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Update: 09.08.2008
Aids conference ends with warning
An international Aids conference has ended with a warning that commitments made by wealthy countries to fund access to HIV treatment may not be met.
The charity Oxfam said there had been an air of complacency from government and UN officials at the Mexico meeting.
In 2005, the G8 industrialised nations set a goal of providing HIV treatment to all who needed it by 2010.
But with less than two years to go, the G8 leaders have committed little more than a third of the promised resources.
Michel Kazatchkine, the head of the Global Fund to fight Aids, tuberculosis and malaria, said that although lives were being saved on an unprecedented scale, he was deeply concerned at the lack of funds.
Three priorities
"We should be deeply concerned that with less than two years to go before our deadline for universal access, the G8 has committed little more than a third of the resources that it has promised to deliver by 2010," said Mr Kazatchkine at the close of the six-day conference.
Millions of lives were at stake, said Robert Fox, the leader of Oxfam International's delegation in Mexico City.
"What we have is the sense of real slippage, that well you know it may not be 2010 and it probably will be 2015, as if that doesn't matter," he said.
Twenty-four thousand people attended the conference, and the organisers said the voices of those who bore the brunt of the HIV-pandemic had been loud and clear.
Mr Kazatchkine highlighted three priorities to take the battle against Aids forward:
Defeating the discrimination against those with Aids virus flourished
Focussing research on more coordinated research
Strengthening health systems in developing nations
The Mexico City conference was the 17th of its kind since acquired immune deficiency syndrome (Aids) emerged in 1981.
The next conference will be held in Vienna in 2010.
Update: 07.08.2008
New data reveal that HIV incidence in the USA is 40 percent higher than previously thought
Improved surveillance methods show that HIV incidence in the USA is 40% higher than previously estimated, according to the US Centers for Disease Control and Prevention (CDC), in a study released at the XVII International AIDS Conference in Mexico City this week.
The new statistics were produced using more precise methods for estimating annual HIV incidence, or the number of people who become newly infected with HIV in a given year. They show that 56,300 HIV infections occurred in the United States in 2006 (the most recent year for which data are available), compared to the previous estimate of 40,000.
The CDC’s previous HIV incidence estimate was based only on reported HIV diagnoses, which can give a misleading picture of the epidemic as some people are tested years after they become infected with HIV. The new method for measuring HIV infection involves a laboratory test that can distinguish recent from long-standing HIV infections.
Dr Kevin Fenton of the CDC, said, “The new estimate does not represent an actual increase in the number of new infections, but reflects our ability to more precisely measure HIV incidence and secure a better understanding of the epidemic.”
The new surveillance system also shows that the impact of HIV remains greatest among certain groups such as men who have sex with men, who accounted for 53 percent of new infections; and rates of HIV among African American communities were found to be 7 times higher than among whites.
“Unfortunately we are far from winning the battle against this preventable disease,” said Julie Gerberding of the CDC. “We as a nation have to come together to focus our efforts on expanding the prevention programs we know are effective.”
Update: 05.08.2008
HIV vaccine 'allows drug breaks'
Scientists are testing a vaccine designed to give HIV patients a prolonged break from their regular medication without side effects.
The Aids 2008 conference in Mexico City was told 345 patients in 21 centres in the US and Europe will take part in the largest-ever trial of its kind.
The vaccine has been developed by a biotechnology company based in Norway, Bionor Immuno.
Results from the trial are due by the end of 2009.
A break from standard HIV therapy would potentially alleviate the adverse side effects associated with the drugs, which can include problems with the heart and liver, diarrhoea, nausea and fat loss
It may also help delay the emergence of drug-resistant viruses, as well as providing substantial savings for health care services.
Dr Barry Peters, of Kings College London, is leading the research in the UK.
He said: "A successful immunotherapeutic HIV vaccine would give patients and doctors enormous advantages over current treatments, both in developed and developing countries.
"Even if this vaccine is not the final answer, it could help the march towards a successful immunotherapeutic HIV vaccine."
However, he stressed the vaccine was still at a very early stage of development.
Immune response
The vaccine works by stimulating an immune system response, in contrast to standard HIV drugs, which block replication of the virus.
It has already been tested in two small trials on 11 and 38 HIV patients with promising results.
The majority of patients were able to refrain from taking their usual antiretroviral therapy (ART) for an average period of 31 months.
During this time their level of key infection-fighting CD4+ cells remained high above the level they had before they started taking ART.
At a follow up 44 months after treatment interruption, 34% of the patients were still not back on ART.
Some patients were still off ART five years after the trial was completed.
ART cannot usually cannot be interrupted for more than three to four months without side effects.
Lisa Power, head of policy at Terrence Higgins Trust said: "Any advance that gives people more treatment choices and delays the progress of the virus is a good thing.
"We are not yet clear whether this vaccine will work, but we'll know more by the end of next year."
Update: 25.07.2008
HIV drugs 'add 13 years of life'
Life expectancy for people with HIV has increased by an average of 13 years since the late 1990s thanks to better HIV treatment, a study says.
Researchers said it meant HIV was now effectively a chronic condition like diabetes, rather than a fatal disease, the Lancet reported.
The team, involving Bristol University staff, looked at over 43,000 patients.
The study found a person now diagnosed at 20 years old could expect to live for another 49 years.
But the Antiretroviral Therapy Cohort Collaboration, which includes scientists from across Europe and Northern America, warned this was still short of the life expectancy for the wider population which stands at about 80.
Antiretroviral treatment for HIV consists of drugs which work against the infection itself by slowing down the replication of the virus in the body.
This method of therapy was introduced in the 1990s, but has since become more effective and better tolerated.
The researchers looked at life expectancy during three time periods after the introduction of the drugs - 1996-9, 2000-2 and 2003-5 - in high income countries.
Just over 2,000 patients died during the study periods.
They found that while patients aged 20 diagnosed in the 1990s could expect to live another 36 years, that had increased by 13 years by 2003-5.
During the middle time period, life expectancy stood at an extra 41 years.
Success
Lead researcher Professor Jonathan Sterne said: "These advances have transformed HIV from being a fatal disease, which was the reality for patients before the advent of combination treatment, into a long-term chronic condition."
He added the development was a "testament" to the success of the anti-HIV drugs.
But the researchers warned those diagnosed later in the course of the infection had a much shorter life expectancy.
Marc Thompson, deputy head of health promotion at the Terrence Higgins Trust, said: "HIV medication has become much more effective since the early days.
"There has been great progress, but research needs to continue, especially for those who have developed resistance to some drugs and are running out of options."
But he added the study also highlighted the need for early diagnosis, pointing out an estimated a third of people with HIV do not know they have it.
Deborah Jack, of the National Aids Trust, said: "Hopefully, this study will encourage more people to come forward for testing but we need to better educate doctors about the signs and symptoms to look for.
"Society also needs to catch-up with the fact that HIV is a long-term condition that thousands of people in the UK are living with everyday.
"HIV is not deserved of the fear or stigma that still surrounds it."
Update: 22.07.2008
Genetic Variant Raises HIV Risk
There's no doubt Africans have borne the brunt of the AIDS epidemic. Now researchers in London and Texas say it may have something to do with a single gene variant that could account for 11%, or about 2.5 million, of Africa's HIV cases.
Published in the journal Cell Host and Microbe, the findings center around one gene variation that blocks a receptor from being expressed on the surface of red blood cells. Scientists had previously studied this genetic variant - found almost exclusively in Africans and their descendants - because it also conferred protection against an early form of malaria. (The malaria parasite needed the receptor to infect blood cells; without the receptor, the parasite starved and died.) More than 90% of sub-Saharan Africans lack the red-blood-cell receptor, along with two-thirds of African-Americans. But the variant that once saved its carriers from one disease now appears to make them more susceptible to another. According to the paper, people with the gene variant were 40% more likely to become infected with HIV than people without it.
This is a finding five years in the making. Virologist Robin Weiss of University College London began to study the relevant receptor in 2003, after seeing earlier research that showed how variation in another gene similarly blocked the receptor that allows HIV to enter white blood cells; far fewer people carry that variant. In the lab, Weiss found that the African-specific receptor, called DARC, or duffy antigen receptor for chemokines, also interacted with HIV: the receptor binds to a wide array of proteins that suppress the virus's replication. Intrigued, but unable to explain why the lack of the receptor increased HIV infection, Weiss teamed up with geneticists at the University of Texas and elsewhere to analyze how the gene variant impacts HIV rates in real populations.
It turned out that among a select cohort of American military personnel who had been followed over decades, the roughly 1,200 carriers of the trait, all of whom were African-American, were 40% more likely after adjustments to be infected with HIV than noncarriers. From that sample, Weiss and his colleagues extrapolated the infection risk attributable to the gene variant in Africa, where a 40% increased susceptibility to infection translates to about 11% of all infections.
Interestingly, among the servicemen who were infected with HIV, those who carried the gene variant lived on average two years longer than noncarriers. "We still can't say exactly why," Weiss says. And though the effect of this gene variant, if confirmed, could help explain a huge number of HIV infections, it still cannot come close to explaining the AIDS burden of Africa. Nearly 70% of all HIV-positive people in the world live in sub-Saharan Africa, and prevalence rates in adults in some African countries top 20%. What's more, the gene variant is most common in West Africa, but HIV-infection rates in that region remain very low compared to those in Eastern and Southern Africa, where the disease has festered longest - and where government and medical officials have often turned a blind eye to risky behaviors in the population.
When asked whether his new findings, if replicated, may help guide current policy, Weiss says, "The straight answer is no. It doesn't really help us think about a vaccine." He adds, "It also doesn't help in other ideas about prevention." Eventually, however, researchers hope to learn how the gene variant slows progression of the AIDS, which may inspire new treatments.
On that front, at least, the British and American researchers may have good company. This week a separate team of researchers at the University of Texas announced they had found what may be the virus's "Achilles' heel" - a stretch of amino acids in the HIV envelope protein, which is necessary for the virus to attach to and infect host cells. Those amino acids, researchers say, could someday be a key therapeutic target and may help change the epidemic's course. View this article on Time.com
Update: 21.07.2008
Cameroon refugee on trial in Poland for infecting women with HIV
WARSAW (AFP) - A Cameroonian poet and activist living in Poland as a refugee since 1999 went on trial Friday in Warsaw charged with having "knowingly infected" 11 women with the HIV virus, his lawyer said.
Held behind closed doors to protect the identity of the victims, the trial of Simon Moleke Njie, 34, also known as Simon Mol, is expected to last "at least a several months," defence lawyer Mikolaj Pietrzak said.
Polish police detained the suspect in January 2007 after one of his victims filed a criminal complaint against him.
Mol told investigators he had not known he was HIV positive and that he had tested negative for the virus in 1999. But Polish police investigators found that several of his partners told him they had tested positive for the disease after having had intimate relations with him.
Mol became a darling of Poland's liberal press for organising vocal campaigns against racism and supporting the cause of refugees in Poland.
The women allegedly infected by Mol range in age from 20-25. Mol is believed to have initially asked them to translate his articles and poems into Polish.
The charges carry a maximum penalty of 10 years behind bars.
Mol is also suspected of infecting two other women, currently residing outside Poland.
Update: 16.07.2008
Congo kids to get free AIDS checks and malaria drugs
BRAZZAVILLE (AFP) - HIV/AIDS tests and anti-malaria medication will be available free to children, Congo Health Minister Emilienne Raoul announced Tuesday.
The services would from now on be free for children up to 15 years old and to pregnant women, said Health Minister Emilienne Raoul at the Brazzaville children's hosptial at the launch of new campaign.
But she warned: "The medicines are for the sick and must not end up on the streets and in neighbouring countries."
The theft and resale of medicines on the black market by hospital staff is a major problem in Congo.
Treatment for tuberculosis, one of the infections linked to HIV, is already free of charge here. TB, malaria and HIV/AIDs are the three top killers in Congo.
Malaria alone kills 21,000 children under five every year, according to the United Nations Children's Fund (UNICEF).
Update: 16.07.2008
Roche to suspend HIV research, seeing no advances
NEW YORK (Reuters) - Swiss pharmaceutical company Roche Holding AG will suspend its HIV research because none of its pending medicines represent significant improvement over existing drugs, a company spokeswoman said on Friday.
"Research scientists currently working in HIV will be reassigned to other activities," Linda Dyson, a spokeswoman in Roche's U.S. office in New Jersey, said in an e-mail.
Dyson confirmed an e-mail sent on Wednesday to some activists informing them of the decision. In that e-mail, the company said it "decided to refocus our resources within virology on diseases in which we can deliver substantial improvements over existing medications."
Dyson declined to specify how much Roche has been investing in HIV research.
She also said she could not specify how many employees worked in the HIV research division. Roche employs 5,000 people in the U.S. and 3,000 in its New Jersey office.
The company said in the e-mail to some activists that it initially had been excited about the potential for drugs in pre-clinical testing, but it has "concluded that none would provide a true incremental benefit for patients compared to medicines currently on the market."
Roche said it would continue to support its molecular diagnostic tests and drugs already on the market, including the fusion-inhibitor Fuzeon.
Roche has partnered with Morrisville, North Carolina-based biotech Trimeris Inc to sell Fuzeon, which netted $266.8 million in sales last year.
But the drug struggled because of its cost -- $25,000 for a year's supply -- exceeding the cost of other HIV drugs on the market, said Peter Staley, founder of AIDSmeds.com, which tracks HIV- related news.
The launch of new drugs and an uptick in HIV cases is set to make AIDS medicine a $10.6 billion market by 2015, according to a study published last year by independent market research firm Datamonitor.
More than 20 separate HIV drugs are available, with several combination pills also available. None can cure the fatal disease, which infects an estimated 33 million people globally and which has killed 25 million.
The drugs fall into various classes, each of which interferes with the replication of the virus at a different stage. The human immunodeficiency virus hijacks immune system cells, forcing them to create copies of itself.
Activists said they would not mourn the withdrawal of Roche from the field.
"They're not beloved in the AIDS community," said James Love, Director of Knowledge Ecology International, an advocacy group that focuses on access to medication.
"They are criticized a lot by people in the AIDS field because they are the least willing to give discounts on their AIDS drugs."
The decision reflects "the lack of productivity among the groups that they have working in this area," he said, adding that "a lot of the big pharma companies haven't been very impressive in terms of their big internal pipeline."
Staley said Roche has never come up with an AIDS drug that has sold really well.
"Roche is a big company and they've been trying to get this right for many, many years." Staley said.
"It is disappointing that there is one less big pharmaceutical company in this field. I don't think it's a sign of a serious problem in pharma's commitment."
Update: 11.07.2008
Kenyan wins landmark HIV ruling
A HIV-positive Kenyan woman has won $35,000 in a landmark ruling against her employer for unfair dismissal.
Jacqueline Adhiambo Ongur, a 45-year-old waitress, also sued her doctor for revealing her HIV status without her consent.
The High Court ruled that it was unlawful to end employment on the grounds of a person's HIV status. None of the defendants admitted liability.
About 2.5m out of 32m Kenyans are currently living with HIV/Aids.
Mrs Ongur's former employer, Home Park Caterers, said the company had not requested a medical test, and was not aware of her status when she was sacked.
But the former waitress told the court that her letter of termination said she had been sacked on medical grounds, and for being unable to perform her duties.
The High Court's decision is the first such ruling in Kenya.
Victory
Mrs Ongur says she filed the case to focus attention on the rights of people living with HIV/Aids.
She says she has endured hardship since she was sacked and has not been able to get another job.
Her lawyer said the case had been very challenging as Kenya's constitution does not expressly prohibit discrimination on grounds of HIV.
HIV/Aids activists have lauded the ruling saying it is a victory in the fight for the rights of people living with HIV/Aids.
"It's a lesson and a message to employers that people living with HIV and Aids have got rights like any other person to work," activist Inviolata Mbwavi told the BBC's Focus on Africa programme.
"It will bring up many people who have suffered at the hands of their insensitive employers to come out and know that the law protects them."
People living with the virus still face immense stigmatisation, Ms Mbwavi said.
'Invasion of privacy'
Mrs Ongur told the court that when she went to hospital complaining of chest pains and rashes, Dr Primus Ochieng tested her for HIV without her consent.
She told the court that Dr Ochieng and the Metropolitan Hospital then disclosed her status without her consent to her employer, in breach of doctor-patient confidentiality.
The court declared that testing employees or prospective employees for HIV without consent constituted an invasion of privacy and was unlawful.
Disclosing an employee's status to their employer without their consent was also unlawful, the court ruled.
The former waitress said her employer and colleagues knew about her HIV status before she did.
She said that she only found out it when she went back to the hospital and requested her medical report.
Mrs Ongur had worked for Home Park Caterers for eight years before she was dismissed.
Update: 08.07.2008
Magic Johnson's wife in public eye on HIV campaign
LOS ANGELES - Magic Johnson's normally publicity-shy wife Cookie is emerging as a spokeswoman in a campaign urging black women to get tested for HIV.
Cookie Johnson is appearing with the former LA Lakers star in a five-year, $60 million public service campaign with ads directed by moviemaker Spike Lee.
She was two months pregnant when her husband tested positive for HIV in 1991,
The Henry J. Kaiser Foundation says almost a third of cases diagnosed among blacks in 2006 were women, double the rate for white women.
Cookie Johnson, who tested negative for the virus, says part of the community still has the attitude that "it can't happen to me."
Update: 08.07.2008
G-8 discusses system to follow-up on aid pledges
RUSUTSU, Japan - An aid group founded by U2 frontman Bono calculates that the Group of Eight top industrialized nations has delivered only $3 billion of the additional $25 billion promised for Africa for everything from AIDS drugs to training peacekeepers.
Now the Africans and their allies want a new system to make sure rich nations come through.
The G-8 opened their summit in northern Japan on Monday with a discussion with eight African leaders over the progress in aid increases to the continent — and how the wealthy countries have fallen short.
Along with Algeria, Ethiopia, Ghana, Nigeria, Senegal, South Africa, Tanzania and the head of the Africa Union Commission, the G-8 discussed setting up a mechanism to measure their progress in fulfilling pledges and to hold them to their word, said leaders and aid groups.
"When the G-8 leaders make various commitments, it's important to have a monitoring system," said World Bank President Robert Zoellick, who joined the talks. "I think countries need to deliver on their promises, and that was the tone that was generally set in the discussion."
French President Nicolas Sarkozy and German Chancellor Angela Merkel were among leaders who proposed that top Africa advisers in each G-8 country track promises and periodically compare notes with African countries on compliance, a Sarkozy aide said. Aid groups said Japan had floated a similar proposal for aid goals.
"The good thing about the discussion was that it became quite clear that the Africans want to take their fate more and more into their own hands," Merkel said. "But they also demand that we fulfill our promises and keep on helping them."
The G-8 — the United States, Japan, Germany, France, Britain, Italy, Canada and Russia — have been making a lot of well-publicized promises at their summits.
At the meeting in Gleneagles, Scotland, in 2005, the group laid out an ambitious plan to boost aid to Africa by $25 billion a year by 2010 — more than doubling aid to the continent compared to 2004.
Last year in Heiligendamm, Germany, the G-8 followed that up with a $60 billion pledge to combat the spread of HIV/AIDS and other diseases in Africa.
Bono's aid group, ONE, calculated that the G-8 had delivered only $3 billion of the additional $25 billion for Africa and that development assistance for agriculture — increasingly important because of rising food prices — had fallen as a percentage of total aid from 1980 to 2004.
A plan to stop tuberculosis has been significantly underfunded, 33 million African children still do not have access to school, and drugs for HIV/AIDS patients were available to only 30 percent of Africans needing them — far short of the goal of 80 percent, a report by ONE said.
Charles Abani, regional director for Oxfam in Nigeria, said one problem was that countries recycle pledges, announcing aid in one area such as education, and then moving the same money to another area to meet new demands — meaning the total amount of money promised does not increase.
"This whole business of announcing and reannouncing the same sums of money in different configurations ... seems to be a habit now," he said, calling for a mechanism "to get us to a point where we can work out when people are recommitting the same money that they've committed time and time again."
Update: 06.07.2008
Health officials renew investigation of South African AIDS doctor
Health officials in South Africa have renewed their investigation of a doctor who provided HIV positive pregnant women with the antiretroviral drug AZT to prevent their babies being born with HIV.
Dr Colin Pfaff of Manguzi Hospital, in KwaZulu-Natal province, began giving AZT to HIV positive pregnant women in August 2007, purchasing the drug with money donated by the AIDS organisation AVERT to the Manguzi Mission Fund. In February 2008 the provincial health department charged Dr Pfaff with misconduct for contravening government policy, even though the South African government officially endorsed the use of AZT in January 2008.
Within days the charges were dropped, following an outcry among rural doctors, scientists, AIDS activists and organisations. On May 21st the Treatment Action Campaign (TAC - South Africa's largest AIDS activist group) met with the ANC’s leadership in KwaZulu Natal including the head of the provincial health department, Peggy Nkonyeni. It was resolved that the Department of Health would convene a meeting to amicably resolve the dispute. This meeting was never held.
Now Ms Nkonyeni has renewed her campaign against the doctor. She has asked the provincial treasury to "probe the disposal of donor funding" used to purchase AZT for preventing mother-to-child HIV transmission. The treasury has hired private consultants, Ubunye Consortium, to carry out the investigation.
AVERT, as the AIDS organisation that provided the funding, is fully satisfied with how its money has been used, and is pleased that so many children’s lives have been saved as a result of them not being born with HIV.
TAC have said: "Ms. Nkonyeni's smear campaign against the doctors of Manguzi Hospital has undermined health care service delivery in the district, further exacerbated the province's already acute shortage of human resources for health, and jeopardised the future of Manguzi's exceptional prevention of mother to child transmission programme, potentially putting the lives of many women and infants at risk."
AVERT believes that the investigation of Dr Pfaff is unjustified and should be dropped.
Update: 03.07.2008
People with HIV living longer, study shows
LONDON (Reuters) - People with HIV in the developed world are no more likely to die in the first five years following infection than men and women in the general population, British researchers said on Tuesday.
The risk for people infected through sex creeps up after that, according to the study published in the Journal of the American Medical Association that highlights the power of AIDS drugs introduced in the mid-1990s.
The findings did not include men and women infected through injected drug use, and their death risk remained higher in the five years after infection, said Kholoud Porter of Britain's Medical Research Council, who led the study.
"This is looking really good that life expectancies are becoming close to the uninfected population," said Porter, an epidemiologist. "It also underscores the importance that people are identified and treated early."
The advent of combination drug therapy in the 1990s called highly active antiretroviral therapy, or HAART, has greatly extended the lives of many HIV-infected people, particularly in developed countries.
There is no cure or vaccine but the drugs, which interfere with HIV at several levels, can keep people healthy for years even if they never eradicate the virus. This means people must take them for life.
Leading manufacturers of AIDS drugs include GlaxoSmithKline, Gilead Sciences Inc, Roche, Pfizer, Merck Inc, Bristol-Myers Squibb and Abbott Laboratories.
The British team compared the death risk in the five years following infection of 13,000 men and women to uninfected people of the same age and gender who were living in the same country at the same time.
Before 1996 when the drug cocktails were not widely available, the heightened death risk ranged from nearly 8 percent to 20 percent depending on age before falling each year to zero in the year 2000 for all age groups, Porter said.
The risk rises again after five years, possibly because people become less likely to take the drugs regularly or maybe because they are less able to tolerate the drugs, Porter said.
"From a practical point of view, people with HIV infections want to know how long they can expect to live for," she said in a telephone interview.
The youngest group - people aged 15 to 24 when infected - had a 5 percent higher risk of dying at 10 years following infection and a 7 percent greater risk at 15 years than average healthy people.
For people over 45, the raised risk was 5 percent at 10 years and 12 percent at 15 years, Porter said.
The AIDS virus infects an estimated 33 million people globally, mostly in sub-Saharan Africa, and has killed 25 million.
Update: 29.06.2008
NYC urges docs to do routine HIV testing on adults
NEW YORK - Health officials are trying to persuade doctors to offer HIV tests to nearly every patient in a New York City community hit harder than most by AIDS.
Under a new program announced Thursday, officials have set an ambitious goal of testing a quarter million adults in the Bronx, one of five boroughs that make up New York City, within three years.
"We need every single individual to know their status," said Dr. Monica Sweeney, an assistant health commissioner who specializes in HIV prevention.
Like dozens of other states, New York now requires doctors to obtain a patient's written consent and provide a brief counseling session before giving them a test for the AIDS virus, a process that can take up to 20 minutes. That's enough to deter doctors and nurses from suggesting HIV tests to patients routinely, according to the city.
Now officials want health clinics to offer the tests to anyone who seeks care, even for something as simple as a broken wrist.
Federal health officials recommended routine HIV testing for all Americans ages 13 to 64 nearly two years go, but the effort has stalled. Some doctors have questioned whether so much testing is necessary, or worth the bureaucratic cost.
HIV testing in the Bronx is already fairly widespread. Nearly 7 of 10 Bronx adults have been tested at least once in their lifetime. But as many as 250,000 adults have never been tested, and statistics indicate that many are diagnosed far too late.
AIDS killed 357 residents of the borough in 2006, about a third of all AIDS deaths in the city.
City health officials have also urged changes in state law that would do away with both the consent form and the mandated counseling sessions, arguing that they have little benefit. Those changes have been opposed by some AIDS activists.
"We find that period of time extremely useful," said Marjorie Hill, chief executive officer of the Gay Men's Health Crisis.
She said it gives doctors a time to talk with patients about ways to avoid HIV, or deal with an HIV infection.
Update: 28.06.2008
Central Asia's child Aids tragedy
Dilfusa wept as she rocked her baby, Bekhruzbek, to sleep.
She had taken her son to hospital near their village in southern Kyrgyzstan because he had heat stroke.
Eight months later he was diagnosed with HIV. "I thought my life was over," she said.
The doctors who treated Bekhruzbek are now on trial, accused of infecting him.
There are 78 other babies who have contracted HIV inside hospitals in Kyrgyzstan. Three of them have died, and new cases continue to emerge.
Most of their parents do not want to talk - so great is the stigma.
"My husband left me, he is in Russia now. The night when we got the test results he slept on the other side of the bed. I accidentally touched him and he kicked me," said Dilfusa.
Dilfusa, in her early twenties, is now also HIV positive. Like 16 other mothers in Kyrgyzstan, she contracted the virus through breastfeeding.
It is rare, but it happens - yet no-one warned her, she says, that she should not have nursed.
Fourteen medical workers in Kyrgyzstan have been accused of negligence, malpractice and corruption.
The prosecution alleges that doctors charged parents for equipment which they had used again and again.
Crumbling system
But it is not just individual doctors, it is the entire medical system in Kyrgyzstan and across Central Asia that is on trial.
This system is part of the region's Soviet legacy.
Soviet healthcare - just like much in the USSR - was huge, centrally managed and inflexible.
Doctors followed the orders of the Communist Party, but they were well paid and had plenty of resources.
As the USSR fell apart, so did its health system. Hospitals lost funding, many doctors left for better paid jobs overseas, leaving the crumbling medical system unprepared for new challenges like HIV/Aids.
As the international community began to pour tens of millions of dollars into HIV/Aids prevention, very little was spent on reforming the health system itself.
Donors are beginning to realise that this was a mistake.
"I think trying to address the problem of HIV/Aids without investing in health systems is inefficient use of resources," says Gabit Islmailov of the World Health Organisation.
"I think this is a realisation that is coming to the mind of many donor agencies."
But it has come too late for the growing number of children already affected, and not only in Kyrgyzstan.
Drug users
Across the border lies Central Asia's richest nation, Kazakhstan.
It boasts one of the former Soviet Union's most successful economies. But away from the buzz of the capital, the country's health system is in ruins.
One year ago, an unprecedented trial took place in the southern city of Shymkent.
Twenty-one medical professionals were found guilty of infecting more than 70 babies with HIV. The number of infected children now stands at 149.
Most of the babies were infected through blood transfusions as doctors made money by prescribing unnecessary transfusions and selling blood to parents.
Court documents show one child received more than 50 transfusions during just one treatment.
It is not clear where the infected blood came from. But the prosecution suggested drug users could be one possible source.
They are the biggest HIV risk group in Central Asia. In Shymkent three drug users said it had been standard practice for them to give blood for money, and that when they did they were not checked for HIV.
The government says this is no longer the case and that all blood donors are now carefully screened, but the problem, some believe, is that the underlying cause of the outbreak still exists.
"Corruption is a particularly dangerous infection for society," says Bahit Tumeneva, a former senior Kazakh health official who left her job several years ago to protest against corruption in the medical sector.
"The doctors have to bribe in order to get jobs or to get a place for their children in school, and then they start taking bribes too. When the power of law is substituted by the power of money, all of us become hostages to situations like the one in Shymkent," she says.
Ms Tumeneva, like many, is convinced that the Shymkent and Osh outbreaks are part of a larger regional trend.
"The situation in hospitals is similar everywhere. It just happened that it was discovered in Shymkent," she says.
Wasted lessons
More than a year after he was first diagnosed with HIV, two-year-old Syatt now lives with his grandmother, Salima, in the outskirts of Shymkent.
The government provided accommodation for 10 of the 149 families. Their houses stand on the edge of a landfill. The air reeks of rotting rubbish, and their neighbours want them out.
"When the neighbours found out that Syatt was ill, there was a big scandal - there was even fighting. They wanted to evict us," she said.
When Syatt was seven months old, Salima took him to hospital to check a swelling on his knee. It was inside the hospital, she says, that he got sick with pneumonia and doctors administered several transfusions
"I'm heartbroken. None of our relatives want to know us. They told me to abandon him, to put him in an orphanage. But it's not his fault, it's the state's fault and the doctors' fault," she said.
As she speaks, Syatt is playing with his only friend, Ruslana.
She is another of the HIV babies. Salima hopes that maybe one day the two will get married. No healthy girl will ever marry my grandson, she tells me.
But Ruslana is already very sick and only one stage away from getting full-blown Aids.
Fifteen babies have died of Aids in Shymkent, killed in places that are built to cure.
Salima has heard of the new outbreak in Osh.
Syatt and Ruslana's tragedy, she says, is all the more pointless because elsewhere the painful lessons of Shymkent have already been wasted.
Update: 26.06.2008
AIDS a growing global "disaster"
GENEVA (Reuters) - HIV/AIDS infection rates are growing among intravenous drug users, prostitutes and gay men around the globe but they are often viewed as outcasts and refused treatment, according to a report issued on Thursday.
The report, from the International Federation of Red Cross and Red Crescent Societies, also called on governments and humanitarian agencies to pay more attention to AIDS in their response to natural disasters and armed conflicts.
"HIV is a long-term and complex disaster on many levels ... For marginalized groups across the world -- injecting drug users, sex workers and men who have sex with men -- rates are on the increase," said the Geneva-based humanitarian agency.
Those groups, living on the fringes of society in many countries and especially in the developing world, "often face stigma, criminalization and little, if any, access to prevention and treatment services," it added.
The 248-page study, an annual World Disasters Report, gave no new figures for AIDS sufferers but cited United Nations statistics that 2.1 million died from the disease last year.
The Federation said the HIV virus was at the root of a rolling social crisis across southern Africa.
Its officials told a news conference the recent violence in Zimbabwe -- where until recently the battle against AIDS had benefited from a widespread treatment network -- could disrupt medical care and make that situation worse.
"We must not let what we have achieved be put into reverse," Federation specialist Mukesh Kapila said. The body's deputy secretary general Ibrahim Osman said it would help the Zimbabwe Red Cross double the HIV sufferers it supports to 260,000.
The Federation said it centered its 2008 World Disasters Report on the immune-destroying disease rather than floods or earthquakes because for many communities the epidemic "is undoubtedly a disaster."
"Government services are overwhelmed by the need for support and treatment, stigma still prevents access for many, even where services exist, and communities are devastated by its effects," it said.
There were 405 natural disasters worldwide last year, compared to 423 in 2006, the Federation said. Those killed just under 17,000 people, the lowest annual figure for a decade, but the numbers affected rose by 40 percent to 201 million.
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Acquired Immunodeficiency Syndrome (AIDS) - INTRODUCTION
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Acquired Immunodeficiency Syndrome (AIDS), human viral disease that ravages the immune system, undermining the body’s ability to defend itself from infection and disease. Caused by the human immunodeficiency virus (HIV), AIDS leaves an infected person vulnerable to opportunistic infections. Such infections are harmless in healthy people, but in those whose immune systems have been greatly weakened, they can prove fatal. Although there is no cure for AIDS, new drugs are available that can prolong the life spans and improve the quality of life of infected people.
Infection with HIV does not necessarily mean that a person has AIDS. Some people who have HIV infection may not develop any of the clinical illnesses that define the full-blown disease of AIDS for ten years or more. Physicians prefer to use the term AIDS for cases where a person has reached the final, life-threatening stage of HIV infection.
More than 42 million people around the world are currently infected with human immunodeficiency virus (HIV), the virus that causes acquired immunodeficiency syndrome (AIDS). New HIV infections have leveled off or even declined in most developed countries, but the virus is spreading rapidly through much of the developing world. In some areas of sub-Saharan Africa, one in four adults is carrying the virus.
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Next: PREVALENCE
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