Friday, April 20, 2012

[socialactionfoundationforequity:15191 Landmark report on HIV among Zambia’s young people highlights challenges and charts the way forward

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Landmark report on HIV among Zambia's young people highlights challenges and charts the way forward

20 April 2012

A new report provides an extensive synthesis and analysis of recent data, gaps and challenges in AIDS prevention, treatment, care and support for young people in Zambia.

For Zambia's young people the AIDS response has seen a number of important successes, with a significant 25% decline in HIV incidence over the last decade. However, according to a groundbreaking new report, the AIDS epidemic continues to have a huge effect on the country's youth, especially young women, and much more needs to be done to achieve an HIV-free generation.

Situation Assessment of the HIV Response among Young People in Zambia provides an extensive synthesis and analysis of recent data, gaps and challenges in AIDS prevention, treatment, care and support for this key age group. It was launched at a high level meeting held from 17-18 April in Lusaka.

The event was supported by Zambia's United Nations Joint Team in collaboration with the National HIV/AIDS/STI/TB Council (NAC), and the ministries of Health; Education; Youth and Sport; and Community Development, Mother and Child Health.

"We must reduce the number of new HIV infections among young people if we are to meet the targets set in the 2011 Political Declaration on AIDS," said Deputy Minister of Youth and Sport Nathaniel Mubukwanu. "We are committed to continue developing high impact interventions using a combination of HIV prevention strategies to effectively respond to the epidemic," he added.

Good progress but gaps remain

The assessment, focusing on 10 to 24 year olds, shows that HIV incidence decreased between 2001 and 2009 among young people and the proportion of young people having sex before the age of 15 has halved, from about 17% in 2000 to some 8% in 2009. There has also been a rise in the number of young people who were tested and received their HIV test results, from 7% in 2005 to 34% in 2009.

Providing young people with access to HIV testing, condoms, male circumcision and other reproductive health services, including sexuality education, will significantly contribute to Zambia achieving the UNAIDS' vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths

Helen Frary, UNAIDS Country Coordinator, Zambia

Despite these achievements, HIV prevalence among young people remains high. In 2007 prevalence among those aged 15-19, for example, was 6% for women and 4% for men.

This is attributed to a number of factors. Dr Clement Chela, NAC Director General, citing the report said these factors included, "Poor comprehensive knowledge of HIV; gender inequality, poverty and the combination of transactional and intergenerational sex, early marriage, alcohol use, peer pressure and the negative gatekeeper attitudes towards condom promotion among young people."  Data shows that only 53% of adults expressed support for condom education for HIV prevention among young people.

The report also highlights that there is no comprehensive sexuality education package for pupils in school and a high level of stigma towards young people on treatment from their peers.

Way forward

One of the key recommendations in the report for increasing protection of young people is the promotion of their meaningful involvement in HIV policy and programme design and implementation. This can be facilitated by building their capacity as change agents and service providers and encouraging them to generate demand for HIV-related services.

As Youth Representative Chipasha Mwansa contended, while hoping that her peers' recommendations would be taken with the seriousness they deserve: "Nothing for young people without meaningful involvement of young people."

According to the report, bottlenecks that need to be addressed in order to meet young people's needs are those that affect access to condoms, HIV counseling and testing, male circumcision and behavior change communication among young people in and out of school. Furthermore, youth friendly services should be expanded at the health facility and community level, including those integrating HIV care and treatment and legal protection for adolescents living with the virus.

Helen Frary, UNAIDS Country Coordinator, noted that a multipronged approach was necessary. "Providing young people with access to HIV testing, condoms, male circumcision and other reproductive health services, including sexuality education,  will significantly contribute to Zambia achieving the UNAIDS' vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths."

To ensure that measurable progress is made in Zambia, the UN has pledged to work with relevant ministries and stakeholders to translate these main recommendations –and others— into a clear, costed and time-bound action plan which puts young people centre-stage.

--
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[socialactionfoundationforequity:15191 [AIDS INDIA] New WHO Guidance on Couples HIV Testing and Counselling [1 Attachment]

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--- On Thu, 19/4/12, Joe Thomas <joe_thomas123@yahoo.com.au> wrote:

From: Joe Thomas <joe_thomas123@yahoo.com.au>
Subject: [AIDS INDIA] New WHO Guidance on Couples HIV Testing and Counselling [1 Attachment]
To: "AIDS-INDIA e FORUM" <aids-india@yahoogroups.com>
Date: Thursday, 19 April, 2012, 8:42

 
[Attachment(s) from Joe Thomas included below]

From: "HIRNSCHALL, Gottfried Otto" <hirnschallg@who.int>

Dear colleague,
 
This is to inform you that today WHO releases new “Guidance on couples HIV testing and counselling, including antiretroviral therapy for treatment and prevention in serodiscordant couples: Recommendations for a public health approach� (http://www.who.int/hiv/pub/guidelines/9789241501972/en/index.html).
 
WHO developed this guidance to encourage the provision of couples HIV testing and counselling (CHTC) to support increased testing and earlier access to treatment and prevention.  The guideline also considers the benefits of offering ART for HIV prevention for serodiscordant couples, irrespective of CD4 count. The guideline makes five main recommendations and discusses the range of opportunities, challenges and operational issues associated with providing CHTC:
 
1. Couples and partners should be offered voluntary HIV testing and counselling with support for mutual disclosure.
2.  Couples and partners in antenatal care settings should be offered voluntary HIV testing and counselling with support for mutual disclosure.
3.  Couples and partner voluntary HIV testing and counselling with support for mutual disclosure should be offered to individuals with known HIV status and their partners.
4.  People living with HIV who are in a serodiscordant couple and who are on ART for their own health should be advised that ART is also recommended to reduce HIV transmission to the uninfected partner.
5.  HIV-positive partners with CD4 counts above 350 cells/µL in serodiscordant couples should be offered ART to reduce HIV transmission to uninfected partners.
 
We realise that in making a global recommendation on a health intervention, there is always the understanding that there will be issues of cost and feasibility that vary with context. Countries and programmes will often have to make difficult choices when resources are limited. In situations of limited or inadequate resources, the guidelines recommend that individuals who require ART for their own health should always be given priority. However, countries are also encouraged to expand CHTC services, and strive to offer earlier treatment to HIV-positive partners in serodiscordant couples.
 
We appreciate the active involvement of many of you in the development of this guideline, and are looking forward to our continued close collaboration in helping countries close the testing gap and generate additional prevention benefits.
 
Please do not hesitate to get back to us for further clarification; the technical focal point on HIV Testing in the Department is Dr Rachel Baggaley (baggaleyr@who.int, GPN 13652).
 
Best regards from Geneva,

Gottfried Hirnschall
 
 
Dr Gottfried Hirnschall
Director
HIV/AIDS Department
World Health Organization
20, Avenue Appia
1211 Geneva 27
Tel: +41 22 791 27 96
Fax: +41 22 791 15 75
e-mail: hirnschallg@who.int
http://www.who.int/hiv

__._,_.___

Attachment(s) from Joe Thomas

1 of 1 File(s)

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--
Truth resides in every human heart, and one has to search for it there, and to be guided by truth as one sees it. But no one has a right to coerce others to act according to his own view of truth. - Mohandas Gandhi
 
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