Showing posts with label HIV Discrimination. Show all posts
Showing posts with label HIV Discrimination. Show all posts

January 19, 2017

An Indian Prince Fighting Ignorance About Sex and HIV/AIDS



Prince Manvendra Singh Gohil, India's first openly gay royal and AIDS activist, speaks during an interview in New Delhi. A member of a royal warrior clan and heir apparent to the throne of Rajpipla in Gujarat, Gohil uses his fame and status to educate the gay community about safe sex and their rights in a country where gay sex is a criminal offense. (Originally AFP)

“People say homosexuality is a part of western culture. It is absolutely wrong,” Gohil told AFP in an interview, citing the Kamasutra and the homoerotic sculptures that feature in ancient temples across the country.

“It is the hypocrisy in our society which is refusing to accept this truth. And this motivated me to come out openly and tell the world ‘I am gay, so what? And I am proud of it’.”

Gohil has been part of a campaign against the colonial-era law that bans homosexual acts in India, which he says has contributed to the spread of HIV/AIDS.

His charity, Lakshya Foundation, works with homosexual men and the transgender community to promote safer sexual practices, though they face constant obstruction from police.

“People are having sex under fear and unsafe sex practices are going on,” he said.

“When we started work among the MSM (men having sex with men), we were harassed and threatened by police.

“We would keep condom packets in public toilets, and even hang them on trees in public parks because we did not want to stop them from having sex in toilets or behind the bushes. We just wanted them to have safe sex.”


Gohil says some of his NGO’s workers “were arrested and taken to the police station where the cops themselves had forced sex with them without condoms.” (AFP)
‘Spreading homosexuality’

Gay sex was effectively decriminalised in 2009 when the Delhi high court ruled that prohibiting it was a violation of a person’s fundamental rights.

But in 2013 the Supreme Court ruled that the responsibility for changing the 1861 law rested with lawmakers and not judges.

Prosecutions are rare, but gay people say they face significant discrimination as well as harassment from the police.
Gohil said even a government contract to distribute condoms did not protect his workers from police harassment.

“They said we were spreading homosexuality,” he recalled.

“Some of our workers were arrested and taken to the police station where the cops themselves had forced sex with them without condoms.”

India has the third highest number of HIV/AIDS cases in the world according to the United Nations, with about 2.1 million people in 2015, although the rate of infection is falling.

In another positive sign, two bills designed to end discrimination against transgender people and individuals infected with HIV are currently going through the Indian parliament.

Working with people in the transgender community is a priority for the government in its national AIDS response plan, but social isolation means the community is still at particularly high risk of HIV transmission.

The bill seeks to prohibit discrimination in any form and specifically bans denying them access to public places, on pain of up to two years’ imprisonment and a fine.

But campaigners have objected to a clause which would force people to undergo tests to determine their gender identity. 

They say this is against the spirit of a 2014 Supreme Court judgement that allowed anyone to “self identify” which gender they are.

“When the social empowerment ministry itself is not clear who a transgender is how will they address their issues?” said Gohil.

“It is a challenging situation. I don’t blame any political party. It’s not the party but the individuals who are either homophobic or gay friendly.

“It’s our duty to educate them because they are ignorant.”

December 22, 2016

Missouri C.A. Vacates 30 yr Sentence for HIV’er Caught Up on Disclosure Laws




Michael Johnson - Photo: St. Charles County Police Department.
Michael Johnson – Photo: St. Charles County Police Department.
The Missouri Court of Appeals has thrown out a 30-year prison sentence and ordered a new trial for a former college wrestler accused of failing to inform some of his sexual partners of his HIV status. Michael Johnson, an HIV-positive black man with learning disabilities, was convicted last year of violating an out-of-date Missouri law that criminalizes the sexual conduct of people living with HIV.
The court of appeals’ decision is based on the state’s failure to turn over last-minute conversations recorded at the county jail that were subsequently used to obtain Johnson’s conviction. By failing to notify the defense of the evidence in their possession, the court found, the prosecution had essentially railroaded Johnson in a way that could have significantly altered the case, reports The Associated Press.
Presiding Judge James Dowd, in his ruling overturning the conviction, chastised the prosecution, accusing them of adopting a “trial-by-ambush strategy.” Johnson will now face a new trial, in which he’s been charged with one count of recklessly infecting another with HIV, and four counts alleging he exposed or tried to expose others to the virus between January 2013 and October 2013.

Prosecutors maintained throughout his first trial that Johnson had deliberately lied to sexual partners about his HIV status. During the trial, St. Charles Police Detective Don Stepp testified that more than a dozen other men had approached the department claiming to have had sex with Johnson after learning of his arrest under Missouri’s HIV criminalization statute. But Stepp also said those men didn’t want to file formal complaints, because they were not out to their families.
BuzzFeed‘s Steven Thrasher reported in 2014 that prosecutors have a form from the state of Missouri, dating back to January 2013, signed by Johnson, acknowledging that he had been diagnosed with HIV. However, Thrasher also noted in his article that Johnson was never given legal counsel when he signed the form, many months prior to his arrest, and may not have understood the legal implications of the document he was signing.
 Lambda Legal, the American Civil Liberties Union, and other LGBT and HIV/AIDS advocates have taken issue not just with Missouri’s law, but similar laws, which were written at a time when HIV diagnosis was considered a death sentence. At that time, little was known about how the virus was transmitted or what safeguards can be used to protect against infection, such as the positive partner maintaining an undetectable status, the use of PrEP for the negative sexual partner, or the use of condoms by both partners.
“Living with HIV is not a crime,” Schoettes said in a statement. “Except in the most extreme cases, the criminal law is far too blunt an instrument to address the subtle dynamics of HIV disclosure. Willingness to be open about HIV status will be created only by the destigmatization of HIV and policies that ensure people living with HIV are not singled out for discrimination or special prohibitions and punishments. Prosecutions like this — under antiquated laws like Missouri’s — take us in the opposite direction.
“Given the outdated nature and extremely punitive nature of Missouri’s law, Lambda Legal is hopeful the State will not appeal this decision, and will instead work to resolve the case without the need for another trial,” Schoettes added.
John Riley is the local news reporter for Metro Weekly. He can be reached at jriley@metroweekly.com

December 8, 2016

Thanks to a Deadly Corrupt Duterte Gov. HIV Rates are Out of Control ‘No Condoms No Testing’




 A friend of mine in California with friends and trips to the Philippines told me unless you work and have good insurance there are no HIV meds in the Philippines for you. He said "the government sees these people as throw aways and they are deplorable that have no redemption. The sooner they die the better off the government is.”





Policies like restricting gay men from using condoms while having sex are causing an HIV epidemic in the Philippines, Human Rights Watch said in a report released on Thursday, 8 December.

According to official statistics, there has been a tenfold rise in the prevalence of the sexually transmitted virus in the country, the 46-page report, titled "Fuelling the Philippines' HIV Epidemic: Government Barriers to Condom Use by Men Who Have Sex With Men" notes.
 
The group said that among all Asia-Pacific nations, the Philippines is facing one of the fastest-growing HIV epidemics. It blamed the national and local governments for failing to address the growing HIV prevalence among gay men, which emerged as the biggest source of the spread of the deadly virus in the recent past.

The report states that although President Rodrigo Duterte's predecessors took adequate measures in the 1990s to prevent HIV spread in the country, they focused only on commercial sex workers and completely ignored same sex relations. The government even ignored data from the Department of Health that indicated that 81% of the 35,000 recorded HIV cases in the country between 1984 and June 2016 have been among men who have sex with men. The first HIV case was recorded in the country in 1984.

HIV Epidemic

Human Rights Watch has warned the Philippine government of an HIV epidemic in the country due to policies preventing gay men access to condoms and HIV testing facilities

"President Duterte has inherited a legacy of failed or counterproductive policies of previous administrations that are contributing to the alarming increase in HIV infections among men who have sex with men," Carlos H Conde, a Philippines researcher, said in a statement released by the human rights group.

"Reducing HIV transmission isn't rocket science. But it does require the Duterte government to implement an HIV prevention program and remove obstacles to condom and HIV testing access so that young Filipinos – particularly men who have sex with men – can protect themselves from an otherwise preventable illness," the researcher added.

According to health department data for 2015, at least 11 cities in the Philippines have recorded HIV prevalence rates of more than 5% among gay men, with the second largest city, Cebu City, recording a 15% prevalence rate.

The overall prevalence rate for the Asia-Pacific region is 0.2% and for Sub-Saharan Africa, it is 4.7%, which are way lower than the prevalence rates recorded in the Philippines, the report notes, adding that the dismal scenario was a result of “longstanding resistance of the Roman Catholic Church to sexual health education and condom use".


December 1, 2016

In Russia Healthy Living and Family Values is giving them an Increase of Straight HIV Transmission

 Do You Know What Dec.1st is?(Even if You don’t use condoms, now there is no reason to get HIV in many countries, ask me!


or



- For a few weeks in 2012, Yury had a family: His wife, Katya, had given birth to a girl.

But when Yury took his ailing baby daughter to the hospital two months after she was born, he learned that she was HIV positive, and his world began to collapse. After he was tested and came up positive, he said, Katya told him that she had given him the virus -- and had known she had it while pregnant but kept it secret from him out of fear.

A month later, their daughter was dead. Katya, who refused to take antiretroviral therapy to prop up her ailing immune system, died last year.

"We didn't separate or run away from each other. We went to the end," said Yury, a 40-year-old auto mechanic from a gritty Moscow suburb who preferred not to be identified by his surname. "I've come to terms with it all. How can I blame the person who gave me a daughter?"

Russia's HIV epidemic passed a grim milestone in January as the country registered its millionth HIV-positive citizen -- double the number in 2010. About 200,000 of that million have died since HIV was first registered in Russia in 1987.

With less than one percent of the population of Russia's 142 million infected, the situation is less dire than epidemics that have ravaged Sub-Saharan Africa. And yet while the rate of new HIV infections across the world is ebbing, in Russia it is on the rise.

Russia accounts for the lion's share of infections in a Eurasian region, which UNAIDS -- the United Nations' program on HIV/AIDS -- says is the "only region in the world" where the HIV epidemic has "continued to rise rapidly." More than 93,000 new cases were registered in 2015 -- compared, for example, to 44,000 new diagnoses in 2014 in the United States, whose population is more than twice as large.

Yury does not know how Katya contracted HIV, but his own story fits into a trend that some leading experts say President Vladimir Putin's government must face up to fast: The number of Russians infected through straight sex is rising.

Vadim Pokrovsky, the longtime head of the Federal AIDS Center and an expert who has been tracking the disease's progress in Russia for almost three decades says the epidemic is advancing beyond traditional high-risk groups and spilling into general circulation.

Pokrovsky said that infections through heterosexual contact accounted for 45 percent of overall infections in 2015, compared with 10 percent 10 years ago.

He believes Russia stands at a critical juncture: The government should forsake what he casts as conservative policies that deviate from established global practice in the fight against HIV.

"I think it is now spreading into the heterosexual population," Pokrovsky told RFE/RL. "We can no longer keep on saying 'nyet-nyet' [Russian for "No-No"]. We have to urgently take measures."

'HIV Belt'

For years, the chief mode of transmission in Russia has been intravenous drug use, which boomed after the Soviet collapse as the social fabric frayed and factories shut down or slashed workers' jobs, particularly in industrial towns in the Urals and Siberia. Rampant drug abuse tore through cities on the heroin trail from Afghanistan westward in the 1990s and 2000s, forming something of an "HIV belt" across central Russia where the virus remains most prevalent today.

Pokrovsky believes the situation is moving from a "concentrated epidemic" among at-risk subgroups such as injecting drug users to a "generalized epidemic" -- defined by the World Health Organization as a situation with "HIV prevalence consistently exceeding 1 percent among pregnant women."

Pokrovsky said that in over 15 of Russia's 82 regions, more than one out of every 100 women who becomes pregnant has HIV.

"The trouble at the moment is that the number of people contracting HIV through heterosexual sex is rising," Pokrovsky said. "We cannot say that these transmissions are connected to the traditional vulnerable groups."

Other experts say there has been no major shift in the way HIV is spreading in Russia.

In e-mailed comments to RFE/RL, UNAIDS said that "the majority of the new HIV cases in Russia remain concentrated among key populations -- particularly injecting drug users and their sexual partners."

But almost all agree on the need for urgent action in Russia, where several factors -- including the persistent stigma attached to homosexuality, a strained health-care system, a lack of education about risks, government pressure on NGOs, and logistical problems that critics say have been created or aggravated by the state -- are making the HIV/AIDS problem worse.

Rising Concern?

There are some signs of new attention from the government, and the media that serve it, to an issue that was long considered peripheral.

Recently, newspapers such as Komsomolskaya Pravda, a popular pro-Kremlin tabloid, have carried stories with headlines like: "HIV can happen to anyone: go out and get tested!"

Prime Minister Dmitry Medvedev declared the situation a matter of "national security" in March, and on October 20 signed off on a five-year strategy to combat the crisis through 2020. 

But despite the indications of increased concern, activists, doctors, and NGO workers fear that the new government plan remains hamstrung by the same conservative, go-it-alone approach that has stymied efforts to rein in the epidemic so far.

Among other things, the strategy prioritizes raising awareness, with the help of NGOs, among "key groups of the population." But in a common point of criticism, Pokrovsky said the strategy fails to clarify how the government plans to work with key HIV risk groups such as injecting drug users, sex workers, and gay or bisexual men.

"No one has answered the question of how we are going to warn people about the circulation of HIV among drug users -- although about 20 percent of intravenous injecting drug users already are infected," said Pokrovsky. "Nothing is said about how to prevent the infection of the remaining 80 percent."

"The same goes for sex workers," he told RFE/RL. "There is not a word about prevention among them. Everyone knows there are many of them. But there are no special programs planned for this group. The same goes for men who have sex with men."

The state "just does not pay enough attention to prevention -- prevention is very weak in Russia," Pokrovsky said, adding that this is reflected in government funding to fight HIV. "If 18 billion rubles ($278 million) are spent on treatment, only 400 million rubles ($6 million) go to prevention."

Zero Tolerance

There are no well-known state outreach organizations or programs working with high-risk groups. This is the exclusive preserve of largely foreign-funded NGOs such as the Andrey Rylkov Foundation For Health and Social Justice -- the only group in Moscow that distributes clean needles, contraceptives, and medication to drug users, the main group incubating and spreading the virus.

The Rylkov foundation receives no financing from the Kremlin and relies on grants from abroad. In July, the group was labeled a "foreign agent" under legislation signed by Putin early in his third term in 2012 that pressures and marginalizes many NGOs with foreign funding.

Foundation activists also encounter street harassment. In October 2013, police threatened to arrest activists who had traveled to a pharmacy in a rundown district in southeast Moscow where they handed out clean needles, bandages, condoms, and ointments. The police ordered them to disperse, prompting them to move to a new location where they continued their work. 

Although 1 million Russians have been registered with HIV in the last 30 years, Pokrovsky estimates there could be another 500,000 living with the virus who have not been identified -- many of them injecting drug users.

"Over half of our cases are contracted through drug use," said Elena Orlova-Morozova, a doctor at the Moscow Region AIDS Center. "It is very hard to identify HIV in this group and make progress with this group. Drug use is criminalized here and there is no talk of decriminalizing it."

“Drug users therefore are scared, of course, and cannot go to state buildings [such as hospitals] to be monitored,” she added. 

Activists also criticize Russia's refusal to legalize heroin substitution therapy which has been used widely across the world -- including in authoritarian countries such as Iran -- to wean drug users off heroin by giving them orally imbibed methadone.

Anya Sarang, head of the Andrei Rylkov Foundation, dismissed Medvedev's strategy as more of the same policy that has brought the epidemic this far. She suggested that one big obstacle to improvement is the growing prominence during Putin's third term of conservative ideas, anti-Western sentiment, and views espoused by the Russian Orthodox Church leadership.

"I guess the Health Ministry is still trying to figure out the 'Russian' and more godly way to deal with the problem since they are not in favor of internationally accepted, evidence-based prevention programs such as needle and syringe distribution and opioid substitution therapy," Sarang said.

'My Son Died Today'

LaSky, an HIV NGO that works with homosexual and bisexual men in Moscow, has not been labeled a foreign agent despite receiving money from abroad. But it has had to adapt to other restrictive legislation passed during Putin's third term.

On a November afternoon, Aleksandr, 29, a shop director who moonlights at LaSky, pasted "18+" stickers onto fliers and pamphlets about HIV and homosexuals so as to avoid being accused of violating a 2013 law that criminalizes the spread of gay "propaganda" to minors.

Rights groups and Western governments say the law marked a major setback for gay rights in Russia, encouraging prejudice and adding to the stigma attached to the lesbian, gay, bisexual, and transgender (LGBT) community in Russia, where homosexual relations were a crime in the Soviet era.

Ilya, a 20-year-old gay man who has attended counseling sessions at LaSky, has felt the stigma firsthand since he contracted HIV in December 2015 and was disowned by his family, which is prominent in his Siberian hometown. 

When he called his mother with the news of the test result, she said "my son died today" and hung up the phone.

Ilya, who did not want his last name published, said he became depressed and fell behind on his studies at a Moscow university. When exam time came in May he asked for an extension, citing his HIV status and a doctor's note, but was swiftly expelled, he said.

"In Russia, HIV-infected people are not seen as people who need help and are sick, but as people deliberately spreading the plague," said Ilya.

Activists at LaSky say the lack of information about HIV is a major problem. Aleksandr, a gay man from a Volga River town who preferred not to be identified by his surname, said he had no idea when he contracted HIV in 2013 that sexually active gay and bisexual men are at a high risk of infection.

"This information is nowhere, no one talks about it, no one knows anything about it," he said.

Activists say sex education in schools is grossly insufficient. At his high school, Aleksandr said, there was just one lecture that talked about condoms -- and it focused on using them to prevent unwanted pregnancy.

"There was nothing specifically about HIV," he said. "No one in the regions gets that. As a rule, they say superficially that there are sexually transmitted infections and you need to use a condom."

LaSky offers support in getting around a major logistical hurdle for many HIV sufferers in Moscow: The state guarantees free medical treatment for citizens, but only in the locale whether they officially reside -- and many Russians who live in the capital formally remain residents of their hometowns.

After Aleksandr tested positive for HIV, he had to travel back home -- 400 kilometers east of the capital -- for time-consuming treatment. He tried to hold onto his job by asking in advance for time off, but eventually was forced to resign. He has now managed to get registered for treatment by registering at the Moscow Region AIDS Center with LaSky's help.

Champagne, Not Condoms

Activists criticize some of the awareness campaigns that do exist, such as state-sponsored signs at Moscow train stations that make no mention of the use of condoms as a preventive measure.

One public-service poster sponsored by the Moscow government says simply, "Ignorance puts you in the risk group," without further explanation. Another suggests that adhering to traditional family values is key, warning: "Infidelity puts you in the risk group."
  
Pavel Lobkov -- a TV presenter who broke a taboo last year when he disclosed his HIV-positive status on the air on World AIDS Day, December 1 -- said condoms should be far more accessible.

"They should be handing them out free of charge in clubs where there is a heightened sexual atmosphere, or at rave parties, and so on," Lobkov told RFE/RL in an interview.

"When in a normal shop a pack of 12 condoms costs as much as a bottle of Soviet champagne, a couple of 18-year-olds will buy the champagne and not those boring condoms."

Lobkov said that "there were outreach programs for many years" -- but that times have changed.

"In the 1990s, I remember in all gay clubs or rave clubs there were free condoms at the bar," he said. They've disappeared now. They should be in your face" he said.

But social conservatives who have gained influence during Putin's public push for adherence to what he and the Russian Orthodox Church cast as traditional values tend to oppose such measures.

Lyudmila Stebenkova, a long-time Moscow legislator who heads the city Duma's public health committee, called on November 15 for a ban on the distribution of free condoms.

Stebenkova, who has won awards from the church, said condoms only offer 80 percent protection from infection and that their free distribution inculcates "irresponsible sexual behavior."

In a follow-up Facebook post, Stebenkova attacked foreign NGOs whose methods she called "strange and even irresponsible: giving out one-use needles to drug addicts and propagandizing condoms, which they give out even to schoolchildren." 

“In Moscow we decided to go down a different route: the propaganda of healthy living and family values," she wrote


May 19, 2016

American Culture Wars Like LGBT and HIV Hits the UN



Image result for world un  aids
                                                                                                                                                
                                                                          










THE PHENOMENON known in American domestic affairs as the culture wars has gone well and truly global. If anyone needs proof of that, consider the row that has erupted at the United Nations in recent days over plans for a high-level meeting next month on the fight against HIV/AIDS. The United States, the European Union and Canada are appalled by the fact that 11 gay and transgender groups have been barred from the gathering under pressure from the Organisation of Islamic Cooperation (OIC), which groups 57 mainly Muslim lands. Egypt spearheaded the OIC’s diplomatic moves.

According to agency reports, America’s UN ambassador Samantha Power (pictured) raised the matter in an indignant letter to the president of the General Assembly. She wrote:

Given that transgender people are 49 times more likely to be living with HIV than the general population, their exclusion from the high-level meeting will only impede global progress in combating the HIV/AIDS pandemic...The movement to block the participation of NGOs on spurious or hidden grounds is becoming epidemic and severely damages the credibility of the UN.
Around UN headquarters on New York’s East River, the origins of this “movement” are clear enough: it reflects a social-conservative diplomatic coalition orchestrated mainly by the OIC and Russia, with some opportunistic support from China. Last year, all those parties tried to overturn a decision by Ban Ki-moon, the UN secretary-general, to recognise same-sex marriages among the world body’s staff. Feelings are running high this week because of yesterday’s International Day against Homophobia. 

This traditionalist coalition has been rallying its forces even as LGBT rights gain prominence in the diplomatic agenda of Western countries. Ms Power, a respected writer on the subject of genocide, has made the LGBT question a personal priority. She recently invited 17 of her fellow UN ambassadors, including the envoy of Russia, to watch a musical set in a small American town about a father and daughter who are both gay.

It’s striking that Vladimir Putin’s Russia, while taking a strident stance against Islam-inspired terror, has been eager to team up with Islamic governments in resisting the global movement for LGBT rights and same-sex marriage. Moscow’s foreign-policy rhetoric has raised the standard of “traditional” values and cultures which have a common interest in resisting the liberal tide. As is pointed out by Lucian Leustean, a scholar of geopolitics and religion at Britain’s Aston University, Russia’s new national-security strategy makes prominent mention of “spiritual security”, in other words the idea that Russia’s moral and metaphysical values are under global threat. This converges, at least in part, with the concept of “faith security” which has been used by the Egyptian government to justify strict government oversight of religion, clamping down on atheism and “blasphemy” as well as ultra-pious extremism.

And in Russia and Egypt alike, being an international advocate for traditional values seems perfectly consistent with dealing fairly harshly at home with forms of religion that don’t conform to officially approved norms. Forum 18, an independent religious-freedom campaign, said today in a report that it knew of 119 individuals who had been prosecuted in Russia last year for exercising freedom of religion; they ranged from Jehovah’s Witnesses and Mormons to followers of China’s Falun Gong movement. Most had received fines, a few found themselves briefly in custody. The total was a sharp rise on the 2014 figure of 23 prosecutions. 

ERASMUS

              LGBT Group from Jamaica Barred from Attending UN AIDS Conference

The United States and the European Union are protesting a UN decision to bar at least 20 non-governmental groups from taking part in a major AIDS conference next month.
US Ambassador Samantha Power said the NGOs taken off the list of participants "appear to have been chosen for their involvement in LGBTI, transgender or youth advocacy."
In a letter to UN General Assembly president Mogens Lykketoft, Power requested that these groups, including the US-based Global Action for Trans Equality, be allowed to take part in the June 8-10 high-level meeting on HIV/AIDS.
European Union Ambassador Joao Vale de Almeida said the NGOs had been struck from the list following objections from member states and requested information on which countries opposed their presence. 
One of the European NGOs that has been barred from taking part is the Eurasian Coalition on Male Health, based in Estonia, which has been vocal on gay rights in Russia and other former Soviet republics.
Egypt requested that 11 groups be barred from attending the AIDS conference, in a request sent on behalf of 51 countries of the Organisation of Islamic Cooperation (OIC), according to a letter seen by AFP on Tuesday.
Aside from the Estonian and US gay activist groups, Egypt objected to the participation of Ishtar Men Who Have Sex With Men group from Kenya and the Asia Pacific Transgender Network from Thailand.
The list cited groups from Egypt, Guyana, Jamaica, Peru, Ukraine as well as African Men for Sexual Health and Rights, a coalition of 18 LGBT groups across Africa.
The EU ambassador wrote in his letter sent last week that changes to an initial list of delegations were made without consulting member states.
"Given that transgender people are 49 times more likely to be living with HIV than the general population, their exclusion from the high-level meeting will only impede global progress in combatting the HIV/AIDS pandemic and achieving the goal of an AIDS-free generation," Power wrote in her letter.
The high-level meeting is aimed at fast-tracking measures to end the HIV epidemic by 2030.

May 18, 2016

Study: HIV Cancer Patients Less Likely to be Treated


 
Image result for cancer cells






 






ATLANTA -A new study finds HIV-infected patients with cancer in the United States appear to be less likely to receive cancer treatment, regardless of insurance and other existing health conditions. The study, by researchers at the University of Utah, National Cancer Institute and the American Cancer Society, appears early online in Cancer.

Cancer is an increasingly common cause of morbidity and mortality among individuals infected with the human immunodeficiency virus (HIV). In the United States, cancer incidence rates in this population have increased since the introduction of highly active antiretroviral therapy (HAART). Cancer is now the second most common cause of death among HIV-infected individuals, after AIDS-related deaths.

While previous studies have shown that cancer patients who are infected with HIV are less likely to receive cancer treatment compared with HIV-uninfected individuals, whether that was due to insurance status and other conditions was largely unstudied. For the new study, researchers led by Gita Suneja, MD, MSHP, from the Department of Radiation Oncology at the University of Utah used the National Cancer Data Base to study non-elderly adults diagnosed with ten common cancers from 2003 to 2011. They examined associations between HIV status and lack of cancer treatment, taking into account insurance status and comorbidities.

After adjusting for those two known predictors of lack of treatment, the disparity remained for all cancers studied, except anal cancer. HIV-infected patients were more likely to lack cancer treatment for cancers of the head and neck (relative risk [RR] = 1.48); upper gastrointestinal tract (RR = 2.62); colorectum (RR = 1.70); lung (RR = 2.46); breast (RR = 2.14); cervix (RR = 2.81); prostate (RR = 2.16); Hodgkin lymphoma (RR = 1.92); and diffuse large B-cell lymphoma (RR = 1.82).

The authors say factors that predicted a lack of cancer treatment among HIV-infected individuals varied by tumor type (solid tumor vs lymphoma), but black race and a lack of private insurance (e.g.: having Medicaid, Medicare or no insurance) were found to be predictors for both groups. However, even among privately insured cancer patients, HIV-infected cancer patients are less likely to receive cancer directed treatment compared to HIV-uninfected patients.

The study says several factors may contribute to the finding. HIV-infected patients have historically been excluded from cancer clinical trials, thereby limiting the applicability of clinical trial results for this population. Cancer treatment guidelines specific to HIV-infected patients are not available for most cancer types. Clinicians may lack experience treating HIV infected patients with cancer. Furthermore, the psychosocial and economic challenges associated with the dual management of cancer and HIV treatment may make adherence to treatment a challenge.

"...cancer care providers and policy makers need to devote special attention to the HIV-infected patient population to understand and address the factors driving differential cancer treatment," write the authors. "Cancer treatment not only extends survival from cancer, but also can improve quality of life, even for patients with advanced stage disease. The observed disparity is of particular importance given the extended survival of HIV infected patients treated with antiretroviral therapy and the rising number of cancer cases."

###

The study was a collaboration between the University of Utah School of Medicine Department of Radiation Oncology, American Cancer Society Intramural Research, Emory University Epidemiology, and the National Cancer Institute Division of Cancer Epidemiology and Genetics.

Article: Disparities in Cancer Treatment among Patients Infected with the Human Immunodeficiency Virus, CANCER; published early online May 17, 2016 DOI: 10.1002/cncr.30052
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