AIDS 2010 studies, releases: Criminalization, discrimination of high-risk groups; Test-and-treat; UNAIDS launches HIV prevention commission

Jul 23 2010

The criminalization of men who have sex with men (MSM) and transgender people in Asia is holding back efforts to contain HIV/AIDS in the region, according to a report presented Wednesday by the U.N. Development Program (UNDP) and Asia Pacific Coalition on Male Sexual Health at the International AIDS Conference-AIDS 2010, VOA News reports. The report "linked the criminalization of homosexual behavior to an increase in the infection rate of HIV and AIDS in Asia," the news service writes (Dewan, 7/21).

As described in the report (.pdf), researchers analyzed "legislation, cases, and published research and grey literature regarding laws, and law enforcement policies and practices" to assess the "legal environments affecting HIV responses among  MSM and transgender people in 48 countries and territories of the Asia and Pacific region … from August 2009-June 2010" (July 2010).

"Of the 48 countries in the region, 19 of them - including Afghanistan, Bhutan, Kiribati and Malaysia - have outlawed sex between consenting male adults, with these laws often used by vigilantes in ways that lead to abuse and rights violations," the U.N. News Centre writes. Despite these laws, nearly half of the countries in the Asia-Pacific region identify MSM as being high-risk for HIV/AIDS, the news service adds. The report also looked at how police in these regions target MSM and transgender people, and how such targeting interrupts HIV prevention services and educational programs.

"Data showed that HIV-prevention services in the Asia-Pacific region reach only 9 to 20 percent of men who have sex with men, meaning that countries are falling short of their universal access targets," AOL News reports. "The report underscored that the eight countries with anti-discrimination laws (including Fiji, Philippines, South Korea, Australia and New Zealand) had greater coverage of prevention services."

The "new report … warned that unless prevention efforts receive a boost, nearly half of all new infections in Asia will be among men who have sex with men by 2020," the news service adds.

"The Asia Pacific region is truly at a critical moment in its response to HIV," the report said. "The window of opportunity to address these issues is fast closing" (Sharma, 7/21).

PTI/Zee News examines several positive developments towards protecting the rights of sexual minorities in Asia-Pacific, including Nepal's decriminalization of male-to-male sex. "India is one of the four countries in Asia along with China, Cambodia and Indonesia that have specific action plans to combat HIV and AIDS among MSM, but implementation of several schemes continue to suffer, [the report also] said," the news service writes (7/22).

"Among the new report's recommendations are the repealing of laws criminalizing sex between consenting adults, as well as supporting community-based education and advocacy on the human rights of MSM and transgender people," U.N. News Centre writes. The report "also calls for anti-discrimination laws to be enacted across the region in relation to sexual orientation and transgender status" (7/21).

World Bank Report Looks At How Discrimination Of Sex Workers, IDUs Is Fueling HIV/AIDS In S. Asia

A World Bank report released Wednesday at AIDS 2010 also noted the growing prevalence of HIV/AIDS among sex workers as well as other high risk groups in South Asia, the Times of India reports.

"Despite prevention and other efforts to reduce high-risk behaviours such as unprotected sex, buying and selling of sex, and injecting drug use, HIV vulnerability and risk remain high, says the report by a team from the International Centre for Research on Women and the World Bank," the newspaper writes (7/22).

"Stigmatizing attitudes in the general population and discriminatory treatment by health providers and local officials, among others, intensify the marginalization of vulnerable groups at highest risk, driving them further from the reach of health services and desperately needed prevention, treatment, care, and support services. Daily harassment and abuse also cause health problems and affect mental health, thereby leading to depression, social isolation, and an array of adverse socioeconomic outcomes related to HIV," according to a World Bank press release (7/21). The Times of India details how World Bank grants totaling $1.4 million split between 26 programs in six countries helped to foster new ideas about how to decrease HIV stigma and discrimination (7/22).  

Growing concerns among HIV/AIDS leaders about how the criminalization of sex workers and injection drug users (IDUs) impacts efforts to contain the virus in Asia were also a leading topic of conversation at AIDS 2010 Wednesday, Agence France-Presse reports.

While injection drug use is recognized as a leading cause of HIV/AIDS transmission, "[t]wenty-five countries in the Asia-Pacific region still impose the death penalty for offences related to the possession and abuse of drugs, creating a huge stigma that means abusers often avoid treatment for fear of imprisonment, said Anand Grover, a lawyer and special rapporteur for the U.N. Human Rights Council," according to the news service.

"In some countries, 'drug users still have to go to jail before they actually can access harm reduction services', said Rachel Ong, of the Asia Pacific Network of People Living with HIV (APN+)," AFP writes. "Ong meanwhile criticised that Asian governments lacked visibility in the fight against HIV/AIDS, compared to the richer nations, which donate much of the aid to fighting the disease." She also called upon the region to increase its commitment to human rights, the news service writes (7/21).

Researchers To Begin 5-Year Study On 'Test-And-Treat' Theory

Researchers from France and South Africa plan to begin a study of about 40,000 South Africans in 30 regions around the country to test a theory for reducing transmission of HIV, Bernard Hirschel, head of the HIV/AIDS unit of Switzerland's Geneva University Hospital, told reporters at AIDS 2010 on Wednesday, Bloomberg reports.

In half the regions, researchers will begin treatment "immediately for those who test positive. In the other half, they'll wait until the patients' immune systems deteriorate to a certain level, Hirschel said" of the five-year study, which is set to start this year, the news service writes. "If you apply this on a large scale, you could theoretically eradicate HIV by diminishing transmission," Hirschel said.

"The experiment is designed to see whether starting treatment straight away can reduce or eliminate transmission of HIV … The World Health Organization recommends that patients not receive HIV drugs, which can have serious side effects, until their infection-fighting cells fall below a certain level. The drugs lower HIV to undetectable levels in the blood, reducing patients' chances of transmitting the virus, studies have shown," Bloomberg reports, noting a 2008 mathematical model that found the spread of HIV could be reduced by 95 percent in hard-hit African countries if everyone with HIV started taking drugs immediately. "That so-called test-and-treat theory has been disputed in other mathematical models that say those projections are based on flawed on assumptions," the news service adds (Bennett, 7/21).

UNAIDS HIV Prevention Commission Launched

UNAIDS "has tapped some big names" for its new HIV prevention commission launched on Wednesday at AIDS 2010, the Associated Press reports. The commission aims to create a "prevention revolution" by reaching out to lawmakers and others, Michel Sidibe, the head of UNAIDS, said.

Former basketball star Magic Johnson, former French president Jacques Chirac, Facebook co-founder Chris Hughes and Nobel laureates scientist Francoise Barre-Sinoussi and former nuclear agency head Mohamed ElBaradei are included in the commission (7/21).

All of the Kaiser Family Foundation's webcasts of select sessions from AIDS 2010 are available at www.kff.org/aids2010.