HIV and AIDS: June 2007

June 28, 2007

Laura Bush in Senegal for anti-HIV/AIDS, malaria campaigns

The First Lady of the United States, Laura Bush arrived in the Senegalese capital of Dakar Monday at the start of a four-nation Africa tour to bolster the US government's anti AIDS and malaria strategies.

She was met at the airport by President Abdoulaye Wade's wife Viviane.

From Senegal she is due to travel to nearby Mali then Zambia and Mozambique during a five-day long trip to the continent which will also focus on education and women's empowerment.

She is due to visit US-funded 15 billion dollar projects under the President's Emergency Program for AIDS Relief (PEPFAR), which was launched by President George W. Bush in 2003 and is due to expire in September 2008.

Bush last month asked Congress to set aside 30 billion dollars over five years to fight AIDS worldwide.

Sub-Saharan Africa remains by far the worst-affected region and is home to two-thirds of all people living with HIV.

In 2005 Bush launched a anti-malaria campaign aimed at funding pesticide spraying, handouts of bed nets and provision of anti-malarial drugs.

Malaria remains a leading killer worldwide, claiming more than one million lives every year, most of them in Africa.

The mosquito-borne illness is the number one cause of death in children under the age of five, causing one death every 30 seconds.

Ninth HIV-infected child dies in Kazakhstan

An HIV infection scandal in Kazakhstan deepened Tuesday with the death of a ninth child who contracted the virus at a hospital due to negligence, an AIDS centre said.

The death came as a court began reading a verdict in a suit against 21 officials accused in the case for negligence, corruption and fraud. If sentenced they could face between four and nine years in prison.

The accused have all denied the charges over the infections at hospitals in Kazakhstan's southern Shymkent region. The case has rocked the country and claimed several scalps, including that of the health minister.

A total of 118 children and 14 mothers were infected with the virus that can lead to AIDS, mainly during blood transfusions. Often the medical equipment used was not sterilised properly.

"A ninth child, a two-year-old boy, died on Tuesday after contracting HIV at Shymkent's hospital for infectious diseases," a statement from the AIDS centre in the city said.

An investigation has revealed abysmal health standards at local hospitals in the country's south and the fact that people paid bribes to get safe blood transfusions.

Experts believe the first cases of HIV diagnosed among Kazakh children were probably contracted last spring during blood transfusions or from non-sterilised medical equipment.

Ninth HIV-infected child dies in Kazakhstan

An HIV infection scandal in Kazakhstan deepened Tuesday with the death of a ninth child who contracted the virus at a hospital due to negligence, an AIDS centre said.

The death came as a court began reading a verdict in a suit against 21 officials accused in the case for negligence, corruption and fraud. If sentenced they could face between four and nine years in prison.

The accused have all denied the charges over the infections at hospitals in Kazakhstan's southern Shymkent region. The case has rocked the country and claimed several scalps, including that of the health minister.

A total of 118 children and 14 mothers were infected with the virus that can lead to AIDS, mainly during blood transfusions. Often the medical equipment used was not sterilised properly.

"A ninth child, a two-year-old boy, died on Tuesday after contracting HIV at Shymkent's hospital for infectious diseases," a statement from the AIDS centre in the city said.

An investigation has revealed abysmal health standards at local hospitals in the country's south and the fact that people paid bribes to get safe blood transfusions.

Experts believe the first cases of HIV diagnosed among Kazakh children were probably contracted last spring during blood transfusions or from non-sterilised medical equipment.

India Inc joins hands to fight HIV/AIDS

In a unique initiative, the National AIDS Control Organisation (NACO) has signed an MoU with Ballarpur Industries and ACC Cement to provide free anti-retroviral drugs at their therapy centres.

Joint Director (IEC) NACO Mayank Agarwal told The Indian Express that the move was part of a public private partnership. NACO aims at providing a supportive environment, specially when corporate conglomerates such as Ballarpur Industries and ACC Cements have joined hands to fight HIV/AIDS under the aegis of the Confederation of Indian Industry (CII).

The corporate anti-retroviral therapy (ART) centres are being facilitated by CII for workplace employees and even nearby communities suffering from HIV. NACO will provide free diagnostic test kits (HIV/CD4), ARV drugs (first line) and drugs for opportunistic infections at Ballarpur Industries' unit in Chandrapur, Maharashtra and at the ART centre of ACC Cements at Wadi in Karnataka. These centres will be recognised as NACO designated centres.

Meanwhile, a project-Access to Care and Treatment (ACT)-has been initiated by CII along with four other NGO partners through a consortium approach. The consortium comprises Population Foundation of India, Engender Health, Freedom Foundation, Indian Network of Positive People and CII. Corporate India has responded by having a workplace policy which includes a plethora of services which corporates have signed up for.

What's more, India Inc is training employees to conduct HIV/AIDS awareness sessions at the workplace. HUL, Pepsi, Coca-Cola, SRF group, Bilt, Apollo Tyres and Transport Corporation of India are some of the companies which have partnered the International Labour Organisation (ILO), whereby the ILO trains the companies' employees on disseminating information about HIV/ AIDS at the workplace.

Not only that, corporates are educating truckers about HIV/ AIDS prevention, control and care at their factories and have also tied up with the state AIDS control societies for awareness sessions.

Health workers jailed in Kazakh baby AIDS death case

A Kazakh court jailed more than a dozen health workers on Wednesday for infecting 78 babies with HIV/AIDS but provoked parents' outrage for sparing senior officials.

Ten babies have died as a result of being infected.

A group of medical workers went on trial in the southern city of Shymkent in January on charges of criminal negligence for allowing the children to be infected, mainly through blood transfusions in hospitals.

Campaigners accuse the oil-producing former Soviet state of doing too little to improve hospitals, raise medical standards and root out discrimination against HIV-positive patients.

In a Soviet-style courtroom adorned with a portrait of Kazakh President Nursultan Nazarbayev, relatives shouted "They deserve death!" after the judge gave suspended sentences to senior health official Nursulu Tasmagambetova, among others.

"This is not what I call justice," said Kanat Alseitov, whose son was among the infected children. "I didn't think it would be this way. Those who got suspended sentences are the most senior ones and thus most responsible for all this."

Most defendants -- doctors and health officials -- received jail sentences ranging from a few months to eight years.

After the verdict, the relatives, mostly headscarved women in traditional colorful clothes, scuffled with police shouting "Death!" and "What for?" as those convicted looked on.

Some fell to the floor in fits of extreme emotion. A court doctor took the pulse of a woman in her 30s who seemed unconscious. Relatives threw stones and plastic bottles at a police van that drove the convicted people away.

BABIES

The case has exposed the vulnerability of HIV patients in Kazakhstan, where the World Bank says the number of registered cases has almost doubled every year since 2000. As the trial went on, the number of infected babies rose to 118.

Judge Ziyadinkhan Pirniyaz listed evidence of negligence, theft of health funds and the abuse of patients. He said many babies received transfusions without their parents' consent.

The victims' lawyers said they would appeal against the decision.

The relatives, most of whom did not want to give their names for fear of stigma, described sparing senior officials jail terms -- including Tasmagambetova, the sister of the powerful mayor of the financial capital Almaty -- as a slap in the face.

They said state healthcare payments were not enough for them to provide for the future of their HIV-infected children.

"I think the court had its own intentions," Alseitov said. "For such violations, criminals must get much more serious sentences."

Key AHCA Finance Official Doubts New HIV/AIDS Disease Management Vendor's Financial Ability

During the process of appealing the recent award of a state program to provide HIV/AIDS disease management (DM) services to Florida's Medicaid population, testimony from a key Florida Agency for Health Care Administration (AHCA) official revealed a legal and bureaucratic bombshell: The only AHCA evaluator who has reviewed the financial status of the proposed new vendor, determined that the vendor lacks the financial capacity to actually run the program, which provides crucial services to 8,000 Floridians with HIV/AIDS The AHCA official, a certified public accountant, also admitted that these concerns have not been shared with higher ups at AHCA.

"Early last month, AHCA announced that it intended to award its HIV/AIDS disease management program for the oftentimes hard-to-reach and vulnerable Medicaid population to a private, for profit vendor with little experience in HIV/AIDS," said Michael Weinstein, President of AIDS Healthcare Foundation (AHF), the nation's largest AIDS organization which has operated Positive Healthcare-Florida (PHC), the successful and cost-effective HIV/AIDS disease management program serving over 8,000 Florida Medicaid recipients for the past eight years. "In her eye-opening deposition, AHCA's financial expert testified that to significant concerns that the vendor that AHCA ultimately selected is not a financially stable company; that its financial condition was deteriorating and 'below average' and that the company lacked the financial resources to adequately perform and manage a contract of this size on behalf of Florida and the patients it serves. We will share these alarming revelations with AHCA officials immediately and ask AHCA to revisit and fully examine its process of awarding this crucial program for lifesaving HIV/AIDS services in Florida."

On Wednesday, June 20th, AHF attorneys deposed the sole AHCA financial official who reviewed the financial statements submitted by both AIDS Healthcare Foundation Disease Management and Specialty Disease Management Services, Inc. (SDM), in response to AHCA's request for proposals for its HIV/AIDS disease management program. The deponent testified that she had never communicated her concerns about SDM's lack of resources and financial instability to anyone else at AHCA because she had been specifically instructed to not communicate with anyone else about her evaluation of the proposals submitted in connection with the RFP.

"In light of this information, we are calling upon AHCA to take the only responsible course of action available to it at this point and throw out the bids and issue a new RFP," said Tom Myers AHF's General Counsel. "In contrast, if AHCA awards this contract to SDM and SDM proves incapable of performing its duties-a significant risk in light of its lack of experience managing HIV/AIDS programs in the past five years and its unstable and deteriorating financial condition-the consequences for HIV/AIDS patients in Florida will be devastating. Through an official letter to AHCA, we are putting the agency on notice of the significant concerns voiced by its very own financial evaluator."

Changes to Florida's HIV/AIDS Disease Management Program

Florida has, over the past two years, also slashed the budget for this innovative, cost-saving disease management program from $11 million down to $4.5 million annually. When Florida announced that it intended to award its HIV/AIDS disease management program to this new, financially-unstable vendor, HIV/AIDS patients, nurses, and HIV and community activists immediately engaged in a grass roots effort to stop this looming disaster, including passionate protests in Tallahassee (June 13) where some activists had the opportunity to meet and discuss the issue with Governor Charlie Crist, Miami, (June 7), Tampa (May 31), Ft Lauderdale (May 11) and spearheaded a letter-writing campaign to Florida Governor Charlie Crist to urge him to reconsider the changes to this disease management program. To date, more than 5,000 letters have been drafted.

At an appearance in St. Petersburg this past weekend, Governor Crist was again met with protesting nurses and AIDS patients and spoke publicly for the first time about the drastic cuts to Florida's AIDS programs. Many of the same nurses and AIDS patients gathered in St. Petersburg had also protested the Governor at two previous community appearances earlier in the day in Ocala and Inverness. In Ocala, as he was leaving, the Governor spoke with some of the group and told them, "I love your cause. I love what you are doing. Keep coming back." However, by the third encounter of the day with the group in St. Petersburg, the Governor reversed himself and seemed to trivialize the nurses and AIDS patients' message and goals. Referring to the protesters outside, Crist told those gathering for his official appearance, "Jeb Bush told me I wouldn't know what it's like to be governor until I had protesters. These protesters are upset that they did not get a contract ..., but that's the way it goes. It was to save you (pointing to audience) money! I'm here to tell you that AIDS patients do have care in Florida."

Regarding its own disease management program in Florida, AHF, which operates Positive Healthcare, has met or exceeded all medical performance measures for its patients, and simultaneously saved the state more than $20 million in healthcare costs over the past eight years. Positive Healthcare is the first of only two disease management organizations to receive full accreditation from the National Committee for Quality Assurance (NCQA), a national non-profit organization that measures and advocates for health care quality.

World Bank loans Kenya 80 million dollars to boost war on AIDS

The World Bank has approved a loan of 80 million dollars (60 million euros) to boost Kenya's efforts to fight HIV/AIDS, which poses a major challenge in the country, an official statement said Wednesday.

The funds will be used to strengthen the National AIDS Control Council (NACC), the country's frontline agency in fighting the deadly disease that has killed at least 1.5 million people since 1984.

"We are determined that the support should reach the five million people in Kenya - especially orphans and young women - who are directly and indirectly affected and made very vulnerable by the disease," said Colin Bruce, the bank's representative in Kenya, in the statement.

Britain's Department for International Development (DfID) is also expected to provide 33 million dollars (25 million euros) in additional funding towards the country's war against the scourge, the statement added.

The NACC said Tuesday the rate of HIV/AIDS infections in the country of nearly 35 million fell from 6.1 percent in 2004 to 5.9 percent in 2005.

A shift in sexual habits and the more widespread use of condoms had played a large part in curbing infections, whose prevalence Kenya aims to slash to a rate of 5.5 percent by 2010, said the agency.

At least 1.3 million people are currently living with HIV/AIDS in Kenya, 65 percent of whom are women between the ages of 19 and 45, according to NACC statistics.

Last year, Kibaki announced that public hospitals would no longer charge HIV/AIDS patients for life-prolonging anti-retroviral drugs, in a new bid to fight the disease.

Kenya says HIV/AIDS rate drops to 5.9 percent

The Kenyan governmment said Tuesday the rate of HIV/AIDS infections had dropped to 5.9 percent, but conceded the disease still posed a major challenge in the country.

The state-run National Aids Control Council (NACC) said the rate fell from 6.1 percent in 2004 to 5.9 percent of the country's nearly 35 million people.

"Of notable significance is the decline in new infections from 85,000 in 2004 to 60,000 in 2005 as well as the drop in HIV prevalence from 6.1 percent to 5.9 percent in the same period," said NACC chairwoman Miriam Were.

She said a shift in sexual habits and the more widespread use of condoms had played a large part in curbing infections, whose prevalence Kenya aims to slash to a rate of 5.5 percent by 2010.

The UN's frontline agency for AIDS, which in 2004 cautioned the country against relying on dubious statistics to assess its performance in combating the disease, commended the Kenyan authorities' efforts.

"Kenya has made remarkable improvement in bringing down the prevalence rate. UNAIDS is pleased with these efforts," said UNAIDS co-coordinator Dr Erasmus Morah.

The rate of prevalence stood at 10 percent in the late 1990s.

At least 1.3 million people are currently living with HIV/AIDS in Kenya, 65 percent of whom are women between the ages of 19 and 45, according to NACC statistics.

Last year, Kibaki announced that public hospitals would no longer charge HIV/AIDS patients for life-prolonging anti-retroviral drugs in a new bid to fight the deadly disease.

But public health experts have cautioned against the excitement caused by antiretrovirals (ARVs).

"Some people may begin to think a cure has been found, so we need to keep reminding everybody that ARVs are not a cure. The only thing they do is reduce the burden of the virus so that you can lead your life normally," health expert William Muraah told AFP.

Speaking at a teachers' assembly Tuesday, Kibaki lamented what he said was a surge in AIDS infections in schools.

"The current trends of indiscipline, drug and substance abuse, and HIV infection among teachers and students in our schools are worrying," said the president, who called for tough action to buck this phenomenon.

Since 1984, at least 1.5 million people are said to have died from AIDS in Kenya, according to health ministry estimates.

Sub-Saharan Africa accounts for almost two-thirds of all people infected with HIV and 72 percent of global AIDS deaths, according to UNAIDS.

As of June last year, around one million Africans were receiving antiretroviral drugs which roll back the AIDS virus, a tenfold increase since December 2003.

But this was still less than a quarter of the estimated 4.6 million people in need of the drugs on the continent.

June 25, 2007

"Girl, Positive" a stirring HIV tale for teens

The Lifetime original movie "Girl, Positive" should give girls and their parents a good dose of reality.

The story of a teen who fears that she might be infected with HIV is told in a straightforward, no-nonsense way and benefits from a cast that is believable all the way.

The story revolves around two women, a teenager named Rachel (Andrea Bowen) and her substitute teacher, Sarah (Jennie Garth). Rachel becomes alarmed when a boy she has slept with dies from AIDS complications. The only person she can really talk to is Sarah, who, wouldn't you know, already is infected but has kept it a secret from most people. Sarah gets Rachel to go to a free clinic to volunteer -- and to get tested.

The no-frills story pulls a few punches. In addition to two sympathetic actresses who take the lead, we also are treated to "Law & Order" mainstay S. Epatha Merkerson in a thankless role as Sarah's friend who oversees the free clinic. Unfortunately, Merkerson has to put up with dialogue shot full of "supporting girlfriend" cliches, but she's effective nonetheless.

Nancey Silvers' script is down-to-earth and dramatic enough to overcome material that otherwise could have seemed pedantic. Director Peter Werner keeps the characters moving and looking authentic.

David Beatty's editing also helps to keep the story moving, giving it a good pace and rhythm. Richard Marvin's music offers the right mood as well. The story easily could have become bogged down by the weight of its serious subject, but fortunately for its viewers, this never happens.

"Girl, Positive" is successful because it keeps the delicate balance of "message" movie and drama in tow and never lets us down. What we get is a fine dramatic re-enactment of some very real and very worrisome statistics in this country: Half of all new HIV infections occur in people 25 and younger.

Weaning prisoners away from drugs and HIV tough but possible

Drug use among prisoners is a huge problem that leads to HIV transmission in overcrowded jails and weaning them away from it is possible but tough, according to the UN Office on Drugs and Crime (UNODC) regional centre for South Asia here.

As a result, 'all over the world, rates of HIV infection among prison populations are much higher than in the general population,' Jayadev Sarangi of UNODC points out.

'Drug use in general, and injecting drug use (IDU) in particular, as well as violence and the practice of men having sex with men are widespread in prisons, leading to HIV transmission,' Sarangi says. 'Many prisoners share needles to inject drugs. This is also an important mode of HIV transmission.'

Most prisons in South Asia are overcrowded, leading to higher risk of infection. According to the International College for Prison Studies in Kings College, London, in 2004-05 the occupancy levels in prisons were 277.1 percent in Bangladesh, 139 percent in India, 147.4 percent in the Maldives, 142.6 percent in Nepal and 193.2 percent in Sri Lanka.

UNODC is working among more than 20,000 prisoners in South Asia on issues related to drugs and HIV. It has also been building the capacities of 4,250 prison officials, welfare officers, doctors and volunteers to work with prisoners on these issues.

'Currently there is growing awareness and widespread concern about drugs and HIV/AIDS in prisons, though it may take a while to change the legal and institutional framework for working with prisoners,' Sarangi says. UNODC has found that there is an urgent need for training custodial and rehabilitation agencies, and of greater coordination between them.

The process of weaning anyone away from drug abuse involves giving him smaller and smaller doses of the drug. The UN organisation has suggested that these drugs be made available by the authorities to ensure that they are not contaminated, and that voluntary groups be involved in the detoxification process.

UNODC has stressed several other issues that need attention while working with prisoners. These include reduction in overcrowding, other sentencing programmes and separation of juveniles from adult prisoners.

Many people are in prison for the sole crime of being drug users, Sarangi points out. UNODC has suggested that treating these people may be an alternative to imprisonment.

UNODC has also suggested confidential and voluntary counselling and testing for HIV among prisoners. Sarangi says: 'This should be followed by psychosocial support, antiretroviral therapy, improved hygiene, sanitation and diet for HIV-infected prisoners.'

The UN organisation has also suggested similar care for prisoners suffering from other sexually transmitted infections, tuberculosis and hepatitis B and C.

The intervention programme has not reached most of the prisoners in South Asia. But UNODC has found positive results wherever it has reached. 'As people prepare to observe June 26 as the International Day against Drug Abuse and Illicit Trafficking, the need is to expand this and similar programmes many times,' according to Sarangi.

Stars sign up for Press Aids Test

Ugly Betty star Vanessa Williams, Nick Cannon and Ray actress Regina King are all getting tested for HIV as part of a new drive to urge African-Americans to get tested for AIDS.

The trio will be part of a Los Angeles press conference which will take place two days before America's National HIV Testing Day at the end of June.

As part of the press stunt, the stars will officially be tested for HIV.

Event spokeswoman Linda Jones says, "The purpose of the press conference is to draw attention to the AIDS epidemic in the black community and to urge people, particularly black people, to get tested.

"Black Americans, more than any other racial ethnic group, are disproportionately affected by HIV/AIDS. Of the 1.3 million Americans living with HIV/AIDS nearly 50% of them are black."

And organisers of the hard-hitting press conference are hoping to persuade other big name African-American stars to step forward and get tested.

The spokesman adds, "Our goal is to get a broad cross section of actors to participate in the press conference."

Each star will be tested for HIV and then they'll talk about the experience and how important they think it is for fellow African-Americans to get tested.

AIDS-ravaged Mozambique to recruit African doctors

Mozambique hopes to recruit 8,000 doctors from other African nations to improve a health-care system battered by one of the continent's worst AIDS epidemics, the country's health minister said on Monday.

There are some 650 doctors serving Mozambique's estimated 20 million people. That figure is about three times fewer doctors than recommended by international health authorities.

In an interview with Reuters, Health Minister Ivo Garrido said a shortage of doctors and rising numbers of patients, many stricken with AIDS, had created a crisis in state-run hospitals and clinics across the impoverished southern African nation.

"The main problem in the Ministry of Health is the shortage of (medical) staff. We need specialized doctors, not just general practitioners, and we would love to recruit 8,000 African doctors in the next 10 years," he said.

Garrido, however, added that Mozambique might look to Asia and Latin America to supply doctors if they could not be found in Africa, where many nations are dealing with shortages of doctors, nurses and medical assistants.

About 16 percent of adults in Mozambique, including many health-care workers, have the virus.

The country's high HIV infection rate has further squeezed its capacity to provide basic medical services, including pre-natal care.

"The shortage of qualified staff is significant in every area, but as with doctors, the deficit is huge and AIDS is going to cause the loss of many workers in our sector," Garrido said.

HIV testing and treatment in Mozambique are now widely provided by nurses and medical helpers, although health officials have warned poor salaries and enormous workloads threaten their ability to continue doing so.

Nurses in Mozambique, whose health-care system was devastated by a 17-year civil war that ended in 1992, earn on average about $230 a month, while doctors make about double that amount.

Parents boycott India school after HIV kids allowed back

A group of HIV-positive children trying to attend school in southern India have faced a fresh setback with parents of their classmates pulling their kids out of class, officials said.

The move was the latest twist in a six-month battle that has highlighted the stigma suffered in India by those living with HIV and AIDS -- in this case one boy and four girls aged between five and 11.

The children appeared to have won a victory last week when the Christian school in southern Kerala state that threw them out six months ago allowed them to return to class -- but it was short-lived.

"Among the 65 students on our rolls, only three children came to school on June 21 and the next day none turned up," principal Elsamma Mani told AFP.

"Today also the school remained closed as no students turned up to attend class."

Officials have assured parents that HIV is not transferred by sitting next to or touching an infected person, but suspicion remains.

"I will not let my children attend classes with the HIV-positive children, come what may," an irate mother who had pulled her kids from the school told the NDTV news channel Monday.

Another father, speaking to AFP, questioned why the shelter that houses the kids had not admitted them into its own school if there was no risk of transmission.

The school's parent-teacher association has said it will not send children to class in protest against state government pressure over the affair, which has seen the establishment threatened with the loss of its permit to operate.

The kids were first "outed" when a local paper published photographs of them attending an event on world AIDS day in December, a report in the Hindustan Times said, prompting other parents to call for their expulsion.

Three of the five children are infected with HIV but all were living in a shelter for infected mothers.

Officials in Kerala state -- reputed to be one of the country's most progressive -- said they would continue to work to make sure the children were accepted.

"I hope that the villagers will realise their mistake and accept the children," said Kerala education minister M.A. Baby.

India, with a billion-plus population, has 5.7 million people infected with HIV -- the world's highest in absolute numbers per country.

Officials said this month that under new data being compiled, the number of HIV-positive could be as low as 3.4 million.

June 22, 2007

Fighting Ancient Virus May Have Left Humans Vulnerable to HIV

Humans' distant ancestors beat back a now-extinct virus 4 million years ago, but that victory left the species vulnerable to HIV today, scientists believe.

The finding may also explain why chimpanzees, gorillas and other primates resist infection with the virus that causes AIDS, while humans are much more easily infected.

The difference lies in a human gene called TRIM5alpha, which, in lab experiments, effectively blocked infection from a reconstructed portion of the ancient retrovirus, called PtERV1. That virus probably flourished 4 million or 5 million years ago but is extinct today.

Writing in the June 22 issue of Science, the researchers say PtERV1 left behind telltale traces of its DNA inside the genomes of many primates -- with the notable exception of humans, suggesting it never gained a foothold there.

In fact, when geneticists first compared the genomes of humans against those of chimps, "the biggest difference is the presence [in nonhuman primates] of this virus, PtERV1," said study senior author Michael Emerman, a member of the Human Biology and Basic Sciences divisions at the Fred Hutchinson Cancer Research Center, in Seattle.

"There are about 130 copies in the genomes of chimps and gorillas, and maybe other primates, but it's not present at all in the genome of humans," Emerman said.

That could mean one of two things, he said: Either the ancestors of Homo sapiens already carried the TRIM5alpha gene and couldn't be infected by PtERV1, or PtERV1 wiped out all but a few individuals who were lucky enough to carry the gene. Those individuals might then have passed the gene on through their progeny, right up to the humans of today.

However, that early antiviral victory may have a darker legacy.

The experts found that various primate species carry slightly different versions of TRIM5alpha, one of a class of infection-blocking genes called "cellular restriction factors." In the case of Homo sapiens, the gene's ability to block infection against PtERV1 does not seem to extend to another dangerous retrovirus, HIV.

"We know that the human version of TRIM5alpha isn't good at all against HIV," Emerman said.

On the other hand, the TRIM5alpha found in chimps and gorillas appears to be very effective in denying HIV access to cells. It probably wasn't much good against PtERV1, however.

This type of "either/or" situation often happens in genetics, Emerman said. Genes change so that species "get better at something -- but they get worse at something else," he said.

The end result in this case is that "the human type of TRIM5alpha does not restrict HIV, and yet the TRIM5alpha in other primates can restrict HIV infection," explained Rowena Johnston, vice president for research at the Foundation for AIDS Research (amfAR) in New York City. "The critical question is, what do they have that we don't have?" she said.

She and Emerman agreed that the Hutchinson discovery isn't of immediate practical benefit to the fight against AIDS. But Johnston said research focused on cellular restriction factors such as TRIM5alpha remains "one the most promising and interesting areas of research that we have going on in the HIV world right now."

"Is there a way for us to be able to use that information to make our TRIM5alpha more potent against HIV, or at least to work out how it is that TRIM5alpha works in other animals?" she asked. "Or, to see if we can come up with some kind of mimic that would do something similar in humans?"

Advances along those lines are likely to be a "long way off," Johnston cautioned.

"What we are really talking about here are millions of years of human evolutionary history that's made us how we are today," she said. "As the paper says, we've ended up with this trade-off. We have this great protection against PtERV1, and none of the protection against HIV."

Ancient viral battle left people vulnerable to HIV

A battle won by human ancestors against a virus that infected chimpanzees and other primates millions of years ago may have left people today more vulnerable to the AIDS virus, scientists said on Thursday.

That ancient battle helped humans evolve and rely on a gene that may not protect so well against a modern retrovirus, the human immunodeficiency virus or HIV, the researchers said.

They focused on an ancient virus, known as Pan troglodytes endogenous retrovirus, or PtERV1, to find clues as to why HIV has exacted such a high toll on humanity.

"Events that happened millions of years ago have shaped human evolution, in particular susceptibility to modern human infectious diseases," Michael Emerman of the Fred Hutchinson Cancer Research Center in Seattle, Washington, who led the study, said in a telephone interview.

There is genetic evidence that the PtERV1 virus infected chimpanzees, gorillas and old-world monkeys about 4 million years ago, but no evidence it infected humans. The virus is believed to have gone extinct perhaps 2 million years ago.

Emerman's team was able to resurrect a small portion of the PtERV1 by using DNA remnants of the virus lodged in the genome of chimpanzees.

Working with cells in a laboratory, they found that an old virus-fighting gene present in people, known as TRIM5a, succeeded in neutralizing PtERV1.

The gene makes a protein that binds to and destroys the virus before it can replicate within the body, they report in the journal Science.

"However, while TRIM5a may have served humans well millions of years ago, the antiviral protein does not seem to be good at defending against any of the retroviruses that currently infect humans, such as HIV-1," Emerman said in a statement.

VIRAL INFILTRATION

Small mutations may account for this. TRIM5a taken from baboons and African green monkeys carried mutations that helped it reduce HIV in lab dishes but it was almost useless against PtERV1.

When TRIM5a worked well against PtERV1, as in humans, it was ineffective against HIV.

"In the end, this drove human evolution to be more susceptible to HIV," Emerman said.

Retroviruses have been infiltrating the genomes of human ancestors and other animals for millions of years. These viruses go into the chromosomes and DNA of the cells they infect and can get passed on from generation to generation.

In fact, such vestiges of primitive infections comprise 8 percent of the human genome, Emerman said.

Other researchers found remnants of the PtERV1 retrovirus in the genomes of chimpanzees, gorillas and some other primates in Africa, but not humans or another great ape, the orangutan.

When the chimpanzee genome was mapped, a major difference compared to the human genome was the presence of about 130 copies of PtERV1 in chimpanzees and zero in people, the researchers. The retrovirus is so mutated in living chimps that it is inactivated, the researchers said.

While the study sheds light on the historical human susceptibility to pathogens, Emerman said, it does not appear to provide immediate clues as to how to beat HIV.

Expanded HIV Testing Pays Off: Studies

Making HIV screening routine in emergency rooms and at gay pride events expands the number of people getting tested and helps those who are HIV-positive get access to needed health care, new research found.

About one-quarter of the estimated one million people in the United States infected with the virus that causes AIDS don't know they have it. Consequently, they are at heightened risk for transmitting the virus to others, according to two reports published in the June 22 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

The reports come out just in time for National HIV Testing Day, June 27, and planned gay pride celebrations in many U.S. cities this weekend.

Study co-author Patrick Sullivan is chief of the behavioral and clinical surveillance branch, part of the CDC's division of HIV/AIDS Prevention. He said, "Routinely offering testing at emergency departments for people seeking care for other conditions is feasible and acceptable. The goal is to make testing available to as many people as possible."

"This is an important strategy to help people know their status," he said.

For the first report, researchers analyzed routine HIV testing that had been implemented in one hospital emergency department in Los Angeles, one in New York City and one in Oakland, Calif., in 2004 and 2005 as part of a CDC initiative.

Between January 2005 and March 2006, 186,415 people visited the emergency departments, 18.6 percent of whom (34,627) were offered rapid HIV tests. Nearly 60 percent (almost 21,000) of those offered agreed to be tested, and 9,365 received a rapid test.

Of those tested, 1 percent (97 patients) received a preliminary positive result for HIV infection, and 88 percent of those identified as HIV-positive were linked to appropriate care.

If only those persons reporting risky behaviors (male-to-male sexual contact, intravenous drug use, commercial sex work, or diagnosis of a sexually transmitted disease) had been offered testing, 48 percent of the people with newly diagnosed HIV infection would not have been tested, the study said.

These findings essentially paved the way for the CDC's revised recommendations in 2006 that call for HIV testing to become a routine part of medical services, using a voluntary "opt-out" approach.

For the second study, CDC researchers analyzed data from a survey of minorities who had attended gay pride events in nine U.S. cities from 2004 to 2006.

CDC representatives offered rapid HIV testing to survey participants who reported that they had not previously been diagnosed with HIV. Of 543 men surveyed, 133 agreed to be tested. Six percent (eight men) of those tested were HIV-positive. Four had had a negative test within the past year.

More than one-quarter of 229 participants had not seen a health-care provider within the past year and, of those who had, only 40 percent had been offered an HIV test.

The CDC sees HIV testing at gay pride events as part of a larger strategy to encourage testing among gay men. Testing in such settings is especially important to reach people who may not have regular access to health care, the CDC said.

Dr. Lisa Kudlacek Cornelius is an assistant professor of internal medicine with the Texas A&M Health Science Center College of Medicine and chairwoman of infection control/hospital epidemiologist with Scott & White Hospital in Temple. She said, "The important thing is to bring people into care sooner, before they have an AIDS-related illness."

With rapid testing, she added, "They have their answer within 20 minutes, but with testing, you also need counseling."

Male circumcision overstated as deterrent to global AIDS pandemic

While previous research has suggested that circumcision 'significantly' cuts HIV risk in men, a new study has found that it is much less important as a deterrent to the global AIDS pandemic than previously thought.

Author John R. Talbott who conducted statistical empirical research across 77 countries of the world conducted the study.

He found that the number of infected prostitutes in a country is the key to explaining the degree to which AIDS has infected the general population.

Prostitute communities are typically very highly infected with the virus themselves, and because of the large number of sex partners they have each year, can act as an engine driving infection rates to unusually high levels in the general population.

He also made two important discoveries.

First, male circumcision, which in previous studies had been found to be important in controlling AIDS, becomes statistically irrelevant once the study controls for the number of prostitutes in a country.

The study finds that the more Muslim countries of North Africa do indeed suffer much less AIDS than southern and western Africa, but this lower prevalence is not due to higher numbers of circumscribed males in these Muslim communities, but rather results from the fact that there are significantly fewer prostitutes in northern Africa on a per capita basis.

In a frequently cited academic paper, Daniel Halperin, an H.I.V. specialist at the Harvard Center for Population and Development and one of the world's leading advocates for male circumcision, weighted results from individual countries by their population. When this artificial weighting was removed Talbott found that circumcision was no longer statistically significant in explaining the variance in AIDS infection rates across the countries of the World.

Second, to date, there has not been an adequate explanation as to why Africa as a continent is experiencing an AIDS epidemic far in excess of any other region of the world with some African countries' prevalence rates exceeding 25 percent of the adult population and tens of millions dying from the disease on the continent.

Talbott's new study suggests that the reason is that Africa as a whole has four times as many prostitutes as the rest of the word and they are more than four times as infected.

Some southern Africa countries have as many as 7 percent of their adult females infected and working as prostitutes while in the developed world typically this percentage of infected prostitutes is less than .1percent.

If these infected prostitutes in Africa sleep with five men in a week that means they are subjecting 35 percent of the country's male population to the virus weekly. The virus is not easy to transmit heterosexually, b ut over time with multiple exposures, infection is inevitable. These men then act as a conduit to bring the virus home to their villages, their other casual sex partners and to their wives.

The study has important policy implications. Several international AIDS organizations have begun to provide funding for male circumcisions as a deterrent to AIDS.

The research is published in the online, open-access, peer-reviewed scientific journal PLoS ONE.

Libyan AIDS families say deal held up over compensation

Lack of agreement on compensation is holding up a deal in the case of six foreign medics sentenced to death in Libya after being convicted of infecting children with the AIDS virus, the children's' families said on Friday.

"Despite difficult negotiations, a compromise was found on the different points of the deal, including the children's care and treatment, but there is still one sticking point concerning the compensation," they said in a statement.

And Bulgaria's foreign minister confirmed on Friday that a deal was still far from being reached to resolve the case of the five Bulgarian nurses and a Palestinian doctor.

"There's been dynamism (in negotiations with the families) in the past few weeks but the case is still far from a solution," Ivailo Kalfin told Bulgarian national radio over the phone from Brussels.

"I cannot say when a deal will be agreed or announced as talks are still underway," the minister added.

On Thursday, EU External Relations Commissioner Benita Ferrero-Waldner had also played down reports of an imminent deal in the case.

Nevertheless, an official with the Kadhafi Foundation, a charity headed by the son of Libyan leader Moamer Kadhafi that has been involved in the negotiations, saw hope in the families' statement.

Their acceptance of a deal in principle "shows that we are close to the end of the tunnel," Salah Abdessalem said on Friday.

Families' spokesman Idriss Lagha also voiced optimism, saying that "if a compromise is reached on the last point (of compensation) the agreement will be considered a renunciation by the families of the death sentence handed down to the medics."

Libyan sources had said a simultaneous announcement could be made on Friday in Tripoli and Brussels, where EU leaders are gathered for a summit meeting.

The nurses and Palestinian doctor, who recently obtained Bulgarian citizenship, were arrested in 1999 accused of infecting 438 children with HIV-tainted blood at a hospital in the Mediterranean city of Benghazi.

They were sentenced to death in May 2004, while 56 infected children have died.

The six have denied the charges and foreign health experts have said the epidemic in Libya's second city was probably the result of poor hygiene.

If there was a deal, their death sentences could be commuted and any new sentence served out in Bulgaria, as Libya and Bulgaria have an extradition agreement.

The EU has expressed its opposition to any deal it sees as blackmail or compensation to the families.

Instead it has supported "a special assistance fund" which will serve, among other elements, to ensure free medical treatment of the sick.

"For us, the essential thing is to guarantee treatment of the children," another spokesman for the families' association, Ramadan al-Fituri, said on Thursday.

A Libyan official told AFP on Friday that Tripoli had persuaded "certain European countries, including Bulgaria" to convert Libya's debts into contributions into a medical fund which would ensure free treatment of the sick.

Negotiations were now underway to persuade the families to review and reduce their financial demands, said the official, who asked not to be named.

The case has sparked mounting criticism from the EU and the United States and hindered Libya's efforts at rapprochement with the West after Kadhafi's regime renounced efforts to develop mass destruction weapons in December 2003.

US President George W. Bush appealed for the release of the medics last week during a visit to Bulgaria.

Bulgaria in talks over Libyan AIDS case

Bulgaria's foreign minister said Friday that negotiations were taking place with the families of Libyan children with HIV, but he cautioned that a deal to allow the release of six medics convicted of infecting them was far from being reached.

Foreign Minister Ivailo Kalfin told Bulgarian National TV that there has been "dynamism" in the past few weeks in the AIDS case, in which five Bulgarian nurses and a Palestinian doctor have been sentenced to death for deliberately infecting 400 Libyan children with HIV in the city of Benghazi.

All six, who have been in Libyan custody since 1999, say they are innocent. Libyan court officials said they admitted infecting the children, but some of the nurses have since said they confessed under beatings and torture.

"I do not expect anything to be announced today, nor can I say when this could happen as talks are still under way," Kalfin said, speaking from Brussels, Belgium.

German Foreign Minister Frank-Walter Steinmeier led a European Union mission to Libya this month to help win the medics' release. The EU has released $3.4 million in aid to help Libya cope with an outbreak of HIV-AIDS in the city of Benghazi.

On a visit to Bulgaria last week, President Bush also urged Libya to free the six, who have been sentenced to death twice, in 2004 and again in 2006 following an appeal.

Last month, nurses Kristiana Valcheva, Nasya Nenova, Valentina Siropulo, Valya Chervenyashka and Snezhana Dimitrova, and Dr. Ashraf al-Hazouz were cleared of defamation charges in a related case, which raised hopes among their supporters.

Libya's Supreme Court will rule on July 11 on their latest appeal.

If the court upholds the convictions and sentences, it is not necessarily the final word. The decision would then go to Libya's Supreme Judicial Council, which could approve the verdict, annul the conviction or set a lighter sentence.

Earlier this week, Bulgaria announced that al-Hazouz, the Palestinian, has been granted Bulgarian citizenship. This would ensure he is treated in the same way as the Bulgarian nurses under an agreement Sofia has with Libya.

June 21, 2007

Libya court to rule July 11 on AIDS case

Libya's Supreme Court said Wednesday it would rule July 11 on the appeal of five Bulgarian nurses and a Palestinian doctor sentenced to death on charges of infecting about 400 Libyan children with the AIDS virus.

The court announced the date after final arguments from lawyers of the nurses and the families of the infected children and from the state prosecutor, who called for the verdict to be upheld.

The nurses and the doctor were not present at the session, which was attended by ambassadors from several European countries.

If the Supreme Court upholds the conviction and sentence, it is not necessarily the final word. When the December verdict was announced, Libya's foreign minister said a decision by the Supreme Court to uphold the sentence would go to a judicial board that could itself uphold or annul the decision.

Libya is under intense international pressure to free the six medical personnel, who deny infecting the children. The case has become a sticking point in Libya's attempts to rebuild ties with the United States and Europe. President Bush called on Libya last week to free the medics.

The prosecution insists that the six infected the children intentionally in experiments to find a cure for AIDS. Defense experts testified that the children were infected by unhygienic hospital conditions. In their testimony, the workers said the confessions used by the prosecution had been extracted under torture. Several of the nurses have said they were also raped to force confessions.

The six began working at the hospital in the city of Benghazi in March 1998 and were arrested the next year after more than 400 children there contracted HIV. Fifty of the children have died.

The medical workers were convicted and sentenced to death in 2004, but the Supreme Court ordered a retrial after an international outcry over the verdicts.

But in a ruling that shocked many in Europe, the second trial issued the same verdict in December — despite a scientific report weeks earlier saying HIV was rampant in the hospital before the six began working there.

Two Libyans — a police officer and a doctor — were put on trial on charges of torturing them and were later acquitted — which led to the six medics being put on a new trial for defamation.

They were acquitted of defamation in late May, a ruling that raised hopes in Bulgaria that the main conviction and death sentences against them could be overturned by the Supreme Court.

Also Wednesday, the judge refused a prosecution motion that an announcement from the Bulgarian government that the Palestinian doctor had been granted Bulgarian citizenship be used as evidence against him.

Bulgaria announced Tuesday that the doctor, Ashraf al-Hazouz, had applied for citizenship several years ago and that the procedures for his acceptance were completed last week.

Hepatitis B Drug a Threat to Those With HIV

Patients infected with both hepatitis B and HIV should not take the hepatitis-fighting drug Baraclude on its own, new research confirms.

The problem is that Baraclude (entecavir) can cause HIV to become resistant to life-extending AIDS medications, according to a study in the June 21 New England Journal of Medicine.

Co-infection with the two sexually transmitted viruses is relatively common -- for example, one 2006 study found that half of HIV-positive American gay men also carry hepatitis B, which is a major cause of fatal liver disease, including liver cancer and cirrhosis. More than 1.2 million Americans are thought to be infected with hepatitis B.

Baraclude, which was first approved to fight hepatitis B in early 2005, does perform well at keeping hepatitis B at bay. But it could also undermine the potency of combination drug therapies in patients who are also HIV-positive, the new study showed.

"This means that if you are going to go ahead and treat for hepatitis B, you better be screening for HIV, too," said Dr. Michael Horberg, director of HIV/AIDS Policy, Quality Improvement and Research at Kaiser Permanente in Santa Clara, Calif. "You can't just say, 'I need to treat the hepatitis B with entecavir, and they'll be fine,' because we now know that that is not the case," said Horberg, who was not involved with the study.

The new findings were first presented in February at the Conference on Retroviruses and Opportunistic Infections in Los Angeles.

Soon after the findings' initial release, Baraclude's maker, Bristol-Myers Squibb, changed the medication's labeling to warn of the potential for HIV drug resistance. The U.S. Department of Health and Human Services also revised its hepatitis B treatment guidelines to warn against using Baraclude as a stand-alone treatment in patients co-infected with HIV who are not yet treated for the latter virus.

According to experts, the findings are not a huge surprise, since other drugs used to suppress hepatitis B are also known to effect changes in HIV.

"The active site [of drug action] -- a polymerase enzyme -- is similar on HIV and hepatitis B," explained the study's lead author, Dr. Chloe Thio, an associate professor of medicine at Johns Hopkins University School of Medicine in Baltimore.

Her team tracked changes in HIV levels in the blood, as well as blood counts of CD4 T-cells (a marker of HIV's impact on the immune system) in three men co-infected with hepatitis B and HIV. The patients were using Baraclude to treat their hepatitis B but had not yet begun combination drug therapy to help suppress HIV.

Even though these men were not taking any anti-HIV medicine, their levels of the virus began to fall and their CD4 counts began to rise soon after they started on Baraclude, the study found.

"That sounds like it should be a good thing," Thio said. "But, in fact, it's not good, because we know that one-drug therapy against HIV always leads to resistance."

This healthy dip in HIV levels is always temporary when single drugs are used, Thio said. Sooner or later, a mutation will arise that causes the virus to come back even stronger. That mutation makes HIV more resist ant -- not just to Baraclude but to other antiretroviral therapies, as well.

It's a familiar scenario, Horberg said. "All consecutive single agents work for a time and will dramatically drop the [HIV] virus," he noted. "But the virus doesn't have enough pressure in these cases to stop it from mutating."

Especially alarming was the fact that one of the patients tested positive for an HIV mutation called M184V. "That's one of the strongest mutations the virus can create," in terms of upping its resistance to AIDS medications, Horberg said.

So, the bottom line is that patients newly diagnosed with hepatitis B must be tested for HIV before any drug therapy is initiated, the experts said.

The danger extends beyond the individual patient, because people with undiagnosed HIV who are being treated with Baraclude might end up passing a much more highly drug-resistant strain of HIV to their partners, the experts warned.

If a patient does prove to carry both viruses, he or she will probably need to start anti-hepatitis B and anti-HIV therapies simultaneously, Horberg said.

"They may not want to go on [combination] HIV therapy early, but if they want to get very effective therapy for their HIV, it's likely that they will need to," he explained.

Signs "encouraging" on Libya HIV nurses, but no deal yet

An international fund and families of HIV-infected children in Libya have not yet agreed a financial package for them, a lawyer for foreign medics sentenced to death in the case said on Thursday.

However, the lawyer and European Union officials said there were grounds for optimism that an accord could be reached soon which could in turn allow the release of five Bulgarian nurses and a Palestinian doctor found guilty of infecting the children.

"We are optimistic but we remain extremely cautious ... because there is no deal yet, because nothing is certain about the verdict that will possibly be given on July 11, as it could also be postponed," lawyer Stephane Zerbib told Reuters.

Zerbib was referring to a scheduled July ruling by Libya's Supreme Court on an appeal by the medics, convicted in December of infecting 426 children in a trial that has slowed OPEC member Libya's efforts to end its international isolation.

Families of the foreign medics, who have been sentenced to death for infecting the children with the virus that causes AIDS, urged European Union leaders in Brussels on Thursday to help clinch a deal to end their "nightmare."

"If we are here today, it is to save the lives of our mothers, to see if the EU can help," said Gergana Ouzounova, 25, daughter of 52-year-old nurse Valia Cherveniashka, in an interview of the families of the medics with Reuters.

A spokeswoman for EU External Relations Commissioner Benita Ferrero-Waldner, who has been deeply involved in European efforts to produce an agreement with the families of the children, said: "Talks are ongoing. The signs are encouraging."

NO ADMISSION OF GUILT

Sofia says it will not compensate the families, arguing that would be an admission of guilt. But it has set up a solidarity fund along with the EU and the United States to provide medical aid and financial support to the children and their relatives.

The association representing the families is seeking around 10 million euros (almost $14 million) for each family.

Relatives of the Palestinian doctor and four of the five nurses came to Brussels hoping to meet German Chancellor Angela Merkel, chairing a summit of EU leaders on Thursday and Friday, and European Commission President Jose Manuel Barroso.

They had not yet received an answer.

"We hope that very soon all this nightmare will end," said Ahmed Jumaa, 65, father of the doctor Ashraf Alhajouj, who has lived most of his life in Libya and says the police fabricated the charges.

Asked what she would ask EU leaders, Tzvetanka Siropoulo, step-sister of 48-year-old nurse Valentina Siropoulo, said she wanted the wealthy 27-nation bloc to commit itself to a deadline for a deal and help the HIV-infected children.

Most refused to comment on the on-going talks. But Ivailo, the son of 54-year-old nurse Snezhana Dimitrova, whose health is the most fragile, said: "I do not expect there will be a deal."

A spokesman for the families of the infected children has said any financial deal agreed in coming days would not affect the Libyan Supreme Court's decision on July 11.

The court is widely expected to confirm the death sentences, a move that would leave the fate of the medics in the hands of Libya's High Judicial Council, a government-led body which has the power to commute sentences.

Nurse Dimitrova's son Ivailo said commuting a sentence of guilt would not be fair since the medics were all innocent.

Male circumcision overstated as deterrent to global AIDS pandemic

While previous research has suggested that circumcision 'significantly' cuts HIV risk in men, a new study has found that it is much less important as a deterrent to the global AIDS pandemic than previously thought.

Author John R. Talbott who conducted statistical empirical research across 77 countries of the world conducted the study.

He found that the number of infected prostitutes in a country is the key to explaining the degree to which AIDS has infected the general population.

Prostitute communities are typically very highly infected with the virus themselves, and because of the large number of sex partners they have each year, can act as an engine driving infection rates to unusually high levels in the general population.

He also made two important discoveries.

First, male circumcision, which in previous studies had been found to be important in controlling AIDS, becomes statistically irrelevant once the study controls for the number of prostitutes in a country.

The study finds that the more Muslim countries of North Africa do indeed suffer much less AIDS than southern and western Africa, but this lower prevalence is not due to higher numbers of circumscribed males in these Muslim communities, but rather results from the fact that there are significantly fewer prostitutes in northern Africa on a per capita basis.

In a frequently cited academic paper, Daniel Halperin, an H.I.V. specialist at the Harvard Center for Population and Development and one of the world's leading advocates for male circumcision, weighted results from individual countries by their population. When this artificial weighting was removed Talbott found that circumcision was no longer statistically significant in explaining the variance in AIDS infection rates across the countries of the World.

Second, to date, there has not been an adequate explanation as to why Africa as a continent is experiencing an AIDS epidemic far in excess of any other region of the world with some African countries' prevalence rates exceeding 25 percent of the adult population and tens of millions dying from the disease on the continent.

Talbott's new study suggests that the reason is that Africa as a whole has four times as many prostitutes as the rest of the word and they are more than four times as infected.

Some southern Africa countries have as many as 7 percent of their adult females infected and working as prostitutes while in the developed world typically this percentage of infected prostitutes is less than .1percent.

If these infected prostitutes in Africa sleep with five men in a week that means they are subjecting 35 percent of the country's male population to the virus weekly. The virus is not easy to transmit heterosexually, b ut over time with multiple exposures, infection is inevitable. These men then act as a conduit to bring the virus home to their villages, their other casual sex partners and to their wives.

The study has important policy implications. Several international AIDS organizations have begun to provide funding for male circumcisions as a deterrent to AIDS.

The research is published in the online, open-access, peer-reviewed scientific journal PLoS ONE.

June 20, 2007

Sharon Stone to raise AIDS awareness in Dubai

Actress Sharon Stone and other star are heading for Dubai to raise funds for AIDS victims and the actress and the project amfAR hopes top raise maximum money from the pockets of rich nobles in the Gulf emirate known for its discrimination towards HIV patients, as well as gay people.

According to a report prepared by the US state department, 'government officials discriminated against prisoners with HIV by not granting commuted sentences or parole that other prisoners with similar records had received'.

Gay people on tour have been asked to be careful about their sexuality during the visit to UAE, for the country has strict laws for homosexual activities.

According to the report, the country 's civil and Islamic law also 'criminalize homosexual activity'.

Offenders of the law face arrest, imprisonment and deportation.

AmfAR spokeswoman Deborah Hernan said the charity accepted the film festival invitation hoping to raise awareness.

"(We hope to) raise awareness for HIV/AIDS. Financial success would enhance amfAR's ability to deliver on its programs," the New York Daily News quoted her, as saying.

Huge rise in AIDS cases among Nepalese housewives

Kathmandu, June 20 (IANS) While the Nepalese government's attention is focused on preventing the spread of Acquired Immuno Deficiency Syndrome (AIDS) among migrant labourers, intravenous drug users and sex workers, housewives have become one of the most vulnerable groups in the country with the rate of infection rising by more than 100 percent.

According to Nepal's National Centre for AIDS and STD (sexually transmitted disease) Control, 1,883 housewives were found to be infected with the Human Immunodeficiency Virus (HIV) till mid-May this year while the number had been 765 till December 2005.

In the past 18 months, the number of HIV infected children has also soared from 138 to 428 signifying a staggering 200 percent rise.

'We are extremely concerned,' said Giridhari Sharma Poudel, executive director of the Family Planning Association of Nepal (FPAN). The association runs intervention programmes in four remote districts as well as other campaigns and mobile health camps across the country.

Poudel attributed the rise in HIV cases among housewives to growing migration both within the country and abroad, mainly India and the Middle East.

'You have all these migrant men leaving home in search of work and remaining away for periods of one to three years.

'They have sexual contact while away from home, get infected and spread the infection to their wives when they return. The low condom use among families helps the infection spread,' said Poudel.

There is also an increase in the spread of infection through other ways. Till 2005, nine people who had received blood transfusions or organ transplants had became infected. Since then, the number has gone up to 22.

The number of infected intra uterine device (IUD) users has also risen sharply, by over 67 percent, from 1134 to 1900.

The number of people infected from sex workers has also increased to 4421 from 2994. However, fewer sex workers have been infected as compared to clients. In 2005, their number was 606. In May, it increased to 675.

Poudel attributes this to various awareness campaigns targeting sex workers.

FPAN conducts campaigns in four districts, regarded as having a large number of sex workers. Dang, Kailali and Banke districts in western Nepal are regarded as the home of the Badi community where families have been practising prostitution for generations as a matter of tradition.

FPAN also focuses on Chitwan district in southern Nepal, a popular tourist destination, where health workers have reported the presence of a substantial number of commercial sex workers.

'But the national AIDS prevention programme lacks strategies to prevent infection among housewives,' said Poudel.

In 2005, 5647 people in Nepal were recorded as being HIV positive. The May records show the number has grown to 9329.

Half of Papuans unaware of AIDS: Indonesian report

early half the people in Indonesia's remote Papua region have never heard of
HIV/ AIDS despite having the country's highest prevalence rate of the disease, a government study says.

While 48 percent of Papuans are unaware of AIDS, the number of cases per 100,000 people in Papua is nearly 20 times the national average, said the report, funded by the World Bank, the U.S. government and U.S. organization Family Health International.

"Education on HIV needs to be extended. Education efforts have to target populations at risk, particularly groups with high-risk behavior such as those with multiple sexual partners and who pay for sex," said the report, to be released on Wednesday.

"Prevention services and condom availability have to be improved for the entire Papuan region."

Papua, which lies on the easternmost fringe of the sprawling archipelago of about 17,000 islands, has a population of 2 million, many of them indigenous tribes that still live in virtually Stone Age conditions.

Some 2 percent of the population is infected with the disease and the high prevalence rate in remote mountainous areas is largely due to poor knowledge of the disease and lack of access to condoms among isolated tribes.

Only 5.1 percent of people in mountainous regions know where to find condoms, compared to 34.8 percent living in cities, said the report.

Health experts say the disease has been spreading rapidly due to several factors -- high rates of promiscuity, rituals in some Papuan tribes where partner swapping takes place, poor education about AIDS and a lack of condoms.

The report gave no estimates on cases in Indonesia, but Health Minister Siti Fadilah Supari warned in November that the country could see half a million HIV cases by 2010, and double that if preventive steps are not taken.

At that time, estimates put the number of cases in a range of 169,000-216,000 in Indonesia although only about 7,000 full-blown AIDS cases had been reported.

That represents an overall estimated HIV infection rate of about 0.1 percent of the population.

June 18, 2007

U.S., Britain provide $27 mil. to support Cambodia's health sector

The United States and Britain jointly granted Cambodia $27 million Monday to support Cambodia's health sector and HIV/AIDS program.

The project will improve help women access affordable, high-quality contraceptives to be able to better plan the size of their families, space out births and ensure children are healthy.

The grant was announced at a ceremony in Phnom Penh in which Marshall Elliot, deputy director for South East Asia of Britain's Department for International Development, and Erin Soto, USAID/Cambodia mission director, signed on behalf of their governments with Eng Huot, secretary of state of Cambodia's health ministry.

The grant will support work through nongovernmental organizations and the media with groups at high risk of HIV infection to help increase knowledge of key facts around HIV transmission and provide access to condoms for HIV prevention.

Soto said, "Under this new project, USAID and DFID will partner with the royal government of Cambodia to support national social marketing systems which promote health products, education and services to prevent HIV transmission, increase birth-spacing and reduce child mortality."

"The project will provide vital support to achieving the objectives of key Cambodian strategic plans for the health sector and the response to HIV," she added.

Under the project, USAID and DFID will jointly fund, and USAID will manage, a five-year program providing support and commodities for achievement of Cambodian strategic plans for the health sector, as well as contributing to Ministry of National Health program objectives in "HIV/AIDS, Reproductive and Sexual Health, and Child Survival."

The program will be implemented through a nongovernmental organization or organizations.

Cambodia has one of the highest HIV/AIDS infection rates in the region.

Elton John performs AIDS charity concert

Elton John sang for tens of thousands of Ukrainians at a charity concert in Kiev's main square in a bid to raise money and increase awareness of the rapidly growing HIV/AIDS epidemic in this ex-Soviet republic.

The concert, held late Saturday, was the British singer's first performance in Ukraine and part of his Elton John AIDS Foundation's efforts to fight the spread of the disease.

Organisers said the group had already donated US$2.6 million ($A3.12 million) to fight the spread of HIV/AIDS in Ukraine over the past six years. Volunteers handed out condoms before the concert.

Ukraine has one of the fastest-growing HIV/AIDS epidemics in Europe. Government officials say nearly 77,000 people have been registered as HIV-positive since the first reported case in 1987.

Some experts have suggested that the epidemic in Ukraine is greater than the official figures, with as many as half a million people - 1 per cent of Ukraine's population - infected.

President Viktor Yushchenko and other politicians and public figures attended the concert, which was broadcast live on local TV.

AIDS no longer a death sentence for South Africa's children

Abandoned in a bar as a baby and given just weeks to live by doctors seven years later, Tommy Jarvis is living proof AIDS is no longer an automatic death sentence for youngsters in South Africa.

Tommy, now a strapping 13-year-old who spends his spare time riding his bike and practicing karate, makes light of the day that medics gave up on him.

"They said I would be dead in three weeks but look at me now," says the still slightly incredulous teenager who now wants to serve as an inspiration to youngsters with a similar story.

Thea Jarvis, who adopted Tommy after his birth mother abandoned him in a township drinking hole when he was one-year-old, recalls how the family became aware of his HIV-positive status when he later contracted pneumonia.

Although AIDS-fighting anti-retroviral drugs (ARVs) had come on the market, they were prohibitively expensive and she was faced with a dreadful dilemma.

"I had four children who were HIV positive and couldn't afford to put them all on ARVs," Jarvis told AFP at her sprawling family home on the outskirts of Johannesburg where she and an army of assistants care for more than 70 abandoned babies.

It was not until Tommy, then aged eight, was "on his deathbed" that she managed to scrape together the money to put him and the other children on a course of ARVs which have given them all a new lease of life.

Tommy was one of the stars of the show at last week's national AIDS conference in Durban where he addressed delegates about his life and how he hopes to help others replicate his stirring story.

"I want to look after albino babies that can't be looked after by their mums and dads," he said alongside his visibly proud adoptive mother.

The arrival on the market of more affordable ARVs has helped reduce the mortality rate among HIV-positive youngsters as has a shift in government priorities, with the recent five-year AIDS programme specifically pledging to address the plight of vulnerable children.

The scale of the problem remains daunting however with the Medical Research Council estimating that some 45,000 children under 15 died due to AIDS in 2006.

According to Farai Dube of Johannesburg's Wits Paediatric HIV clinics, the change of attitude from the government is to be welcomed but only goes so far.

"No one was concentrating on children. There were very few advocacy groups and very few clinics taking responsibility of putting children on treatment. Only now are people beginning to analyse the children," he said.

But, as Dube pointed out, only 27,000 of the 123,000 HIV-infected children who are considered sick enough to require ARVs actually receive them.

Glenda Gray, director of the Johannesburg-based Perinatal HIV Research Unit, said drug firms had not prioritised treatment for children as rates of mother to child transmissions were much lower in the developed world than Africa.

"Paediatric formulations are not a big priority for big pharma. You don't make lots of money from children," Gray told AFP.

"It's an ongoing battle, the pressure for paediatric formulations is still required. Sometimes the medicine tastes terrible and you have to get your toddler to drink disgusting medicine."

The first person who really opened the world's eyes to the plight of Africa's young AIDS victims was 11-year-old Nkosi Johnson who delivered an electrifying speech at the 2000 international AIDS conference in Durban.

"I hate having AIDS because I get very sick and I get very sad when I think of all the other children and babies that are sick with AIDS," the diminutive youngster told 10,000 delegates from around the world.

Nkosi, who was at the time the country's longest-living HIV positive child, died the following year but his legacy persists.

His adoptive mother Gail Johnson, whose campaign for young AIDS victims is being turned into a Hollywood movie starring Naomi Watts, said Nkosi would have been thrilled children can get the medicines and live longer lives.

"But he would definitely, knowing him, be disappointed there are not as many as there should be," she told AFP.

Even when children manage to access ART, some have nobody to make sure they take them correctly, as their parents die or are too sick to care for them.

Those HIV sufferers who do survive beyond childhood often face huge challenges that their friends can only imagine, including how to develop relationships and have healthy children themselves.

Another face to the children's crisis also remains -- the estimated 11 million children in sub-Saharan Africa who have lost one or both parents to the disease and are often left to fend for themselves.

Seventeen-year-old Silindile Ncwane, from South Africa's eastern KwaZulu-Natal province, explained the tribulations of living with his elderly grandmother who took him and his siblings in after his mother died.

"For me it's very hard to get them ready for school every day and help them with their homework...(they) always ask questions I don't know how to answer and it's very hard for me. I am being a mother to them," he said.

Barred HIV-positive kids allowed back to school in India

A school in southern India allowed a group of HIV-positive children back to class after a six-month battle that has highlighted the stigma suffered by the country's
AIDS sufferers.

The Christian-affiliated school in the southern coastal state of Kerala, reputed to be one of the country's most progressive areas, had thrown out five children last December following complaints by the parents of other pupils.

Three of the five were infected with HIV, the virus that can lead to AIDS, and the expulsion prompted intervention by the state government. All five children -- one boy and four girls aged between five and 11 -- were back in class on Monday, and relieved a part of their ordeal was over.

"We all love to go to school and study with our friends," said nine-year-old Jyoti, one of the children who had been shut out.

The school -- which has 65 students on its roll -- relented this month after the state government threatened to withdraw its permit to operate.

Authorities at the school insisted teachers were ready to accommodate the children, but added they would face an uphill struggle to convince the other parents.

"They didn't listen to our reasoning as a majority of the parents are ill-educated and poor," said headmistress Elsamma Mani.

During the ban, the children continued their studies at a non-profit home for the destitute and were able to sit for annual tests.

"They learn their lessons very fast and I enjoyed teaching them," said Annie Mathew, who taught them at the Asha Kiran (Ray of Hope) home, where 15 women with HIV and eight children live.

India, with a population of 1.1 billion, has 5.7 million people infected with HIV -- the world's highest in absolute numbers per country.

Officials said this month that under new data being compiled, the number of HIV-positive could be as low as 3.4 million.

Social activists welcomed the school's climb-down, but said the case merely served as a reminder of continued widespread discrimination.

"Though Kerala claims 100 per cent literacy, social discrimination against people with HIV is more evident in the state," said P.B. Bindu, secretary of Kerala Positive Women Network.

Bindu said nearly 2,000 women and 1,000 children living with HIV were facing social alienation in the state, among a handful of India's 29 states to claim 100 literacy rates.

In 2004, two children were shut out of another Kerala school after they were found to be HIV-positive.

"Even today, the attitude of society has not changed much. It's a shame for all," Bindu said.

June 17, 2007

Verdict Wednesday in Libya AIDS trial: Kadhafi son

A verdict in the appeals trial of five Bulgarian nurses and a Palestinian doctor sentenced to death in Libya's high-profile AIDS case will be handed down Wednesday, Libyan leader Moamer Kadhafi's son said in an interview published here.

He also appeared to suggest that the death penalty would be upheld, but that the sentences could be commuted if a compensation package is worked out between the Bulgarian government and the European Union.

"The Supreme Court will pronounce the sentence Wednesday and immediately after the verdict, we will begin to work...on a package (of measures) with a view to a solution," Saif Al-Islam told the Corriere della Sera.

In Tripoli, an official of the Kadhafi Foundation, headed by Islam, denied he had stated that a verdict would be announced on Wednesday and said remarks made by the Libyan leader's son to the Italian newspaper were mis-translated.

"Seif al-Islam told the newspaper that the (appeal) process will start on June 20 and did not say if a verdict will be announced," the official told AFP, requesting anonymity.

The Bulgarian foreign ministry said Friday that the appeal would begin on Wednesday but did not say when a verdict was expected.

Meanwhile, Othman al-Bizanti, a Libyan lawyer for the foreign medics, told AFP: "It's improbable that the court will hold more than three sessions before announcing its verdict."

The five nurses -- Kristiana Valcheva, Nasya Nenova, Valya Cherveniashka, Valentina Siropulo, and Snezhana Dimitrova -- and the Palestinian doctor, Ashraf al-Hadjudj, were sentenced to death by a Libyan court in May 2004. They had been found guilty of intentionally infecting 438 children with HIV-tainted blood at a hospital in the northeastern city of Benghazi.

Al-Islam, whose foundation is for Libyan charities, suggested that the accused would avoid the death penalty by agreeing compensation with the families of the victims.

"The package has to satisfy the families of the Libyan victims, otherwise we will not be able to find a solution," the daily quoted him as saying.

"The first step is a compromise with the families in order that there can be a pardon, in such a way that the death sentence is not carried out," he added, suggesting that the court will confirm the death penalty.

In the event of a negotiated settlement, "the high council of judicial affairs can say 'now that there is a compromise with the families, the Bulgarian government and the European Union, we can commute the death sentence to a prison term'," he said.

He said any compensation would include medical assistance for the infected children, and EU financing of Libya's "national action plan against AIDS" and an eventual "partnership" between Brussels and Tripoli.

HIV drugs unaffordable for common man

Urging the medical community to develop 'much cheaper' drugs to combat HIV/AIDS, President A P J Abdul Kalam today said the available first and second line treatment of the deadly disease is still out of reach of the common man in the country.

Stating that the Indian companies have done formidable job in bringing down the price of first and second line HIV drugs, Kalam said: "Even this reduction does not make the drug affordable to the common man in our country."

Speaking at Mahatma Gandhi Institute of Medical Sciences (MGIMS) at Sevagram, he said: "We have Technology Vision 2020 Document prepared by TIFAC (Technology Information, Forecasting and Assessment Council), which indicates about the typical disease pattern which will be faced by the country during the period now to the year 2020."

"It is expected that HIV and TB combination, water borne diseases, cardiac diseases will be the predominant diseases and we have to find solutions for diagnosing and treatment," he added.

Kalam emphasised the need for providing quality health care to our rural citizens.

Commenting on the infant mortality rate, Kalam called for bringing infant mortality to less than 10 per thousand.

On the menace on malaria, he said: "Italian scientists have recently found a bacteria that lived symbiotically inside the pest. They claim that such bacteria could potentially be genetically altered later to attack the Malaria parasite when it reaches the Mosquitoes."

A first in the city: HIV test on home inmates

FOR the first time, Lucknow has woken up to the fact that girls and women living in protection homes, who are mostly trafficking victims, also fall in the high-risk category of people who are vulnerable to HIV-AIDS. The realisation dawned on a local NGO, Abhaas, that there is a need to carry out HIV tests on these girls and women. Undertaking this first-of-its-kind project, Abhaas has started organising HIV check-up camps at various protection homes and orphanages across the state capital.

The first such camp was organised at the Leelavati Munshi Balgrih at Moti Nagar on Wednesday. Similar camps will be organised at other homes as well, with special emphasis on homes where trafficking victims are sent, said Anoop Yadav of Abhaas, which functions from Triveni Nagar area.

"So far, there have been no facilities to test these inmates for HIV. One cannot forget that some of these victims are either rescued after they were trafficked, or have been exploited. So they belong to the high-risk category of HIV positive people," he said.

Yadav said it is important not to just carry out tests on these inmates, but also to make them aware of HIV-AIDS.

"No one has ever tried to look into this. Children who are orphans because their parents died because of AIDS are also living in these orphanages," said Yadav. After the first HIV check-up camp on Wednesday, with support from the Family Planning Association of India, Abhaas now plans to organise similar camps in other homes as well.

"Since most of the protection homes are state run, I'm trying to talk to the government departments to help us in organising such camps. We initially want to work in Lucknow only, but if get enough support, I would like to conduct this camp in all districts," said Yadav.

Apart from the protection homes and orphanages, Yadav also plans to organise HIV testing and awareness camps in Charbagh area for street children and sex workers.

"At present, I am spending my own money for organising the camps. But I am looking for some monetary support for the project, so that more and more people can be benefited," said Yadav.

City-based institute to evaluate HIV drug resistance across Asia

A City-based institute is part of an undertaking to evaluate HIV drug resistance in 20 centres among HIV patients across Asia. The Institute of Infectious Diseases has tied up with Geneom Bio tech lab to make available the drug resistance test for the first time in Pune. This project is part of the Therapeutic Research Education and AIDS Training (TREAT)-Asia Network, funded by the Dutch government and American Foundation for AIDS Research.

Institute director Dr Sanjay Pujari says that an observational study would be undertaken at the TREAT centres in Asia. In India, centres in Pune and the YRG Care centre at Chennai will participate in the study of 3,000 HIV patients.

Pujari also says while there is reasonable improvement in the access to first line treatment of anti-HIV drugs, other issues are slowly emerging. "We see a lot of drug resistance in patients who have been on anti-HIV treatment," he says.

This could be because the patient is not adhering to the treatment, besides the fact that the virus multiplies rapidly. Use of Anti-Retroviral Therapy drugs in developed countries has been associated with the development of HIV drug resistance. HIV's high mutation rate and the lifelong treatment of the disease are known to contribute to some degree of HIV drug resistance among patients, Pujari says.

The resistance testing device available in Mumbai is extremely expensive and ranges from Rs 16,000 onwards, according to Sachin Purohit, managing director of Geneom Bio lab. So to make it commercially viable - at one-third the cost - the two collaborating partners have combined several technologies to analyse a viral genome, predict and identify the particular strain that is resistant to an anti-HIV drug.

Singapore's HIV/AIDS cases rise by record levels in 2006

New HIV/ AIDS infections in Singapore rose by a record 357 cases in 2006, bringing the total number of people diagnosed with the disease to 3,060, the Ministry of Health said.

The 2006 figures released Friday on the ministry's website showed an increase of 12.6 percent from 2005 when there were 317 new cases -- then a record high number of new infections -- from a population of just above four million.

More than 90 percent of new HIV cases detected in 2006 were through sexual transmission with two-thirds of the infections from heterosexual sex, the ministry said.

Of the 3,060 cases overall in Singapore, 1,048 have died, 1,307 show no signs of the illness while 705 have AIDS-related illnesses, said the ministry.

More than half of those detected with the disease in 2006 were already at a late stage of HIV/AIDS infection, it said.

"This was similar to the pattern in previous years," said the ministry.

"There is thus an urgent need for persons who engage in high risk behaviour such as unprotected casual sex and intravenous drug abuse to test themselves for HIV," it said.

HIV is the virus that causes deadly Acquired Immune Deficiency Syndrome (AIDS), which is transmitted largely through unprotected sex and sharing intravenous needles. There is no cure for AIDS.

It breaks down a person's immune system, rendering them vulnerable to infection and disease.

Singapore has expressed alarm over the growth of HIV infections but the government has rejected widespread promotion of condom use, preferring instead to focus on using more effective and cheaper methods such as preventing mother-to-child infections.

HIV/AIDS cases rise to 41 in Tibet

The number of reported HIV carriers and people with full-blown AIDS has risen to 41 in southwest China's Tibet autonomous region, compared to 30 cases last year.

Three people in the remote region have died of AIDS, according to Yuzhan Lhaco, deputy director of the institute for prevention and control of AIDS and sexually transmitted diseases.

HIV/AIDS infections have been found in urban and rural areas and more men than women have been infected, said Yuzhan

Two state-level outposts are monitoring the spread of HIV/AIDS and the Tibet government has set up an HIV/AIDS prevention and control centre along with counselling and testing services.

'Testing is free of charge and HIV carriers are treated with free medicines,' said Yuzhan, who said the vast region and spare population makes it difficult to monitor the spread of HIV/AIDS.

Official statistics show that among the 650,000 Chinese living with HIV/AIDS, 44.3 percent were infected through drug injection, 10.7 percent through blood transfusions and 43.6 percent through unsafe sex.

June 15, 2007

Indian military wives enlisted in AIDS battle

India, alarmed at the prospect of a military hit by AIDS, has begun training wives to promote awareness about the disease especially in the revolt-hit northeast.

"The rapid spread of HIV/AIDS in the armed forces has alarmed authorities," said a statement from India's Ministry of Defence at the end of a two-day workshop Wednesday to educate army wives about prevention.

"Wives of serving soldiers, drawn from the three services, will form peer group leaders who will disseminate awareness among peer groups of about 20 wives of soldiers in the field units."

Almost 0.03 percent of troops have HIV, the government says, far lower than the infection rate among the country as a whole. But servicemen in remote areas are at much greater risk.

Some 100,000 army and paramilitary troopers are deployed for long periods in the rugged jungles of several northeast states against some 30 guerrilla groups waging a variety of separatist insurgencies.

The Assam Rifles, a premier paramilitary force of 55,000 troops in the region, admitted this year that 180 of its soldiers had HIV -- an infection rate 10 times higher than the army faces as a whole.

"We are taking healthcare issues very seriously with annual mandatory medical checkups, including blood testing, for all the ranks," Narender Singh, an army spokesman in Assam, told AFP Thursday in the state's main city.

A member of the Armed Forces Wives Welfare Association from tiny Manipur state said military spouses were being trained to discuss AIDS with couples and other wives.

"Wives of soldiers are the best counsellors to educate their husbands and are now being made aware how the virus contracts and the need to tell their husbands how to remain safe while out of home," said the army wife, who asked not to be named.

The northeast, home to around 40 million people, has been declared one of the country's high-risk zones with nearly 100,000 people infected with the virus, particularly in Manipur which borders Myanmar.

The spread of AIDS there is fueled both by prostitution and by drug injections, with the region a major conduit for heroin from the 'golden triangle' of neighbouring Myanmar, Laos and Thailand.

"In most cases we have found the soldiers mingling with the locals and then going for unprotected sex to fight stress and fatigue," said S.I. Ahmed, chairman of the AIDS Prevention Society, a community health care group in Assam.

"Life away from families for a longer duration is one of the reasons. I have scores of defence personnel coming to our clinic for voluntary counseling and testing."

India has the most HIV/AIDS cases in the world at a high-end estimate of 5.7 million, though the figures are disputed and may be revised down sharply next month in a new study.

India also has one of the largest armies in the world with nearly 1.8 million personnel, besides an estimated 1.3 million paramilitary troopers.

AIDS programs work best when nations take lead

Countries that take the lead in directing domestic efforts against HIV and AIDS seem to have the greatest success, global AIDS experts said on Tuesday.

"We get the best results in countries where the host government assumes the leadership for the response," said Dr. Tom Kenyon, chief deputy coordinator of the President's Emergency Plan for AIDS Relief or PEPFAR, a U.S. effort to combat AIDS globally.

"We want to be led by the host country," he told reporters before a four-day meeting of AIDS experts later this month in Kigali, Rwanda.

Delegates will compare notes on the best ways to fight HIV and AIDS.

"We have made tremendous scientific advances over the years, but it is not until we implement them that we make a difference. And it is not until we implement them on a large scale that we have true public health impact," Kenyon told the briefing.

Experts said Rwanda stands out as a model for coordinating global relief efforts.

"They've taken ownership of the response," Kenyon said. "Where we have voids in that kind of leadership, we don't move as fast."

Doreen Mulenga, acting chief of HIV and AIDS for the United Nations Children's Fund, said significant progress has been made in several countries including Botswana, India, Rwanda and South Africa in scaling up HIV treatment for children.

She said efforts to integrate pediatric treatment into adult care settings are allowing more children to get care.

"A key barrier in many countries is not yet fully integrating treatment for children. This is really limiting access to treatment," she said.

The meeting, taking place June 16 to 19, will bring together 1,500 representatives from international relief organizations and governments.

President George W. Bush in 2003 launched PEPFAR, a five-year, $15 billion plan to provide drugs to people infected with the human immunodeficiency virus that causes AIDS and support prevention efforts. That commitment is set to end in September 2008.

Last month, Bush asked Congress to double the U.S. financial commitment to global AIDS fight and extend the program another five years.

More than 25 million people have died of AIDS since the incurable disease was first recognized in 1981. About 40 million people now live with human immunodeficiency virus, or HIV. Most are in sub-Saharan Africa, where the virus is spread primarily through heterosexual sex.

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