NEW YORK BLUES
In the city that never sleeps three of every 100 men have AIDS
NEW YORK
AIDS prevention policies in the United States have fallen short of their mark in large cities like New York.
A study conducted in New York City in 2001 found that 2.8 percent of all males in the borough of Manhattan were HIV positive, including 2.3 percent of the black male population. Among men aged 40 to 49, the proportion infected with HIV hit 3.9 percent.
David Nash, who headed the research project for the New York Health Department, said that while "New York City comprises three percent of the US population, it accounts for over 15 percent of the nation's AIDS cases and 18 percent of HIV-related deaths in 2001."
The potentially lethal disease continues to affect blacks and Hispanics significantly more than whites: The risk factor is five times greater among black New Yorkers and 2.5 times greater among Hispanic New Yorkers. And almost one-third of all HIV/AIDS cases in New York are detected in the advanced stages of the disease, reducing the chances of survival, said Nash.
Another study conducted at the University of North Carolina indicated that high-risk sexual habits prevailed among black homosexuals. "This is a wake-up call. The HIV is still being transmitted," said Lisa Hightow, who took part in the study conducted at the University of North Carolina at Chapel Hill between January 1, 2001 and March 1, 2003.
It showed that unprotected anal sex was practiced by 25 percent to 40 percent of students participating in the study, whose average age was 22. And during the two years in which the study was conducted, 423 new AIDS cases were reported among men in all of North Carolina-13 percent were students, 88 percent were blacks and 91 percent were homosexuals.
Researchers at the Centers for Disease Control and Prevention also focused on possible HIV transmission between the homosexual and heterosexual populations.
CDC expert Greg Millett studied a group of poor black men who described themselves as heterosexuals but who regularly had sexual contact with other men. He concluded that this group could contribute to homosexual-to-heterosexual HIV transmission.
Another study found that 70 percent of all HIV/AIDS-infected people in the US went to prison at some point in their lives. The study, however, questions the theory that AIDS transmission is running rampant in the prison system.
Some two million people are behind bars, and 10 million people are imprisoned temporarily each year in the US.
The studies were presented here during the 11th annual Conference on Retroviruses and Opportunistic Infections attended by some 4,000 experts in early February.
AFP
STD Cases Also Rising in US
WASHINGTON
Sexually transmitted diseases mainly affect 15- to 24-year-olds in the United States, totaling nine million cases a year. While the age group accounts for only one quarter of sexually active people, those affected represent half of all cases of STDs.
Human papillomavirus (HPV), trichomoniasis, and chlamydia are the three diseases that affect nine in 10 of all new cases of STD infections in the group, a study published in the journal Perspectives in Sexual and Reproductive Health said.
"It is not surprising that teens and young adults contract a disproportionate number of infections," noted Sharon Camp of the Alan Guttmacher Institute that funded the study. "Most young people are sexually active, and many are ill equipped to prevent STDs or seek testing and treatment," Camp said.
New estimates suggest that the direct medical costs associated with a lifetime of treating cases of STD infection diagnosed in young people in 2000 could reach US$6.5 billion. Ninety percent of that cost, however, is due to treatment of HIV/AIDS, and the small percentage of cases that result in cervical abnormalities or genital warts.
The authors emphasized prevention and education to cut the future cost of STD infections. "Investing money today in STD prevention and education could dramatically reduce the incidence of these infections, and thus future treatment costs," they said.
Adolescents "need realistic sex education that teaches them how to prevent STDs and unwanted pregnancies," Camp said. "It is essential to have medically accurate information about condoms and other contraceptive methods, and guidance in how to access appropriate prevention, testing and treatment services."
20 Million STD Cases
There are 20 million STD infections each year in the United States.
Ronald Valdiserri, deputy director of STD programs at the CDC, said there had been success in bringing down herpes cases but "overall, STD rates in the US remain alarmingly high."
The rate of syphilis infection in 2003 rose from 2.4 to 2.5 cases per 100,000, totaling 7,082 cases. The disease jumped 18 percent from 2000, when the rise began, to 2003, the CDC said. About 60 percent of the 2003 syphilis cases were among gay men compared with five percent in 1999.
Papillomavirus infections, a factor in colon and uterine cancers, has spread, according to researchers at the University of Colorado Health Sciences Center, which found that 30 percent of women and 19 percent of men had been infected.
Another CDC study found that among 300 adolescent girls treated at a public clinic 72 percent had been infected with a high-risk strain of the disease.
Chlamydia has taken root among youths, with infection reaching 11 percent of girls, who are most affected by the bacteria, which also causes infertility, according to authors at the Minnesota Department of Public Health.
The only bright spot in the figures was a fall in the number of genital herpes cases by 17 percent between 1988 to 1994 and 1999 to 2000. The incidence is falling faster among men than women and the fall in the number of cases has been particularly noticeable among people aged under between 14 and 29.
AFP
Chinese Don't Know They Have AIDS
BEIJING
Just 10 percent of China's HIV/AIDS cases know they have the disease, the United States Centers for Disease Control and Prevention (CDC) said as it launched a US$15-million campaign to help fight the crisis. The initiative is part of the Global AIDS Program that focuses on 25 countries including China.
It targets 10 provinces, including central China's Henan, which has been hit by a major AIDS outbreak from farmers selling blood in unsafe government-run schemes.
In the next five years, the US-CDC China office and China's CDC will work together to use the funding to prevent HIV infections, and improve treatment, care and support.
One goal is to help China address the key problem of not knowing how many cases of HIV/AIDS there are in the country and finding the people who are infected but are not aware they have the disease.
The Chinese government estimates there are 840,000 people infected with HIV/AIDS, but international experts believe the total number of infections is much higher and have warned there could be 10 million cases by 2010. Many officials have no idea how many cases exist in their areas and those that do are reluctant to reveal them for fear of the economic consequences.
"Even though China's overall numbers [are fewer] than that of the United States ... based on our estimate, only 10 percent of the patients in China know they are infected," Ray Yip, director for the US-CDC in China said. "That means 90 percent of China's HIV/AIDS patients don't know they have HIV/AIDS and each day that they don't know, they can infect others."
In contrast, about 70 percent of those infected in the United States know they have the disease.
Yip said a crucial task for China was finding the people infected so that they do not transmit the disease. "I've heard from several provinces. They didn't think they had a problem. Once they tested people, they found 30 percent infection rates in some areas and they were shocked," Yip said.
Results from HIV testing are sometimes kept for official use and individuals are not informed, according to a CDC statement. Without sufficient antiretroviral treatments, local officials are reluctant to test people or inform them for fear they would demand free treatment.
Intense fear and discrimination among the public and health workers also hamper efforts to test and care for patients, it said. While China's top leadership has shown greater attention to AIDS in the past year, more commitment is needed, the CDC said.
"China can still prevent HIV/AIDS from reaching catastrophic proportions," US Ambassador Clark Randt said during the program's launch. "However, an HIV/AIDS catastrophe can only be avoided if China responds now urgently and forcefully with sufficient resources to stem this deadly tide." Cindy Sui,
AFP
SLOW DRIVE
Lack of political will hampering campaign against tuberculosis
NEW DELHI
Vietnam is effectively controlling tuberculosis but most countries affected by the disease are making scant progress because of a lack of political commitment. A report by an alliance of private anti-TB groups said Russia was making the least effort to tackle the disease with Brazil, China, Ethiopia, Kenya, Nigeria, and Pakistan also ranking low.
Some 24,000 people are infected each day by tuberculosis and around two million die each year.
The report said Vietnam was tackling tuberculosis by adopting the Directly Observed Treatment Short-course (DOTS) strategy. "Vietnam is the only country on the global report card on TB control that has earned a distinction, curing 76 percent of all infectious TB cases with the highly effective DOTS treatment strategy," said Bobby John, a representative of Massive Effort Campaign, which is part of the anti-TB alliance. "Brazil, Nigeria, and Russia are making minimal use of the DOTS strategy and cure less than 10 percent of their TB cases," he said.
Joanne Carter of Results International said the dismal performance by such countries was not due to "technical" problems but lack of political will. "What is needed is political commitment to follow up on the programs implemented," she said.
She also appealed to developed countries to increase their funding of anti-TB programs, describing the disease as the "greatest curable killer in the world." "About US$ 2.2 billion are needed every year to run an active antituberculosis program. But the shortfall is of about US$1 billion," she said.
The international humanitarian group Doctors Without Borders or Medicins Sans Frontieres (MSF) warned that much diagnosis of tuberculosis, particularly among children, relied on the "archaic" method of looking at symptoms.
"Delivering adequate care would require a reliable diagnostic test for TB to begin with, but we don't have one," Rowan Gillies, MSF international president said. "The HIV/AIDS pandemic has magnified this problem as tuberculosis often coincides with and is made harder to treat by HIV/AIDS," he added.
But John said Cambodia, the Democratic Republic of Congo, Myanmar, South Africa, Uganda and Zimbabwe were making progress against tuberculosis, although not with the same success yet as Vietnam.
India, which has 30 percent of the world's tuberculosis patients, has also made progress, he said. "India has been dramatically scaling up its DOTS-based TB control services. India has contributed the most to the global expansion of TB control in the last four years and other countries should follow its lead," John said.
Aided by SARS
Meanwhile, the World Health Organization said the outbreak of SARS in Asia boosted efforts to fight infectious diseases, particularly tuberculosis, which kills 1,000 people and afflicts 5,500 in the Western Pacific daily.
In many countries in the region, SARS resulted in renewed attention to public health issues and in particular to the control of infectious diseases, WHO regional director Shigeru Omi said. This led to a substantial increase in resources available to address SARS and other public health threats, such as tuberculosis, he said.
"SARS could indirectly help us fight TB since greater resources for the surveillance and control of infectious diseases mean we can find and cure more of the two million TB sufferers in our region," he said in a statement released by the WHO regional headquarters in Manila.
The WHO seeks to detect at least 70 percent of the people in the region with tuberculosis and expand access to the WHO-approved DOTS. Many Asian countries have high rates of TB with low access to DOTS, the WHO said, singling out China as facing "a major test."
China, Cambodia, Laos, Mongolia, Papua New Guinea, the Philippines, and Vietnam are among the countries with high rates of TB. Cambodia, Mongolia, the Philippines, and Vietnam have expanded the reach of the DOTS system to nearly all of their TB patients, the WHO said.
Omi warned that many cases of TB were going undetected because many of those with the disease were afraid of the stigma and the cost of treatment. "Thousands continue to suffer from TB without realizing that their illness is curable and that treatment will cost them nothing under the DOTS program," Omi said.
AFP
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