IAC 2012: No Progress on Visas for Drug Users or Sex Workers

Via Housing Works.

One year from the International AIDS Conference in Washington, D.C., prospects are looking dim for sex workers and drug users who want to attend.

The International AIDS Society has announced that it will release a document in August that details the U.S. visa process for IAC 2012. That document will describe entry restrictions for sex workers and drug users, and it will provide instructions on how to apply for a waiver if a delegate’s visa is denied. IAS will post that information here.

Still no obvious solutions

Strict U.S. regulations that block entry for people who admit to sex work or drug use could keep hundreds from participating in the world’s largest gathering on HIV/AIDS. Recognizing the key role these individuals play in charting the future of the fight against the disease, the IAS formed a working group to troubleshoot avenues for getting marginalized groups into the country.

The working group, however, has already explored—and discarded—a number of options. In June, it released a document stating that it will not lobby to change U.S. immigration policy before the conference.

The group did meet with U.S. officials to ask the federal government to issue a blanket waiver for all conference delegates who are denied a visa. The U.S. government rejected that proposal, and immigration authorities will have to review each waiver individually—a process that will cost delegates both time and money.

Read the rest here.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

What's preventing prevention?

How national AIDS responses are failing in prevention efforts for key populations – an analysis of available data

via International HIV/AIDS Alliance

Several decades after the start of the global AIDS pandemic, data confirms that most low- and middle-income countries still do not adequately focus their HIV prevention efforts on the key populations of sex workers, men who have sex with me, transgender people, and people who use drugs.

Of all low- and middle-income countries that report standard information to the United Nations on their AIDS responses, more than half fail to include timely data concerning these key populations.

According to the International HIV/AIDS Alliance, which has conducted a review of 132 country reports, this is a strong indicator of the current level of national AIDS efforts devoted to reaching populations that are most affected by HIV.

Read more.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Debate PrEP based on facts

Via Ebar, by Dr. Robert Grant

A robust public debate is under way about the potential use of anti-HIV drugs to prevent HIV infection (also known as pre-exposure prophylaxis or PrEP). Our study, called iPrEx, provided the first conclusive evidence that the daily use of PrEP with the FDA-approved HIV treatment Truvada can significantly reduce HIV infection risk in gay, bisexual, and other men who have sex with men and transgender women, when delivered as part of a comprehensive package of prevention services, including condoms.

Recently, a private health care provider has begun a paid advertising campaign urging the FDA not to even consider approving the use of PrEP – charging, among other things, that MSM will stop using condoms if PrEP is permitted. The pros and cons of PrEP use should be vigorously debated – but that debate should be based on facts, rather than the assumption that MSM will not act to protect themselves and others from infection. Here are the facts about the iPrEX study:

The protection provided by PrEP and condoms together could have a substantial impact in reducing new HIV infections among MSM worldwide.

A diverse group of 2,499 HIV-negative MSM and transgender women on four continents with a range of sexual practices participated in iPrEx. All participants received a comprehensive package of HIV prevention services. Half also received Truvada, while the other half received a placebo (blank pill). Neither the study participants nor the investigators knew which pill they received during the study.

Men in both study groups reduced their risk behaviors and increased their condom use – demonstrating that MSM can use PrEP and condoms together. PrEP does not protect against other sexually transmitted infections and should never be considered as a substitute for condom use or other safer sex precautions.

Much more work lies ahead to determine whether PrEP can help stop HIV infections in other populations, such as heterosexuals and injection drug users, to better understand possible side effects of PrEP, to support consistent pill use among people who want to use it, and to ensure that PrEP is seen as one element of an HIV prevention strategy that includes regular condom use.

Additional studies are also under way to test whether other anti-HIV medicines (including pills, gels, and other formulations) are safe and effective for HIV prevention.

Read the rest

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

New Report: World’s Premier AIDS Event Neglects Populations Most at Risk for HIV

 via Global Forum on MSM and HIV

Independent assessment indicates severe underrepresentation of gay men, transgender people, sex workers and people who use drugs at the biennial International AIDS Conference

A new report indicates that the International AIDS Conference (IAC), a biennial event convened by the International AIDS Society (IAS) that has become the world’s premier gathering for people working in the field of HIV, suffers from gross underrepresentation of populations most at risk for HIV infection, including men who have sex with men (MSM), transgender people, sex workers and people who use drugs.  The independent audit, conducted by the Global Forum on MSM & HIV (MSMGF), confirms suspicions long-held by activist groups and calls for a comprehensive review of IAC governing structures.

Produced in response to growing concern among community groups that the IAC has repeatedly neglected these key populations, the report focuses on program content at the most recent IAC, held in Vienna, Austria in July 2010.  The analysis reveals that the percentage of all sessions at the conference exclusively focused on these groups was limited to 2.6% for MSM, 1.1% for transgender people, 3% for sex workers and 4.5% for people who use drugs.

“While the International AIDS Society turns a blind eye, HIV rates among these populations continue to climb around the world,” said Dr. George Ayala, Executive Officer of the MSMGF.  “The IAC is the world’s most important opportunity for international exchange and collaboration on HIV and AIDS.  Such abysmal representation of most-at-risk groups only serves to reinforce the invisibility, discrimination and disregard that drive the epidemic among these communities.”

Research has shown that these four populations are at higher risk for HIV infection than the general population in nearly every country context where reliable data exist.  MSM represent more than a quarter of HIV infections in Latin America and the Caribbean, people who inject drugs account for more than half of HIV infections in Eastern Europe,  and sex workers across Sub-Saharan Africa experience HIV prevalence rates of up to 50%.  Infection rates among transgender people in El Salvador, Indonesia and India are as high as 25%, 35%, and 42% respectively. 

The IAC takes place in a different city every two years, gathering tens of thousands of experts and advocates from around the world to share the field’s most recent developments and engage in strategic collaboration.  The most recent conference hosted an estimated 25,000 people.

“Ostensibly, the IAC offers chances for local healthcare providers to learn ways to improve their services, provides channels for advocates to engage in dialogue with powerful decision-makers, and creates opportunities for community members to shape global funding and research agendas,” said Dr. Mohan Sundararaj, Policy Associate at the MSMGF.  “This really is a phenomenal platform, but how useful can it be when those who need it most are locked out?”

The report recommends a number of steps to bring the IAC’s program coverage of these key populations up to a level proportionate to their epidemiological burden.  Among these recommendations are efforts to ensure transparent processes for abstract review and program design, the development of targeted support to authors developing abstracts focused on key populations, and open representation of civil society on the committees responsible for developing conference programs.

“The International AIDS Conference has unparalleled potential to impact the global AIDS epidemic,” said Dr. Ayala.  “It is incumbent upon the organizers to ensure that the IAC becomes a vehicle for change, shifting the global landscape so that funding, research and programs are directed to those who need them most.  Right now it’s part of the problem.”

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Heterosexual anal sex reported by women receiving HIV prevention services in Los Angeles County

Womens Health Issues. 2010 Nov-Dec;20(6):414-9.

Heterosexual anal sex reported by women receiving HIV prevention services in Los Angeles County.

Reynolds GL, Fisher DG, Napper LE, Fremming BW, Jansen MA.

California State University, Long Beach, Center for Behavioral Research and Services, Long Beach, California 90813, USA. greynol2@csulb.edu

Abstract

BACKGROUND: This study examined reported heterosexual receptive anal intercourse (HRAI) in a sample of women recruited from HIV prevention providers in Los Angeles County.

METHODS: The majority of women surveyed were Latina and the modal age was 19 years. Women reporting HRAI were more likely to use both injected and non injected drugs and to have sexual partners who injected drugs.

RESULTS: Factors associated with HRAI in a multivariate regression model included use of methamphetamine; use of alcohol before, during, or after sex; and use of dental services at the interview agency. Factors inversely associated with heterosexual anal sex were being African American (compared with Latina) and endorsing the use of condoms for episodes of vaginal sex from start to finish.

CONCLUSION: HIV prevention providers in Los Angeles County should be aware of the need for basic prevention messages concerning condom use and injection behavior in young Latina women.



[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]