HIV contaminated blood

click image for video

Raj Shekhar was 30-years-old when he needed a blood transfusion after an accident. That transfusion, more than the accident itself, changed his life unexpectedly. Nearly a year later, he tested HIV positive when he was hospitalized after experiencing massive chest pains. Instead of being admitted to the operating room, he says, his doctor refused to perform the required surgery. His wife abandoned him soon after.

Raj is among the approximately five to ten percent of the global HIV+ population that was infected through contaminated blood five years ago. The World Health Organization (WHO) estimated in 2003 that nearly seven percent of AIDS patients who have reported their condition to the National AIDS Program in India acquired the virus after a transfusion of blood or blood-related products like plasma.

WHO research shows that regular, unpaid voluntary donors provide safe and sustainable blood supply because they are less likely to lie about their health status and are also more likely to keep themselves healthy. South Africa, for instance, has an HIV prevalence of 23.3 percent in the adult population but only 0.03 percent among its regular blood donors, the WHO reported this week for World Donor Day 2006 on Wednesday.

International health organizations have made a concerted effort to improve and secure the standards of blood collected for transfusion by proposing 100 percent unpaid, voluntary blood donation. But the world is making slow progress towards that goal. Most developing countries still depend on paid donors (many of whom are in dire economic situations from drug or alcohol abuse) or family member donors (who are often too ashamed to reveal their HIV status).

The WHO survey shows that out of the 124 countries that provided data to WHO, 56 saw an increase in unpaid voluntary donation. The remaining 68 have either made no progress or have seen a decline in the number of unpaid voluntary donors. Of the 124 countries, 49 have reached 100% unpaid voluntary blood donation. Out of those 49, only 17 are developing countries.

However, some countries such as Malaysia and India have shown progress in the last two years by applying stricter principles within their AIDS prevention programs. The WHO said Malaysia went from 50 percent in 2002 collected blood coming from unpaid volunteers to 99 percent in 2004 and India from 45 percent to 52.42 percent.

Raj was transfused five-years ago when blood harvesting programs in India had few safeguards. In this video interview, Raj reflects on how his life changed after he was transfused with HIV tainted blood.

The Age of AIDS

click for video preview

Lives in Focus editors highly recommend a new documentary titled “The Age of AIDS” which is produced by Frontline, one of the world’s best television news magazine programs. The four-hour documentary is a must-see if you want a deeper understanding of this disease. The program describes itself thus:

After 25 years of political denial, social stigma, scientific breakthroughs, bitter policy battles and inadequate prevention campaigns, HIV/AIDS continues to spread rapidly throughout much of the world. Through interviews with AIDS researchers, world leaders, activists, and patients, FRONTLINE investigates the science, politics, and human cost of this fateful disease and asks: What are the lessons of the past, and what can be done to stop AIDS?

The full program will be available here beginning Friday, June 2 at 5pm New York time.

Despite setbacks, Bikhshapati is full of life

click image for video

When I first asked Bikhshapati his age, he didn’t understand my question. I asked again, “Are you five? Six?”

He answered in English but seeing the confusion on my face, he reached down and scrawled the number “12″ in the sand.

I was shocked. For a moment I suspected he wrote the wrong number.

His doctor told me later that Bikhshapati looks half his age because of the ravages of HIV. Although he is on anti-retro viral drugs, his body constantly struggles against the virus. On many occasions over the past few years, he has fallen deathly ill. He has missed school so often that he is now years behind those his own age.

Bikhshapati’s hardships have not dimmed his enthusiasm for life, however. For those of you struggling emotionally with being HIV positive, this young Karate fighter’s bright disposition might provide some inspiration.

A glimmer of hope: HIV infection drop in South India

Dr. K. Venu, chief of Hyderabad’s Government General Chest Hospital, treats an unrelenting stream of patients who come to the hospital for Tuberculosis treatment only to find that they have AIDS. In India, TB is the most lethal opportunistic infection preying on those weakened by AIDS.

click image for video

Despite the human toll he witnessed over the past decade, Dr. Venu remains optimistic about controlling the spread of HIV/AIDS.

He might have reason to be hopeful.

A study published March 30, 2006 in the British medical journal, The Lancet, provides a glimmer of hope.

The research, conducted by a joint Indian and Canadian team, found that India’s safe sex awareness campaign has had a dramatic impact on reducing HIV infection rates in South India—the epicenter of India’s AIDS crisis. The study suggests that HIV infection rates have fallen by a third in the worst hit regions of South India.

The research tracked HIV infection rates at the clinics where people normally find out they are infected, including among young women attending pregnancy clinics, and young men attending sex disease clinics.

The researchers studied HIV prevalence data from 294,050 women attending 216 antenatal clinics and 58,790 men attending 132 sexually transmitted infection clinics in the north and south from 2000 to 2004.

Despite his optimism, Dr. Venu warns that while the trend is encouraging, there is no time for apathy.

Related Previous Posting:
Opportunistic Infections (Photography).

Shabana’s hopes

click image for video interview

Shabana, 20, realized she was HIV+ after her husband’s health began rapidly deteriorating. A Muslim woman, she now serves as a counselor trying to educate those in her community about the dangers of HIV/AIDS and how it spreads. Many Muslims, she says, still believe that the illness will not enter their community. Shabana, who was married off at 13 and with a child at 14, says she is dedicating whatever of her life remains to making sure that her six-year-old daughter and others can avoid her fate.

Related Previous Posting: Facing the Glare (Photography).

A medical miracle

During the 90s, most HIV+ children in the United States were not expected to survive more than a few years. If a child did survive beyond a short period, people considered it a “medical miracle.”

click image for video interview

At one center today in the US, the average age of HIV-infected children is 13 and rising, according to a New York Times Magazine article published this summer, because of the new line of AIDS drugs like protease inhibitors and other developments in the treatment of the disease.

In India today, the HIV+ children who are provided with nothing but the first line anti-retro viral drugs (drugs that were used a decade ago in the US) are surviving and thriving beyond the expectations of their caregivers.

Deepti has lived in an AIDS orphanage since she was eight years old. She is on the verge of reaching her teen-years.

How can you help?

Many of the readers of this blog have asked: How can we help the people in the orphanages and centers profiled on Lives in Focus. It is obvious but what they need most is money to provide the treatment, the care and the activities to keep the children healthy. Others need funds to help pay for representation in the courts.

Lives in Focus has compiled a list of places you might send a check. Remember the exchange rate between the dollar and the Indian Rupee turns even $5 dollars into a windfall for these places. The centers below are also international tax-deductible charities. Please do mention that you heard about them through Lives in Focus:

• Network of HIV Positive People (Family Counseling Center)
  ATTN: M. Swapna
  H.No. 8-3-167/30, Venkateswara Housing Society, Erragadda
  Hyderabad-38, India
• Lawyers Collective HIV/AIDS Unit
  Programme Management Unit (PMU)
  ATTN: Anand Grover
  Jalaram Kripa, Ground Floor
  No. 61, Janmabhoomi Marg, Fort
  Mumbai 400001 , Indiaemail: aidslaw@lawyerscollective.org
  website: www.lawyerscollective.org
• Freedom Foundation Bangalore
  ATTN: Ashok Rau
  Office - 180, Hennur Cross,
  Bangalore - 560 043. India
• Freedom Foundation Hyderabad
  ATTN: Dr. Troy Cunningham
  21 Cariappa Road, Bolarum
  Secundrabad 500 010, India
  Telephone: 011 91 40 2786 2148 or 011 91 40 2786 5530

Condoms and morality

In my previous post about HIV/AIDS prevention public service announcements, I noted that they are “as direct as they can be in a culture that still shows very little kissing in its movies and television programs.”

But India is not alone in letting “morality” issues affect its fight against HIV/AIDS. Just last year, Texas voted to adopt health textbooks that focus on abstinence and barely mention the role condoms can play in preventing sexually transmitted diseases.

The Texas Board of Education even considered one textbook that asserts that “respecting yourself and getting enough rest are two steps to preventing sexually transmitted diseases,” according to the San Antonio Express-News. As the second-largest buyer of textbooks, decisions made by the Texas Board have tremendous influence across the country.

While abstinence appears to be a good idea to conservative Americans, the reality is far from what they envision. An eight-year study released earlier this year by researchers from several universities, including Columbia, found that people who pledge to protect their virginity until marriage are almost as likely to contract sexually transmitted diseases (STDs) as kids who make no such pledge.

click image for video interview

“The sad story is that kids who are trying to preserve their technical virginity are, in some cases, engaging in much riskier behavior,” such as oral and anal sex, said Peter S. Bearman, a professor at Columbia’s Institute for Social and Economic Research and Policy, and the lead author of the study told the Washington Post. “From a public health point of view, an abstinence movement that encourages no vaginal sex may inadvertently encourage other forms of alternative sex that are at higher risk of STDs.”

President George W. Bush pledged $15 billion over five years for AIDS treatment and prevention in countries where the disease is running rampant. But one of the conditions of the legislation requires that one-third of the prevention funding go to abstinence-only programs.

Government-funded domestic HIV prevention programs that encourage people to use condoms are required to point out condom-failure rates despite scientific studies that show that condoms are 90 percent effective for preventing the transmission of HIV and other sexually transmitted diseases like syphilis and gonorrhea.

American television commercials bombard viewers with images of women with ample bosoms and long legs to sell everything from beer to cars. But the mere mention of the role condoms can play in protecting against sexually transmitted diseases is considered by many people (including President Bush) to be a moral lapse.

Understandably, the far more traditional Indian culture is now struggling to adapt to the need to openly discuss sex education with its youth. In this video clip, Anand Grover, an attorney and project director for the Lawyers Collective HIV/AIDS Unit in Mumbai, India, talks about this hurdle.

The Collective’s attorneys represent indigent people in court to help win them access to medicines or to protect their jobs against discrimination. The Collective is also trying to influence Indian legislation to make access to health services a government obligation.

This is a public service announcement

click image for video

This summer in Hyderabad, I walked past shiny new malls and mammoth glass buildings housing the growing number of outsourced American companies; through parks where men furtively sought other men for a quick, no-names-asked encounter; down roads lined with women selling their bodies.

I paced the platforms at train stations; interviewed people in their one-room homes in the slums and was hosted in an affluent neighborhood. In those 12 days in Hyderabad, the main city in Andhra Pradesh, a state that ranks among the top 5 Indian states with the highest rate of HIV infections, I saw one single poster with a message about HIV/AIDS.

The poster appeared, of all places, in front of a private hospital. I don’t recall seeing any public service posters in Bangalore, Chennai or Mumbai.

click image for video

The AIDS campaign appears to have shifted onto television, which reaches the richest and poorest audiences in India. Sometimes, several slum-dwellers share a single television or servants and their kids sit on the floor at an employer’s home to watch some of the popular programs. People find a way to watch television.

A television-based AIDS awareness campaign might actually be more effective in presenting an accurate and understandable message. Vivek Divan, a former project coordinator for the advocacy group Lawyers
Collective HIV/AIDS unit in Mumbai, India, told me in 2004 that posters left too much to the imagination.

“There is a problem of not making HIV real for the reader of these messages,” said Divan. ” It presented
messages in very abstract ways—a painted slogan. It doesn’t make any sense to me when I pass by it on the railway tracks.”

The advertisements I watched on television stressed that this was a disease everyone needed to fear. They depict middle class families that many Indians recognize as their own discussing this fast spreading
disease.

These Public Service Announcements appear on Doordarshan’s local and national channels. Doordarshan is one of India’s most watched stations. Many of the spots were dubbed into six local languages.

The messages are about condom usage; how HIV is transmitted; and about living and working with
people who are living with AIDS. The spots are as direct as they can be in a culture that still shows very little kissing in its movies and television programs.

The BBC World Service Trust created the following spots for India’s National AIDS Control Organization (NACO) and Doordarshan. The BBC World Service Trust owns the copyright but allows non-commercial use.

Ambulance ride

click image for video

My 5 1/2 year old daughter entered kindergarten a few days back. The most exciting part of the experience so far for her has been riding the school bus.

That reminded me of how the HIV+ orphans at Bangalore’s Freedom Foundation get to and from school.

After this video, you may want to revisit a previous one about the kids at play.