XPost: alt.politics.homosexuality, hiv.aids.data, alt.society.liberalism   
   XPost: alt.atheism   
   From: npf@outlook.com   
      
   HIV epidemics are becoming more concentrated in marginalized   
   groups such as sex workers, drug users and gay men, and could   
   defy global attempts to combat AIDS if attitudes do not change,   
   a U.N. expert said.   
      
   Michel Kazatchkine, U.N. Special Envoy for HIV/AIDS in Eastern   
   Europe, says he would like to be able to celebrate without   
   reservation global progress made in the past decade, but   
   stubborn infection rates and alarming growth of outbreaks in   
   hard-to-reach populations make that difficult.   
      
   The risk, he says, is that as the world turns the tide of the   
   global AIDS epidemic, the virus will return to being a disease   
   that plagues only certain groups and the political will to   
   overcome it may fade.   
      
   "If we do not address the roots of the problem, if we do not   
   address stigma, discrimination and inappropriate legislation, if   
   we don't look at these people from a public health perspective,   
   rather than from a delinquent, criminal perspective as we do   
   now, then the trend will only go on," he said in an interview.   
      
   "Then the AIDS epidemic will become more and more a sum of these   
   concentrated epidemics."   
      
   Extraordinary progress   
      
   Some 35.3 million people worldwide are infected with the human   
   immunodeficiency virus (HIV) that causes AIDS, but the rising   
   number of patients reflects great strides in recent years in   
   developing sophisticated HIV tests and combination AIDS drugs   
   and getting them to many of those who need them to stay alive.   
      
   The annual AIDS death toll is falling, dropping to 1.6 million   
   people in 2012, down from a peak of 2.3 million in 2005, and   
   there are also steadily declining rates of new HIV infections: a   
   third fewer in 2013 than in 2011.   
      
   The progress has generated much hope about the possible end of   
   AIDS, or a potential world without HIV, or the chance of an AIDS-   
   free generation, in our lifetimes.   
      
   Kazatchkine, who was due to speak at a City Health Conference in   
   the Scottish city of Glasgow on Monday, refers to both the   
   progress and the hope as "extraordinary".   
      
   "I'm really concerned about the future of the AIDS epidemic,   
   especially at a time when we are perhaps a little too optimistic   
   because of the huge progress we are making from a technological   
   and scientific perspective," he said.   
      
   "As we celebrate the extraordinary progress, we should also be   
   conscious that we will not stop HIV and AIDS by just having more   
   sophisticated drugs and only focusing on the generalized   
   epidemic and not focusing enough on the complexities of the   
   concentrated epidemics."   
      
   The worrisome groups are fairly clearly defined: Injecting drug   
   users, who can pass the AIDS virus to each other by sharing   
   needles and syringes, prostitutes and sex workers, who are often   
   criminalized and have little access to health services, and gay   
   and bisexual men - the population in which the HIV epidemic   
   started.   
      
   A tale of two women   
      
   To illustrate how little has changed in the battle against HIV   
   among drugs users - particularly in regions such as Eastern   
   Europe and central Asia - Kazatchkine tells of two women.   
      
   The first is Andrée, a drug user he met in Paris in 1986 who had   
   no hope of effective HIV treatment, since there was none yet   
   developed, and who ultimately died a lonely death. The second   
   was Larissa from Yekaterinburg in Russia, a drug addict   
   repeatedly arrested and locked up, deprived of medications for   
   years and at one time sentenced to five years in a labor camp.   
      
   "These stories are remarkably similar," he said. "But Larissa's   
   is not from 1986, it's from this year. Some 25 years passed   
   between my meeting these two women, but their predicament was   
   depressingly, tragically, the same."   
      
   Among gay men, Kazatchkine said, the situation is little better.   
   In poor and middle-income countries, men who have sex with men   
   (MSM) and female sex workers are 19 and 13 times more likely to   
   have HIV, respectively, than the rest of the population.   
      
   Even in wealthy regions like western Europe and North America,   
   HIV rates among gay men - or MSM as Kazatchkine refers to them -   
   stubbornly refuse to shift.   
      
   HIV among gay men   
      
   "In MSM populations, there is no sign it has decreased," he   
   said. "It has either been a stable number of new infections   
   every year for 10 years, or it is an increasing trend. And this,   
   in western Europe at least, is in the context of basically free   
   and easy access to therapy and services."   
      
   Elsewhere, in China, for example, gay men alone account for more   
   than 33 percent of new HIV infections, and projections indicate   
   that gay men may account for half or more of all new infections   
   in Asia by 2020.   
      
   Kazatchkine admits that he is as frustrated and worried now,   
   faced with these smaller but relentless HIV epidemics, as he was   
   more than a decade ago when the vast generalized HIV and AIDS   
   outbreak in Africa looked too overwhelming to begin to tackle.   
      
   "We are a bit in disarray. We don't know quite what it is that   
   we should do. Here we are, we have all the technology, we have   
   extraordinary scientific progress, and we just cannot translate   
   that into making a difference in these populations."   
      
   Yet if nothing changes, the AIDS virus may never be beaten.   
      
   Kazatchkine called for a "shift in the collective mindset" to   
   put equity and human rights at the center of the battle against   
   HIV in these groups: "If we do not deliver the right response,   
   we will fail to deliver an end to AIDS," he said.   
      
   http://www.foxnews.com/health/2013/11/04/could-concentrated-hiv-   
   epidemics-make-aids-unbeatable/?intcmp=obnetwork   
      
   --- SoupGate-Win32 v1.05   
    * Origin: you cannot sedate... all the things you hate (1:229/2)