AIDS

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Good News in the Fight Against HIV

March 12, 2012 in Health Care Around the World, Health Care in Developing Nations, Public Health | No comments

Almost one in five South Africans have HIV.  South Africa is the country with the most individuals living with HIV (5.6 million); it also has the most HIV deaths annually (310,000).

Despite these grim facts, there is some good news.  The Economist reports:

“Although the number of South Africans living with the disease continues to rise…the tally of new cases each year has tumbled by half since 1999—thanks largely to a dramatic increase in the use of condoms, according to new research…

 National surveys show the proportion of young South African men aged 16-24 who reported using a condom at their last sexual encounter leaping from 20% in 1999 to 75% in 2009. This, more than an equally dramatic rise in anti-retroviral treatment, is the “most significant factor” in the fall of new infections, say the British and South African authors of the study.”

Let’s hope the South Africa has truly turned the corner.

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AIDS turns 30

June 6, 2011 in Contagious Disease | 1 comment

The Center for Disease Control issued the first official notice of the disease that would become known as AIDS 30 years ago on June 5.  My current home, San Francisco, was especially hard hit.  NPR interviews physicians at the San Francisco General Hospital and the Center of AIDS Research at University of California, San Francisco.

“At the beginning, we knew all of the patients that we took care of in San Francisco and we knew all the patients in San Francisco with the disease. But then the numbers started to increase, increase, increase, even in those early years and then we didn’t know their names. And then I said, wow, this is big. I think, let’s say, 1991, San Francisco was just devastated. I mean, men were walking around in the Castro as skeletons suffering from the wasting syndrome.

I remember on a TV interview telling the woman interviewing me that my grandmother complained that all of her friends were demented or dying. And I said, yeah, grandma, so were mine and I’m, you know, quite a bit younger than you are. But it was exhausting but we fought on.”

To help fight to cure AIDS, you can donate to UCSF’s AIDS Research Institute or the International AIDS Vaccine Initiative (IAVI).

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World AIDS Day + CoR

December 1, 2010 in Carnivals, Current Events | No comments

Today is World’s AIDS Day.  Typically this is a day for bad news, but there are some positive trends in the AIDS epidemic.  Time notes that “The number of new infections is falling, as are AIDS-related deaths. Overall, 33 countries have seen their infection rate drop by more than 25% between 2001 and 2009, thanks, in part, to HIV prevention efforts. ”  In addition, condom usage is gaining ground even around conservative cultural circles.  This year, the Pope stated that there are some cases where condoms are acceptable.  Nevertheless, over 33 million people are still living with HIV or AIDS, including 2.6 million people who were newly infected in 2009.

In other reading, the Huffington Post has gathered a list of the seven best books about HIV/AIDS.

On a lighter note, for those of you wanting to engage in risky behavior…head over to Insurance Coverage Law in Massachusetts blog for the latest edition of the Cavalcade of Risk.

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AIDS Crowds-Out

May 27, 2009 in Contagious Disease, Health Care in Developing Nations | 1 comment

Case and Paxson (2009):

“We document the impact of the AIDS crisis on non-AIDS related health services in fourteen sub-Saharan African countries…Regions of countries that have light AIDS burdens have witnessed small or no declines in health care, using the measures noted above, while those regions currently shouldering the heaviest burdens have seen the largest erosion in treatment for pregnant women and children.“

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The Intensive and Extensive Margins of Teenage Sex

March 12, 2009 in Contagious Disease, Public Policy | No comments

HIV is a huge health issue around the world and especially in sub-Saharan Africa.  Many American NGOs have promoted abstinence programs as a way to prevent the spread of HIV/AIDS.  However, most evidence finds that this approach has been ineffective.

An NBER working paper by Dupas (2009) adds more support that abstinence programs do not work.  In the paper, the author used a

“…randomized fi…eld experiment involving 328 primary schools to compare the effects of providing abstinence-only versus detailed HIV risk information on teenage sexual behavior. Half of the schools, randomly selected, received teacher training on the national HIV/AIDS curriculum, which focuses on abstinence until marriage, but does not discuss risk reduction strategies (such as condom use or selection of safer partners). In 71 schools, randomly selected after stratifying by teacher training status, an information campaign provided teenagers with information on the prevalence of HIV disaggregated by age and gender group (the relative risks information campaign).”

The authors finds that the abstinence program had no effect on pregnancy rates.  However, the “risk reduction” educational program decreased the probability a girl had started childbearing within a year by 28%.  The decreased pregnancy rates were not, however, due to less frequent sexual activity.  Instead, teenage girls switched their sexual partners from older partners to teenage boys in their age cohort.

This leads to the finding that teenage girls are having the same amount of sex, teenage boys are having more sex, but pregnancies are decreasing.  Why is this?

The author explains that when teenage girls have sex with teenage boys, “…teenage girls report higher rates of condom use, presumably in order to avoid pregnancy with resource-constrained teenagers.”  It is also possible that teenage girls can more easily convince boys of their same age to wear a condom whereas it may be more difficult to convince older men to use a condom.

Thus, we see that these “relative risk” educational programs do not decrease sexual activity on the extensive margin (teenage girls are having the same amount of sex), but do decrease risky behaviors on the intensive margin (more condom use when teenage girls have sex with people of their same age).

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World AIDS Day

December 1, 2008 in Contagious Disease, HC Statistics | No comments

There are now 33 million people living with HIV, including 2 million children. About 2.7 million people became newly infected with the virus each year.   Combating this epidemic is one of the top priorities facing public health workers around the world.

With limited resources, what strategy should be pursued?  As of now, a vaccine for AIDS is years away from viability.  So should resources go towards improving the health of those with AIDS or should funds be used to reduce the incidence of the disease?  

The Economist (“The ideal and the good“) reports on the efforts of Dr. Reuben Granich to treat patients and reduce incidence using the same drugs.  Dr. Granich finds that although first-line antiretroviral drugs (ARVs) do not offer a cure, they are cheap, reduce the symptoms of HIV and reduce the level of the virus in the person to the point where they are unlikely to pass on the virus.  Second-line treatments can be used for the 3% of individuals who do not respond to first-line ARVs.  ”Employing the logic of vaccination using proven drugs may be an idea whose time has come.”

You can support the fight against AIDS by donating to one of these fine organizations:

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