China Says HIV Among Migrant Workers a Concern

Chinese Health Minister Chen Zhu said Tuesday he is concerned about the "fast spread" of HIV/AIDS among migrant workers. "My major concern about our situation is the migrant population because the health service towards the migrant population has yet to be improved," Chen said.

China had around 211 million migrant workers in 2009, a record high, and state media say that figure could top 350 million by 2050. Migrant workers in China often are poorly educated and have limited access to health care. "We are promoting institutional reform of medical health to establish a system that delivers basic health care to all Chinese people," said Chen. "I believe this will enable us to deliver better health services, also in terms of major diseases among the migrant population."

Chen made his comments at a media briefing ahead of Premier Wen Jiabao's trip to New York City for the UN summit on the Millennium Development Goals, one of which is to curb the spread of HIV/AIDS by 2015. China, said Chen, is "moving towards" that goal and has contained the rapid spread of HIV.

"On the whole in China, the spread of HIV is at a low occurrence rate, but in some parts of the country we are seeing a higher occurrence of the disease," Chen said. In 2009, the country had 740,000 people living with HIV/AIDS, he said. The main mode of transmission is unprotected sex, particularly among men who have sex with men, he added.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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San Francisco Adapts for Health Reform

Health care reform may place unsustainable pressure on some safety-net systems created for the uninsured and low-income persons on Medicaid, according to Dr. Mitch Katz, San Francisco's director of health.

"Overall, I think health reform is good for people who are HIV-positive because, if they are low-income, it is going to make them eligible for Medicaid, regardless of their health status," Katz said. Medicaid patients with HIV can begin treatment much earlier, rather than when they progress to AIDS, he noted.

However, if enough Americans opt for private sector health providers, safety-net programs, particularly in rural areas, may be unable to cut costs fast enough or access resources to support infrastructure improvements, Katz said. Such an exodus would leave safety-net programs largely serving "only those people who are not eligible for health reform, by and large the undocumented."

The Healthy San Francisco program covers 53,000 uninsured people, and all are required to choose a medical "home." About 55 percent of program patients choose facilities operated by the city Department of Public Health (DPH), and 45 percent choose community clinics.

Safety-net providers can offer services that private providers and small group practices may not - such as language capabilities, links with other social services, and assistance with childcare and transportation, Katz noted. DPH's web-based application also identifies clients and their family members who are eligible for other public benefits.

The city's HIV programs provide "some of the best models" for delivering the best and most cost-effective care, and they ensure patients are linked with pharmacists, Katz said. "Often pharmacists are better than doctors on drug side effects, when to take medications," he said.

"The question to me, is, how to make sure that safety-net systems thrive under health reform," Katz said.

Katz earlier enumerated his concerns in a commentary, "Future of the Safety-Net Under Health Reform," published in the Journal of the American Medical Association (2010;304(6):679-680).

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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No Change Seen in Ban on Entry of People with HIV

Bahrain is among approximately 31 countries that continue to ban entry by people with HIV and deport expatriates found to be infected with the virus.

The tiny island nation is highly dependent upon its foreign workforce. Half of Bahrain's 1.05 million-strong labor pool is composed of foreign-born persons in jobs ranging from laborers to executives. Indians and Bangladeshis are the largest migrant communities, comprising 300,000 and 90,000 people respectively.

Official data show that in the last 20 years, 325 Bahrainis and around 500 expatriates have been recorded as having HIV/AIDS. The primary mode of transmission is contaminated needles. In expatriates, the disease is usually diagnosed during the medical check-up required for a work permit.

Though the country has had a long-standing campaign aimed at increasing HIV awareness and discouraging stigma, many Bahrainis continue to view HIV/AIDS patients as having participated in "un-Islamic" activities, making a change in the immigration policy unlikely.

Somaiya Al Jowder, head of Bahrain's National STD Program, said, "We are aware of the approach of the World Health Organization of linking HIV with human rights principles to avoid discriminating the rights of carriers of the virus. But we cannot do much as current efforts to change the policy will meet strong rejections from the public."

"Most of Bahrainis infected with the virus are keeping their ailment secret from their children and close relatives to avoid being cast away, so accepting foreigners with the ailment wouldn't happen soon," said Al Jowder.

Bahrain also cannot afford the high costs of treating expatriates with HIV, Al Jowder argued. The state presently provides free treatment for HIV-infected Bahrainis, spending $3,700 per patient per month. No private clinic offers HIV treatment.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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Namibian Women with HIV Tell Court of Forced Sterilizations

Friday is expected to be the final day of testimony in the case of three Namibian women who say they were forcefully sterilized while in labor because they are HIV-positive. Sixteen women are suing the Namibian government for $1.2 million (US $165,000) each for allegedly sterilizing them without their consent.

In August 2008, legal aid groups and a women's AIDS organization presented to the Health Ministry the cases of more than 40 women who have suffered a similar experience. The current case is the first of its kind in Africa.

The incidents occurred at three state hospitals - two in the capital, Windhoek, and one about 440 miles north in Oshakati, the women claim. In court testimony last week, one of the women said she was given a document to sign, during labor, that would authorize a Caesarian section. "I did not know this was also for sterilization," she told the court, speaking through an interpreter. She discovered she had been sterilized only after she overheard two nurses saying the surgery was conducted because she has HIV.

According to the government, an investigation at state hospitals around the country found that all the women had signed consent forms for the sterilization procedure. "The investigation clearly established that all women who had had a Caesarian section as well as a sterilization had signed the relevant consent forms before the operation was done," Health Minister Richard Kamwi told Parliament ahead of the trial.

Forms signed while a woman was already in labor should not be considered valid, gynecologist Matti Kimberg told the court. Priti Patel, AIDS program manager at the Southern Africa Litigation Center, noted, "The women were not aware of their right to say 'no' to sterilization."

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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Blood Donor Ban Upheld in Canada

In a 187-page decision released Thursday, Justice Catherine Aitken of the Superior Court of Justice upheld the Canadian Blood Services' (CBS) ban on donations by men who have sex with men (MSM). Giving blood is not a civil right on par with voting, marrying or holding public office, Aitken said.

In Canada, any man who has had sex with a male partner since 1977 is ineligible for blood donation.

Aitken pointed to epidemiological evidence showing that HIV and other STDs are more prevalent in the blood of MSM than heterosexuals. Though concerns about the validity of the scientific research have been raised, CBS has a right to err on the side of caution, the judge said.

"It would be irresponsible of [CBS] as a blood operator to wait until there is clear scientific evidence regarding a risk before taking reasonable steps to avoid it," Aitken said.

Aitken acknowledged that many MSM may feel a sense of injustice over being denied the opportunity to donate blood, a reaction that could be "all the stronger and more poignant" given the history of discrimination against the MSM community. "That impact, however, is not in the same league as the impact on a blood recipient who has to use blood or blood products in order to survive or make life livable and who is asked to accept lower safety standards," she wrote.

Aitken awarded $10,000 (US $9,648) in damages to CBS after finding that a gay man, Kyle Freeman, committed negligent misrepresentation when he donated blood as many as 18 times between 1990 and 2002, falsely denying he had ever had sex with another man. In 2002, his donation was discarded after it tested positive for syphilis. In an anonymous e-mail to CBS, which the blood service obtained a court order to trace, Freeman admitted his deception and voiced his objections to the ban. Aitken dismissed Freeman's counterclaim of equality rights against CBS and the federal attorney general.


The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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Global Cash Support to Fight AIDS Is Falling

The global effort to fight HIV/AIDS is suffering due to the poor economy, UNAIDS Executive Director Michel Sidibe said today in Tokyo.

"Governments and donors are second-guessing in terms of their budget and priorities. For the first time in 15 years, we are seeing the global commitment beginning to falter," Sidibe told a press conference. Simplified, less-expensive treatment plans are needed to save the lives of millions of patients, he said, noting that many in Africa still struggle to access costly care dispensed by highly trained professionals. Sidibe called on Japan to maintain its support for the Global Fund to Fight AIDS, TB and Malaria. He also challenged Tokyo, which recorded 370 new HIV cases last year, to set a goal of no new infections in five years.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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Needle-Exchange Program Offers Resources, Counseling

The needle-exchange outreach, Any Positive Change (APC), in August celebrated 15 years of service. In addition to home delivery, it provides counseling, resource assistance, treatment referrals, and more, said founder Annina van Voorene.

Visiting clients' homes provides APC staff a unique opportunity, allowing them to help solve problems they would not otherwise know about. "We know them. They open up to us," said van Voorene. "We can see the flavor of their lives. It's an incredible opportunity for education and counseling."

For example, APC staff can troubleshoot concerns such as clients who do not have running water. They can also teach users the cleanest and safest way to inject to avoid infection. "If only we had a penny for every person who said, 'You're the only person who ever treated me with any respect,'" van Voorene noted.

According to van Voorene, Lake County has one of the highest rates of HIV/AIDS among California's rural counties. From 2002 to 2009, the county logged 60 HIV cases. Between 1998 and 2009, the county recorded 62 AIDS cases, 65 cases of chronic hepatitis B, and 1,611 chronic hepatitis C cases.

APC is funded through grants and does not receive any county or state support, said van Voorene. In 2008, the county Board of Supervisors adopted a resolution authorizing needle exchange. One year later, APC was recognized by the board as a community-based organization, and the group agreed to provide data to Lake County Health Services.

Board Chair Anthony Farrington said he thinks APC is helping reduce the spread of blood-borne disease and would like to see the program have a fixed site offering additional services.

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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