Novel H1N1 Flu and HIV-Infected Adults and Adolescents

H1N1 and HIV Webinar

This post is long overdue, but earlier this year, Pamoja Mtaani - a videogame I co-wrote and consulted on for Warner Bros was awarded the Global Business Coalition’s Core Competence Business Excellence Award. The excerpt is below.

Congratulations to Award-Winning”PAMOJA MTAANI” (”Together in the Hood”), Behavior Change Video Game

The “PAMOJA MTAANI” (”Together in the Hood”), Behavior Change Video Game, created by Warner Bros, won the Global Business Coalition’s Business Excellence Award.

As a key component of the Partnership for an HIV-Free Generation, this open world five player LAN-Based PC game educates youth in Kenya.

The Global Business Coalition on HIV/AIDS, Tuberculosis and Malaria honored Warner Bros. Entertainment with the Core Competence Business Excellence Award for the video game “Pamoja Mtaani” (”Together in the Hood”) at the GBC Business Excellence Awards Dinner in Washington, D.C. “Pamoja Mtaani”, Swahili for “Together in the Hood”, is an open world, five player LAN-based PC video game created by Warner Bros. Interactive Entertainment in collaboration with technical experts within the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and noted serious games developer, Virtual Heroes, Inc.

Warner Bros. Entertainment, in partnership with PEPFAR, applied its core competence to develop an action-based videogame pilot that is delivering targeted HIV prevention messages to East African youths. The videogame combines traditional gameplay with messages aimed at changing behavior, focusing on key behaviors that can reduce HIV infections among youth. The game development is part of The Partnership for an HIV-Free Generation, a  public-private collaboration among PEPFAR and businesses with critical core competencies such as messaging, new technologies and market research.

The “Pamoja Mtaani” videogame can be played at select youth venues in Nairobi, which are an integral component of this new initiative to revolutionize HIV prevention. The game, intended to engage youth through fun interaction, is designed to help influence HIV risk perceptions, attitudes and behaviors among young people in Nairobi.

Pamoja Mtaani also featured at Games for Health 2009. Below is the presentation that Producer, Kirsten Gavoni, gave some details on what it was like making the videogame (It was Warner Bros. first such project in Africa)

Pamoja Mtaani is available to play at three centres in Nairobi right now, two centres in the Mukuru slum and the National Youth Service along Thika Road. I’d suggest you go play it.

This morning I was happily flicking through the TV channels, when I eventually came to one of the most disliked channels available – The God Channel. Now I know that there is some good stuff out there, but I was deeply disturbed that a person could still stand in a pulpit and speak in such a condemning way to the whole HIV/Aids situation.

The first thing that struck me was that it was the first time I had heard the subject anywhere for absolutely ages. The second was more disturbing though… in a very veiled way, this white senior citizen was spouting that immoral sex was the key to the Aids Epidemic. I thought we had moved on from this to be honest. Why did this raise my hackles? Well, around 2001 I came across a guy who was slumped in his car in Leeds. At first I thought he’d done the exhaust pipe trick and committed suicide, but he hadn’t. He had driven down from the North East of England and just wanted to end his life… why? He had contracted Aids from a blood transfusion, his brother had also but had died a short time earlier. He had Haemophilia, and a long list of other things, but the thing that shocked me most was that he was right. Nobody could do anything to help him.

At the moment, I am sat down watching ‘Philadelphia’ with Tom Hanks and Denzil Washington. It’s a powerful film, a film that was made a fair back now, but it seems that in some places things haven’t changed. It’s a very moving film, about a subject that hasn’t featured in the headlines for so long. In Britain we have been bombarded by the media regarding a flu pandemic. It has had a lot of coverage promoted through fear in my opinion, and yet we haven’t heard about the numbers of people who are still probably dying of Aids. We forget things that are not new news stories don’t we……

Through my background research I’ve become familiar with some of the names of the movers and shakers in the sport and social change space. I would like to briefly profile three leaders whose organizations, I believe, are making progress on tackling issues such as HIV AIDS, poverty and homelessness.

Ethan Zohn, an American reality TV star and co-founder of GrassRoot Soccer has harnessed his fame to generate awareness about HIV AIDS in Africa. Grassroot Soccer has developed an innovative curriculum in partnership with the U.S. Center for Disease Control to confront HIV AIDS awareness and prevention in Sub-Saharan Africa. Having personally coached soccer to AIDS orphans in Uganda, I see the value of their approach.

Johann Olav Koss, the CEO of Right to Play, is a four time Olympic gold-medalist in speed skating from Norway, trained as a physician and holds a MBA. He is one of the strongest advocates in the sport for development and peace movement where on behalf of Right to Play, he has successfully developed partnerships with UN agencies, third world governments and the private sector. As a former UN Volunteer, I have seen the power of private public partnerships to bring about change.

Mel Young, a Scotsman, is the Co-Founder of the Homeless World Cup and has been a game changer in social inclusion. Homelessness is a social stigma, but through this football tournament with 48 nations and 500 homeless players it has given new meaning for marginalized people to get out of drugs, find jobs and move into permanent homes. Having passed several homeless people on the streets of Cambridge, Massachusetts I can only imagine the impact of Mel Young’s program.

To close, I will leave you with a clip about Lungi, an AIDS orphan who has benefited from the GrassRoot Soccer program.

The HIV Women’s Project at Women’s Health Statewide, CYWHS, and PEACE (Multicultural HIV and Hepatitis service at Relationships Australia) will co-host a lunch to ‘Celebrate and Honour Women’ on World AIDS Day 2009.

Each year on World AIDS day (http://www.acsa.org.au/aaw.html), the HIV Women’s Project hold an event that highlights the issues for women who live with HIV.

This year’s event is an opportunity for women from diverse cultures to open up conversations between communities.

The lunch will be held 12.30 – 2.30pm, Tuesday 1 December 2009 at Relationships Australia (SA), 49a Orsmond Street, Hindmarsh. Please RSVP for catering purposes, to the HIV Women’s Project on 8239 9600.

Look out for the red ribbons which will be sold throughout Adelaide on Friday 27 November, to support South Australian’s living with HIV.

According to the UNAIDS 2007 Statistics: 33.2 million people are living with AIDS, 22.5 million are in Sub-Saharan Africa and 4 million are in SouthEast Asia. New HIV infections in 2007 alone is at 2.5 million, and deaths on that same year is 2.1 million.

In the Philippines, the 1984-2008 data are as follows:

• Total Reported Cases = 3,589
• Asymptomatic Cases = 2,787
• AIDS Cases = 802
• Children = 50
• Reported Deaths = 311

Aside from knowing the numbers, don’t we want to know how HIV-AIDS came about?

If HIV was engineered, who was responsible for it?

So how do we stop HIV? Do we have the technology to do it? Do you really believe that man had already conquered the moon yet can’t conquer the parasites within himself?

Yes, we do have the technology. And you can download the US Patent for it here. And it’s awarded to the inventors as early as 1991. Not only that, it is only a rediscovery.

So, the question now is, why does the health department and the media are still trumpeting, up to this day, that there’s no cure for HIV-AIDS? Are we being lied to? Or, are they afraid that people will soon realize that the same technology could be used to defeat cancers and all other parasitic diseases?

It seems we are left to ourselves as to how we should deal with it. And now that you have in your hand the knowledge of an anti-HIV/anti-cancer technology, wouldn’t it be nice to just use it and spread the good news?

Penghapusan prostitusi bukan jawabannya !

Saat ini prostitusi/pelacuran atau transaksi komersial seks masih dikaitkan dengan penyebaran berbagai penyakit/infeksi menular kelamin, termasuk juga untuk penularan HIV.

Maka tindakan pemerintah untuk menghapuskan prostitusi dinilai tepat.

Benarkan demikian ?

Jawabannya adalah : TIDAK !

Prostitusi sudah terjadi sejak jaman dahulu kala, dan akan selalu ada dalam peradaban manusia.
Munafik lah orang-orang (pemerintah) yang menyangka dengan menghapuskan prostitusi maka akan menyumbang kebaikan pada lingkungan sekitar.

Perlu diketahui, kenapa ada yang namanya prostitusi.

Pertama, manusia adalah makhluk hidup yang membutuhkan seks.

Ini benar adanya, oleh karena itu agama dan kepercayaan membuat suatu institusi yang disebut pernikahan. Ini yang dianggap sah (oleh norma-norma sosial di timur pada umumnya).

Tetapi, bagaimana dengan mereka yang belum menikah tetapi sudah memasuki usia pubertas?

Penelitian dan studi lapangan menyebutkan ada anak-anak muda kita (ya, di Indonesia, bukan di belahan dunia yang lain) memulai hubungan seks pertama dalam usia yang sangat dini. Antara usia SMP atau sekitar 14-15 tahun.
Pada masa ini tentulah belum ada (atau jarang) orangtua atau institusi sosial yang mengizinkan mereka untuk menikah dengan alasan ingin melampiaskan nafsu seksualnya.

Belum lagi pendidikan di sekolah dan di rumah yang tidak pernah (mengganggap tabu) membahas soal seks, sehingga anak-anak muda semakin tidak tahu dan akhirnya mencari tahu sendiri. Praktek yang salah adalah, mereka mencari pada sumber yang salah (yang sangat mudah didapat, internet contohnya) dengan cara menonton tontonan pornografi.

Akuilah, manusia sejak jaman dahulu kala, terutama kaum laki-lakinya, memang ngefans sama yang namanya pornografi.
Mau dilarang atau tidak, ini adalah industri yang marak di berbagai belahan dunia.

Praktek selanjutnya adalah, mengaplikasikan teori pornografi tersebut.
Ini sangat wajar dalam perjalanan hidup seorang manusia, bahwa pada suatu titik mereka membutuhkan pelepasan dalam pemenuhan kebutuhan seksual.

Beruntunglah para laki-laki yang gak jelek-jelek amat (atau baik, bermulut manis), mereka bisa mempraktekan teori bagaimana berhubungan seks kepada pacar/cewe yang mau sama mereka.
Juga untuk para lelaki yang not-so-good looking tapi punya uang, UUD- ujung ujungnya duit. Kelompok inilah yang mendorong majunya perekonomian di Indonesia juga. Terutama pada duit yang disumbangkan untuk transaksi jual beli seks.

Balik lagi ke penelitian, penularan dan penyebaran infeksi menular seksual terutama transmisi HIV dapat dicegah jika :

1. Semua klien/ laki-laki yang berhubungan seks dengan wanita (pekerja seks komersil, pacar, pacar sementara, TTM, bahkan istrinya) selalu memakai kondom
2. Semua wanita selalu memakai kondom jika berhubungan dengan laki-laki (pacar, pacar sementara, TTM, bahkan suaminya)
3. Semua pekerja seks (laki-laki, perempuan, maupun waria) selalu memakai kondom jika berhubungan dengan klien/pacar/pasangan seksualnya.
4. Semua pemakai narkoba jarum suntik selalu menggunakan jarum suntik steril, bukan bekas orang lain.

Ini adalah solusi yang sangat mudah, tapi sulit untuk diterapkan !

Salahsatu kesalahan besar, yang sering kita (juga pemerintah) buat adalah, dengan menutup lokalisasi tempat prostitusi/ pelacuran.

Ini sama sekali tidak menyelesaikan masalah.

Pertama, para pekerja seks sebenarnya tetap ada, tapi mereka tidak terpusat (terpencar-pencar) dan lebih susah untuk ditarget oleh kelompok LSM yang ingin memberikan bantuan kesehatan/ dukungan sosial kepada mereka.

Kedua, para klien/ pelanggan laki-laki juga selalu ada, dan mereka lah yang lebih ‘bersalah’ dalam hal penyebaran virus, dengan berpindah-pindah tempat dari satu lokalisasi ke lokalisasi lain. Belum ada undang-undang/ peraturan yang menjaring mereka untuk ikut ‘bertanggung jawab’ mengatasi permasalahan ini.

Kenapa oh kenapa lagi-lagi pelacur yang disalahkan, ditangkap, diperas (padahal mereka jualan seks sering kali karena faktor ekonomi) sedangkan para pelanggan laki-laki bebas berkeliaran dan menularkan HIV kepada istri dan anak-anaknya ?

Kondom.

Adalah cara yang mudah dan sederhana yang bisa diterapkan oleh semua orang.

Mulai dari tukang beca, supir taksi, tukang ojek, anak SMP sampai kuliahan, PNS maupun pegawai swasta, dokter maupun insinyur, semua bisa diajarkan cara memakai kondom dan bisa (mampu) membeli kondom.

Sekarang waktunya kita bertanggung jawab atas diri sendiri.
Pemerintah sudah tidak mampu diandalkan karena kebanyakan urusan.

Stop epidemi HIV sampai disini.

When Scott Pelley of “60 Minutes” asked HHS Secretary Katheleen Sebelius about political punditry critical of the public health response to novel H1N1, she pointedly said, “I tend to like to get my health advice from doctors and scientists.”

She’ll be getting some of her advice about treating flu from UNC. Charlie van der Horst and Christopher Hurt, from our much heralded Center for Infectious Diseases, are each leading the first studies of medications for IV treatment of influenza.

ID at UNC is known around the globe for groundbreaking work in HIV/AIDS and other  scourges. They’ve identified who’s most at risk for HIV and potential ways to prevent infection. But this is the first inpatient flu study.

“We’ve never had IV drugs (for flu) before. Ever,” says van der Horst, who ran his first clinical trial in 1983 at UNC. “Each year in the U.S. 35,000 people die from flu … We’ve had nothing to offer these people,” vdHorst says. “We’ve routinely had patients die.”

Novel H1N1 put a scare in the medical community because, Hurt and vdHorst say, it resembled “Spanish” flu that killed tens of millions of people around the world from 1918 to 1920. Both bugs started in spring and made a come-back in the fall. If you get the flu now, you can bet it’s H1N1, vdHorst says.

Late-20th century medicine gave us the anti-flu drugs Tamiflu, Relenza (zanamivir) and peramivir. Tamiflu is taken orally; Relenza is aerosolized. They prevent the flu or shorten its duration. So it made sense to provide them in IV form, which provides a more accurate, assurable dosage that goes directly to the bloodstream in people who are hospitalized and beyond the help of chicken soup.

Hurt is studying peramivir, a medication that had not been tested until recently. It’s only available in IV form, and the criteria for receiving the drug in the study are pretty tight; prior treatment with Tamiflu eliminates a lot of people.

But viruses mutate for a living, and novel H1N1 has beefed up its resume by showing some resistance to peramivir’s close kin, Tamiflu, in an isolated instance. One of the usual seasonal flu viruses from last year had widespread resistance to Tamiflu. Both medications operate by blocking the same protein to keep the virus from spreading.

So far, novel H1N1 hasn’t shown widespread resistance to zanamivir, the drug vdH is studying. And to get into that trial a patient has to be sick enough to be hospitalized for five days and, basically, have the flu. It’s open to pregnant women, people on ventilators, people who have received other flu meds, etc.

As for the protection against pundits, some are more innoculated than others. VdHorst waves them off. “Vaccine and medication development in the US is based on pure science, not science fiction,” he says.

** Blog update: Dr. Hurt was informed yesterday (Nov. 17, 09) that he was the first to enroll a patient in the BioCryst (peramivir) study. Way to go! We hope the patient is doing well.

Para pelancong menunjukkan dokumen ke petugas immigrasi di Lapangan Udara Los Angeles

Obama berkata para pelancong dengan virus AIDS bukan merupakan suatu ancaman. Juga para peneliti memastikan bahwa studi vaksin HIV mereka di Thailand membuahkan hasil-hasil yang terbatas.

Pada sembilan belas delapan puluh tujuh, HIV/AIDS masuk ke dalam daftar penyakit yang dapat menyebabkan seseorang tidak bisa memasuki Amerika Serikat. Di kemudian hari pemerintah mencoba membatalkan keputusannya. Namun Kongres membuat larangan perjalanan itu sebagai bagian dari undang-undang immigrasi. Orang-orang dengan H.I.V, virus yang menyebabkan AIDS, dapat mencari suatu pengecualian, tetapi itu berarti perlu lebih banyak usaha.

Tahun lalu, Kongres dan Presiden George W. Bush mulai proses pengakhiran larangan perjalanan tersebut. Sekarang Presiden Obama menyelesaikan proses itu.

BARACK OBAMA: “Kita berbicara tentang mengurangi stigma penyakit ini, tetapi kita telah memperlakukan seorang pelancong yang mengidap virus itu sebagai sebuah ancaman. Kita memimpin dunia ketika membantu menghentikan penyebaran wabah AIDS yang mendunia, tetapi kita adalah salah satu dari beberapa negara yang masih melarang orang yang mengidap HIV agar tidak masuk ke negara kita sendiri.”

Sebuah peraturan terbaru yang diterbitkan hari Senin akan mengakhiri larangan perjalanan yang mulai berlaku pada empat Januari. HIV tidak lagi menjadi sebuah syarat yang dapat melarang orang masuk ke Amerika Serikat. Dan pengujian HIV tidak akan diminta lagi bagi orang-orang yang membutuhkan sebuah pemeriksaan medis bagi proses immigrasi.

AIDS telah membunuh lebih dari dua puluh lima juta orang sejak awal sembilan belas delapan puluhan.

Pada bulan September, ada berita bahwa sebuah vaksin menunjukkan sedikit kemampuan untuk mencegah infeksi H.I.V. pada manusia untuk pertama kalinya. Hasil selengkapnya dari studi vaksin itu dipresentasikan di akhir Oktober pada sebuah konferensi internasional di Paris. Hasil-hasil penelitian itu dimuat pula di New England Journal of Medicine. Para peneliti memastikan bahwa studi di Thailand membuahkan hasil-hasil yang “modest.”

The United States Army membiayai pengujian vaksin itu. Studi tersebut mengombinasikan dua vaksin, menggunakan versi H.I.V. umum di Thailand. Tak satu pun dari masing-masing vaksin menunjukkan kesuksesan pada penelitian-penelitian sebelumnya.

Para peneliti Thai menguji kombinasi itu di lebih dari enam belas ribu sukarelawan. Setengah dari sukarelawan mendapat vaksin itu. Yang lainnya mendapat sebuah placebo, suatu zat yang tidak aktif. Semuanya diberikan kondom dan konseling mengenai pencegahan AIDS selama tiga tahun. Studi itu mendapati tiga puluh satu persen kasus infeksi yang lebih sedikit dalam kelompok vaksin daripada dalam kelompok placebo.

Namun para pengritik berkata temuan-temuan itu mungkin terjadi karena kebetulan. Pengumuman pada bulan September didasarkan pada enambelas ribu sukarelawan. Hampir sepertiga dari mereka, tidak mengikuti semua langkah-langkah yang diminta dalam studi itu. Hasil-hasil dari mereka yang menaati adalah sama dengan kelompok yang lebih besar, tetapi pengaruh kebetulan adalah lebih dari sebuah possibility.

Namun, para peneliti berkata bahwa studi itu menghasilkan informasi berharga yang menawarkan harapan baru bagi penelitian AIDS. Dan inilah VOA Special English Health Report. Transkrip siaran radio 3 November 2009. Saya Bob Doughty, diterjemahkan oleh Charles Roring.

Baca juga:

• CT Scans dan risikonya pada anak-anak
• Combination Pil kombinasi menurunkan tekanan darah dan kolesterol buruk
• Pengujian vaksin AIDS di Afrika Selatan

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Since the boisterous town hall meetings with wall to wall media coverage in August, it seemed like the public option was on life support. That lopsided coverage sent moderate Democrats scurrying although poll after poll has shown that a majority of Americans support a public option. With so many on Capitol Hill running from the public option as if it were Ebola, you would think that public support was in the in single digits.

But was the industry report prepared by Pricewaterhouse Coopers the prescription the public option needed to move out of intensive care?

The report states that under the Baucus plan premiums would raise 111% by 2019 as opposed to 79%

The White House and many respected economists are calling out the report for being flawed. Pricewaterhouse Coopers has acknowledged that they failed to take into account government subsidies that would be provided to help moderate-income Americans purchase insurance. A minor point if one has a casual relationship with the facts.

The insurance industry is positing that the bill doesn’t have stiff enough penalties for people who do not agree to being fleeced through obscene premiums. The industry is afraid they will not have enough new customers to feed their insatiable greed and would be forced to pass the cost of that greed to the rest of us.

While everyone is shouting about the validity of the report and whether or not the Baucus plan will increase premiums by 111% or not, there is something here being lost in the debate- the number 79.

The insurance industry admits that left to their own devices, they would increase their premiums by 79% over 10 years, or an average of 7.9% each year. Inflation rates have mostly hovered around 3.5% between 2000 and 2009. We haven’t seen inflation rates near 7.9% since the early ‘80s.

Raising premiums twice the rate of inflation is acceptable? This rare honesty puts their hubris on display and makes the case for a public option. The debate about the cost of the Baucus bill is important because we like truth based policy debates. The real story is the industry’s outrageous admission that, unchecked, they intend to escalate their assault on the American’s pocketbook to the tune of 79%. Only a 79% increase? How magnanimous! This hubris is just what the doctor ordered for the public option. Let’s hope Congress takes notice.

Antes de iniciar o artigo quero deixar explícito (calma, não é nada pornográfico) a minha admiração por essa figura que é o Marcelo Vitorino, o “Urso”. Sei também que a ideia de dar vida a essa incrível plataforma de mobilização social batizada de “Doe mais que um clique”. O projeto conta com outra mãozinha de uma das pessoas mais conhecidas na blogosfera, Edney Souza (fundador do Interney Blogs).

Em um artigo publicado em seu blog recentemente, o “Urso” explica de forma bastante clara como surgiu a idéia da plataforma, e cita algumas empresas que contribuiram para que tudo se tornasse realidade, como a Pulso Comunicação, que doou a programação, a Polvora!, que doou a personalização dos canais, a Insight Publicidade, que doou o layout, a Insite, doou a hospedagem e o Hospital 9 de Julho, que cedeu um de seus profissinais responsáveis de hematologia para conceder uma entrevista.

Enfim, a proposta está aí! Quem possuir um blog, ou outro canal web onde possa contribuir para a iniciativa divulgando, com certeza todos aqueles que precisam, ou irão um dia precisar desse líquido tao vital para a sobrevivência humana, ficam agradecidos desde já. Assim, não basta apenas uma simples divulgação, ou seja, vá além e também doe sangue!

Veja abaixo se você atende aos requisitos necessários para doar sangue:

• Você deve ter mais de 18 e menos de 65 anos
• Seu peso deve ser superior a 50 kg
• Se homem, deve ter doado há mais de 60 dias
• Se mulher, deve ter doado há mais de 90 dias; não estar grávida; não estar amamentando; já terem se passado pelo menos 3 meses de parto ou aborto
• Se você não teve Hepatite após os 10 anos de idade
• Se você não teve contato com o inseto barbeiro, transmissor da Doença de Chagas
• Se você não teve malária ou esteve em região de malária nos últimos 6 meses
• Se você não sofre de Epilepsia
• Se você não tem ou teve Sífilis
• Se você não é Diabético
• Se você não tem tatuagens recentes (menos de 1 ano)
• Se você não recebeu transfusão de sangue ou hemoderivados nos últimos 10 anos
• Se você não tiver ingerido bebidas alcoólicas nas 24hs que antecedem a doação
• Se você estiver alimentado e com intervalo mínimo de 2 horas após a re 
• Se você dormiu pelo menos 6hs nas 24hs que antecedem a doação
• Se você tiver comportamentos que evitem contrair o vírus da AIDS, tais como:
• sempre usar preservativos em relações sexuais
• não ter tido mais de dois parceiros sexuais nos últimos 3 meses
• não usar drogas injetáveis

Antes da doação você passará por uma entrevista de triagem clínica, na qual podem ser detectadas algumas condições adicionais que possam impedir sua doação. Após cada doação serão realizados os seguintes exames em seu sangue:

• Tipagem sangüínea ABO e Rh
• Pesquisa de anticorpos eritrocitários irregulares
• Teste de Coombs Direto
• Fenotipagem do Sistema Rh Hr (D, C, E, c, e) , Fenotipagem de outros sistemas.
• Testes sorológicos para: Hepatite B, Hepatite C, Doença de Chagas, Sífilis, HIV (AIDS), HTLV I/II

Sempre que você doar sangue serão feitos todos esses testes e você receberá o resultado em cada doação. Caso haja qualquer alteração no resultado dos testes sorológicos talvez seja necessário repetir os exames. Lembre-se que esses testes tem o objetivo de triagem e não de diagnóstico e que, como em qualquer exame laboratorial, podem ocorrer resultados falsos-positivos. Assim, o eventual resultado não negativo para um ou mais testes não deverá ser interpretado como diagnóstico. Portanto, se você for convocado para orientação médica ou mesmo para repetição de exames, não deve se preocupar. Em geral a doação traz poucos riscos para o doador. Porém, eventualmente, alguns doadores podem apresentar reações adversas, tais como:

• Queda passageira de pressão arterial
• Hematoma no local da punção
• Náusea

Fonte: Banco Paulista de Sangue

Artigo relacionado:
Ignorância: uma das barreiras para a doação de sangue

Some more snippets from the IAAH 9th World Congress

Youth Commentary

Dr Illias Adam Lee

This is a blog, not a word for word recount of the conference, so I must say that I was disappointed in this ‘youth commentary’ as very little of it was a youth commentary, much more of it was a service profile. Some interesting points were made though.

Dr Lee reiterated the fact that youth and young people are not a homogeneous group. They are made up of different subcultures and groups and are going through a transitional time in their lives, as workers we need to be ready to adapt to these changes.

He spoke also about the five As of Penang Family Planning Association which could be a good framework for our health promotion

• Advocacy
• Abortion
• Access
• Adolescents
• AIDS/HIV.

Teenz Bistari Program

Dr. Siti Nurbaya binti Shahir

Dr. Shahir responded to a double in the number of unwed mothers in her district of work in 2005/06. It was a particular problem for her area because all the young women becoming pregnant would stop study, and most would end up relying on Malaysian welfare payments.

In response, Dr. Shahir started a three prong program which included an education session, promotion materials and an SMS service. The education sessions were open to 100 girls from each of the 5 schools in the area who are identified as problematic. To be problematic a girl could fall under any of the following categories:

• Has had a boyfriend
• Has been reported for truancy
• Has run away from home
• Difficult family issues
• Parents dissatisfied with children’s behaviour

The program is interesting for a few reasons. The education session is run by the local doctor (Dr. Shahir) and the teachers of the girls, and includes a question and answer section. Due to Muslim custom, abstinence is the line put forward, but the doctor makes it know that if girls require help with contraception she is willing to do that outside the realms of the education session. At each session she has run she has had between 15 and 30 questions, which indicates a group willing to learn.

The SMS service is run solely by the doctor, who will even reply to SMSs at 3am, if she is up. AT least 31 girls use the service and most use it more than once, having conversation and follow up, often including referral to the doctors office.

The SMS service is advertised with banners and bookmarks available to see by all school children in the area and focus on the messages that ’sex before marriage can cause damage’, ‘girls deserve to be treated with respect’ and ‘the SMS service is confidential’. Fantastic messages.

I’m in Control : Community Based Skill Building

Norzila Ahmad

In Malaysia, over 50% of HIV new infections are occurring in under 25s.

A baby is left abandoned every 5 days.

50% of rape victims are under 18.

84% of rape victims know their victims.

The situation in the home of the conference can be dire for young people, and the levels of education are not great either.

Only 54% of young people in a survey could identify reproductive organs.

Ms. Ahmad spoke about the service Kafe@TEEN which has three health services in Malaysia. It was inspiring to see a health service which was so holistic and had so many soft entry points, and was working so well. In three years of operation they have provided counselling to 5000 young people and provided outreach service to over 84000 young people.

Services provided included net cafes, gyms, libraries, camps and of course clinical health services and counselling.

Now, that’s a good model to look up to.

News from Uganda that the government is seeking to reaffirm penalties for homosexuality and criminalize the “promotion of homosexuality” will only serve to drive people of same-sex orientation underground. The implications for public health efforts are dire, and there is no doubt that if the bill is passed into law, it will deal a body blow to HIV prevention efforts.

In Uganda, as in many parts of Africa, the health of Lesbians, Gays, Bisexuals, Trans and Intersexual Peoples is marginalized. This sub-group is already faced many challenges including HIV, STDs and STIs, and mental health problems due to lack of access to services.

“This bill is a blow to the progress of democracy in Uganda,” said David Kato of Sexual Minorities Uganda. “Its spirit is profoundly undemocratic and un-African.”

According to the International Gay and Lesbian Human Rights Commission the Ugandan Parliament is now considering a homophobic law that would reaffirm penalties for homosexuality and criminalize the “promotion of homosexuality.”

The Anti-Homosexuality Bill of 2009 targets lesbian, gay, bisexual, and transgender (LGBT) Ugandans, their defenders and anyone else who fails to report them to the authorities whether they are inside or outside of Uganda.

The proposed law will effectively criminalize homosexuality, and consequently bar any person of same-sex orientation from seeking public health services.

“The bill criminalizes “promotion of homosexuality” in the form of funding and sponsoring LGBT organizations and broadcasting, publishing, or marketing materials on homosexuality and punishes these acts with a steep fine, 5-7 years of imprisonment, or both,” says the IGHLRC.

“The bill effectively bans any kind of community or political organizing around non-heteronormative sexuality. It will lend itself to misapplication and abuse, and implicitly encourages persecution of LGBT people by private actors,” adds the IGHLRC.

The bill has a massive potential to put paid Uganda’s response to HIV and AIDS. As the IGHLRC puts it, HIV prevention activities in Uganda, which rely on an ability to talk frankly about sexuality and provide condoms and other safer-sex materials, will be seriously compromised.

Women, sex workers, people living with AIDS, and other marginalized groups may also find their activities tracked and criminalized through this bill.

In addition, the bill will only worsen the stigma and discrimination against people of same-sex orientation, including violence. In many parts of the world, the criminalization of persons of same-sex orientation has only resulted in the denial of HIV prevention services and education to this target group.

“Discrimination and punitive laws like this aimed at marginalised groups and at those often among the most affected by HIV drives people underground and does nothing to help slow down the AIDS epidemic,” said Daniel Molokele, Africa programme officer at the World AIDS Campaign to South Africa’s Times newspaper.

Failure to reach persons of same-sex orientation with effective HIV interventions or prevention education can have severe implications to the rest of the populace. Due to stigma and discrimation, persons of same sex orientation may be left out of government HIV and AIDS programmes.

The Ugandan Parliament needs to reconsider the proposed legislation, and instead of focusing criminalization, ensure that appropriate public health services reach same-sex practicing Africans and that their human rights are protected.

Take Action Now

Join the International Gay and Lesbian Human Rights Commission (IGLHRC) and Sexual Minorities of Uganda (SMUG) in calling for the swift dismissal of the Anti-Homosexuality Bill of 2009 and the protection of all Ugandans, regardless of their sexual orientation or gender identity.

Contact:

President Yoweri Kaguta Museveni

State House Nakasero

P.O. Box 24594

Kampala, Uganda

Tel: 256-41-343-311

Fax: 256-41-346-102

info@statehouse.go.ug

Prime Minister Apollo Nsibambi

Post Office Building, Yusuf Lule Road

P.O. Box 341

Kampala, Uganda

Tel: 256-41-423-6252

Fax: 256-41-434-1139

ps@opm.go.ug

Speaker of the Parliament Edward Ssekandi Kiwanuka

P.O. Box 7178, Parliamentary Avenue

Kampala, Uganda

Tel: 256-414-377-100

Fax: 256-414-231-296

speaker@parliament.go.ug

Minister of Gender, Labour, and Social Affairs

Honorable Opio Gabriel

P.O. Box 1494

Kampala, Uganda

Tel: 256-41-510-732

ps@mglsd.go.ug

Med Kaggwa, Chair of the Uganda Human Rights Commission

Plot 20/22/24 Buganda Road

P.O. Box 4929,

Kampala, Uganda

Tel: 256-414-348-007/8

Fax: 256-414-255-261

uhrc@uhrc.ug

Directorate for Ethics and Integrity

P.O. Box 7142

Kampala, Uganda

Tel: 256-(0)41-430-1600

Fax: 256-(0)41-434-3177

info@dei.go.ug

Mathisen Gørild

Chair of the Uganda Diplomatic Human Rights Working Groups

gorild.mathisen@mfa.no

Send a copy to:

Jerry P. Lanier, Ambassador to the Republic of Uganda

Embassy of the United States of America

P.O. Box 7007,

Kampala, Uganda

Tel: 256-414-259-791/2/3/5

Fax: 256-414-259-794

kampalawebcontact@state.gov

IGLHRC

communications+action.alert@iglhrc.org

Send an email and fax to:

Perezi K. Kamunanwire, Ambassador to the US

Tel: 1-202-726-4758

Fax: 1-202-726-1727

pkamunanwire@ugandaembassyus.org

Dr. Ruhakana Rugunda

Permanent Representative of the Republic of Uganda to the United Nations

336 East 45 Street

New York, NY 10017

Tel: 1-212-949-0110

Fax: 1-212-687-4517

ugandaunny@un.int

Sample Letter:

Your Excellencies:

I am writing to express concern about legislation that would severely restrict the rights of Ugandan citizens, including lesbian, gay, bisexual, and transgender (LGBT) people and their defenders, in direct contravention of domestic and international law. The Anti-Homosexuality Bill of 2009 would not only reaffirm penalties for homosexuality, but would criminalize the “promotion of homosexuality,” including funding and sponsoring LGBT organizations and broadcasting, publishing, or marketing materials on homosexuality. Any person in authority who fails to report known violations of the law within 24 hours will also be subject to a significant fine and up to 3 years in prison – even when this means turning in their colleagues, family, or friends.

The negative repercussions of the bill in Uganda will be immediate and severe. It effectively bans the free association and expression that are necessary for a flourishing civil society, and creates a climate of fear and hostility that undermines the citizenship and solidarity of all Ugandans. It will lend itself to misapplication and abuse, and implicitly encourages persecution of LGBT people by private actors. Effective HIV prevention activities in Uganda, which rely on an ability to talk frankly about sexuality and provide condoms and other safer-sex materials, will be difficult, if not impossible.

The Anti-Homosexuality Bill violates National Objective 5(2) of the Ugandan Constitution, which provides that “the State shall guarantee and respect the independence of non-governmental organizations which protect and promote human rights.” Moreover, it directly violates the right to equality and freedom from discrimination (Article 21), the right to privacy (Article 27), the right to freedoms of speech, expression, association, and assembly (Article 29), the protection of minorities (Article 36), and the protection of civic rights and activities (Article 38) to which all Ugandans are entitled. It also violates the African Charter on Human and People’s Rights, the International Covenant on Civil and Political Rights (ICCPR) and other international human rights treaties to which Uganda is a party. This bill undermines Uganda’s commitment to the international human rights regime and threatens the basic human rights of all its citizens.

The Bill’s revocation of fundamental rights would also seriously undermine the country’s reputation and credibility in the international arena. Because it claims jurisdiction over Ugandans who violate its provisions while outside of the country, the Bill will strain Uganda’s relations with regional and international partners.

While people may hold differing opinions about sexual orientation and gender identity, the legislation before Parliament is an ineffective and fundamentally illegal way to express opposition to a minority group. In recognition of the importance of a diverse, dynamic civil society and the domestic and international commitments that Uganda has made, I urge you to swiftly dismiss the Anti-Homosexuality Bill of 2009 and reaffirm the rights and responsibilities of all Ugandans.

Sincerely,

Name:

Organization:

Country:

After arriving in Kuala Lumpur at 10 and finally getting to bed at 11:30 the first day of the IAAH 9th World Congress began in earnest.

I left the hotel at 7:30, and by 7:32 I was sweating more than I have in my life, without breakfast in my tummy (I thought a sleep in would be better). The conference kicked off (and remained) on time, the whole day. Fantastic. Below are a few highlights from the day, with more to come later.

Safer Sex from A-Z : Teaching Youth the Whole Alphabet

Plenary by Willard Cates Jr.

Willard commented on the issue of HIV and STIs as a youth problem. For those of us working in the youth health field, this comes as no surprise, but it always helps to have a refresher. When we look at adolescents we are dealign with a multitude of factors that increase their link to HIV and STIs.

• Biological Disposition
• Behavioural Disposition
• Social Networks
• Lack of life experience and being at a time in their life where they actively seek sex to see what they like

Add to this the fact that youth sexual health is a political lightning rod and it is a dangerous topic to broach.

And when it is broached, it is often broached in a very polarising way, which Willard likes to describe as the ABC approach. We choose from Abstinence and Being Faithful, or Condoms. This approach divides people greatly, and makes us think about sexual health in terms of ‘prevention from illness’, but there is a real opportunity to start thinking about ’sexual health’ in terms of wellness and staying well.

To give a bit of a global perspective on the issue, consider the statistics provided:

• 1/4 of women under 19 have an STI in the USA
• There is a massive racial disparity between Caucasian, Latina and Black women, with Caucasian women having the least number of infections
• There is a very high prevalence of STIs soon after sexual debut, so much so that future thinking might see the genital herpes virus not so much as an STI, but as a marker of sexual activity.
• An increase in STI infection in rural youth is occurring

Willard went on to talk about the two ABC arguments.

The Abstinence Group states that abstinence provides 100% protection against STIs. When we look at how it works, this is essentially true, so funding and legislation was provided for that method, however it got to the point where funding and legislation removed condom education from the picture, going so far as to talk negatively about condoms.

So, they have a point, when used perfectly abstinence is great, but it is rarely used perfectly. When used perfectly, the chance of a non HIV+ partner in a relationship with a HIV+ partner contracting the illness is near to 0%, but when used ‘typically’, that chance increases to around 80%. In saying that, there is a lot of research on either side, that suggests comprehensive and abstinence only sexual health education programs do or do not work, some with more bias than others.

Overall, the main problem with abstinence only is adherence.

On the other hand, the Condom argument people argue for aggressive condom distribution tactics, which can be culturally inappropriate. Some programs which encourage 100% condoms use, like sex work parlours in Cambodia, have seen massive reductions in new HIV infections in these environments, so perhaps there is merit in that argument.

Some more stats, for those who are interested:

In a HIV discordant couple (one positive partner, one negative) for those who always use condoms, there is an 0.9% chance of contracting HIV, for those who report sometimes 5.1% and for those who report never – 6.5%.

The main problem with condoms (get ready for a punchline) is also adherence

Now, the main benefit in both condoms and abstinence is they create a delay. And delay is one of the greatest things we can create in health promotion. And as both can be effective, we need to use the right message for the right audience at the right time. No approach should be used alone. We can move towards a holistic view of healthy sex, rather than absence of disease, where we talk about sex as consensual, non-exploitative, honest, protected and pleasurable. And for many of us, pleasure will be the hardest to to talk about.

BRAC and the NYC Dept. of Transportation are pleased to inaugurate
Aurora–a new temporary public art sculpture by DIEGO MEDINA

RECEPTION: Thursday, October 29 (5 – 8pm)

The sculpture is located one block away from BRAC, at the base of West Farms Square/East Tremont Avenue subway
station at the corner of East Tremont Avenue and Boston Road in the Bronx. The reception will commence at West Farms
Square Plaza and continue at BRAC’s gallery.

Bronx River Art Center | 1087 East Tremont Avenue | Bronx, NY 10460
718.589.5819 | www.bronxriverart.org

Subway:  #2 or #5 to West Farms Sq./East Tremont Ave. Walk one block East.
Bus:         #’s 9, 21, 36, 40, 42 or Q44 to East Tremont & Boston Road
Car:          Bruckner Expwy to Sheridan Expwy, Exit at Tremont Ave.
or Cross Bronx Expwy to Rosedale Ave., North to Tremont Ave., West to Bronx St.
Also:        Bronx River Pkwy South to Exit 5 (177th St.), two blocks to Devoe Ave.
Right two blocks to E. Tremont Ave., Left one block to Bronx St.

Legislation to “reauthorize the Ryan White Act, which regulates the primary federal assistance program for low-income AIDS and HIV patients, is headed for President Obama’s desk,” Congressional Quarterly reports.

The House on Wednesday cleared the bill by 408-9. The Senate had passed it two days ago by voice vote.

About the bill:

The measure would reauthorize through fiscal 2013 the law named after a young Indiana hemophiliac who became an activist in the fight against AIDS in the 1980s when he was expelled from school after contracting the disease from contaminated blood. He died in 1990 at age 18.

The bill would require states to adopt name-based reporting for patients by 2012. For privacy reasons, some states assign AIDS patients a code or number to use for the purpose of federal reporting requirements. However, other communicable diseases, such as tuberculosis, require name-based reporting.

The measure also would set a national testing goal of 5 million tests per year.

The Senate measure is S. 1793 (Ryan White HIV/AIDS Treatment Extension Act).

Update (10/30): President Obama has signed this bill into law.

The power of education in fostering a better and effective response to HIV and AIDS is undeniable.

Education promotes knowledge and with knowledge about HIV and AIDS, individuals, families and communities have the ability to make informed choices about their behavior.

However, governments and international donor organizations often underplay this important intervention, particularly in the emergency phase of the cycle of displacement, says a report recently issued by UNHCR and UNESCO on the importance of education to populations that find themselves victims of displacement due to conflict, disaster or other emergencies.

Education can play a key role in helping refugees and internally displaced persons (IDPs) cope with the negative excesses of their circumstances, such as ignorance, exploitation, violence and the risk of HIV infection.

Many factors combine to put IDPs and refugees at the risk of HIV infection, including loss of livelihoods, lack of access to basic services, poverty, alcohol and drug abuse, and violence.

According to the report, internal displacement also increases sexual violence against women and girls, including the use of rape as a weapon of war, and breaks down social networks and institutions that usually provide support and regulate behavior.

“The additional disruption to health and education services reduces access to HIV prevention commodities, information and HIV-related treatment and care during conflict and flight,” the report acknowledges.

The institutional disintegration that characterizes internally displaced communities poses a huge challenge to developing interventions to prevent HIV transmission and provide sexual and reproductive health services.

“For example, both the general socioeconomic situation of refugees and the specific provision of formal and non-formal education are quite different from elsewhere,” states the UNESCO/UNHCR report, which is aimed at influencing policy-makers and implementers in ministries of education, civil society organizations and funding organizations involved in emergency, reconstruction and development responses.

In a time of crisis, education can offer structure, stability and hope as well as promote the acquisition of skills for life and support conflict resolution and peace-building. With increased knowledge, IDPs and refugees can acquire the necessary skills that can significantly help them to prevent HIV and cope with AIDS. Policymakers can improve the lives and livelihoods of IDPs and refugees by directing resources towards the education of displaced populations.

“It is critical that efforts be made to ensure that refugees and IDPs, particularly children and young people, have access to educational opportunities as education provides the knowledge and skills essential for the prevention of HIV, and protects individuals, families and communities from the impact of AIDS,” says the report.

In addition, education can foster understanding and tolerance that can contribute to reduced stigma and discrimination against people living with HIV.

According to UNESCO and UNHCR, the needs of refugees and IDPs should be an element of national education sector policies on HIV and AIDS in affected countries. In other words, governments need to allocate funds in national budgets to cater to the educational needs of displaced populations.

But to ensure success, the affected communities should be involved in the design and implementation of programs. “Educational programs developed through consultation and consensus with the displaced and local host communities have a better chance of success than those imported and implemented directly,” the report recommends.

Ignoring the needs of displaced populations will only impact negatively on the efforts of governments to develop a comprehensive response to HIV and AIDS. “Failure to address HIV-related needs of refugees not only denies refugees their rights, but undermines the effectiveness of HIV prevention and care efforts for surrounding communities,” the report concludes.