AIDS fight slowed by global financial crisis

Trafficking victims more at risk of HIV

Women and girls trafficked into the sex industry in Southeast Asia are at greater risk of contracting sexually transmitted infections (STIs) than other groups of female sex workers, a new study shows. "The mistreatment these people have suffered makes it more likely they are going to become HIV-positive," lead author Dr Jay Silverman, a Harvard School of Public Health expert on violence against women and its links to HIV, said Wednesday. Three-quarters of Cambodian trafficking survivors tested positive for STIs. That number increased to 90 percent among those rescued after less than two months, indicating tremendous exposure to STIs during initiation into sex work. "Sex Trafficking and STI/HIV in SoutheastAsia: Connections between Sexual Exploitation, Violence and Sexual Risk" was released at the International Congress on AIDS in Asia and the Pacific, which concludes in Bali, Indonesia, on Thursday.

NATHAN GREEN

The Phnom Penh Post
Thursday, 13 August 2009
Nathan Green

Donor-dependent countries such as Cambodia must curb new infections as funds evaporate.

Bali, Indonesia

THE GLOBAL financial crisis has heightened the need for HIV-prevention programmes to contain new infections and prevent treatment costs from spiralling out of control, experts said Wednesday.

Cambodia's reliance on donations means it can only continue funding HIV-treatment and -prevention programmes if donor funds keep flowing, Asian Development Bank consultant Ross McLeod said. The only way to contain longer-term costs is by limiting new infections, he said, making continued investment in targeted prevention plans crucial.

Of the US$900 million spent on funding for prevention and care in Asia in 2007, less than $100 million was spent on men who inject drugs, men who have sex with men, men who pay for sex and women involved with those men.

Dr Christophe Benn, director of external relations and partnerships at the Global Fund to Fight AIDS, Tuberculosis and Malaria, warned the economic downturn would impede its ability to increase funding further.

Shiba Phurailatpam, a coordinator for APN+ (the Asia Pacific Network of Positive People), said funding for treatment was already insufficient, with just 26 percent of people living with HIV in Asia on antiretroviral (ARV) regimes.

"We don't have enough money," he said. "We all need to work together to increase funds and close those gaps."

The International Congress on AIDS in Asia and the Pacific, held this week in Bali, Indonesia, heard Monday that existing treatment regimes were out of touch with the latest scientific knowledge.

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THERE SHOULD NOT BE TWO STANDARDS OF CARE...
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World Health Organisation guidelines for "resource limited settings" call for ARV treatment to begin when CD4, or T-cell, counts - a key measure of immune system health - drop below 200 CD4 cells per cubic millimetre of blood.

Professor David Cooper, director of the National Centre in HIV Epidemiology and Clinical Research, condemned the guidelines, saying: "There should not be two standards of care: one for rich countries, where we start antiretroviral treatment around [CD4 counts of] 350 or possibly higher and one for lower income countries, where we start at less than 200."

Global Fund Executive Director Michel Kazatchkine replied that raising the threshold for treatment was "absolutely right scientifically", but would double the funds needed to provide universal treatment.

Figures from the UN General Assembly's Special Session show 25,353 people, or 78.7 percent of the estimated number of adults with advanced HIV in Cambodia, were receiving antiretroviral treatment by September 2007, up from 12,247 in December 2006.

Caitlin Wiesen, UNDP's regional HIV/AIDS practice leader and programme coordinator, said poverty and social safety nets should prioritise HIV households with a range of microcredit and financing schemes, as well as medical and life insurance and pension support.