Thursday, November 30, 2006

World AIDS Day: December 1st

Today is World AIDS Day and this year's message is "STOP AIDS. KEEP THE PROMISE." The news is full of articles about HIV and AIDS in the spirit of World AIDS Day. Here are some of particular notice:

The International Herald Tribune reports on a collaboration between the Clinton Foundation and two Indian drug companies. The result? Anti-retrovirals designed for children will be provided for an average price of 16 cents a day, or $60 a year, which is about 45 percent lower than the lowest current price. The news report also states that the prices will be available to 62 developing countries and will lead to the treatment of an additional 100,000 people in 2007. Jon Liden, a spokesman for the Global Fund to Fight AIDS, Tuberculosis and Malaria, based in Geneva, said the deal announced Thursday would allow grants already made by the foundation to treat substantially more people in 2007. "It's a hugely positive step," he said, "because one of the really difficult areas in rolling out treatment has been to have a steady and huge supply of pediatric dosages and packaging."

The BBC had a very interesting piece on how HIV affects the global workforce. The article states that the virus has had a crippling effect on the workforce of many countries. Without this, it estimates that the cumulative loss to the global workforce from the virus could rise 45 million by 2010 and almost double again by 2020. The ILO said increased access to ARV treatments could significantly reduce the impact on the global workforce. "The prospect of averting between one-fifth and one-quarter of potential new losses to the labour force should serve as a powerful incentive to target the workplace as a major entry point to achieve universal access to ARVs," the report concluded.

AIDS in Punjab: II

Intravenous drug users (IDUs) inject themselves in a public park at Ludhiana. — Tribune photo Sayeed Ahmed

India’s most innovative city, known throughout the world for its ingenuity — is making news for all the wrong reasons. The number of suspected and confirmed HIV positive cases here has puts the city into a category that can be classified as the one facing an “HIV epidemic”. The first-ever survey conducted to ascertain the extent of HIV infection in the region puts the city high up in the list. The exact position will however be known after the results of the survey are tabulated later this month.

Investigations by The Tribune have revealed that free exchange of needles by drugs users and unabated prostitution in more than half a dozen localities has accelerated the spread of the disease. Apart from industrial workers, many migrant workers visiting these CSWs have tested positive.

The situation can be gauged from the fact that out of 48 blood samples taken from IDUs in Ludhiana, 16 have tested positive. As per NACO and UNAIDS guidelines, in random sampling if more than 5 per cent cases are reported in the high-risk category and over 1 per cent in general population the situation can be termed as an epidemic. According to unofficial results, Ludhiana is heading to be the first city in the state to achieve this dubious distinction.

Saturday, November 25, 2006

AIDS in Punjab

I came across a story on Sikhnet that really caught my attention. I had to read it over twice to make sure i was reading it correctly. The story was about a Punjabi man who was diagnosed with HIV about eight years ago. He had gone to a doctor who told him that his HIV test was positive. He was subsequently put on ARVs (anti-retroviral) drugs for his infection. The man had always questioned his results as, according to him, he had been faithful to his wife and could not understand how he got HIV.

The story then goes on to say how eight years after his "positive" test, he was retested and the results were "negative." Initially i thought that the virus was somehow cleared from his system but i then went onto read that the initial test was most likely incorrect, and he did not in fact have HIV. It was disheartening to read how the ARVs had already taken a toll on his body and his health was debiliated from years of taking the drugs.

It is understandable, then, to read the low numbers of HIV infections reported in Punjab. Something is amiss and tests are not being completed correctly. There needs to be attention focused on Counseling and Testing sites -- as this is where cases can be identified and treated. Numbers will always be in question until a public health infrastructure is built and abided by.

Sunday, November 12, 2006

Domestic Abuse in South Asian Communities

After the recent reportings of two killings and an attempted murder, all involving Canadian women of South Asian descent, a sense of urgency has finally been sparked for people to start taking notice of a very important matter affecting our community. During a forum in Vancouver, 1500 people congregated to discuss the issue of domestic abuse in the South Asian community. Radio India, a Punjabi radio station based in Surrey, hosted the forum. CBC Canada reports, "Several women said isolation, shame and cultural barriers have hidden the problem of domestic violence in the community."

Babita Chumber, who spoke at the forum, said her six-year marriage started with high hopes but quickly became a nightmare. "My husband would spit on me, kick me, emotionally degrade me. I would go to work with bruises. Pieces of hair would be out of my head and I would cover it up because of the shame that is involved," she said.

Kavinder Lehal said she was beaten and threatened with knives and a gun during her 11-year marriage. Lehal said many South Asian women stay in abusive relationships out of fear they will bring shame to their families. "You're not shaming your husband or his family. He shames his family when he raises his hand on you. He shames his family when he beats you up," she said.

These are words that are most likely felt by a large number of South Asian women. However, the incidence of abuse amongst this community is only recently being seen as a problem as more and more women are speaking up and coming forward with their stories. Even though we have a long way to go in terms of educating our community, these conversations are a first step.

In a related issue, my advisor (Dr. Anita Raj) from Boston University School of Public Health recently published a paper related to domestic abuse among south asians. She finds that Indian-American women who are victims of marital violence are also being abused by their in-laws. Dr. Raj and her team examined the link between abuse by the women’s husband and abuse by her in-laws. Specifically, their research showed that in-laws themselves may be abusive to their daughter-in-law, emotionally and physically. Also, they often provide a supportive context for wife abuse by ignoring it when it occurs or even actively encouraging it. The study also revealed that mother in laws were aware of and tolerated the physical abuse perpetrated by their son. And in some cases the mother-in-law herself committed physical abuse.

Raj and her colleagues argue that to effectively address IPV (Intimate Partner Violence) with South Asian women, advocates and practitioners must simultaneously explore the problem of abuse from in-laws.

Details of the study, entitled 'Victims of Intimate Partner Violence More Likely to Report Abuse From In-Laws,' were published in the October 2006 issue of the journal 'Violence Against Women.'