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AIDS Prevention
Group 6
Megan Felske
Holly Teige
Mary Ballingham
PREVENTING AIDS CAMPAIGN
What impact has AIDS had in the past?
This figure shows the number of adults infected with HIV,
according to region 1980 to 2003.
http://content.nejm.org/cgi/content/full/351/2/115/F1
2006 Statistics
• For the United States, annual AIDS deaths peaked at slightly over 51,000 in
1995, just prior to the introduction of more effective drug therapies, and
since 1998, AIDS deaths nationally have hovered around 15,000 per year
(Henry J. Kaiser Family Foundation 2006).
• With controlling for the panel nature of the data, the results of this study
show that AIDS mortality in the United States is noticeably influenced by
per capita income, physician supply, per capita prescription drug
expenditure, and race. (Gallet, Craig Arthur)
• In the united states treatment for the HIV virus starts later than what is
recommended. 38.3% of people that are newly diagnosed with the virus
were diagnosed with AIDS one year later.
• In the united states, an estimated 1.1 million people were living with the
HIV infection, 56,000 of them were newly infected. (World AIDS Day)
Carriers of AIDS/HIV in 2006
• Gays Bisexuals-
53% of all new infections
• Heterosexuals-
31% of all new infections
• IV Drug users-
12% of all new infections
2008 HIV/AIDS Dilemma
• On August 2nd 2008, CBS News correspondent Priya David reported that today over 56,300
new HIV infections are reported yearly, opposed to the 40,000 annual estimate used for the
last dozen years.
• It is said that the reasons why the numbers have increased is because of the advance in blood
testing's. With these advancements scientists can determine when exactly a person
conducted the HIV virus.(CBS 2009)
• U.S. HIV cases are 40% higher than what was estimated.(CBS 2009)
• In 2008 650 million dollars is being funded for HIV/AIDS relief which is about the same as a
decade ago, More new cases of people infected with the virus does not increase the resource
supply.(CBS 2009)
• Based on new calculations, officials believe annual HIV infections have been stable around
55,000 for several years now.(CBS 2009)
• The new estimate is "evidence of a failure by government and society to do what it takes to
control the epidemic," said Julie David's, executive director of the Community HIV/AIDS
Mobilization Project. (CBS 2009)
• "This is the biggest news for public health and HIV/AIDS that we've had in a while," said Julie
Scofield, executive director of the National Alliance of State and Territorial AIDS Directors.
• Various biologic, cultural, and political factors combine to make women especially vulnerable
to HIV. In 2008, estimated 16.5 million women worldwide were living with HIV infection.
(World AIDS Day)
Incorporating the health and economic variables as well as the sociodemographic variables, state fixed effects, and state time trends, the
complete AIDS mortality rate specification for each gender becomes:” (Gallet,
Craig Arthur)
Life Expectancy
The average life expectancy after HIV
diagnosis increased from 10.5 to 22.5 years
from 1996 to 2005. Life expectancy was
better for women than for men. In 2005, life
expectancy for African American males were
reported the shortest, followed by Hispanic
Males. ( Kathleen McDavid Harrison)
2008 CBS Video
“ This is the most reliable estimate we’ve had since the beginning
of the epidemic” –Dr. Julie Gerbending (CDC Director)
..\..\Downloads\watch.htm
Hyperlink)
(Highlight- right click- click open
MTV and Staying Alive Ignite
• MTV and the U.S. President’s Emergency Plan for AIDS relief (PREFAR) and
UNICEF unveiled at International Conference 2010, that new research on
its “Staying Alive Ignite Campaign” found that creating compelling prosocial entertainment for young people can positively impact the attitudes
and behaviors towards HIV/ AIDS.
• The funding from the Bill & Melinda Gates Foundation and MTV,
commissioned Johns Hopkins University to evaluate the Project Ignite HIV
prevention and education campaign.
• Alive’s TV drama series Shuga, which is Africa’s hard hitting drama for
young adults with compelling HIV prevention and educational messages.
Evidence from the Johns Hopkins study suggests that young adults took a
liking to receiving important information about HIV/ AIDS through
programming. According to Jimmy Kolker, the Chief of HIV and AIDS for
UNICEF, “ Preventing new HIV infections among young people requires
more knowledge, but even more important, changes in behavior and
attitudes, Shuga has been successful because it presents realistic
information in a way that adolescents see as relevant to their own lives and
behaviors.” ( Obesity, Fitness & Wellness, Aug 7th, 2010,: p3040)
Success in Thailand
• “ Analysis of HIV transmission rates has provided insight into
the impacts of HIV related prevention programming and
policies in the United States by providing timely information
beyond incidence or prevalence alone. The purpose of this
analysis is to use transmission rates to assess past prevention
efforts”. (Findings from School of Public Health in HIV/AIDS)
• “A national HIV/AIDS program implemented in Thailand in
the 1990’s that targeted sex workers and the general population
was correlated with a decrease in new cases despite high
prevalence. The epidemic in 1991 was when the national
transmission rate was 32%, and by the late 1900’s, the rate had
dropped to less than 4%. This outcome is the result of a
prevention success correlated with the national HIV/AIDS
program” (L.S. Park and colleagues, School of Public Health)
Population Services International
• PSI (Population Services International) is a leading global organization
operating in more than 60 countries around the world, they are currently
attending the 18th International AIDS Conference in Vienna to showcase
PSI’s innovative, evidence based HIV prevention methods, which in fact
have helped to successfully avert more than one billion cases of HIV
infection over the past 40 years. This meeting is considered a critical
gathering for those who work within the fields of HIV/AIDS to assess
current progress and evaluate scientific developments in the fight to
prevent the spread of HIV. (Global Health)
• Krishna Jafa, the Director of HIV, Reproductive Health and Tuberculosis at
PSI says, “ As attempts to find a cure continue, we must renew our
commitment to HIV prevention and treatment programs that have been
proven to work”.
• PSI/ Zimbabwe and the partners at the UK Department for International
Development and USAID, launched a highly successful HIV prevention
program which consisted on counseling, HIV testing’s, Male circumcision,
concuuency communications and condom promotions. ( Obesity, Fitness &
Wellness Week, Aug 7th 2010)
HAART
• HAART ( Highly Active Antiretroviral Therapy) is estimated to
have saved at least three million years of life at a discounted cost
that depends on when therapy is initiated of $350,000 or more per
person.
• HAART provides many programs for people to cope with HIV/AIDS
such as:
– “Helping Hands” a transitional supportive housing program (SHP)
– “Homes In Harmony” a permanent housing program (HOPWA)
– “Hope For Healing” housing for disabled persons with other challenges (SHP)
• To Reach HAART: HAART (HIV/AIDS) alliance for region two, Inc
4550 North Blvd., Suite 101
Baton Rouge, LA 70806
(225) 927-1269- Phone
(225) 927-7365- Fax
Use of Needle Exchange Programs to
Reduce New HIV Infection Rates
Biological Anthropology
Cascadia Community College
Summer 2010
Holly Teige
“There is no successful intervention for HIV
that does not include a comprehensive
prevention package for intravenous drug
users. That is non-negotiable.”
– International AIDS Society President Julio Montaner
By the Numbers…
How many intravenous drug users (IDUs) are there?
• The real number is unknown due to the notorious
unreliability of self-reported usage data from users.
How many HIV infections are caused by intravenous drug
use?
• Outside of sub-Saharan Africa approximately 30% of
HIV infections are believed to be caused by IV drug use
(Fabio Mesquita 2004).
• In the United States 12% of new HIV infections
originated in the IDUs (PBS:Frontline 2006).
Needle Exchange Programs (NEP)
What is an NEP?
• A community-supported organized system
providing IDUs the ability to safely swap dirty
needles and syringes for sterile ones, reducing
infection rates from blood-borne pathogens,
such as HIV and Hepatitis. (PBS:Frontline
2006)
Is IV Drug Use Driving HIV Infections?
• In many countries, including several in Asia and
Eastern Europe, IV drug use is a significant
contributing factor in rising HIV infection rates
among IDUs (Fabio Mesquita 2004).
• Injection drug use makes up 75% of HIV infections in
Kuala Lumpur, Malaysia, 69% in Ukraine, and 90% in
Russia (ibid).
Needle Exchange Programs (NEP)
EARLY HISTORY (1970s – 1980s):
• In the beginning of the AIDS epidemic IDUs were quickly
identified as a large source of new infections.
• Initial needle distribution efforts were illicit and unsupported
by local governments.
• Amsterdam Junkiebond, a drug-users advocacy group, began
the first documented open needle exchange in 1984.
• First efforts in the United States were underground often
driven by users and/or supportive friends and family. In 1986
John Parker, a needle exchange activist, began an informal
program in New Haven, Connecticut.
• In April 1988 Dave Purchase formed the first openly operated
needle exchange program in the US, based in Tacoma,
Washington.
–
This program ultimately grew to become the Point Defiance AIDS project.
(Sandra D. Lane 1993)
Needle Exchange Programs Cont’d
RECENT HISTORY (1990s – 2000s)
• Globally there are NEPs in 77 countries including:
–
–
–
–
Western Europe: 25,000 NEPs
United States: 185 NEPs
Latin America and Brazil: 122 NEPs
Eastern Europe and Central Asia: All countries except Kosovo
and Turkmenistan have NEPs
– China: 775 NEPs
(Avert.org 2010)
• Until December 2009 when the Obama administration
repealed a 21-year-long ban, the policy the US was the only
country to explicitly bar the use of government funds for
NEPs (Dillon 2009).
Needle Exchange Programs:
Clean Needles Save Lives - Needle Exchange in the US
http://www.youtube.com/watch?v=zpTKQAaC-Yw
Needle Exchange Program: Costs
Financial
• Initial investment in needle exchange sites can be high.
• Ongoing investment in staffing, site maintenance, and needle/syringes/injection
equipment is required to provide long-term support.
• Possible increase in crime rates and low-income residents in and around needle
exchange sites decrease property values.
• Increased IDU population also strains public budgets due to their often lowincome status and high level of need for supportive services, often publicly
funded.
Social
• Needle exchange program sites are often considered detrimental to the local
community safety although this has not proven true overall.
• Increased IDU population in and around region of needle exchange location can
drive down community satisfaction.
• IDUs may be less likely to pursue treatment for drug abuse if the use of the drug
itself is openly permitted. This has not been a consistent outcome however,
studies have routinely showed no change in the rate of IDUs entering rehabilitative
treatment.
(Beiser 2008)
Needle Exchange Program: Benefits
Financial
• Reduced taxpayer-funded expenses to provide
healthcare for HIV infected IDUs, saving over $600k per
user in potential HIV treatment costs (Schackman, et
al. 2006).
Social
• Improved capacity for understanding and awareness
among both the community members and the IDUs
themselves.
• Increased ability for IDUs to begin effectively
contributing to the community through jobs and
volunteer efforts.
Research Summary
Drawbacks
• Insufficient confirmation that a large enough supply of
syringes was available to make sure every syringe was
replaced in every facility within all programs.
– NEPs may indeed reduce new HIV infection rate but available
data may reflect a gap between what has been done and what
can be done.
• Uncertainty remains regarding exactly how many needles
are required per user.
– Impacts cost-benefit analysis in program evaluation.
• Information is often reported by the IDUs themselves and
as such can be inaccurate and subjective. (Beiser 2008)
Are Needle Exchange Programs
Effective at Reducing New HIV
Infections in Intravenous Drug Users?
Yes. All available data reflects at least some
reduction in HIV infection rates among
intravenous drug users in areas with operating
needle exchange programs.
Works Cited
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Avert.org. Needle Exchange and Harm Reduction. 07 20, 2010. http://www.avert.org/needle-exchange.htm
(accessed 08 05, 2010).
Beiser, Vince. Vancouver's Safe Environment for Drug Addicts. 10 27, 2008. http://www.millermccune.com/health/first-reduce-harm-4151/ (accessed 08 05, 2010).
Dillon, Connecticut State Rep. Patricia. Needle Exchange Ban Lifted; Ball's in Rells Court. 12 21, 2009.
http://newhavenindependent.org/index.php/archives/entry/needle_exchange_ban_lifted_balls_in_rells_court/
(accessed 08 03, 2010).
Fabio Mesquita, Telma de Souza, Joan R. Villalbi, M. Teresa Brugal, Patricia Garcia de Olalla, Joan A. Cayla, Gregory
M. Lucas, Robert Newman, Paisan Suwannawong, Michel Kazatchkine, France Lert, Jay Franklin Dobkin, Mario
Pecheny. Breaking Down Barriers: Lessons on Providing HIV Treatment to Injection Drug Users. New York: Open
Society Institute, 2004.
Jauffret-Roustide, M., J. Emmanuelli, M. Quaglia, F. Barin, P. Arduin, A. Laporte, and J.-C. Desenclos. "Impact of a
Harm-Reduction Policy on HIV and Hepatitis C Virus Transmission Among Drug Users: Recent French Data—The
ANRS-Coquelicot Study." Substance Use & Misuse 41, no. 10-12 (11 2006): 1603-1621.
PBS:Frontline. Frontline: The age of AIDS: Past/Future: Needle Exchange: A Primer. 05 30, 2006.
http://www.pbs.org/wgbh/pages/frontline/aids/past/needle.html (accessed 08 03, 2010).
Sandra D. Lane, R.N., Ph.D., M.P.H. "Needle Exchange: A Brief History." HIV/AIDS Information provided by
AEGIS.org. 1993. http://www.aegis.com/law/journals/1993/HKFNE009.html (accessed 08 03, 2010).
Schackman, Bruce R. PhD, et al. "The Lifetime Cost of Current Human Immunodeficiency Virus Care in the United
States." Medical Care 44, no. 11 (11 2006): 990-997.
Sexual Education
Mary Ballingham
Biological Anthropology
Summer, 2010
Abstinence Only Education
• Abstinence Only Education emphasizes following a
specific set of strenuous moral guidelines which
include:
– Abstinence from sexual activity outside the
context of marriage
– A mutually faithful, monogamous relationship
between two people with no other sexual
partners
Abstinence Only Education (cont.)
• The majority of supporters of abstinence only
education believe/emphasize:
– Abstinence is the only way to prevent unwanted
pregnancy and the spread of Sexually Transmitted
Diseases
– Sexual activity of any kind outside the context of
marriage has consequences, both psychologically,
physically, and socially
– The teaching of comprehensive sexual education
encourages early onset of sexual behavior
Avert.org
Comprehensive Sexual Education
• Comprehensive sexual education addresses
both the benefits of abstinence and ageappropriate medical information about
reproduction and the use of contraceptives
• It usually includes developmentally
appropriate information on relationships, peer
pressure, and self-esteem
Advocates for Youth
Abstinence Only v. Comprehensive
• Many abstinence only supporters believe that
comprehensive education will promote or encourage
sexual activity. However, studies have shown that
teen pregnancy and rates of STD’s actually decreased
in schools that taught comprehensive sex-ed
• The biggest difference is that comprehensive
education acknowledges that some teens will have
sex, while abstinence only refuses to acknowledge
that youth will be sexually active
Collins
Statistics
• Between 1995 and 2002, the
number of teens aged 15-17 who
had ever engaged in sexual
intercourse declined 10%.
• Approximately 14% of the decline
in teen sexual activity between
1995 and 2002 was due to teens
delaying sex or having sex less
often, while 86% was due to an
increase in contraceptive use.
• By 2002, one-third of teens had
not received any formal
instruction about contraception.
• More than one in five adolescents
(21% of females and 24% of
males) received abstinence
education without receiving
instruction about birth control in
2002
• In 2002, only 62% of sexually
active female teens had received
instruction about contraception
before they first had sex
• More than nine in 10 teachers
believe that students should be
taught about contraception, but
one in four are prohibited from
doing so.
Guttmacher
Support of
Comprehensive Sexual Education
• Evidence shows that comprehensive sex education
programs that provide information about both
abstinence and contraception can help delay the
onset of sexual activity among teens, reduce their
number of sexual partners and increase
contraceptive use when they become sexually active.
These findings were underscored in all to Action to
Promote Sexual Health and Responsible Sexual
Behavior, issued by former Surgeon General David
Satcher in June 2001.
Guttmacher
Programs and Organizations
• Advocates for Youth
– http://www.advocatesforyouth.org/index.php?option=com_content&task=view&id=450
&Itemid=336
• Healthy Teen Network
– http://www.healthyteennetwork.org/vertical/Sites/%7BB4D0CC76-CF784784-BA7C-5D0436F6040C%7D/uploads/%7B4C5F842E-E67A-4AC2-921B287950431BD7%7D.PDF
• AVERT.org
– http://www.avert.org/abstinence.htm
Works Cited
• "AVERT.org Abstience and Sexual Education." July,
2008.http://www.avert.org/abstinence.htm (accessed July 22, 2010).
• "Advocates for Youth - Comprehensive Sexual Education." January,
2008.http://www.advocatesforyouth.org/index.php?option=com_content
&task=view&id=46&Itemid=75 (accessed July 22, 2010).
• Collins, Aligiri, Summers, "Abstinence Only vs. Comprehensive Sexual
Education: What are the facts." March, 2002."Advocates for Youth Comprehensive Sexual Education." January,
2008.http://www.advocatesforyouth.org/index.php?option=com_content
&task=view&id=46&Itemid=75 (accessed July 22, 2010). (accessed July 22,
2010).
• "Facts on Sex Education in the United States." Jan,
2010.hhttp://www.guttmacher.org/pubs/fb_sexEd2006.html (accessed
July 22, 2010).
Conclusion
• AIDS is a very serious virus that effects
millions of people every day
• The best defense against AIDS is to be
educated and protected