CTV News

From dark days to a critical turning point in the AIDS epidemic: The landscape has changed dramatically in the two decades since the world’s largest AIDS conference last met in the United States.

Back in 1990, the first good medicines were still a few years away. Before they arrived, caring for patients with HIV was like “putting Band-Aids on hemorrhages,” said the leading U.S. AIDS researcher, Dr. Anthony Fauci.

Fast forward: Today’s anti-AIDS drugs work so well they not only give people with HIV a near-normal life expectancy, they offer a double whammy — making those patients less likely to infect other people.

On Sunday, the International AIDS Conference opened in the U.S. capital with the goal of “turning the tide” on HIV. Even without a vaccine or a cure, the goal is to finally stem the spread of the virus, using that so-called “treatment as prevention” and some other powerful protections. The conference runs through Friday.

“There is no excuse, scientifically, to say we cannot do it,” Fauci, infectious disease chief at the National Institutes of Health, told reporters Sunday.

But the challenge that more than 20,000 scientists, doctors, people living with HIV and policy-makers will grapple with this week is how to get to what the Obama administration calls an AIDS-free generation. Where’s the money? What works best in different countries and cultures?

And with HIV increasingly an epidemic of the poor and the marginalized, will countries find the will to invest in the most vulnerable?

“Rich countries think, ‘Who cares? We have the treatment, I hear now that HIV is a chronic condition,”‘ a worried French Nobel laureate Francoise Barre-Sinoussi, co-discoverer of HIV, told The Associated Press. “I really think there is not the same political commitment as it was in the past.”

That political commitment must expand to fight laws that are driving some of the populations most at risk — gay and bisexual men, sex workers and injecting drug users — away from programs that could help protect them from getting or spreading HIV, said Michel Sidibe, director of UNAIDS, the United Nations AIDS program.

“It’s outrageous that in 2012, when we have everything to beat this epidemic, that we still have to fight prejudice, stigma, exclusion,” he said.

More than 1,000 people — many of them living with HIV — marched through downtown Washington Sunday to urge the public and policy-makers to pay attention to a disease that, in the U.S., doesn’t get much publicity anymore.

Organizers said the aim of the “Keep the Promise” march was to remind world leaders and policymakers that AIDS remains a threat to global health. Marchers used red umbrellas to create a human red ribbon in advance of the march. Some carried balloons in the shape of globes as they marched, and others carried signs reading “Test & Treat Now” and “Yes we can control AIDS.”

“The war against AIDS has not been won and now is not the time to retreat,” said AIDS Healthcare Foundation president Michael Weinstein in an interview Sunday.

Weinstein’s Los Angeles-based group organized the march, which began near the Washington Monument. He said that despite financial hardships worldwide, the struggle against AIDS needs to keep advancing. Weinstein’s organization called for the funding of programs that fight AIDS and lower prices on AIDS drugs. They also are pressing for universal access to condoms and increased rapid HIV testing.

Comedian Margaret Cho, civil rights leader Al Sharpton, former United Nations ambassador Andrew Young, and radio cohosts Tavis Smiley and Cornel West spoke to the crowd before Sunday’s march. Musician Wyclef Jean also performed.

The AIDS conference — remarkable for giving a forum not just to leading scientists but to everyday people who live with HIV — hasn’t returned to the U.S. since 1990, in protest of the longtime ban on people with the virus entering the country. The Obama administration lifted the travel ban in 2010, finishing a process begun under the Bush administration. Not lifted was a ban on sex workers and injecting drug users, and protesters briefly interrupted the opening news conference to decry their absence from the meeting.

The conference comes at a time when scientists increasingly say they have powerful new tools to add to tried-and-true condoms.

Studies show treatment-as-prevention, treating HIV right away rather than after someone is sick, lowers patients’ chances of spreading the virus through sex by a stunning 96 per cent. Already, Fauci said regions that are pushing to get more people tested and rushed into treatment are starting to see infections drop, from San Francisco and Washington to part of South Africa.

The U.S. Food and Drug Administration just approved a daily AIDS medicine, Truvada, for use by healthy people hoping to lower the risk of infection by a sexual partner. Hard-hit poor countries are grappling with how to get that protection to their highest-risk populations.

Other goals include getting more HIV-infected pregnant women treated to protect their babies, and getting more men circumcised in developing countries to protect them from heterosexual infection.

But the hurdles are huge.

Since the first reports of AIDS surfaced 31 years ago, a staggering 30 million people have died from the virus and 34.2 million now are living with HIV around the world.

There’s still no cure and no vaccine. For every person who starts treatment, two more are becoming infected.

In poor countries, a record 8 million people are getting HIV drugs, but the United Nations says it will take up to $24 billion a year — $7 billion more than is being spent now — to reach those most in need.

The epidemic is worst in developing countries, especially in Africa. Progress has stalled even in the U.S., which has seen about 50,000 new infections every year for a decade. Here, nearly 1.2 million people live with HIV, and one in five don’t know it.

Register Citizen

Should people living with HIV be charged with a crime if they fail to disclose their status to sex partners?

That’s currently the law in many places. But a new study suggests that such prosecutions might actually deter at-risk individuals from seeking medical advice and getting tested — thus making them more likely to transmit the virus.

In the wake of a series of high-profile HIV nondisclosure prosecutions, researchers surveyed men who have sex with men in Ottawa, Canada. They found that a significant minority of participants — 17 percent — said the prosecutions had “affected their willingness to get tested for HIV,” and nearly 14 percent said the prosecutions “made them afraid to speak with nurses and physicians about their sexual practices.”

The researchers found that this same group reported receiving less testing for HIV and other sexually transmitted infections, was more likely to engage in higher-risk sexual activities, and had a higher number of recent sexual partners.

The findings provide the first empirical support for the contention that HIV-related criminal laws might pose an obstacle to HIV testing. Until now, advocates for those living with HIV have only been able to point to anecdotal evidence that some people at risk for infection might avoid getting tested out of fear of being prosecuted — a phenomenon they have dubbed “take the test, risk arrest.” The reasoning? Knowing of an HIV-positive status can make one criminally liable, while not knowing can be a defense against prosecution.

Patrick O’Byrne, a professor in nursing at the University of Ottawa and the study’s lead author, cautioned that the research has several limitations. The sample was not randomized, subjects were recruited in high-risk sexual activity locations, and the demographic skews to white, gay men. The results, therefore, cannot be generalized.

In addition, O’Byrne says that the research “must be interpreted within its context: Ottawa, Canada within one year after a nondisclosure prosecution involving headline, front-page media attention.” O’Byrne pointed specifically to a case in which law enforcement officials ”released the [accused’s] full name, photograph, and sexual orientation.”

Indeed, according to a 2010 report by the Global Network of People Living with HIV, Canada has convicted more than 60 people of HIV-related crimes. That’s second only to the United States, which has convicted more than 300. (However, other countries had higher rates of prosecution per 1,000 people living with HIV.)

Carol Galletly — a professor, lawyer, and researcher at the Medical College of Wisconsin — says the results of the Canadian study might not translate to U.S. experiences. According to Galletly, preliminary analysis from at least one U.S. study on HIV criminalization currently undergoing review “did not reveal a deterrent effect” on testing.

Still, Galletly says scientists “can’t afford to ignore” O’Byrne’s research.

While HIV nondisclosure laws might be intended to stem HIV transmission, studies have suggested that they have little impact on risk behavior.

“Incidence of HIV infection in states with and without HIV exposure laws does not differ, as one would expect if the laws were preventing new infections,” says Galletly, who has been a leading researcher on the impact of HIV criminalization laws on behavior.

In addition, research suggests these laws may provide a misplaced sense of safety in relying on a partner to disclose his or her infection.

According to Galletly, “Preliminary data from an unpublished study seem to indicate that among persons who are at increased risk for HIV infection, awareness that one’s state has an HIV exposure law may be associated with increased confidence in [HIV-positive] status disclosure — a very problematic HIV prevention strategy.”

The issue of criminalization is slowly shaping into an international dialog. In several U.S. states, citizen groups are working to repeal HIV-specific laws. In Congress, a bill has been introduced by Rep. Barbara Lee that would encourage reform of state and federal HIV policies. And in 2010, President Barack Obama’s National HIV/AIDS Strategy called on states to revisit their laws.

Last week, the Global Commission on HIV and the Law recommended that HIV-specific laws be repealed. The report also recommends that those convicted under such laws be pardoned.

http://www.gayglobe.us

Iol News

A newlywed homosexual Frenchman is on a mission to prove that “being gay and Muslim is possible” after feeling forced for years to choose between his religion and sexuality.

It took Algerian-born Ludovic-Mohamed Zahed, 35, two decades to come to terms with himself, but now that he’s at peace he’s made it his goal to fight Islamophobia and homophobia.

His call comes at a time when France, home to Europe’s largest Muslim community, is warming up to gay marriage.

New Prime Minister Jean-Marc Ayrault, who took over after the Socialist victory in June elections ousted their conservative predecessors, promised this month to offer marriage and adoption rights to same-sex couples “in the first quarter of 2013”.

Zahed, a PhD student in religious anthropology, married his fellow Muslim partner in South Africa, the continent’s only country to recognise same-sex unions. Becoming a spokesman for the community was a long time in the making, a product of much soul-searching.

“I think homosexuality, whatever one says, is not a choice,” he wrote in his memoir “Le Coran et la chair” or “The Qur’an and the Flesh”, published in March.

“And you’d have to be crazy to choose to be homosexual when you come from my socio-cultural background.”

Homosexuality is considered a criminal offence in most Arab states and is “strictly prohibited” by Islam, said Abdallah Zekri, a member of the French Council of the Muslim Faith which acts as an official interlocutor with the French state.

“No imam, unless self-proclaimed, can officiate a gay wedding,” he told AFP.

But that did not stop Zahed from following up his 2011 South African nuptials with a symbolic religious “marriage” officiated by an imam in the Paris suburbs this year.

Although associations for the gay faithful – like David et Jonathan for Christians and Beit Haverim for Jews – have been around for decades in France, until recently there was no group for Muslim gays.

In 2010, Zahed founded Homosexual Muslims in France (HM2F), which counts 270 members.

“To be gay and Muslim is possible,” the slender, bespectacled Zahed wrote in his book. “However the road is still long.”

Born in Algeria and raised in a poor neighbourhood of the 17th district in Paris, Zahed displayed early effeminate tendencies, prompting regular beatings from a brother who hoped it would “teach me to be a man.”

His father, who sensed Zahed was gay, repeatedly told him he’d prefer to “break my back and bury me alive rather than see me become like that,” Zahed said.

Finding refuge in religion, Zahed paid regular visits to Salafists, Muslims who advocate a strict interpretation of Islamic law, when on holiday in Algeria.

But as an adult, his homosexuality bubbled up to the surface. With the sexuality strongly frowned upon by his community, Zahed experienced “great suffering”.

“I told myself, ‘you must choose’ and I violently rejected Islam,” he said. “A long spiritual void” followed amid years of unhappiness.

When he came out to his family, his father accepted it, but his mother cried every night for two months and he fell out with his brother.

The turning point came when he was 30 years old: “I no longer looked to hate anyone for anything, but simply to change the discriminatory reactions facing me,” he wrote in his book.

In 2011, Zekri, who is also an Aids activist and has written about himself being HIV positive, met his future husband in South Africa, where they tied the knot in a civil wedding that year.

Gay culture has flourished there since the fall of apartheid – which harshly penalised homosexuality – in 1994, when South Africa enshrined equal rights in its constitution and allowed same-sex couples to marry and adopt.

Other African nations sentence homosexuals to prison, as in Morocco, where homosexuality is punishable by six months to three years in prison, though it’s tolerated provided practitioners don’t flaunt their difference.

When the pair wed again in a religious ceremony in the Paris suburbs in February, it was a symbolic step that won them threats and insults.

“Visibility is a sensitive issue,” Zahed said.

http://www.gayglobe.us

Chicago Tribune

CHICAGO/WASHINGTON (Reuters) – As a gay black man growing up in Chicago’s infamous Cabrini Green public housing project, Arick Buckles knows first-hand how the stigma of HIV can keep people infected with the virus from seeking treatment.

It took him six years after he tested positive for the human immunodeficiency virus, or HIV, to get care. By then, Buckles was frail and wore turtleneck sweaters to hide his severely swollen lymph nodes.

“I didn’t want to accept it was the HIV that was disfiguring my face, my neck. It was visible,” Buckles said. He finally sought care after suffering pneumocystis pneumonia, a lung infection that strikes HIV patients as their immune systems weaken.

The predominantly black housing project where Buckles grew up was such a hub of crime and poverty that the city tore it down several years ago.

“We thought growing up in Cabrini Green that it was a gay disease. If I were to disclose my status, I felt my homosexuality would be outed,” said Buckles, 40, who was so fearful of that prospect that he kept his HIV status, and his sexual orientation, in the closet.

“It’s looked upon as disgraceful” in the black community, he said.

Buckles’ tale is still too common, despite widespread U.S. efforts to foster awareness of the virus that causes AIDS and its treatment over the last three decades, says Dr. Kevin Fenton, director of the National Center for HIV/AIDS Prevention at the U.S. Centers for Disease Control and Prevention (CDC).

“Stigma is a huge issue,” Fenton said. It can keep people from getting tested, and for those who know they are HIV positive, it can keep them from getting the treatment they need.

He said stigma affects a broad swath of communities in different forms, but for many blacks in America, it exists on top of poverty, poor access to treatment and poor outreach for effective prevention services.

HIV transmission rates have fallen from 130,000 new infections per year during the epidemic’s peak in the mid-1980s to 50,000 a year, a level little changed since the mid-1990s.

Part of the problem is that many Americans are infected and do not know it. Of the estimated 1.1 million Americans living with HIV, nearly one in five of those individuals remain undiagnosed.

Up to 44 percent of new infections are clustered in 12 major cities, including Chicago, Washington, New York and Los Angeles, CDC data show. Within these communities, HIV rates are highest among blacks, Hispanics and gay and bisexual men of all races.

CDC researchers will present the latest U.S. data this week at the International AIDS Society’s AIDS 2012 conference in Washington, where scientists will gather to discuss better ways to prevent, treat and seek a cure for the disease.

BLACKS, GAYS AND HIV

According to a report released last week by the Black AIDS Institute, black gay and bisexual men make up one in 500 Americans overall, but account for one in four new HIV infections in the United States.

It found that by the time a black gay man reaches 25, he has a one in four chance of being infected with HIV. By age 40, he has a 60 percent chance of being infected.

Fenton said there is nothing unique about blacks that make them more vulnerable to HIV infection. Once higher infection rates are seen in a community, the chances of new members becoming infected are simply higher.

“What we believe is that the infection is becoming concentrated in these minority groups as a reflection of the social and structural drivers of health inequalities overall,” he said.

A CDC study published on Friday in the Lancet medical journal found that black men who have sex with men in the United States are 72 times more likely than the general population to be HIV-positive.

http://www.gayglobe.us

Information Hospitalière

D’après une étude qui vient d’être publiée dans le dernier numéro du Journal of the American Medical Association (JAMA), des chercheurs américains ont montré que les personnes infectées par le VIH ont deux fois plus de risque d’avoir un crise cardiaque ou d’être touchées par un accident vasculaire cérébral. La raison en serait l’inflammation des artères provoquée par la propagation du virus dans l’organisme.

Publicité

Alors que la 19e conférence internationale sur le sida s’est ouverte dimanche 22 juillet à Washington avec plus de 25 000 participants venant de 190 pays différents, les principales revues primaires profitent de l’occasion pour mettre en avant des travaux de recherche concernant le VIH et les conséquences de sa propagation dans l’organisme.

A cette occasion Steven Grinspoon et ses collègues de Massachusetts General Hospital de Boston ont pu mettre en lumière leurs travaux portant sur l’état de santé du système cardio-vasculaire de 81 participants dont 27 patients contaminés par le virus du Sida et 27 personnes séronégatives souffrant d’athérosclérose . Afin de comparer l’état des artères des différents volontaires, les chercheurs ont fait une analyse précise des scanners des artères. Ils ont ainsi constaté que les niveaux d’inflammation dans l’aorte des personnes séropositives étaient nettement plus élevés que ceux des individus non contaminés par le VIH, mais similaires à ceux des patients ayant des maladies cardiovasculaires, telles que l’athérosclérose.

En raison de ces données, l’équipe de Steven Grinspoon a ainsi conclu que les personnes séropositives sont davantage menacées par la survenue de pathologies cardiovasculaires et auraient deux fois plus de risque d’avoir une crise cardiaque ou de faire un accident cardiovasculaire. En effet, lorsque l’organisme est contaminé par le VIH, il se défend et entraîne notamment un mécanisme qui active le système immunitaire, qui provoquerait l’inflammation des artères…

http://www.gayglobe.us

Radio-Canada

La médecine sait qu’un cercle vicieux d’hyperactivation du système immunitaire entrave l’élimination du virus lors de l’infection par le VIH. Des chercheurs français de l’Institut Cochin ont montré que cette hyperactivation reposerait sur une population précise de globules blancs qui pourraient éventuellement devenir une cible thérapeutique.

Explications

Le VIH s’attaque principale aux lymphocytes T CD4, des globules blancs du système immunitaire. Dans l’intestin, ces lymphocytes sont en permanence activés par le voisinage des bactéries intestinales. Elles deviennent ainsi la cible de l’infection par le virus, qui entraîne leur destruction.

Fragilisée, la paroi intestinale laisse alors passer des produits bactériens dans le sang (LPS) qui causent une hyperactivation du système immunitaire, avec la production de cytokines inflammatoires, qui à leur tour induisent davantage d’activation de ces lymphocytes.

C’est alors qu’est créé un cercle vicieux difficile à contrôler par les antirétroviraux actuels, même quand ils sont efficaces sur la charge virale dans le plasma, la partie liquide du sang.

L’équipe de l’institut français a confirmé que les personnes qui avaient du VIH détectable dans leur plasma avaient une plus forte réponse de leurs cellules sanguines que ceux qui n’avaient plus de virus dans leur plasma grâce à un traitement antirétroviral.

Elle a analysé toutes les populations susceptibles de produire des cytokines inflammatoires en réponse aux produits bactériens. Elle a trouvé qu’une petite population de globules blancs, des monocytes porteurs de la molécule MDC-8, était plus abondante chez ces patients, et qu’elle était la principale responsable de la production exagérée d’une cytokine inflammatoire.

Les chercheurs pensent qu’une destruction spécifique de cette population pourrait être provoquée par l’injection d’anticorps spécifiques. Cette stratégie thérapeutique permettrait de compléter l’action des antirétroviraux en interrompant d’une manière très ciblée le cercle vicieux d’hyperactivation du système immunitaire.

http://www.gayglobe.us

Canoe

Cindy Mejia, Miss Pérou depuis quelques jours, a affirmé que tous les homosexuels sont le produit d’une enfance abusive ou d’une famille dysfonctionnelle.

Cindy Mejia, la jeune reine de beauté de 23 ans, étudiante en sciences sociales, a été couronnée Miss Pérou Univers à Lima le weekend dernier.

Désormais, elle est couronnée «honte nationale», à la suite de sa déclaration publique discriminatoire sur l’homosexualité.

Selon Mejia, elle aura des enfants « normaux » puisque « les homosexuels reflètent le passé d’enfants violés, agressés, ou provenant de familles dysfonctionnelles. Ce sont les garçons qui vivent uniquement avec leurs sœurs et leur mère qui deviennent efféminés ».

Ce à quoi le chanteur gai portoricain Ricky Martin a répliqué sur sa page Twitter: «Quels commentaires insensés de la part d’une personne complètement ignorante».

Ricky Martin est « sorti du placard » en 2010, en annonçant publiquement son homosexualité. Il est également le père de deux enfants, Valentino et Matteo, nés en 2008 grâce à une mère porteuse.

Martin souhaite désormais épouser son conjoint, Carlos Gonzalez Abella, un homme d’affaires du domaine des finances.

http://www.gayglobe.us

LeMonde

Afrik.com

Le Liberia va-t-il suivre le même chemin que le Cameroun, en menant la vie dure aux homosexuels de son pays ? Toujours est-il qu’un amendement a été voté la semaine dernière interdisant le mariage homosexuel. Les sénateurs du pays, construit sous les valeurs démocratiques et de libertés individuelles, sont à l’origine de ce texte de loi (voté à l’unanimité) qui remet en cause l’union entre personnes du même sexe.

Cependant, pour être promulgué l’amendement doit être validé par la Présidente Ellen Johnson Sirleaf. « Aucune loi n’a été votée pour l’instant. Notre système bicaméral est composé de la chambre du Sénat et de la chambre des Députés. L’accord des députés est nécessaire pour que la loi soit promulguée et cela ne suffit pas, car la présidente du Liberia doit ensuite l’approuver. », a déclaré la ministre de l’information Liwis Brown. Et d’ajouter : « C’est ainsi que notre système fonctionne. Et la présidente a déjà déclaré à plusieurs reprises qu’elle n’approuverait aucune loi criminalisant l’homosexualité. »

Ellen Johnson attendue au tournant

Le hic ? « Plusieurs pays, dont les Etats-Unis, reprochent à la lauréate du prix Nobel de la Paix sa position ambigüe sur le sujet. », souligne RFI. Partagée sur le sujet, Ellen Johnson Sirleaf devra peut-être s’incliner face à l’exigence de Washington qui « prend en considération le respect des minorités sexuelles avant d’attribuer son aide au développement ».

Ce qui ne calme pas les ardeurs des sénateurs libériens qui, au-delà de leur volonté d’interdire le mariage homosexuel, souhaitent sanctionner les relations sexuelles entre personnes du même sexe. Cet amendement vise à contrecarrer le Mouvement de défense des droits des gays et des lesbiennes, qui avait déposé un projet de loi portant sur la légalisation du mariage entre homosexuels. C’est Ellen Johnson Sirleaf qui aura le dernier mot, une occasion de plus pour la présidente du Liberia de conforter son statut de Prix Nobel de la paix.

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