AIDS devastating Africa, 14 million people died since 2000: UN

[Tragic Rabbit]

AIDS devastating Africa, 14 million people died since 2000: UN

June 10th, 2008 - 1:15 am ICT by IANS

New York, June 9 (DPA) The AIDS epidemic has eroded African societies in multiple ways, from threatening government institutions to decreasing agricultural production, a report said Monday, adding that more challenges were expected in coming years. The report by the African Development Forum presented at a conference on HIV/AIDS at the UN headquarters in New York provided a gloomy analysis of the situation in sub-Saharan Africa, which has been hardest hit by AIDS in the world.

?Our overall conclusion is that the epidemic poses a great threat to governance in Africa,? the forum said. ?In many parts of the continent the impact of AIDS already has significant consequences for all forms of social, economic and political activity and thus for governance in the years to come.?

The disease has killed more than 14 million Africans since 2000 when the continent established the African Development Forum to raise awareness of the impacts of HIV/AIDS. Millions had died before that year, but the forum was considered a watershed in the fight against the epidemic.

An estimated 17 million Africans have been infected with the AIDS virus since 2000 and the number of AIDS-related orphans increased from 8.5 million in 2000 to 14 million in 2006. The UN estimated a total of 32.2 million people living with HIV around the world in 2007.

The forum said AIDS deaths in Africa have created a brain drain, reducing the ranks of educated and professional people, and preventing the education of younger cadres.

The most severely hit African countries included Botswana, Zimbabwe, South Africa, Zambia, Lesotho, Tanzania, Central African Republic, Malawi, Kenya and Uganda.

Shortened life expectancy due to AIDS, as low as less than 40 years, have been documented in Botswana, the Central African Republic, Lesotho, Swaziland, Zambia and Zimbabwe.

The gross national product in worst AIDS-hit African nations could contract by 18 percent by 2020, and the disease could kill 13 to 26 percent of the agricultural labour force in those countries by that year.

The UN said its efforts to provide anti-HIV/AIDS anti-retroviral treatments, which reached one million infected people in 2007, was outpaced by the number of infections - 2.5 million in the same year.

?Strong, sustained political commitment and leadership? was needed to fight the epidemic, which has killed more than 25 million people since AIDS was first isolated in the mid-1980s, the report said.

?True leadership is reflected in action, not words.?

The HIV/AIDS conference was aimed at a progress review in order to provide new impetus and activities so the spread of the epidemic could be halted by 2015. The drive is part of the so-called Millennium Development Goals (MDGs) adopted by the UN General Assembly in 2000.

Other MDGs are eradication of extreme poverty and hunger, the achievement of universal primary education, reduction of child mortality rates and improvement in maternal health care by 2015.

DPA

[Fun Tails]

But, but, but the US govt has poured billions into fighting AIDS in Africa. It's in the lead in trying to change behavior that would spread the disease. It has-

Oh what's that? The US is spending most of its money on absolutely useless and unproven 'abstinence' and other faith-based efforts? Almost nothing on programs that use condoms?

Well, I guess Africa just has to suck it up and pay the price so the religious extremists can use it as a guinea pig to showcase their style of AIDS fighting. The kind they could never impose at home.

[Nickolas James]

But, but, but the US govt has poured billions into fighting AIDS in Africa. It's in the lead in trying to change behavior that would spread the disease. It has-

Oh what's that? The US is spending most of its money on absolutely useless and unproven 'abstinence' and other faith-based efforts? Almost nothing on programs that use condoms?

Well, I guess Africa just has to suck it up and pay the price so the religious extremists can use it as a guinea pig to showcase their style of AIDS fighting. The kind they could never impose at home.

I hate to break this to you, but abstinence is the ONLY way to get the AIDS epidemic under control in Africa, barring the discovery of a cure. I don't know what faith based efforts our government is funding in Africa, and if it is, it should stop. But I 100% agree with the abstinence effort.

I also say that any nation that doesn't like the terms of our aid to the continent of Africa for fighting AIDS is free to make their own commitment for funding and can decide what programs their money will go to. The bottom line is this....

If Africans want to get the AIDS epidemic in their continent under control, then they have to practice common sense. Going around having unprotected sex and sticking used needles in their arms isn't exactly an AIDS vaccine. They have to make the effort, and along with the funding for treatment and abstinence programs, they might find that they can overcome this awful disease.

[Fun Tails]

You seem to strangely dismiss the idea of safer sex as a tool.

[DesDownunder]

On abstinence, my doctor pointed out to me that prior to antibiotics, syphilis was a deadly disease that slowly killed and crippled people on epidemic proportions throughout the world. In relation to sex and abstinence his comment was, "As far as people having sex was concerned, syphilis did not stop them but it did kill them."

Abstinence is unnatural, and as such is not going to be worth the effort. People want, even need, to have sex and telling then not to, coaxing them or bribing them not to, for any number of reasons is only likely to create severe mental disturbance in them. Safer sex programs will have a far higher chance of success with much less trauma.

That's my opinion and for what it is worth I have been quite restrained in presenting it.

[Nickolas James]

People who are infected with AIDS and know they are infected with AIDS should absolutely practice abstinence. I'm sorry, but there's no way to have safe sex with someone who's HIV positive or who has full blown AIDS. Should there be safe sex prior to a diagnosis? Hell yes, but a lot of the problem in Africa is with men who continue to have sex after they've been diagnosed. I'm not dismissing anything as an option for fighting AIDS, but abstinence is the only sure way that these people have of not becoming infected until people have been tested and they can at least have some idea what the risk is of engaging in sexual activity.

[DesDownunder]

Perhaps I need to be more precise.

Abstinence is futile. People just won't do it.

[Nickolas James]

Well thats a shame because in that region of the world, until they do, sex is an almost certain death sentence. And sex with a condom when you know your partner has AIDS is like putting your seatbelt on and driving head on at 70 MPH into oncoming traffic. Im not saying that they will do it, I'm saying that if they want to control the disease, they need to do it. Because it's obvious that nothing else is working.

[Tragic Rabbit]

Well thats a shame because in that region of the world,

Perhaps you should consider why you wrote this phrase and why you are compartmentalizing the AIDS epidemic by...hemisphere? continent? colour?

Africa is many countries. America is one. We are in no position to dictate solutions while we have none.

The statement about poz people shouldn't have sex and the 'death sentence' thing make me sad. You can have sex with a partner who is poz and do it safely if you wish. Humans have sex, that's all there is to it.

Abstinence is a concept without content. An individual may end up spending a lifetime abstaining from sex but he or she is a rarity, surely you see that?

You seem to have some misconceptions about PLWAs, human sexuality and the mechanics of HIV infection...

Just a thought.

TR

[Nickolas James]

Perhaps you should consider why you wrote this phrase and why you are compartmentalizing the AIDS epidemic by...hemisphere? continent? colour?

Africa is many countries. America is one. We are in no position to dictate solutions while we have none.

The statement about poz people shouldn't have sex and the 'death sentence' thing make me sad. You can have sex with a partner who is poz and do it safely if you wish. Humans have sex, that's all there is to it.

Abstinence is a concept without content. An individual may end up spending a lifetime abstaining from sex but he or she is a rarity, surely you see that?

You seem to have some misconceptions about PLWAs, human sexuality and the mechanics of HIV infection...

Just a thought.

TR

The idea that you can safey have sex with someone who's HIV positive is a romantic ideal, but that's as far as it goes. We'll simply have to agree to disagree. As far as advocating abstinence for people who know that they're positive, it's not a misconception, it's principle. And that principle does not just apply in Sub-Saharan Africa, either.

[Fun Tails]

Saying that AIDS will end if people practiced abstinence is like saying there would be peace on earth if people would just stop fighting.

What is your response to the claim that abstinence is impractical and cannot work? If you can show me evidence that abstinence can be put into practice in a large scale, I would kiss your boots.

Most likely, though, you'll have to admit that abstinence is a waste of money and the billions that Bush is pouring into abstinence programs in Africa because of his ideology is wasted. It could actually do some good if it were focused on preventative measures that were more practical.

I have to ask... HIV devastated the US gay community in the late eighties. Today, AIDS is ever present but its not 'the gay plague' in the US anymore. Is that because gays learned abstinence or because their sex got safer?

-------

*TR*, I would really be interested in hearing from you or someone with experience about how gay people living with AIDS go about love and sex. I have no HIV+ acquintances (that I know of) so it's an area my knowledge is lacking in, though I would like to learn more.

[Nickolas James]

Saying that AIDS will end if people practiced abstinence is like saying there would be peace on earth if people would just stop fighting.

Actually, I never said that AIDS would end if people practiced abstinence. Please don't mis-characterize my statements. What I said was, the spread of AIDS could be better controlled if those who are infected would practice abstinence.

What is your response to the claim that abstinence is impractical and cannot work? If you can show me evidence that abstinence can be put into practice in a large scale, I would kiss your boots.

I think I've made my response very clear already, but I'll say it again...it's a foolish claim. How can the one sure way not to spread AIDS be impractical when we're discussing a solution to that very problem? I don't want everyone to be abstinent, but I do want those who have been diagnosed with HIV or AIDS to stop screwing around. Having sex with anyone once you've been diagnosed is a very selfish act and people who have done so have contributed to the spread of this disease.

Most likely, though, you'll have to admit that abstinence is a waste of money and the billions that Bush is pouring into abstinence programs in Africa because of his ideology is wasted. It could actually do some good if it were focused on preventative measures that were more practical.

I don't think it's the place of the US government to spend any tax dollars in Africa, or anywhere else in the world except for the US, to fight AIDS. So in my opinion, any money spent over there is wasted, especially if those who are infected continue to pretend that they can have sex with no consequences for others.

I have to ask... HIV devastated the US gay community in the late eighties. Today, AIDS is ever present but its not 'the gay plague' in the US anymore. Is that because gays learned abstinence or because their sex got safer?

I would like to think that anyone, gay or straight, who was infected with the disease was smart enough and had the moral compass to stop having sex once they were diagnosed. Unfortunately, that's not the case. I'm sure that in the beginning, when AIDS was widely reported to be a "gay" disease, there were more cases of AIDS among heterosexual men and women than were being reported. I can't say for sure though because I haven't researched it, and I wasn't alive in the 80's to witness it for myself.

The bottom line is this.... anyone who thinks that there's such a thing as safe sex with someone who's HIV+ or with full blown AIDS is fooling themselves. If they choose to have sex with someone they love who's been diagnosed, that's a personal choice, but not one I can respect. Once they've made that commitment, they should abstain from sex with anyone else but their partner. If they don't, they're playing with other people's lives, condom or no condom.

-------

[Graeme]

How can the one sure way not to spread AIDS be impractical when we're discussing a solution to that very problem?

Actually, abstinence is not a sure way to prevent the spread of AIDS. It merely closes off ONE possible method of transmission. Other (admitedly less common) methods of transmission still exist -- such as infection through the exchange of blood products.

I don't want everyone to be abstinent, but I do want those who have been diagnosed with HIV or AIDS to stop screwing around. Having sex with anyone once you've been diagnosed is a very selfish act and people who have done so have contributed to the spread of this disease.

No arguments with the second sentence and the sentiment in the first sentence I can applaud. However, I believe there is sufficient evidence that the number of people in the world who are that noble is very small. When you have cultures where women can be forced to have sex against their will, then abstinence doesn't help them. Some men may try for a while to abstain, but they don't have the willpower to do it indefinitely. When their willpower fails (assuming they try in the first place), they need to be educated on how to reduce the risk for their partner.

Please note that I used the word 'reduce' deliberately. Safe sex is not perfect. It can, however, reduce the odds of infection significantly, and even to the point where it is unlikely that the spouse of a positive person will become infected. It's not certain, but it means that the people involved can still have a sex life with a much lower risk of passing on the disease.

I would like to think that anyone, gay or straight, who was infected with the disease was smart enough and had the moral compass to stop having sex once they were diagnosed. Unfortunately, that's not the case.

And that is the sad truth. As was said above, all we have to do to have world peace is to stop fighting. Simple, effective, but not human nature.

That's why we need other options. In the case of HIV, abstinence is an ideal that is rarely met, so other options, like condoms, have to be available and people need to be aware of them.

[Tragic Rabbit]

*TR*, I would really be interested in hearing from you or someone with experience about how gay people living with AIDS go about love and sex. I have no HIV+ acquintances (that I know of) so it's an area my knowledge is lacking in, though I would like to learn more.

Sure. Do you not live where there are many gay people?

A good number of my friends, perhaps half or more(?), are positive. I've had poz lovers. I know quite a number of men (and two women) who have been 'living with AIDS' since the 90s or even the 1980s.

The cocktails that came into use...can't remember when really, they made a huge difference in survival rates, so that sometime during the 90s it became more possible to live a....well, not normal life but pretty close and experience downtime in cycles rather than a single downward slide into death.

That is not to say it's fun to be poz and for that reason I disapprove of the medication adverts that portray such healthy active patients in their visual ads...that's maybe on a good day but that's not really life with AIDS.

The thing is, though, that a poz diagnosis is not the end of your life (anymore) and that includes bonds of love and/or sex.

Some PLWA choose to abstain from sex, most take precautions and that's all anyone can do outside just opting out of sex or out of some sex practices. There are dating clubs, parties, ads, potlucks for PLWA. You can meet someone who is also poz.

Most men have a condom handy? I'd think so but never done a survey. Guys tend to keep condoms handy these days or engage in acts with low risk rates, such as fellatio or mutual masterbation. People do tend to disclose in intimate settings, I honestly think the number that willfully do not is minute but that's only an opinion.

What isn't just my opinion is that the length of time between exposure to the HIV and when a test might come up poz can be years. Yes, years.

Most of the Poz people I know do one of these things: (1) are moderately to very sexually active (btw a lot of this is within semi-closed groups of friends,though seeking out anonymous encounters is something every category of human does...not just gay men), (2) have a partner to whom they have pledged sexual fidelity or some such and trust to that arrangement (going by het stats, it's not ironclad), (3) date within a poz community, (4) date outside the poz community but disclose (knowing they may be asked to leave or play by a different set of rules...and I guess (5) some knowingly don't disclose but even then might only engage in low-risk acts.

I think the idea that all gay men with AIDS go around doing #5 is a myth born of ignorance. That it happens is undeniable, that it is anywhere in the vicinity of the norm is fantasy.

Most gay men know signs of someone living with AIDS, slight though they may be, and has an effect on who sexually interacts with whom. And in gay contexts, friends or acquaintances do often disclose their HIV status in non-sexual situations.(but it's illegal for you to do so, btw, about other people). HIV status is protected information.

The important thing is to regularly get an across the board STD test series at your local men's clinic or health clinic and practice whatever reasonable precautions you personally choose. As I said before, individuals may choose abstinence, either short term or over a lifetime, but wow, that's a very tiny percentage of the human animal. If you practice abstinence, that's fine but that doesn't make it do-able, workable or even remotely desirable to another human. We are what we are.

I mean this in the fullest sense because HIV is transmitted in other ways than between two men.

Sex is not the only entry vector for the HIV. And coming up poz for HIV does not mean you have AIDS. And if your HIV infection brings you AIDS, it can go into remission for long periods. You would still come up poz, but all the counts would be good and you could be more active.

People with are HIV poz live all different sorts of lives. They are not lepers: you can drink after them, kiss them and, yes, even have sex with them without risk of exposure. Nor did they 'get' AIDS from being 'bad' or acting immorally. It is the nature of humans to crave touch, friendship, love, and sex right along with food and shelter. It's just a dice roll, who is poz and who isn't --- no matter what the colour of your skin or the continent of your birth.

What seems forgotten in this thread (and why I posted it) is that the HIV has nothing to do with being gay, that just happened to be the vector it entered America, so far as anyone knows. Mere chance. Patient Zero might just as easily been, say, a heterosexual man involved in the 'swingers' community who went about spreading it that way (unknowingly, of course) and within those very different groups. Would the early cases then have been called in the news victims of The Housewife Plague or something?

There are other ways to contract the virus than sex and there are all kinds of sex.

I'm getting the feeling that's another facet of misunderstanding here. Eg. One of my best friends is an AIDS activist (in the true sense) and has assured me that current medical opinion does confirm that saliva kills the virus and that, for example, performing fellation on someone who is poz is a lot less risky than the auto drive to Starbucks next morning.

I don't think Americans will be abstaining from automobiles or sex anytime soon, despite dangers - dangers which can be minimized with a tad of effort.

AIDS never was a 'gay plague' in any country, whether America or Africa.

This whole 'Africa' thing on this thread has me a little disappointed, its diverse society and complex history lumped into some colonialist view suggesting 'Africans' need to be 'led' or taught because they are childlike. That's just the old 'White Man's Burden' prejudice living on in the Eurocentric arena (yes, AU, US and UK) and we ought to be really, really leery hasn't managed to lurk in the attics of our minds.

[Adam Donaldson Powell]

Thank you T.R.

You have written everything that I had thought to write myself, but you managed to do so with a lot less emotion than I would have demonstrated ... seeing as how I have been an HIV/AIDS activist internationally for fifteen years. It is amazing that this same information must be repeated constantly, even after so many years -- but that is the reality.

[Tragic Rabbit]

The idea that you can safely have sex with someone who's HIV positive is a romantic ideal, but that's as far as it goes. We'll simply have to agree to disagree.

I wasn't trying to be romantic (by which you mean untruthful or wishful?), only practical.

Let me be specific. [warning: sexual content ahead]

Aside from the non-sex ways one can come into contact with the HIV, 'having sex' is...a broad and happy category , a thing that makes life more loving and fun even when practiced among friends or strangers. Some sex acts have zero risk of HIV infection.

Don't forget that you take risks every day: driving a car, walking in crowds, turning on the cooker or booking a plane flight. Don't let words like 'risk' keep you living in a box all your life, that's what life is --- risk.

Forget 'risk' and think, if you'll pardon the expression, positively!

In the words of Cole Porter 'experiment!'

Humans, like bonobos, have a intrinsic urge, need, for touch and contact and the ultimate contact is sex, though a nice cuddle, hug or kiss is worth ten times its weight in gold.

Ways for an HIV- person to 'have sex' with someone whom they know to be poz (ranging from zero probability to very low statistical risk for the neg party) include, but are not limited to:

* getting naked and rubbing against one another, skin to skin, will bring more than orgasm, it brings peace of mind, in my opinion, it's something our bodies and brains are wired to want, to need, even to crave. And bonobos do it with all their friends, why must humans (close relatives of bonobos) make it so...fraught with morals or meaning beyond the very goodness of the act itself?

* fellatio - saliva kills the HIV, no one says you have to swallow or even use your mouth to completion - god gave us hands and many other parts for a reason...why not use them to make your and others' lives happier ones? Fellatio can be mutual or take-turns, fellatio can be a feather that drives you mad with want or a rough and tumble quickie backseat after work.

Sex is fun!

Sex is...human, warm and makes you feel loved (among other things). God wasn't punishing us when syphilis or HIV popped up, it's just how humans work in groups, diseases are born and transmit themselves...but, like humans through the ages, we should learn to adapt and cope without penalizing or denying ourselves or others the joys of life.

* lying naked, side by side, and using hands to bring one another to completion while kissing and otherwise making lots of lovely skin contact. If this doesn't sound fun, then you've never tried it (my opinion).

* intercourse (part A) can be performed without condoms and/or without insertion into partners' body parts (between buttocks or thighs) and still be immensely satisfying.

And this is a game two can play. Taking turns is such fun with the game of sex, don't you think?

And (B) intercourse with penetration (technically fellatio is penetration, BTW, but talking anal here) can be performed in various ways that severely limit risks: with a condom, without a condom, external ejaculation ('pulling out' prior to emission), 'femidoms' (prob misspelled that - it's a sort of reverse condom), only engaging in it when recipient is sure his skin has no breaks or lesions, or simply choosing not to be penetrated in that fashion.

One can simply prefer penetration with different body part or a 'toy' of one's choosing.

Local sex toy stores stock all sorts of interesting and fun toys, even dildoes where two can be penetrated at the same time, and many other toys worth trying. If there are no local toy stores in your area, try online, there are a good number of reputable companies that deliver discretely.

Shopping at a toy store with a friend, BTW, whether RT or online, can be playful or romantic if you let it.

Penetration can be pleasurable without directly involving the penis, penetration with fingers, hands, toys, etc is not an uncommon practice and also not limited to gay male community.

As far as advocating abstinence for people who know that they're positive, it's not a misconception, it's principle. And that principle does not just apply in Sub-Saharan Africa, either.

It makes me very sad to know that people wish their fellow humans to opt out of one of the greatest joys of living just because they are poz for HIV.

There are other STDs, BTW, and many more diseases transferred without any sex at all...from the common cold to Ebola or, maybe, autoimmune diseases. We take risks every time we start our car engines, every time we step outside our homes to encounter our fellow humans, every time we touch a surface or take a breath.

Unless you are a 'boy in a bubble', you are risking infections each and every day.

Is the answer to this to isolate ourselves from all touch, all friendship, all love? That's autism...and it's a serious and terribly sad psychological disorder.

Humanity is a communal and highly social animal and always will be. You ought to kiss and hug (or whatever) men whom you love as friends, no matter their HIV status, and it's been my experience that those kisses, hugs and whatever else are treasured all the more by PLWA for the very reason that there are those out there who consider them to have contagious leprosy or inhabit some sort of Untouchables category.

I don't, won't and can't believe people get infections because they are 'bad' or gain wealth and health because they are 'good'.

If anything, I'd say the opposite but know, in reality, that there is no such connection. All rolling the dice, from day one: what parents you are born to, how much money and love and time they have, right down to how you deal with the misfortunes and fortunes that Life flings at you over the years.

HIV is not a death sentence, but it can deprive you of the minimal amount of love, kindness, friendship and love that makes these small lives of ours worth living. Try not treating your HIV+ friends any differently, or maybe go out of your way to treat them better than others...trust me, they'll notice.

TR

[DesDownunder]

Would all those people wishing to offer themselves in marriage to the honorable Rabbit, please form two lines, one to his front and one to his er...rear.

Outstanding TR! A fine example of a passionate yet objective post of your knowledge and thoughts on the subject.

I can see also, that much of your knowledge has come from sacrificing yourself to abundant research for the sake of human relationships.

Well done.

[Tragic Rabbit]

I can see also, that much of your knowledge has come from sacrificing yourself to abundant research for the sake of human relationships.

Well, one does one's best

TR, oft stirred but seldom shaken

[Trab]

Indeed, TR, well done. I only have one little quibble, and that is in regards to this, "Is the answer to this to isolate ourselves from all touch, all friendship, all love? That's autism...and it's a serious and terribly sad psychological disorder."

Autism is not psychological in nature, in any way, shape, or form. In fact, autistic people need love, friendship and affection too, but in most instances our sensory overload issues cause us to suffer from contacts that are pleasurable to others. Add to that our difficulties in understanding and learning 'normal' contact (connecting with other people) behaviour, and you have lonely people who don't know how to break the barriers down, nor state what is needed for our own pleasures.

Imagine trying to find a gay partner in a very hostile anti-gay environment (which has probably happened to you at some point). The slightest miscue or mis-judgement and you can be verbally assaulted, or worse. You don't know how to do this, and there is no manual to explain things, nor anyone to show you 'the ropes'. Now picture this challenge for every single interaction with everyone, not just trying to find a partner, but even to buying groceries or getting on the bus, and you may have a better idea of how it can be for an autistic person. And, if that isn't bad enough, all the senses are being assailed with stimuli, sounds too loud, smells overwhelming, lights too bright and fluorescent lights seen flickering madly, the breeze brushing painfully against your skin, etc..

The psychological aspect, and I won't deny that there is one, is the eventual withdrawal from even making any attempt at meeting anyone. Continual reinforcement of our failures to meet people successfully will lead to withdrawal from people, and even anger at people making an effort. If those efforts are done correctly, they can work, but often they are not, usually ignoring the sensory overload, and we have another failure, to make things just that little bit worse. Finally, we end up just wanting people to stay away, all the while screaming inside for that love and friendship we need.

I don't want to hijack the thread, but I really felt a need to clarify this one thing, not because it is huge, but because it is huge for me.

As for the whole abstinence position, it is like tell drug addicts and tobacco smokers to 'just quit'. It just doesn't work for the vast majority, and any reasoning person who is truly concerned will search out workable alternatives; ones that take into account the human needs. That type of rigid position is actually very Asperger's Syndrome typical, in which black is black, white is white, wrong is wrong, and right is right, with absolutely no shadings in between. A lie is a lie, and there is no such thing as a white lie. That's why we are blunt to the point of alienating many. It is only with awareness of ourselves and lots of effort to learn other viewpoints that we can understand, if only 'technically' that human nature isn't quite to cut and dry.

[Fun Tails]

I am very comfortable with this thread being focused on Africa because it *is* the major battleground.

India is set to become another battleground soon, but for now, it's Africa where the casualties are greatest.

----------------------------

Nickolas, you seem to assume that HIV positive men in Africa (or elsewhere) are aware of their status.

That is most definitely not the case. Because of the stigma and discrimination associated with HIV in many information poor countries, many men will not even *get* tested because they are afraid that someone might find out that they got tested and just the act of getting tested is stigmatized enough to cause quite a bit of discrimination.

Most HIV+ men in many areas aren't aware of their status and will not try to find out.

Approaching the problem of HIV and AIDS through abstinence is a waste of money (whether its US taxpayer money or otherwise).

To me, the ABC methodology (abstinence, Be faithful, Condoms) needs to be updated.

The priorities should be COndoms and Education to reduce stigma. This has already started. Programs to defeat stigma are much more common and the hope is that they will lead to more people knowing their status.

[Tragic Rabbit]

Indeed, TR, well done. I only have one little quibble, and that is in regards to this, "Is the answer to this to isolate ourselves from all touch, all friendship, all love? That's autism...and it's a serious and terribly sad psychological disorder."

Autism is not psychological in nature, in any way, shape, or form. In fact, autistic people need love, friendship and affection too, but in most instances our sensory overload issues cause us to suffer from contacts that are pleasurable to others. Add to that our difficulties in understanding and learning 'normal' contact (connecting with other people) behavior, and you have lonely people who don't know how to break the barriers down, nor state what is needed for our own pleasures.

Bart, I actually considered naming you and pulling you into the discussion as I wrote that but chose not to, seemed tacky. Sorry if the terms are wrong, they were what I was taught when, as an undergraduate, I volunteered for years at the university's Behavioral Studies Center that treated locals on a sliding scale. Lower echelon positions were filled by student volunteers.

The Center was highly geared toward the Skinner approach and that was why I ultimately stopped volunteering but that is also where I came to know a number of autistic children and adults, along with persons suffering from other disorders but I worked specifically with two very small autistic children, so those memories constitute the majority of what I learned while working there. Autism seemed, and still seems, so frightening to me, particularly given how naturally social the human animal is.

However, my point was only that it is wrong to wish upon others the kind of isolation that autism inflicts (without intervention). Humans are designed to be social and touching maintains health of all kinds. Consigning PLWA to a pseudo-autistic lifestyle based on their HIV status seems beyond cruel.

I posted this article to remind everyone that AIDS is an international issue, not African, not American, not gay and definitely not about morality.

TR

[DesDownunder]

Friends,

I have to announce that this Forum has been considered in a blog as misrepresenting the facts on the transmission and safety of sexual practices in relation to HIV transmission.

This is a very serious charge.

Rather than risk turning a blog or the forum into a futile battle zone for opinions as to whether this is the case or not I am posting this link both in the blog and in the forum, for the (Atlanta) Centers for Disease Control's Fact Sheet on HIV Transmission. This link to Health24 has a list of priorities for safer sex. More information is available by Googling HIV Transmission or from local health care organisations and sexually transmitted disease clinics in tour local area.

It is certainly not the desire of this Forum or its staff to propagate misinformation on any subject.

Local Gay and lesbian organisations also usually have abundant information on sex and disease prevention that provide common sense prevention measures, short of becoming a sexual recluse.

I will not therefore allow the discussion to degenerate into a brawl as to what is safe and what is not. There are any number of sites available with such information.

Postings of reports on what is safe or otherwise in sexual transmission of any disease must be accompanied by a link referring to source material in future.

[Guest Fritz]

For what it is worth, the original PEPFAR bill passed by congress allocated the money be spent in the following manner.

"1. 55% for the treatment of individuals with HIV/AIDS (and in FYs 2006 through 2008, 75% of this is to be spent on the purchase and distribution of antiretroviral drugs)

"2. 15% for the palliative care of individuals with HIV/AIDS

"3. 20% for HIV/AIDS prevention (of which at least 33% is to be spent on abstinence until marriage programmes)

"4. 10% for helping orphans and vulnerable children (and in FYs 2006 through 2008, at least 50% (of the 10%) is to be provided through non-profit, non-governmental organizations, including faith-based organizations, that implement programmes at the community level)."

In light of the above information I find some of the statements in this thread inaccurate. Most of the money was not spent on abstinence and faith based programs. According to my math only 5% of the total monies could be used through non-profit, non-governmental organizations which could include faith-based organizations. I would also point out that it is frequently cheaper to use organizations which are already in place rather than set up, staff, and operate new ones enabling you to get more bang for the buck as evidenced by such organizations as the Salvation Army which manages to accomplish more with fewer dollars than government agencies do.

Even if all the prevention money was spent on the abstinence until marriage programs, that still does not qualify as most of the money. In 2007 only one-third of the prevention money was spent on abstinence until marriage programs, but I don't have the numbers for the complete period. However, that one-third was reported as being similar to 2006 which (if that is reflective of the entire period covered by the bill )would mean that approximately 7% of the total money was used for such programs, hardly most of the money. Also, approximately 25% of the prevention money was spent on condom programs which accounts for 5% of the total monies.

The information quoted comes from Avert, an international AIDS charity. Anyone wishing to become better informed can Google PEPFAR and start in.

[Fun Tails]

Fritz, I'm sorry.

I had read about the 33% figure for abstinence, I just didn't know it was 33% of just the 20% set aside for prevention.

Thanks for the info, though I feel kinda dumb.

[Guest Fritz]

Funtails, we all make mistakes. What we learn from them is what is important, and the lesson to be learned here is that some people will mis-represent things in order to make a political point. It is incumbent upon all of us to try to not be fooled by such people. Since the advent of the internet it is much easier to check such statements.

Something I was surprised to learn is that the prevention programs are starting to show some success according to Aidsmap. From their site I quote the following. "According to Dr Dorothy Mbori-Ngacha of the CDC in Kenya, ?most HIV prevention programmes in sub-Saharan Africa have adopted the ABC approach as a strategy for encouraging behaviour change. These programmes specifically include basic information about HIV, personal risk assessment, coupled with risk reduction counselling and skills building; and the introduction of [prevention to] specific risk categories. [ABC] focuses on the promotion of abstinence and delayed sexual activity for young people who are not sexually active, faithfulness to one HIV-negative partner for those who are sexually active and correct and consistent condom use in all other sexual encounters.?

?[According to] evidence from several countries, this approach is correlated with a reduction in the prevalence of high risk sexual behaviour...? she said, ?and there is now evidence from population-based surveillance surveys that these behavioural indicators have been associated with a decline in HIV prevalence in a number of countries.?

Based on that I would now have to say that perhaps the abstinence money is not wasted like I originally thought it was. Anyhow, there is a lot of information out there if we will only take the time to check it out. The complete Aidsmap article can be found here

I know it is popular to bash Bush for everything, but in the case of PEPFAR much of it appears to be unwarranted. I have no problem with bashing him for his screw ups, but think it unfair to bash him for the programs that are successful. Here is an article from the Boston Globe on that subject.