Tag: HIV

Ugandan Women with HIV speak out against criminalizing HIV

This from the Ugandan Parliament website:

Women oppose bill criminalizing HIV

Women living with HIV have petitioned Parliament opposing clauses of the HIV and Aids bill that   criminalize the act of spreading HIV. They argue that criminalization provisions of the bill will force persons living with HIV underground for fear of prosecution.

“Women Living with HIV will be disproportionately prosecuted, since women often learn their HIV status before their male partners”, said Apea Agnes the Executive Director of the National Community of Women Living with HIV in Uganda (NACWOLA).

She told the Speaker of Parliament that mandatory testing and unauthorized disclosure of results will violate the rights of persons living with HIV and limit the participation in voluntary HIV testing and counseling.

The petitioners appealed to government to scale up its investment in antiretroviral treatment and care to save more than 500,000 Ugandans in urgent need of ARVs.

Speaker of Parliament Rt. Hon Edward Ssekandi hailed NACWOLA for championing the fight against HIV and reaffirmed the commitment of Parliament to funding activities aimed at reducing the spread of HIV.

He confirmed that the HIV Bill before Parliament was tabled with good intentions aimed at reducing the spread of the virus.

The Ugandan Speaker’s response is hopeful. He refers to the HIV and AIDS Prevention and Control Bill (go here for full text) tabled before Parliament in May. A similar argument can be advanced against the portion of the Anti-Homosexuality Bill which uses HIV status to determine the death sentence.

60 Minutes on US HIV/AIDS intervention in Uganda

Last night, 60 Minutes provided a sympathetic review of the PEPFAR intervention in Uganda. As I have discussed here before, the program has been immensely successful. The broadcast puts real faces on the success (especially the kids) and the problems (extraordinary footage of HIV informing sessions). Near the end of the segment, 60 Minutes interviewed Martin Ssempa but without any mention of the Anti-Homosexuality Bill.


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Bob Simon notes that the spread of HIV is driven by polygamy, “sugar daddies” and sexual networks – all heterosexual issues there. He also documents how US backed drug treatment has brought hope to HIV positive people. I could not help but feel touched by the faces of the children and the pain of the couples who found that one or both of them were HIV positive. The presence of Martin Ssempa without mention of his advocacy for the Anti-Homosexuality Bill is a striking omission in light of the potential for that bill to erode more progress on HIV. The main driver of HIV in Uganda is heterosexual behavior. Ssempa does speak about that, but it certainly seems to me that his recent anti-gay crusade has the potential to undo his good work by making gays the scapegoat for a problem that cannot be solved by the Anti-Homosexuality Bill. I addressed some of these issues in a November, 2009 commentary which I am reprinting after the break.

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What percentage of young MSM have HIV?

Recently, a fuss arose over a quote regarding HIV and young men who have sex with men (MSM) from Regina Griggs in a OneNewsNow article regarding youth and sexual identity. She said (in context):

Research shows that individuals often go through periods of gender and sexual confusion as they grow from children to teenagers to adults. Griggs wonders why, then, would schools opt to send children along a dangerous path. “Why are we allowing people to tell them, ‘Try it — you might like it?’ Over 70 percent of young kids 13- to 24-years-old, men having sex with men, are now HIV-positive,” Griggs notes. (see editor’s note)

Griggs here is describing prevalence, which is the total number of people in a population with a certain disease at a given time. However, this is clearly incorrect, as other bloggers have pointed out.
She may have been referring to a fact sheet at the CDC called HIV/AIDS Among Men Who Have Sex with Men when she was quoted by ONN.

In the United States, HIV infection and AIDS have had a tremendous effect on men who have sex with men (MSM). MSM accounted for 71% of all HIV infections among male adults and adolescents in 2005 (based on data from 33 states with long-term, confidential name-based HIV reporting), even though only about 5% to 7% of male adults and adolescents in the United States identify themselves as MSM.

The ONN editors recently added a note pointing out the 71% figure from the CDC fact sheet.
This simply says that men having sex with men accounted for 71% of infections among all males reporting infections in 2005. MSM was a large driver of infections reported in 2005. While this is a sobering statistic, it does not mean what Mrs. Griggs said it means.
I do not know what the actual prevalence of MSM aged 13-24 with HIV is but it would need to be over 800,000 cases in order for her statistic to be true. This does not seem possible.
I arrived at that number by looking US Census data for 2005 which pegged the number of males in the US between 15-24 at about 19.7 million. The CDC estimates 5-7% of this age group as being MSM which yields 1.2 million males. If 70% of this group was HIV positive, then that would mean Mrs. Griggs is claiming that about 840,000 young men have HIV. Of course, these numbers are estimates since I rounded figures and used the Census data starting with age 15 and not 13 as the CDC does.
According to the CDC fact sheet, there are not that many people living with AIDS at present:

At the end of 2005, an estimated 217,323 MSM (191,362 MSM and 25,961 MSM who inject drugs) were living with AIDS, representing 67% of male adults and adolescents living with AIDS and 52% of all people living with AIDS.

These numbers are staggering enough without exaggeration or misinterpretation. I commented here because many have asked about the validity of these numbers and the quote made me curious about the scope of the issue.

Should HIV status ever be disclosed?

This is a question often debated among therapists in situations where an identifiable potential partner can be identified. For instance, here is a case where a husband’s sexual activities will be made a part of an action by an ex-wife where the husband may have (alleged by the ex-wife) infected her with the virus.

If you were a friend of this couple and you knew one of them had HIV, would you tell the other? If you were their marriage counselor? Recently, on the BoxTurtleBulletin blog, Daniel Gonzales said that HIV status should never be disclosed. His advice was in contrast to advice given on a gay dating website (although I don’t fully agree with the advice columnist either) Essentially, the question posed by the scenario was this: If a friend knows the HIV+ status of someone who might be a dating or sex partner, should the knowing friend warn the unsuspecting friend? The gay dating website published advice suggesting that the friend should be warned. Daniel said the unknowing friend should not have been told.

I disagree with Daniel. I would probably inform a friend about much less, if I knew it. And certainly in this case, I believe that such disclosures should be made where there is a clearly identified partner. I sometimes link to Box Turtle Bulletin when Jim and the gang discuss research since he often provides thoughtful commentary and analysis of research on gay related issues. However, I strongly disagree here. While I do not think that HIV status should always be disclosed, and I am sensitive to the issue of stigma, but, in a case like this, I cannot understand why privacy should trump safety. I do not believe it does.

UPDATE: Jim Burroway posted a lengthy response to the dust-up over the advice on his blog regarding HIV+ disclosure. I still disagree and left a comment about it there:

Bottom line, if I knew two friends who might hook up and I knew one of them had a disease that could be spread via intimate contact, I would tell my unsuspecting friend as well as the friend who had the condition that I was going to do so. Sure, I might have to deal with fall out; but I believe I might have to deal with a different kind of fall out if I say nothing.