in the Bronx and connecting them to much-needed care. Additionally, the Assistant Secretary for Health, Dr. Howard Koh, will announce the latest HIV-related data.

Register: http://bit.ly/LaogI4


March 13, 2012

National Women and Girls HIV/AIDS Awareness Day Connects Violence Against Women and Health Disparities

If you’re online early tomorrow morning (Wednesday, March 14), head over to whitehouse.gov/live at 8:30 a.m. (EST) for a White House event commemorating National Women and Girls HIV/AIDS Awareness Day.

According to a blog post by the Office of National AIDS Policy, the multi-agency event “will discuss the intersection of HIV/AIDS, violence against women, and gender related health disparities. Speakers and panelists will examine the juncture of these three important issues that impact women’s lives both domestically and globally.” Join the conversation on Twitter by following @AIDSgov and @PEPFAR and by using this hashtag: #NWGHAAD

Here’s the full agenda:
* Welcome and Event Overview
* Global Announcement
* Framing the Data: A Presentation by the Centers for Disease Control and Prevention
* Research Update: A Brief Update on Ongoing Research by the National Institutes of Health
* Panel Discussion: Linkage between HIV/AIDS and violence against women; a discussion of these issues and gender related health disparities in the global/domestic context.
* Domestic Announcement
* Global and Domestic Synergy
* Closing Remarks

For more on how PEPFAR — the U.S. President’s Emergency Plan for AIDS Relief — is integrating the issue of gender-based violence in prevention and response programs, take a look at this detailed program guide. This introduction is an important statement:

There is growing consensus that HIV prevention programs must not only address the biomedical and behavioral factors involved in transmission, but also the underlying social and structural drivers that increase vulnerability. Social, political, and economic inequities fuel women’s and girls’ vulnerability to HIV and GBV. Likewise, stigma and discrimination, including against MARPs such as MSM, sex workers, transgender people, and people who inject drugs, make it impossible to prevent or treat HIV through biomedical and behavioral approaches alone. While the evidence base for both HIV structural prevention and GBV prevention are limited, strategies to empower women and girls, engage men and boys, and challenge harmful social norms show promise for addressing the underlying drivers of HIV and GBV, simultaneously reducing the risk and vulnerabilities to both.

Domestically, Kaiser Family Foundation last month released an updated fact sheet highlighting the impact of HIV/AIDS on women in the United States. The fact sheet provides current data and trends over time. In 2009 (most recent year), more than 290,000 women were among the approximately 1.2 million people living with HIV/AIDS in the United States. Women of color, particularly black women, are disproportionately affected, as are low-income women. And most women with HIV/AIDS receiving medical care have children under age 18.

Here’s a list of events around the country organized in connection with National Women and Girls HIV/AIDS Awareness Day. The Centers for Disease Control last week launched Take Charge. Take the Test – a HIV testing and awareness campaign from Act Against AIDS. The campaign ill include radio, billboard and transit advertising along with a website and community outreach efforts in 10 metro areas where African American women are most affected by HIV.


March 7, 2012

Pittsburgh, PA Folks – check out the Women and Girls Health Weekend

If you’ll in or around Pittsburgh, PA this weekend, we’d love to see you at the symposium on “Women, HIV, and the 40th Anniversary of Our Bodies, Ourselves,” featuring OBOS co-founder Judy Norsigian.

The symposium is part of Women and Girls Health Weekend coordinated by Educating Teens about HIV/AIDS, Inc. This Friday, there will be a screening of the breast implant documentary “Absolutely SAFE” with filmaker Carol Ciancutti-Leyva, then Judy will speak on Saturday. Registration is required.

Details on the Saturday event:

Saturday, March 10, 8:45 a.m.-2 p.m.
University Club, 123 University Place, Pittsburgh, PA 15213

“Women, HIV, and the 40th Anniversary of Our Bodies, Ourselves,” an inter-generational symposium featuring Judy Norsigian, executive director of Our Bodies, Ourselves; in observance of National Women and Girls HIV/AIDS Awareness Day and in celebration of the 40th anniversary of the book that inspired the women’s health movement. $35 registration includes luncheon.

Presented by Educating Teens About HIV/AIDS, Inc. Co-sponsored by the University of Pittsburgh Graduate School of Public Health and its Department of Infectious Diseases and Microbiology.


October 12, 2011

Women Deserve Answers: Depo Provera and HIV Risk

A recent study published in The Lancet Infectious Diseases drew attention and controversy this month because of its finding that women using injectable types of contraception (known by the brand name Depo Provera) had twice the risk of acquiring HIV from their infected partners.

Heterosexual couples in which one partner had HIV were studied in seven African countries. The participants were sexually active, not pregnant, and not on antiretroviral medicines. Women were HIV-tested quarterly and asked at those times about their contraceptive use.

The researchers found that unprotected sex and sex with other partners was more likely when women used a hormonal contraceptive, but even when they controlled for this, the risk of HIV infection was higher in women using injectable contraceptives compared to oral or no hormonal birth control. Risk of infection in uninfected men from their infected partners was also higher.

The study was limited in that it relied on women’s self-reporting of contraception use and methods. The way participants were selected could have biased the results, and condom use was also self-reported. The study did not randomize women to a birth control method, nor was it designed from the outset as a test of HIV risk and specific types of contraceptive use. It also could not clearly evaluate any risk associated with oral birth control, because there were not enough users of the pill in the study.

Despite these limitations, there is reason to be concerned about whether there is a link between Depo Provera or its generic forms and risk of HIV infection. There are several ideas about how the drugs could potentially increase risk, but the HIV question has been around since at least 1996. That year, researchers working with monkeys and implantable contraceptives published a study suggesting increased risk of a similar virus. Researchers involved with early work on this subject have responded:

How many years has it been that the non-human primate model, and other researchers, have been warning about this and being ignored? What, 15 years now? Shocking.
and
It’s not like we did our work and it was published in an obscure journal. There’s absolutely no excuse for people doing contraceptive work to not have known this, and not to have taken this forward in the late ’90s. We should have had this answered [in humans] ten years ago.

Global health programs often promote long-acting methods like Depo Provera for women in areas where access to regular medical care is difficult and maternal mortality is high. These same areas often have high rates of HIV. I find it unacceptable that the question of contraceptive use and HIV risk has been around for years, and we don’t appear to be much closer to a clear answer. As Charles Morrison wrote in an accompanying editorial:

The question of hormonal contraceptive use and risk of HIV acquisition remains unanswered after more than two decades. Active promotion of DMPA in areas with high HIV incidence could be contributing to the HIV epidemic in sub-Saharan Africa, which would be tragic. Conversely, limiting one of the most highly used effective methods of contraception in sub-Saharan Africa would probably contribute to increased maternal mortality and morbidity and more low birthweight babies and orphans—an equally tragic result. The time to provide a more definitive answer to this crucial public health question is now; the donor community should support a randomised trial of hormonal contraception and HIV acquisition.

Such a trial would require careful design in order to minimize any risk to participants and to stop as soon as any increased risk of one method is clear. It might be impossible to get funding for, but we owe it to women, who deserve clear and accurate information about the potential risks of injectable and all forms of contraception.


August 1, 2011

Yes! HHS Approves IOM Recommendations for Preventive Care for Women

Today, the U.S. Department of Health and Human Services announced that it is adopting the Institute of Medicine’s recommendations for preventive care services for women. This will ensure that women have access to the following services under health insurance plans without having to pay a co-payment, co-insurance or deductible:

  • well-woman visits
  • screening for gestational diabetes
  • HPV testing
  • STI counseling
  • HIV screening and counseling
  • contraception methods and counseling
  • breastfeeding support, supplies, and counseling
  • screening and counseling for domestic and interpersonal violence

Coverage for these services is expected to begin Aug. 1, 2012.

There is one caveat for some women regarding access to contraception without a co-pay — a provision that “Group health plans sponsored by certain religious employers, and group health insurance coverage in connection with such plans, are exempt from the requirement to cover contraceptive services.”

An announcement at the HealthCare.gov site indicates that public comment is welcome on this provision. Although I haven’t yet been able to locate it on Regulations.gov, instructions for comment and more detail about the exemption is provided in this document.


July 20, 2011

Institute of Medicine Recommends Birth Control as a Covered Preventive Service

Good news! You may remember that the health care reform legislation enacted last year included provisions for preventive health care services to be fully covered without requiring patients to have copayments.

It was not clear, however, whether birth control would be included as a preventive service. It seems obvious to us, but the Institute of Medicine was asked to make some recommendations about which preventive services for women should be included, and included birth control in those recommendations, released yesterday.

If they are adopted, preventive services including birth control could become much more affordable and accessible to women in the United States.

The Institute, after reviewing the rate and consequences of unintended pregnancy, effectiveness of birth control, and cost and access concerns, concluded:

The committee recommends for consideration as a preventive service for women: the full range of Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling for all women with reproductive capacity.

In addition to copay-free coverage of birth control, the Institute recommended:

  • screening for gestational diabetes
  • human papillomavirus (HPV) testing as part of cervical cancer screening for women over 30
  • counseling on sexually transmitted infections
  • counseling and screening for HIV
  • lactation counseling and equipment to promote breast-feeding
  • screening and counseling to detect and prevent interpersonal and domestic violence
  • yearly well-woman preventive care visits to obtain recommended preventive services

You can view the Institute’s press release, recommendations, report brief, and full report, “Clinical Preventive Services for Women: Closing the Gap,” online. The Department of Health and Human Services will still need to adopt this list of recommendations for the care to be covered under the Affordable Care Act.

Some other coverage and discussion of this topic:

Seen other good links on this news? Leave ‘em in the comments!


July 7, 2011

Quick Hits: UN Report on Justice for Women, a New Maternity Blog, and More

From dorms at USF to justice for women around the world, here are a few items of interest:

The United Nations’s UN Women group released a report, “Progress of the World’s Women: In Pursuit of Justice,” which looks at the legal rights of women around the world, barriers to accessing and navigating the justice system, and the impact of war/conflict on women, among other issues. It also includes ten recommendations for making justice systems work for women.

The University of South Florida has begun offering students gender-neutral housing options in response to a transgender student who reported hostility and harassment in campus housing. The school is going to offer several housing options and allow students to indicate male, female, or transitioning on their campus housing applications.

NPR’s All Things Considered ran a piece yesterday on mother-to-child transmission of HIV in Mozambique; there is a related piece on breastfeeding and HIV in developing nations.

Childbirth Connection has launched the Transforming Maternity Care blog with Amy Romano, formerly of Science & Sensibility and part of the editorial team for the forthcoming edition of “Our Bodies, Ourselves.” It looks like the blog will focus on quality improvement, patient advocacy, and shared decision-making in maternity care.


February 7, 2011

Today is National Black HIV/AIDS Awareness Day – Find Free Testing

Today is the 11th annual National Black HIV/AIDS Awareness Day, intended to promote testing, treatment and action in Black communities. As part of the day, many places throughout the United States offer free HIV testing, education and other community events; a state-by-state directory at http://www.blackaidsday.org/ for finding events and test sites near you.

Related resources:


July 21, 2010

Microbicide for HIV Prevention Shows Promise

Researchers, advocates and public policy experts have gathered in Vienna, Austria to discuss the latest scientific developments and other issues related to HIV/AIDS at the 18th annual International AIDS Conference.

The biggest news focus coming out of the conference so far is about tenofovir gel, a vaginal microbicide. Tenovir has been part of the CAPRISA trial conducted in South Africa, and has shown some promise in preventing HIV transmission. According to a press release from the trial:

The microbicide containing 1% tenofovir—an antiretroviral drug widely used in the treatment of HIV—was found to be 39% effective in reducing a woman’s risk of becoming infected with HIV during sex and 51% effective in preventing genital herpes infections in the women participating in the trial. Should other studies of tenofovir gel confirm these results, widespread use of the gel, at this level of protection, could prevent over half a million new HIV infections in South Africa alone over the next decade.

The search for an effective microbicide has been ongoing for quite a few years now, as it could represent an important woman-controlled tool for reducing HIV infection, especially when women may not be able to insist on condom use. This is the first time a microbicide product has really been considered to show major promise for prevention.

As the New York Times explains, however, additional work will need to be done before this product becomes widely available to women who might benefit from it:

Broader trials are needed to confirm the results, and it will most likely be years before the product is publicly available, but if produced on a large scale the gel would cost less than 25 cents per application…Because the trial was relatively small and the gel was nowhere close to 100 percent effective, AIDS scientists and public health officials wanted to see another trial get similar results before they undertook the large fund-raising and public education efforts that would be needed to make billions of doses of the gel, as well as the applicators, which are more expensive, and then to persuade women to use them and governments of poor countries to adopt them.

Science magazine has made a paper with scientific details on the trial freely available to the public. The conference blog provides a number of relevant resources for those interested in learning more about this research.

Last night’s PBS Newshour had an interview with Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (part of the NIH), which I think did a great job of explaining the findings; a transcript of the video below is available online.

Also of interest is the Women ARISE coalition, consisting of international women’s groups and organizations whose stated mission is to:

…work together to galvanize and promote a common agenda on women and girls’ rights in the AIDS response and ensure that all women and women’s issues are central and visible in the objectives and program of the International AIDS Conference in Vienna.

The group’s founding document [PDF] outlines important principles and needs for addressing the concerns of women and girls in HIV/AIDS response efforts, including protecting and promoting the human rights (including reproductive and sexual rights) of women and girls, addressing violence against women as a cause and consequence of HIV, addressing sexual and reproductive health more broadly, developing the basic services needed by communities, including women’s leadership, and demanding accountability from the international community.

The International Women’s Health Coalition has also posted on the Women ARISE initiative in their post, Outspoken Women in Vienna Demand Rights and Inclusion, reporting directly from the conference on a demonstration at the conference plenary session intended to make it “clear that the only way to end this epidemic is through gender equality, empowering women, fulfilling our sexual and reproductive rights and health, and providing all young people with comprehensive sexuality education.”

Readers can get updates from the conference on Twitter (@aids2010), on Facebook, and on the conference blog.


April 15, 2010

A Reluctant Hero: Betsy Ryan

View all Women’s Health Heroes. Voting closes May 14. Background info here.

Entrant: Steven Slosberg
Nominee: Betsy Ryan, RN

I’ve submitted a column I wrote about Betsy Ryan several years ago when I was a columnist for The Day, a daily newspaper in New London, Conn.

Betsy continues to work ardently as a nurse in the infectious diseases department at Lawrence & Memorial Hospital in New London, as well as in HIV/AIDS education and prevention in our community, and, as a breast cancer survivor, summons enviable energy in her commitment.

She is most deserving of this honor.

A reluctant hero on front lines of a long fight (originally published 10/01)

Knowing Betsy Ryan, I suspect the Alliance for Living first had to engrave and mail the invitations, post public notice in places beyond her reach and probably put a search party on standby before telling her she was going to be formally honored for her community service. There could be no way out of it.

Even then, says Peter Bowler, one of the Alliance for Living leaders, she tried to persuade the non-profit support group for people affected by HIV/AIDS in this region to give the award to more deserving folk or at least let them share it with her.

“I said, ‘Too late, Betsy,” said Bowler. “See you at the awards dinner.”

That would be next Wednesday night, at the Mystic Hilton, when Lizbeth Love Ryan, a registered nurse and longtime relentless advocate for HIV and AIDS education and prevention, is to receive the organization’s annual outstanding community service award as part of its Awards & Appreciation Night.

The thing is, Ryan, who works in Lawrence & Memorial Hospital’s infectious disease service, has yet to acknowledge that she will attend.

“If we have to track her down and hook her up to an ox and cart, she’ll be there,” said Bowler.

She is that modest, that reluctant to take a public bow, at least about her role in community HIV awareness, but absolutely not in her labors to make lives here better and safer.

There is Betsy Ryan, a slender figure, prim and proper might apply, standing in front of any group, demonstrating, step by step, the proper way to apply a condom, and candidly discussing spermicides and lubricants and why latex condoms are best because they’re man-made and the quality can be assured.

I saw her give such a demonstration for the first time before a roomful of politicians, educators, nurses and health care and human service agency workers at Ocean Beach one September day in 1989. She gave similarly straightforward demonstrations at Frank’s Place, a gay bar, in New London during the annual Celebration of Hope fund-raisers. She’s given hundreds and hundreds of them, all over the region.

She’s been admired as a caregiver and has served as an ad hoc spokeswoman for tracking HIV/AIDS here. Though not always the easiest person for a reporter to find at deadline, she has been consistently helpful in providing statistics, always protecting the confidentiality of those with the disease. She knows just what she can say and won’t be cajoled into saying more.

In her time here she’s coordinated the New London AIDS clinic, has been a mainstay of the AIDS care program at L&M and was president of the Women’s Center of Southeastern Connecticut. She moved here in 1972 and, except for a short time in Hawaii, has been a nurse at L&M. She started out in the emergency room. She’s in her early 50s, was raised in western Pennsylvania and for the last 15 years has lived with Ken Abrahms, who owns Art Unlimited in Ledyard. They have a home in Groton and one in Watch Hill.

Donna M. Greene, president of the Alliance for Living board, has known Ryan for nine years, since Greene was involved with Helping Our People Endure Foundation Inc. (HOPE), which, in April 1998, merged with the Southeastern Connecticut AIDS Project (SECAP) to form the Alliance for Living.

Greene, who works at Pfizer, has not always agreed with Ryan’s positions, notably Ryan’s opposition to needle exchange programs. But Greene admires Ryan’s courage of her convictions.

“She’s a very firm believer in what she stands up for,” says Greene. “She’s got all the facts. She really knows her business.”

She and Bowler and Michael Rosenkrantz, the executive director of Allliance for Living, decided it was time for Ryan to face facts, and receive the recognition.

“She’s one of the few people, out there in daily contact, in the front lines, who never loses her sunny disposition and always has her client’s best interest at heart,” said Greene.

Others will be honored at the dinner for volunteer work and Dr. Frederick Altice, an HIV specialist at Yale-New Haven Hospital, will be the keynote speaker.

Betsy Ryan will be recognized for her abiding dedication, and maybe the only way to assure her being there is the opportunity, with all those people gathered in one room, for her to unroll one more condom and deliver her unflinching AIDS 101 presentation, once again.