This Week in HIV/AIDS News

Some Advocates Urge Obama Administration To Further Policy Changes Regarding Drug Use, Harm Reduction

The Obama administration has reversed a decades-old policy and approved federal funding for needle-exchange programs, and some advocates and others who work with injection drug users worldwide are welcoming the shift in U.S. policy, the Christian Science Monitor reports. Gerry Stimson, executive director of the International Harm Reduction Association, said that the U.S. “has been a big block on harm reduction at the international political level,” but that is “beginning to change, and it’s changed quite suddenly.” According to the Monitor, some advocates are calling on the U.S. to make further changes by supporting programs aimed at IDUs in developing countries.

According to Michel Kazatchkine, executive director of the Global Fund To Fight AIDS, Tuberculosis and Malaria, HIV/AIDS experts say that needle-exchange programs, peer-led education and substitute therapies — like methadone treatments — have proven to be effective in preventing new cases of the disease among IDUs. However, only a small portion of the $14 billion spent globally in 2008 for fighting HIV/AIDS was spent on such programs, he said. In addition, some U.S. diplomats continue to object to including harm reduction strategies in United Nations counternarcotics declarations. The Monitor reports that the Obama administration has not changed rules implemented under former President George W. Bush that ban the use of U.S. foreign aid money to finance needle-exchange programs.

According to the Monitor, several Asian countries have begun to reach out to IDUs in light of the health risks associated with drug use. For example, the Chinese government is starting methadone clinics and outreach services, while Indonesia is inviting advocates to visit its prisons. Gray Sattler, a regional adviser on HIV/AIDS at the U.N. Office on Drugs and Crime in Bangkok, Thailand, said that reducing the spread of HIV is “one of the very powerful arguments that we use with governments and that they need to think about.” He added, “Many of the epidemics of HIV in this region have been, and continue to be, driven by the spread of HIV among drug users because they don’t have access to a comprehensive package (of services)” (Montlake, Christian Science Monitor, 4/21).

“Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily HIV/AIDS Report , search the archives, and sign up for email delivery at www.kaisernetwork.org/dailyreports/hiv. The Kaiser Daily HIV/AIDS Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. © 2009 Advisory Board Company and Kaiser Family Foundation. All rights reserved.”

New High-Level Commission Will Examine Strategies for Maximizing Global Health Aid

The newly formed Commission on Smart Global Health Policy — a bipartisan group of legislators, pharmaceutical executives and other health experts — on Tuesday received a mandate to develop a comprehensive strategy for spending the estimated $10 billion allocated annually for global health aid, the Boston Globe reports. The commission, sponsored by the Center for Strategic and International Studies, plans to issue recommendations early next year to President Obama’s administration. In addition, the commission will tackle some “controversial” issues, such as whether global health spending focuses disproportionally on Africa and whether high levels of HIV/AIDS funding should be balanced with efforts to promote clean water and prevent diseases such as malaria, according to the Globe (Bender, Boston Globe, 4/22).

Stephen Morrison, head of CSIS’ Global Health Policy Center, and Jennifer Kates, vice president and director of HIV policy at the Kaiser Family Foundation, in a paper released Tuesday wrote that one “delicate task” of the commission will be to “decide on the correct balance between HIV and other areas” (Bender, “Political Intelligence,” Boston Globe, 4/21).

According to Helen Gayle, president of the not-for-profit organization CARE and former assistant U.S. surgeon general, the group will examine questions, such as, “How does the U.S. capitalize on current investments? What should we be doing more of? What should we be doing differently?” In addition, another important challenge will be to determine “[h]ow do we better measure our impacts?” Gayle said.

According to the Globe, the 26-member coalition will include members of Congress, such as Sens. Jeanne Shaheen (D-N.H.) and Olympia Snowe (R-Maine); former diplomats and intelligence officials, such as Jon Negroponte; former HHS Secretary Donna Shalala; leaders from not-for-profit groups such as the Bill & Melinda Gates Foundation; and executives of corporations such as Coca Cola, Exxon Mobil and Merck. William Fallon, professor at Massachusetts Institute of Technology‘s Center for International Studies and former commander of U.S. military forces in the Middle East and Asia, will lead the effort. According to Fallon, the U.S. spends a relatively significant amount of funding on global health efforts, but officials could better maximize these resources for long-term gains. “If we could ever get our act together and come up with a comprehensive plan to pool resources … we can probably get some stuff done,” he said. Shaheen added that the commission’s efforts will affect not only the countries receiving aid but also the U.S. She said, “Creating a long-term, strategic policy to address global health care challenges will strengthen our national security, our economy and our standing as a moral leader in the world” (Boston Globe, 4/22).

The Kaiser Family Foundation report provides a comprehensive look at the U.S. government agencies and programs involved in the nation’s global health response, including their funding and their approaches. It also reviews the key laws governing U.S. global health policy. The report is available online.

“Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily HIV/AIDS Report , search the archives, and sign up for email delivery at www.kaisernetwork.org/dailyreports/hiv. The Kaiser Daily HIV/AIDS Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. © 2009 Advisory Board Company and Kaiser Family Foundation. All rights reserved.”

AP/Yahoo! News Examines Increasing Use of Social Networking Sites to Reach People Exposed to HIV, Other STIs

The AP/Yahoo! News on Saturday examined the rising number of public health agencies that are utilizing social networking Web sites to reach people who may have been exposed to HIV/AIDS and other sexually transmitted infections. Health departments traditionally have used letters and phone calls to set up face-to-face meetings with the partners of people with STIs who visit their clinics, test positive or provide their partner’s information to health officials. However, the Internet sometimes allows people to identify their partners only through online names. By accessing popular social networking sites — such as Manhunt, which is targeted at men who have sex with men — health officials can use online names to contact people’s partners and advise them to seek out STI testing and treatment, the AP/Yahoo! News reports.

Health departments in Massachusetts, San Francisco and Washington, D.C., were among the first to use social networking sites — typically those catered to MSM — to reach people who may have been exposed to an STI. Kevin Cranston, director of the Massachusetts Department of Public Health‘s infectious diseases bureau, said that more than 50% of people contacted by the agency have responded since it started using social networking sites in 2006.

In 2007, the National Coalition of STD Directors, consulting with CDC, created guidelines to assist public health departments in creating profiles for confidential online notification. The cost for utilizing social networking sites is a few thousand dollars for a computer and DSL line dedicated to the program, health officials say. Rachel Kachur, a researcher with CDC’s STD prevention division, said that although it is encouraging to see more health departments use online notification, the efforts are not happening fast enough. She said, “The national guidelines help by giving local areas a jumping off point, where they can tweak them to fit their needs,” adding, “But the goal is to get everyone doing this.”

According to the AP/Yahoo! News, public health groups in three Ohio cities — Cincinnati, Cleveland and Columbus — are the most recent to use online meeting sites to contact people possibly exposed to an STI. David Merriman, project coordinator overseeing HIV/AIDS services for Cleveland, said the city recently started using Manhunt and a similar site, Adam4Adam, to reach people who may have been exposed to syphilis, which is increasing in the city. The “goal is to also be on sites like Facebook where we could reach broader populations, including heterosexual adults and adolescents who wouldn’t use sites like Manhunt,” he said (Cornwell, AP/Yahoo! News, 4/18).

“Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily HIV/AIDS Report , search the archives, and sign up for email delivery at www.kaisernetwork.org/dailyreports/hiv. The Kaiser Daily HIV/AIDS Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. © 2009 Advisory Board Company and Kaiser Family Foundation. All rights reserved.”

Routine Testing ‘Imperative’ in Fighting HIV/AIDS Epidemic in U.S., Editorial Says

“The AIDS epidemic is spreading faster than previously thought, even as the American public’s concern about it declines,” a New York Times editorial says, adding, “That dangerous disconnect underscores the urgency of a new campaign announced by the Obama administration to combat complacency about the disease and its potential to strike the unwary.” According to the editorial, complacency regarding HIV/AIDS in the U.S. “may reflect a belief that AIDS is primarily a problem in Africa, or a feeling that AIDS has become treatable, so why worry about infection.”

“Mere awareness won’t be enough to curb the epidemic,” the editorial says, adding, “More than a million people in this country are infected with the virus, and 20% of them don’t know it. Their ignorance jeopardizes their own health and increases the risk that they will spread the virus to others.” According to the editorial, it is “imperative that testing for the virus become routine among all those likely to be at risk.” It adds that the “Bush administration achieved notable success in boosting American support for the fight against AIDS overseas.” The editorial concludes that “President Obama should build on that legacy abroad while also shrinking the size of this country’s epidemic” (New York Times, 4/20).

“Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily HIV/AIDS Report , search the archives, and sign up for email delivery at www.kaisernetwork.org/dailyreports/hiv. The Kaiser Daily HIV/AIDS Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. © 2009 Advisory Board Company and Kaiser Family Foundation. All rights reserved.”