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Commentary & Opinion

Views on AIDS: The Benefits of Male Circumcision; a More Optimistic Battle; the Need to Focus on High-Impact Prevention Strategies

July 24, 2012

A selection of editorials and op-eds from around the country that focus on the campaign to eradicate HIV.

HIV Prevention Done Right
This week, tens of thousands of delegates are meeting in Washington for the biennial International AIDS Conference, striving to advance an agenda for an AIDS-free generation. Achieving such an ambitious goal will require multiple strategies, but virtually all agree that male circumcision -- which provides powerful protection against HIV infection as well as other health benefits for men and women -- must be a core element. Yet although some prevention efforts in Africa have been successful, others have floundered. (Daniel Halperin, Los Angeles Times, 7/24)

Put Women's Health in Women's Hands
At this week's International AIDS Conference, activists and leaders will debate "what's next" in the battle against HIV/AIDS. They should consider Alicia, a young woman in Alameda County, where AIDS is now the leading cause of death among African American females age 20 to 40. Alicia's boyfriend doesn't like wearing condoms, so they don't always use them. She doesn't want to get pregnant, but even if she goes on the pill, she'll remain at risk for HIV and other sexually transmitted infections. Her health, even her life, will be jeopardy. the need for HIV prevention and contraception go hand in hand for many women. (Bethany Young Holt and Mary A. Pittman, San Francisco Chronicle, 7/23)

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Is HIV/AIDS Funding Insufficient?
That is a billion dollar question when we face other competing priorities like heart diseases, diabetes, maternal health, and cancer. the political leaders are talking about an AIDS-free generation. Whether this is possible or not is another debate, but it is a laudable goal. It is possible to have 15 million AIDS patients on treatment by 2015, thus ensuring close to universal access to treatment we dream of. There is also huge cry for more funds. the International AIDS Conference in July 2012 will debate this and other issues. However, serious rethinking must be done and each donor must ask, Is funding for HIV/AIDS sufficient? I think it is. Here is why. (Taifiqur Rahman, The Hill, 7/23)

Toward an AIDS-Free Generation
Since the first cases of what is now known as AIDS were reported in 1981, an entire generation has grown up under the constant cloud of this modern-day plague. Across the globe, more than 34 million people are living with the human immunodeficiency virus (HIV), the virus that causes AIDS, including approximately 1.2 million individuals in the United States. HIV/AIDS has been responsible for the deaths of an estimated 30 million individuals. Although the rate of new HIV infections has declined or stabilized in many countries, the disease continues to exact an enormous toll. ... Despite these daunting statistics, the fight against HIV/AIDS is currently viewed with considerably more optimism than in years past because powerful interventions have been developed, scientifically proven effective, and refined. (Dr. Anthony S. Fauci and Gregory K. Folkers, Journal of the American Medical Association, 7/22)

The Future of HIV Prevention in the United States
In the United States, 1.1 million people live with human immunodeficiency virus (HIV), a 60% increase from 15 years ago. the increasing number of people who can potentially transmit HIV makes prevention more difficult. Yet federal domestic HIV prevention funding, after adjustment for inflation, has not increased since 1991, necessitating a different approach to HIV prevention. (Dr. Jonathan Mermin and Dr. Kevin A. Fenton, Journal of the American Medical Association, 7/22)

Forever Young
Terri understood that taking her medications would improve her immune system and keep her healthy. but like many of them, she still apparently would not take the medicines daily. Perhaps this one action provided a sense of control over her life, a life that was filled with many things that happened beyond her control. for many people in both the United States and abroad, HIV has become a well-controlled chronic disease, but for Terri and other perinatally infected young people, HIV is still capable of claiming lives. (Dr. Alia Chisty, Journal of the American Medical Association, 7/22)

HIV Infection Among Persons Born Outside the United States
Even though HIV poses no risk of casual transmission, the United States has had a very restrictive policy toward entry of persons with HIV. in 1987, the United States prohibited entry of HIV-infected travelers or legal residents. in 1991, the ban was lifted for travelers but remained in place until 2010 for those wishing to reside in the United States. During this time, the United States did not ban persons with latent tuberculosis infection or evidence of hepatitis B infection from traveling or immigrating to the United States, and reentry testing was not required for U.S. travelers who returned home after having visited high-prevalence HIV areas. the ban on entry of HIV-infected persons to the United States was not consistent with public health principles and may have had negative public health consequences. (Dr. Mitchell H. Katz, Journal of the American Medical Association, 7/22)

Aging and HIV-Related Cognitive Loss
Although antiretroviral therapy has had a major effect on improving the survival of individuals with human immunodeficiency virus (HIV), cognitive disorders related to HIV remain an important burden of disease and disability worldwide. (Dr. Farrah J. Mateen and Edward J. Mills, Journal of the American Medical Association, 7/22)

HIV/AIDS in 1990 and 2012: From San Francisco to Washington, D.C.
During the last 2 decades, scientists, public health officials, and AIDS activists have not always agreed, but they have often listened to one another and worked toward common goals. (Dr. Robert Steinbrook, Journal of the American Medical Association, 7/22)

Back to other news for July 2012


This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.



  
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This article was provided by Henry J. Kaiser Family Foundation. It is a part of the publication Kaiser Daily Health Policy Report. Visit the Kaiser Family Foundation's website to find out more about their activities, publications and services.
 
See Also
AIDS 2012 Research & Clinical Coverage

Reader Comments:

Comment by: Hugh7 (Porirua, New Zealand) Wed., Jul. 25, 2012 at 1:29 am EDT
Re the LA Times story:
"Long-term follow-up research indicates this one-time procedure [circumcision] reduces HIV risk in heterosexual men by about 70%."

The figure keeps going up. In a year or two it will pass 100% and the dead will start to rise from their graves. In fact these wild projections are just made up. They are all based on a grand total of 73 men who didn't have HIV two years after being circumcised, while 64 did, out of 5,400 paid volunteers for circumcision. The rest is pure speculation.

Halperin has said he believes his descent from a ritual circumciser has "destined" him to promote circumcision. That's hardly scientific.

In Swaziland, despite the "circumcision riot" 21.8% of circumised men have HIV, compared to 19.5% of non-circumcised men. In Zimbabwe it's 14% of the circumcised men compared to 12% of the non-circumcised, the same ratio as in 2005, before their circumcision campaign began. In Tanzania 6.5% vs 5.4% - and these are countries where he's claiming success!

This promotion has resulted in men thinking they are immune and men being forcibly circumcised - which must be very similar to being raped - but Halperin doesn't seem to care, just so long as "those foreskins keep flying" as his colleague Robert Bailey put it.
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Please note: Knowledge about HIV changes rapidly. Note the date of this summary's publication, and before treating patients or employing any therapies described in these materials, verify all information independently. If you are a patient, please consult a doctor or other medical professional before acting on any of the information presented in this summary. For a complete listing of our most recent conference coverage, click here.


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