Saturday, November 30, 2013

3 surprising global AIDS facts (feat. the HIV Story Project)

At BeforeWeDo, we acknowledge the fact that a lot of the great work in sexual health that is being achieved today does not come from private industry. It is the foundations, the charity institutions and non-profits that are driving awareness and change in this country every day. Today, we want to feature one of them which caught our eye in San Francisco.

This non-profit was started by the two award-winning film directors Marc Smolowitz and Jörg Fockele as they realized that most documentaries about HIV treated the past. However, only looking at the topic from a history perspective might lead to the danger of treating HIV/AIDS as a thing of the past. With still over a million HIV infected individuals in this country, this is clearly not the case. Therefore, they founded the HIV Story Project to use film to tell today’s diverse stories about the disease - in the United States and abroad.

Their latest film 'Keep the Promise - The Global Fight Against AIDS' (IMDB) documents the campaign ‘Keep the Promise’ that brought thousands to Washington, including celebrities like Wyclef Jean, Al Sharpton and Margaret Cho and representatives from over 50 countries. All coming to remind the world governments to keep their promise to maintain funding for HIV/AIDS research, treatment and prevention. 

So I went to the event for you and besides the documentary discussed below I also had the opportunity to listen to the 'Messengers of Hope' - a gospel choir that works HIV/AIDS topics into their songs. Additionally, I had the honor of speaking to Terri Ford, Chief of Global Policy and Advocacy from the AIDS Healthcare Foundation that sponsored not only the event but the documentary as well. The film and her personal stories brought up facets that HIV/AIDS has in other countries that can be quite surprising to people who grew up in the Western hemisphere.

Demonstration in Washington D.C from Keep the Promise film (2013)

1.) On a global scale, HIV can still be a death sentence.
In the US, retroviral medication to keep HIV at bay and the viral load undetectable can cost up to 30,000 USD per year with lifetime costs for patients being estimated at over 500k USD.  Despite the multiple state-level and federal support programs (list by such as ADAP that are providing medication to uninsured with low income, many still struggle with affording their drugs. In many states for example, assistance is limited to individuals with an income less than 22k USD / year - disabling patients to make efforts to leave lower income classes as medication expense would be unbearable. This problem takes another dimension in developing countries. Generics and international drug assistance can lower the costs down to 150 USD / year but even that is hard to afford if you are not making less than 2 USD / day. How many people do you think have such low income worldwide? 10 Million? 100 Million? 500 Million? No, think again - Current estimations are at 2.7 Billion - 38% of the world population.

Terri Ford, AHF
Terri told me about her recent trip to Myanmar. One of the Asia’s poorest country which until AHF made an effort to open office practically had no retroviral medication. "People are still dying from AIDS related complications " - just like in San Francisco in the 80ies and early 90ies. Now, despite bureaucratic hurdles, they are bringing in medication to the country and soon will be enabling  patients access to treatment. So for many, out of poverty, HIV is still a death sentence.

2.) 50% of all HIV-infected individuals are women.
If you like me grew up in a country were most HIV cases affected men who have sex with men, then you must have been as surprised as me to learn that half of HIV+ patients worldwide are women. Many factors are still contributing to this development. Violence is one of them: HIV transmission risks from a positive man to a woman can increase during forced sex due to tearing and lacerations. But also cultural factors such gender norms, lack of mobility and education hinder the lowering of new HIV infection rates amongst women. At the same time, the WHO states that most HIV/AIDS programs do not address gender inequality. There is still a lot to be done!

Margaret Cho, Scene from Keep the Promise film (2013)

Connected to positive women is the topic of positive babies - one of the saddest transmission routes of HIV. Terri told me about her last trip in India where she talked to a positive woman who with her doctor visited 4 different medical aid programs that all refused to give her medication because despite being HIV positive, her T-Cell count was not low enough. "Frist of all, her T-Cell count was below 500 which is the current WHO limit and secondly she is pregnant! The WHO guidelines stipulate all pregnant women to be treated anyway. Her child may be born positive! That makes me angry!" Such stories are incredibly frustrating to ear - especially considering how successful medical treatments can prevent babies from contracting HIV from the mother. 

3.) HIV is most rapidly expanding in Eastern Europe
While we mostly focus on Sub-Saharan Africa when we are talking about the biggest impact, it was surprising to see in the documentary that the highest growth of HIV infections take place in Eastern Europe. The former Soviet Union countries were considered low risk by the WHO just 20 years ago. Travel restrictions into and out of the country during the cold war made it very hard for the virus to invade the country. However, with the fall of the union and subsequent opening of the newly formed countries this changed and with the economic downturn, an increase of drug use accelerated the spread. Until 2007, the main mode of transmission was sharing needles and as we look at the statistics of 2008 further, we see another very sad transmission route: children born HIV-Positive. A very sad fact given that we can already prevent the transmission from mother to child with great success.

Modes of HIV transmission in Ukraine in 2007, UNGASS via Wikipedia

Another concentration of HIV is the prison system. For example, studies in the Ukraine in 2005 showed that between 15 - 30% of prison inmates were HIV positive.

So why, as a US based startup focusing on the American market first are we blogging about the world. It is because we live in a global village, aren’t we? We drive cars from Japan, dance to music from Korea and drink beer from Germany. Lets take a minute during World AIDS day to consider the many aspects the disease has on this little blue planet.

Margaret Cho, Wyclef Jean, Scene from Keep the Promise film (2013)

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