By Syed Akbar
BALI, Aug 13: The Asia Pacific Coalition on Male Sexual Health (APCOM) will
conduct a full-day forum on August 8 on the unique challenges posed by
HIV infection among men who have sex with men (MSM) and transgenders
(TG) in the region.
The interactive consultation is an official pre-conference activity of the 9th International Congress on AIDS in Asia and the Pacific (ICAAP 9) being held in Bali. Authorities from around the world armed with the latest epidemiological data will provide important new insights into the directions the epidemic is taking in the region.
Every 7.5 minutes in Asia Pacific, a man who has sex with men, irrespective of their being homosexual or heterosexual, gets infected with HIV. APCOM, a regional coalition focusing on HIV and MSM of community-based organisations that includes the government sector and the United Nations system, will target its day-long forum squarely on this key affected population.
It will bring together a diverse mix of experts, from developers of national HIV response programmes to scientific researchers to those involved in the UN’s global and regional response to HIV among MSM and TG. They are joined by community leaders from the Asia Pacific region involved in local, national and sub-regional service delivery and community mobilization.
Asia Pacific faces a number of hurdles that make HIV prevention among MSM particularly difficult, including religious and cultural attitudes, legal,
economic and social discrimination, linguistic challenges and varying levels
of awareness. Highly concentrated and severe HIV epidemics among MSM in urban areas across the region are well documented, yet investment in HIV programming for MSM and TG remains limited, ranging from 0% to 4% of the total spending for HIV programming in countries region-wide.
Several major cities across the region are now experiencing HIV epidemics
among men who have sex with men. Recently released data from Myanmar, for example, shows the estimated HIV prevalence rate among MSM in Yangon to be hovering near 30%. In Bangkok, it is 30.7%, Phnom Penh 8.7%, Mumbai 9.6%, and Beijing 5.8%.
Wednesday, 12 August 2009
ICAAP9: Call for stronger commitment to universal access
By Syed Akbar
Bali, Aug 9: The 9th International Congress on AIDS in Asia and the Pacific (ICAAP) opened Sunday with calls for a strengthened commitment to achieving Universal Access and providing prevention, care, support and treatment for those who need it most.
Indonesian First Lady and AIDS Ambassador, Her Excellency Hj. Ani Bambang Yudhoyono, and other AIDS Ambassadors also urged nations to work towards implementing the Declaration of Commitment adopted at the UN General Assembly Special Session on AIDS in 2001 and the Political Declaration of 2006, despite the pressures of the global economic crisis.
More than 3,000 delegates are taking part in ICAAP at the Bali Convention Centre in Indonesia. This year's theme is "Empowering People, Strengthening Networks."
In a message to the Congress, UNAIDS Executive Director Michel Sidibé said some countries in the Asia Pacific were beginning to see success in their efforts to reverse the spread of HIV, but not enough to break the trajectory of the epidemic.
“We must transform the AIDS response in Asia so that it works for people — especially for people who have been marginalized and without a voice," he said.
"This means protecting sex workers, men who have sex with men, transgender, injecting drug users and their intimate partners.”
A meeting of AIDS Ambassadors discussed ways of mobilizing greater action and putting in place stronger accountability measures in responses to the continuing epidemic.
ICAAP is a biennial gathering for the release and discussion of scientific, programmatic and policy developments in the global response to HIV/AIDS and is convened by AIDS Society of Asia and the Pacific (ASAP).
Local Organizing Committee Chair Prof. Dr. Zubairi Djoerban said,
“The 9th ICAAP takes place when this region, like much of the world, is challenged by stability threats and of a new variant of influenza which have claimed lives while leaving many others severely ill the world over.
“For this very reason, let me express my gratitude to all of you who have unaffectedly shown your greatest courage to be here and enhance our commitment to reverse the course of the AIDS epidemic in the region,”
Bali, Aug 9: The 9th International Congress on AIDS in Asia and the Pacific (ICAAP) opened Sunday with calls for a strengthened commitment to achieving Universal Access and providing prevention, care, support and treatment for those who need it most.
Indonesian First Lady and AIDS Ambassador, Her Excellency Hj. Ani Bambang Yudhoyono, and other AIDS Ambassadors also urged nations to work towards implementing the Declaration of Commitment adopted at the UN General Assembly Special Session on AIDS in 2001 and the Political Declaration of 2006, despite the pressures of the global economic crisis.
More than 3,000 delegates are taking part in ICAAP at the Bali Convention Centre in Indonesia. This year's theme is "Empowering People, Strengthening Networks."
In a message to the Congress, UNAIDS Executive Director Michel Sidibé said some countries in the Asia Pacific were beginning to see success in their efforts to reverse the spread of HIV, but not enough to break the trajectory of the epidemic.
“We must transform the AIDS response in Asia so that it works for people — especially for people who have been marginalized and without a voice," he said.
"This means protecting sex workers, men who have sex with men, transgender, injecting drug users and their intimate partners.”
A meeting of AIDS Ambassadors discussed ways of mobilizing greater action and putting in place stronger accountability measures in responses to the continuing epidemic.
ICAAP is a biennial gathering for the release and discussion of scientific, programmatic and policy developments in the global response to HIV/AIDS and is convened by AIDS Society of Asia and the Pacific (ASAP).
Local Organizing Committee Chair Prof. Dr. Zubairi Djoerban said,
“The 9th ICAAP takes place when this region, like much of the world, is challenged by stability threats and of a new variant of influenza which have claimed lives while leaving many others severely ill the world over.
“For this very reason, let me express my gratitude to all of you who have unaffectedly shown your greatest courage to be here and enhance our commitment to reverse the course of the AIDS epidemic in the region,”
UNAIDS guidelines on terms to be used for HIV/AIDS patients
Summary of preferred terminology for use in HIV/AIDS reporting
HIV/AIDS;
HIV and AIDS
Use the term that is most specific and appropriate in the context. Examples include people living with HIV, HIV prevalence, HIV prevention, HIV testing, HIV-related disease; AIDS diagnosis, children made vulnerable by AIDS, children orphaned by AIDS, the AIDS response, national AIDS programme, AIDS service
organization. Both HIV epidemic and AIDS epidemic are acceptable.
There is no “AIDS virus”. The virus associated with AIDS is called the Human Immunodeficiency Virus, or HIV. Please note: “virus” in the phrase “HIV virus” is redundant. Use HIV.
Avoid the term infected. No one can be infected with AIDS, because it is not an infectious agent. AIDS is a surveillance definition meaning a syndrome of opportunistic infections and diseases that can develop as immunosuppression deepens
along the continuum of HIV infection from primary infection to death. Use person living with HIV or HIV-positive person.
There is no test for AIDS. Use HIV or HIV antibody test.
The word “victim” is disempowering. Use person living with HIV. Use the term AIDS only when referring to a person with a clinical AIDS diagnosis.
Use the term patient only when referring to a clinical setting. Use: patient with advanced HIV-related illness (or disease) or AIDS-related illness (or disease).
Use risk of HIV infection; risk of exposure to HIV.
Use key populations at higher risk (both key to the epidemic’s dynamics and key to the response). Key populations are distinct from vulnerable populations, which may be subject to societal pressures or social circumstances which may make them more vulnerable to exposure to infections, including HIV.
Use sex work or commercial sex or the sale of sexual services.
Use only in respect to juvenile prostitution; otherwise use sex worker.
Use injecting drug user. Drugs may be injected subcutaneously, intramuscularly or intravenously.
)
Use using non-sterile injecting equipment if referring to risk of HIV exposure; use using contaminated injecting equipment if the equipment is known to contain HIV or if HIV transmission has occurred.
Use response to AIDS. Use evidence-informed.
Use HIV prevalence. The word “rates” connotes the passage of time and should not be used in most instances.
ions
Please spell out all abbreviations in full.
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Background for commonly used terms and abbreviations
ABC
Prevention strategies: abstain from penetrative sexual intercourse (also used to indicate delay of sexual debut); be faithful (reduce the number of partners or have sexual relations with only one
partner); condomize (use male or female condoms consistently and correctly). ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS) Not…immune deficiency. . .
ADVOCATE
As a verb: write ‘advocate change’ (rather than advocate for change).
AIDS CARRIER
This term is often used to mean any person living with HIV. However, it is stigmatizing and offensive
to many people living with the virus. It is also incorrect, since the agent being carried is HIV not AIDS.
AIDS- or HIV-RELATED ILLNESS OR DISEASE
Although ‘the person died of AIDS’ is commonly said or written, actually people do not die of AIDS, they die of HIV-related or AIDS-related disease. The expression AIDS-related illness can be
used if a person has an AIDS diagnosis.
AIDS RESPONSE
The terms AIDS response, HIV response, response to AIDS and response to HIV are often used interchangeably to mean the response to the epidemic.
AIDS VIRUS
Since AIDS is a syndrome, it is incorrect to refer to the virus as the “AIDS virus”. HIV (the human immunodeficiency virus) is what ultimately causes AIDS (acquired immunodeficiency syndrome).
In referring to the virus, write the full expression at first usage and then use HIV; avoid the term HIV virus (which is a tautology, i.e. it is saying the same thing twice).
ART
Spell out in full, i.e. antiretroviral therapy or antiretroviral treatment. The term ART can be used if it clearly refers to a triple antiretroviral drug combination.
BEHAVIOUR CHANGE (NOT ‘Behavioural Change’)
There are a number of theories and models of human behaviour that guide health promotion and education efforts to encourage behaviour change, i.e. the adoption and maintenance of healthy
behaviours.
CLIENT-INITIATED TESTING
Alternative term for voluntary counselling and testing (VCT). All HIV testing must be carried out under conditions of the “three Cs”: i.e. that it be confidential, accompanied by counselling and
conducted only with informed consent.
CONTAMINATED and NON-STERILE
Drug injecting equipment was “contaminated” if it caused infection, that is, the equipment contained HIV; “unclean”, “dirty” or “non-sterile” if it carried the risk of HIV exposure: that is, it may or may not have carried the virus.
COSPONSORS
The Joint United Nations Programme on HIV/AIDS (UNAIDS) has the following ten cosponsors, listed in the following order (according to UN rules): United Nations High Commissioner for Refugees (UNHCR) http://www.unhcr.org/ United Nations Children’s Fund (UNICEF) http://www.unicef.org/ World Food Programme (WFP) http://www.wfp.org/ United Nations Development Programme (UNDP) http://www.undp.org/ United Nations Population Fund (UNFPA) http://www.unfpa.org/ United Nations Office on Drugs and Crime (UNODC) http://www.unodc.org/odccp/index.html International Labour Organization (ILO) http://www.ilo.org/ United Nations Educational, Scientific and Cultural Organization (UNESCO)
http://www.unesco.org/ World Health Organization (WHO) http://www.who.int/en/ World Bank http://www.worldbank.org/
CRIS
Country Response Information System. Developed by UNAIDS, CRIS provides partners in the global response to HIV with a user-friendly system consisting of an indicator database, a programmatic database, a research inventory database and other important information. The indicator database provides countries with a tool for reporting on national follow-up to the United
Nations General Assembly Special Session on HIV/AIDS (June 2001) Declaration of Commitment on HIV/AIDS. The country-level CRIS will be complemented by a Global Response Information Database (GRID), which will support strategic analysis, knowledge-based policy formulation and subsequent programming. At country and global levels a Research Inventory Database (RID) is also being developed.
CULTURAL DOMINANCE
Familiar terms used in some cultures may not be appropriate in other cultural contexts e.g. seasons of the year—avoid “fall” or “autumn” and prefer instead last quarter of the year or instead of summer prefer mid-year. Similarly remember that different cultures celebrate the New Year at different times and that seasons in the northern and southern hemispheres are opposite to each other.
DESCRIBING AIDS
AIDS is often referred to as a “deadly, incurable disease”, but this creates a lot of fear and only serves to increase stigma and discrimination. It has also been referred to as a “manageable, chronic illness, much like hypertension or diabetes”, but this may lead people to believe that it is not as serious as they thought. It is preferable to use the following description: AIDS, the acquired immunodeficiency syndrome, is a fatal disease caused by HIV, the human immunodeficiency virus. HIV destroys the body’s ability to fight off infection and disease, which can ultimately lead to death.
Currently, antiretroviral drugs slow down replication of the virus and can greatly enhance quality of life, but they do not eliminate HIV infection.
DRIVER
The term relates to the structural and social factors, such as poverty, gender, and human rights abuses that can increase people’s vulnerability to exposure to HIV. It is often reserved to describe underlying determinants.
EPIDEMIC
In epidemiology, an epidemic is a disease that appears as new cases in a given human population (e.g. everyone in a given geographic area; a university, or similar population unit; or everyone of a certain age or sex, such as the children or women of a region) during a given period, at a rate that greatly exceeds what is “expected” based on recent experience. Defining an epidemic is subjective, depending in part on what is “expected”. An epidemic may be restricted to one locale (an outbreak), more general (an epidemic) or global (a pandemic). Common diseases that occur at a constant but relatively high rate in the population are said to be “endemic”. Widely known examples of epidemics include the plague of mediaeval Europe known as the Black Death, the influenza pandemic of 1918–1919, and the current HIV epidemic which is increasingly described as a pandemic (made up of distinct types of epidemics in areas across the globe).
EPIDEMIOLOGY
Epidemiology is the branch of medical science that deals with the study of the incidence, distribution and determinants of patterns of a disease as well as its prevention in a population.
EVIDENCE-INFORMED
This term is preferred to evidence based in recognition of the fact that several elements may play a role in decision making, only one of which may be evidence; others may include cultural appropriateness, cost, feasibility and concerns about equity and so on.
FAITH-BASED ORGANIZATIONS
Faith-based organization is the term preferred instead of e.g. church, synagogue, mosque or religious organization, as it is inclusive (non-judgmental about the validity of any expression of faith) and moves away from historical (and typically European) patterns of thought.
FEMINIZATION
Referring to the pandemic, feminization is now often used by UNAIDS and others to indicate the increasing impact that it has on women. It is often linked to the idea that the number of women
infected has equalled, or surpassed, the figure for men or that women and girls are bearing the brunt of the epidemic in many settings.
FIGHT
Avoid using words such as “fight” and other combatant language e.g. struggle, battle, campaign or war, unless in a direct quotation. Alternatives include: response to; management of; measures against; initiative; action; efforts; and programme. One rationale for this is to avoid a transference being made from the fight against HIV to a fight against people living with HIV.
GAY MEN
Write “men who have sex with men” unless individuals or groups specifically self-identify as
gay. The broader community of men and women and transsexuals should be described as lesbian, gay, bisexual and transgendered—the abbreviation LGBT is often used for such communities, but
UNAIDS’ general preference is to spell out all terms in full.
GENDER and SEX
The term “sex” refers to biologically determined differences, whereas the term “gender” refers to differences in social roles and relations between men and women. Gender roles are learned through socialization and vary widely within and between cultures. Gender roles are also affected by age, class, race, ethnicity and religion, as well as by geographical, economic and political environments. Since many languages do not have the word gender, translators may have to consider other alternatives to distinguish between these concepts.
GLOBAL FUND TO FIGHT AIDS, TUBERCULOSIS AND MALARIA
The Global Fund to Fight AIDS, Tuberculosis and Malaria, established in 2001, is an independent public-private partnership. Its purpose is to attract, manage and disburse additional resources to make a sustainable and significant contribution to mitigate the impact caused by HIV, tuberculosis and malaria in countries in need, while contributing to poverty reduction as part of the Millennium Development Goals. Since 2001, the Global Fund has attracted US$ 4.7 billion in financing through 2008. In September 2007, donors provided initial pledges to the Global Fund worth US$ 9.7 billion over three years. These pledges constitute the largest single financing exercise for health ever and they will allow the Global Fund to move towards annual commitments of US$ 6–8 billion by 2010. http://www.theglobalfund.org/en/
GIPA
An acronym for the “greater involvement of people living with HIV/AIDS”. In 1994, 42 countries prevailed upon the Paris AIDS Summit to include the Greater Involvement of People Living with
HIV/AIDS Principle (GIPA) in its final declaration. http://www.unaids.org/en/Issues/Affected_communities/gipa.asp
UNAIDS does not use the term “high-risk group” because it implies that the risk is contained within the group whereas, in fact, all social groups are interrelated. It may also lull people who don’t identify with such groups into a false sense of security. As well it can increase stigma and discrimination. It is often more accurate to refer directly to “higher risk of HIV exposure”, “sex without a condom”, “unprotected sex”, or “using non-sterile injection equipment” rather than to generalize by saying “highrisk
group”.
Membership of groups does not place individuals at risk, behaviours may. In the case of married and cohabiting people, particularly women, it may be the risk behaviour of the sexual partner that places them in a “situation of risk”. There is a strong link between various kinds of mobility and heightened risk of HIV exposure, depending on the reason for mobility and the extent to which people are removed from their social context and norms. UNAIDS prefers the term “key populations” because it emphasizes that these populations, while being important to the dynamics of HIV transmission in a setting, are equally essential partners for an effective response to the epidemic.
HIGHLY ACTIVE ANTIRETROVIRAL THERAPY (HAART)
This term is now infrequently used in favour of antiretroviral treatment or therapy (ART). It referred to treatment regimens recommended by leading HIV experts to aggressively suppress viral replication and slow the progress of HIV disease. The usual HAART regimen combines three or more different drugs such as two nucleoside reverse transcriptase inhibitors and a protease inhibitor, two nucleoside analogue reverse transcriptase inhibitors and a non-nucleoside reverse transcriptase inhibitor or other combinations. More recently, new drugs have been developed to prevent the virus from entering the cell. These treatment regimens have been shown to reduce the amount of virus so that it becomes undetectable in a patient’s blood.
HIPC INITIATIVE
The Heavily Indebted Poor Countries Initiative is a debt relief tool for increasing the funds that countries have available and for ensuring that they are channelled to core human development
priorities, such as basic health care. The HIPC initiative, created in 1996 by the World Bank and further enhanced in 1999, has already helped some of the poorest nations in the world to free up precious resources for human development that would otherwise have been spent on servicing debt.
Fully funded and implemented, the enhanced HIPC initiative has the potential to be an even more powerful tool to allow countries to devote more resources to combating infectious diseases.
HIV-RELATED DISEASE
Symptoms of HIV infection may occur both at the beginning of HIV infection and after immune compromise sets in, leading to AIDS. During the initial infection with HIV, when the virus comes
into contact with the mucosal surface, it finds susceptible target cells and moves to lymphoid tissue where massive production of the virus ensues. This leads to a burst of high-level viraemia (virus in the bloodstream) with wide dissemination of the virus. Some people may have flu-like symptoms at this stage but these are generally referred to as symptoms of primary infection rather than HIV-related disease. The resulting immune response to suppress the virus is only partially successful and some virus escapes and may remain undetectable, sequestered in reservoirs for months to years.
As crucial immune cells, called CD4+ T cells, are disabled and killed, their numbers progressively
decline. In this manner, HIV-related disease is characterized by a gradual deterioration of immune function. Eventually high viral turnover leads to destruction of the immune system, sometimes
referred to as advanced HIV infection, which leads to the manifestation of AIDS.
HIV-INFECTED
As distinct from HIV-positive (which can sometimes be a false positive test result, especially in infants up to 18 months of age), the term HIV-infected is usually used to indicate that evidence of
HIV has been found via a blood test.
HIV-NEGATIVE
Showing no evidence of infection with HIV (e.g. absence of antibodies against HIV) in a blood or oral fluid test. Synonymous with seronegative. An HIV-negative person can be infected if he or she is in the window period between HIV exposure and detection of antibodies.
HIV-POSITIVE
Showing indications of infection with HIV (e.g. presence of antibodies against HIV) in a blood or oral fluid test. Synonymous with seropositive. Results may occasionally be false positive.
HUMAN IMMUNODEFICIENCY VIRUS (HIV)
The virus that weakens the immune system, ultimately leading to AIDS. Since HIV means “human immunodeficiency virus”, it is redundant to refer to the HIV virus.
HUMAN IMMUNODEFICIENCY VIRUS TYPE 1 (HIV-1)
The retrovirus isolated and recognized as the etiologic (i.e. causing or contributing to the cause of a disease) agent of AIDS. HIV-1 is classified as a lentivirus in a subgroup of retroviruses. Most viruses
and all bacteria, plants and animals have genetic codes made up of DNA, which is transcribed into RNA to build specific proteins. The genetic material of a retrovirus such as HIV is the RNA itself. The viral RNA is reverse transcribed into DNA, which is then inserted into the host cell’s DNA preventing the host cell from carrying out its natural functions and turning it into an HIV factory.
HUMAN IMMUNODEFICIENCY VIRUS TYPE 2 (HIV-2)
A virus closely related to HIV-1 that has also been found to cause AIDS. It was first isolated in West Africa. Although HIV-1 and HIV-2 are similar in their viral structure, modes of transmission
and resulting opportunistic infections, they have differed in their geographical patterns of infection and in their propensity to progress to illness and death. Compared to HIV-1, HIV-2 is found primarily in West Africa and has a slower, less severe clinical course.
INCIDENCE
HIV incidence (sometimes referred to as cumulative incidence) is the number of new cases arising in a given period in a specified population. UNAIDS normally refers to the number of people (of
all ages) or children (0–14 years) who have become infected during the past year. In contrast HIV prevalence refers to the number of infections at a particular point in time (like a camera snapshot). In specific observational studies and prevention trials, the term incidence rate is used to describe incidence per hundred person years of observation.
INJECTING DRUG USERS (IDUs)
This term is preferable to drug addicts or drug abusers, which are seen as derogatory terms and which often result in alienation rather than creating the trust and respect required when dealing with
those who inject drugs. UNAIDS does not use the term “intravenous drug users” because subcutaneous and intramuscular routes may be involved. It is preferable to spell out in full and not use the abbreviation. An acceptable alternate phrasing is people who inject drugs.
INTERVENTION
This term conveys “doing something to someone or something” and as such undermines the concept of participatory responses. Preferred terms include programming, programme, activities, initiatives, etc.
MILLENNIUM DEVELOPMENT GOALS (MDGs)
Eight goals developed at the Millennium Summit in September 2000. Goal 6 refers specifically to AIDS but attainment of several goals is being hampered by the HIV epidemic. http://www.un.org/millenniumgoals/
MONITORING AND EVALUATION REFERENCE GROUP
Established by UNAIDS, the Monitoring and Evaluation (M&E) Reference Group (MERG) has a broad membership of national, bilateral agency and independent evaluation expertise, enabling it to assist in the harmonization of monitoring and evaluation approaches among collaborating organizations
and in the development of effective monitoring and evaluation of the response to the epidemic.
MSM
Abbreviation for “men who have sex with men” or “males who have sex with males”. This term is useful as it includes not only men who self identify as gay or homosexual and have sex only with other men but also bisexual men, and heterosexual men who may, nonetheless at times have sex with other men.
MTCT
Abbreviation for “mother-to-child transmission” (PMTCT is the abbreviation for “prevention of mother-to-child transmission”). Some countries prefer the term “parent-to-child transmission” to
avoid stigmatizing pregnant women and to encourage male involvement in HIV prevention.
OPPORTUNISTIC INFECTIONS
Illnesses caused by various organisms, some of which usually do not cause disease in persons with healthy immune systems. Persons living with advanced HIV infection may have opportunistic
infections of the lungs, brain, eyes and other organs. Opportunistic illnesses common in persons diagnosed with AIDS include Pneumocystis carinii pneumonia, cryptosporidiosis, histoplasmosis, bacterial infections, other parasitic, viral and fungal infections; and some types of cancers. Tuberculosis
is the leading HIV-associated opportunistic infection in developing countries.
ORPHANS
In the context of AIDS, it is preferable to say “children orphaned by AIDS” or “orphans and other children made vulnerable by AIDS”. Referring to these children as “AIDS orphans” not only stigmatizes them, but also labels them as HIV-positive, which they may not necessarily be. Identifying a human being by his/her medical condition alone also shows a lack of respect for the individual.
Contrary to traditional usage UNAIDS uses “orphan” to describe a child who has lost either one or
both parents.
PANDEMIC
A disease that spreads across an entire region, continent or the whole world. Preferred usage is to write “pandemic” when referring to global disease and to use “epidemic” when referring to country or regional level. For simplicity, UNAIDS often uses “epidemic”,
PATHOGEN
An agent causing disease.
PEOPLE LIVING WITH HIV
Avoid the expression “people living with HIV and AIDS” and the abbreviation PLWHA. With reference to those living with HIV, it is preferable to avoid certain terms: AIDS patient should only
be used in a medical context (most of the time, a person with AIDS is not in the role of patient); the term AIDS victim or AIDS sufferer implies that the individual in question is powerless, with
no control over his or her life. It is preferable to use “people living with HIV” (PLHIV), since this reflects the fact that an infected person may continue to live well and productively for many years.
Referring to people living with HIV as innocent victims (which is often used to describe HIV-positive children or people who have acquired HIV medically) wrongly implies that people infected in
other ways are somehow deserving of punishment. It is preferable to use “people living with HIV”, or “children with HIV”.
PREVALENCE
Usually given as a percentage, HIV prevalence quantifies the proportion of individuals in a population who have HIV at a specific point in time. UNAIDS normally reports HIV prevalence among adults, aged 15–49 years. We do not write prevalence rates because a time period of observation is not involved. “Prevalence” is sufficient, e.g. the Caribbean region, with estimated adult HIV prevalence of 2.3% in 2003, is an area to focus on in the future”. HIV prevalence can also refer to the number of people living with HIV as in “by December 2007 an estimated 33.2 million people were living with HIV worldwide.
PROSTITUTION
Use this term in respect to juvenile prostitution only. Otherwise for people of older ages use “commercial sex” “sex work” or “the sale of sexual services”.
PROVIDER-INITIATED TESTING
Under certain circumstances, when an individual is seeking medical care, HIV testing may be offered. It may be diagnostic—as when a patient presents with symptoms that may be attributable to HIV or has an illness associated with HIV such as tuberculosis—or it may be a routine offer to an asymptomatic person. For example, HIV testing may be offered as part of the clinical evaluation of patients with sexually transmitted infections and pregnant women. HIV testing may be offered to all patients where HIV is prevalent. Regardless of the type of testing and the location of the offer,
All HIV testing should always be carried out under conditions respecting the three Cs—confidentiality, informed consent and counselling. Testing without counselling has little impact on behaviour and is a significant lost opportunity for assisting people to avoid acquiring or transmitting infection.
RISK
Avoid using the expressions “groups at risk” or “risk groups”. People with behaviours which may place them at higher risk of exposure to HIV do not necessarily identify themselves with any
particular group. Risk refers to risk of exposure to HIV which may be high as a result of specific behaviours or situations. Examples of the latter include risk in discordant couples unaware of their
serostatus and recipients of unscreened blood or blood products. Behaviours, not memberships, place individuals in situations in which they may be exposed to HIV. Some populations may be at
increased risk of exposure to HIV.
RISK COMPENSATION or RISK ENHANCEMENT
A compensatory increase in behaviours which can result in exposure to HIV brought on by reduced perception of personal risk e.g. uptake of a 50% effective preventive HIV vaccine might tend to encourage abandoning condom use.
SAFER SEX
Use by preference the term safer sex because the term safe sex may imply complete safety. Sex is 100% safe from HIV transmission when both partners know their HIV-negative serostatus and
neither partner is in the window period between HIV exposure and appearance of HIV antibodies detectable by the HIV test. In other circumstances, reduction in the numbers of sexual partners and
correct and consistent use of male or female condoms can reduce the risk of HIV transmission. The term safer sex more accurately reflects the idea that choices can be made and behaviours adopted to reduce or minimize risk.
SEROPREVALENCE
As related to HIV infection, the proportion of persons who have serologic evidence of HIV infection, i.e. antibodies to HIV at any given time.
SEROSTATUS
A generic term that refers to the presence/absence of antibodies in the blood. Often, the term refers to HIV antibody status.
SEXUALLY TRANSMITTED INFECTION (STI)
Also called venereal disease (VD), an older public health term, or sexually transmitted disease (STD), terms that do not convey the concept of being asymptomatic in the same way that the term sexually transmitted infection does. Sexually transmitted infections are spread by the transfer of organisms from person to person during sexual contact. In addition to the “traditional” STIs (syphilis and gonorrhoea), the spectrum of STIs now includes HIV, which causes AIDS; Chlamydia trachomatis; human papilloma virus (HPV) which can cause cervical, penile or anal cancer; genital herpes; chancroid; genital mycoplasmas; hepatitis B; trichomoniasis; enteric infections; and ectoparasitic diseases (i.e.
diseases caused by organisms that live on the outside of the host’s body). The complexity and scope of sexually transmitted infections have increased dramatically since the 1980s; more than 20 diseasecausing organisms and syndromes are now recognized as belonging in this category.
SEX WORK
“Commercial sex work” is considered a tautology, which is saying the same thing twice over in different words. Preferred terms are “sex work”, “commercial sex”, and “the sale of sexual services”.
SEX WORKER
The term “sex worker” is intended to be non-judgmental, focusing on the conditions under which sexual services are sold. Alternate formulations are: “women/men/people who sell sex”. Clients of
sex workers may then also be called “men/women/people who buy sex”. The term “commercial sex worker” is no longer used, primarily because it is considered to be saying something twice over in different words (i.e. a tautology).
SHARING
When referring to injecting equipment UNAIDS does not use the word “sharing” in its publications. Instead, “use of contaminated injecting equipment” is preferred if referring to actual
HIV transmission and “use of non-sterile injecting equipment” if referring to risk of HIV exposure. This is because injecting drug users uncommonly “share” their needles in the usually understood
sense of the word—with the exception of sexual partners who inject together. In the absence of needle exchanges, people may use discarded needles (which are anonymous) or bargain away
drugs for a needle or are injected by professional injectors. They do not regard this as sharing.
Neither does “sharing” distinguish between needle borrowing and needle lending; this is important because (usually) different dynamics are at work. A person aware of his or her HIV-positive status may try to avoid lending, but may continue to borrow or vice versa. Also “sharing” has positive connotations in injecting drug use communities (and wider communities also), e.g. sharing a meal, which are not appropriate in writing about HIV risk.
STIGMA and DISCRIMINATION
As the traditional meaning of stigma is a mark or sign of disgrace or discredit, the correct term would be stigmatization and discrimination; however, “stigma and discrimination” has been accepted in everyday speech and writing, and may be treated as plural.
SURVEILLANCE
Continual analysis, interpretation and feedback of systematically collected data, generally using methods distinguished by their practicality, uniformity, and rapidity rather than by accuracy or
completeness.
VERTICAL TRANSMISSION
Sometimes used to indicate transmission of a pathogen such as HIV from mother to fetus or baby during pregnancy or birth but may be used to refer to the genetic transmission of traits. UNAIDS
primarily uses the term mother-to-child transmission.
HIV/AIDS;
HIV and AIDS
Use the term that is most specific and appropriate in the context. Examples include people living with HIV, HIV prevalence, HIV prevention, HIV testing, HIV-related disease; AIDS diagnosis, children made vulnerable by AIDS, children orphaned by AIDS, the AIDS response, national AIDS programme, AIDS service
organization. Both HIV epidemic and AIDS epidemic are acceptable.
There is no “AIDS virus”. The virus associated with AIDS is called the Human Immunodeficiency Virus, or HIV. Please note: “virus” in the phrase “HIV virus” is redundant. Use HIV.
Avoid the term infected. No one can be infected with AIDS, because it is not an infectious agent. AIDS is a surveillance definition meaning a syndrome of opportunistic infections and diseases that can develop as immunosuppression deepens
along the continuum of HIV infection from primary infection to death. Use person living with HIV or HIV-positive person.
There is no test for AIDS. Use HIV or HIV antibody test.
The word “victim” is disempowering. Use person living with HIV. Use the term AIDS only when referring to a person with a clinical AIDS diagnosis.
Use the term patient only when referring to a clinical setting. Use: patient with advanced HIV-related illness (or disease) or AIDS-related illness (or disease).
Use risk of HIV infection; risk of exposure to HIV.
Use key populations at higher risk (both key to the epidemic’s dynamics and key to the response). Key populations are distinct from vulnerable populations, which may be subject to societal pressures or social circumstances which may make them more vulnerable to exposure to infections, including HIV.
Use sex work or commercial sex or the sale of sexual services.
Use only in respect to juvenile prostitution; otherwise use sex worker.
Use injecting drug user. Drugs may be injected subcutaneously, intramuscularly or intravenously.
)
Use using non-sterile injecting equipment if referring to risk of HIV exposure; use using contaminated injecting equipment if the equipment is known to contain HIV or if HIV transmission has occurred.
Use response to AIDS. Use evidence-informed.
Use HIV prevalence. The word “rates” connotes the passage of time and should not be used in most instances.
ions
Please spell out all abbreviations in full.
----------
Background for commonly used terms and abbreviations
ABC
Prevention strategies: abstain from penetrative sexual intercourse (also used to indicate delay of sexual debut); be faithful (reduce the number of partners or have sexual relations with only one
partner); condomize (use male or female condoms consistently and correctly). ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS) Not…immune deficiency. . .
ADVOCATE
As a verb: write ‘advocate change’ (rather than advocate for change).
AIDS CARRIER
This term is often used to mean any person living with HIV. However, it is stigmatizing and offensive
to many people living with the virus. It is also incorrect, since the agent being carried is HIV not AIDS.
AIDS- or HIV-RELATED ILLNESS OR DISEASE
Although ‘the person died of AIDS’ is commonly said or written, actually people do not die of AIDS, they die of HIV-related or AIDS-related disease. The expression AIDS-related illness can be
used if a person has an AIDS diagnosis.
AIDS RESPONSE
The terms AIDS response, HIV response, response to AIDS and response to HIV are often used interchangeably to mean the response to the epidemic.
AIDS VIRUS
Since AIDS is a syndrome, it is incorrect to refer to the virus as the “AIDS virus”. HIV (the human immunodeficiency virus) is what ultimately causes AIDS (acquired immunodeficiency syndrome).
In referring to the virus, write the full expression at first usage and then use HIV; avoid the term HIV virus (which is a tautology, i.e. it is saying the same thing twice).
ART
Spell out in full, i.e. antiretroviral therapy or antiretroviral treatment. The term ART can be used if it clearly refers to a triple antiretroviral drug combination.
BEHAVIOUR CHANGE (NOT ‘Behavioural Change’)
There are a number of theories and models of human behaviour that guide health promotion and education efforts to encourage behaviour change, i.e. the adoption and maintenance of healthy
behaviours.
CLIENT-INITIATED TESTING
Alternative term for voluntary counselling and testing (VCT). All HIV testing must be carried out under conditions of the “three Cs”: i.e. that it be confidential, accompanied by counselling and
conducted only with informed consent.
CONTAMINATED and NON-STERILE
Drug injecting equipment was “contaminated” if it caused infection, that is, the equipment contained HIV; “unclean”, “dirty” or “non-sterile” if it carried the risk of HIV exposure: that is, it may or may not have carried the virus.
COSPONSORS
The Joint United Nations Programme on HIV/AIDS (UNAIDS) has the following ten cosponsors, listed in the following order (according to UN rules): United Nations High Commissioner for Refugees (UNHCR) http://www.unhcr.org/ United Nations Children’s Fund (UNICEF) http://www.unicef.org/ World Food Programme (WFP) http://www.wfp.org/ United Nations Development Programme (UNDP) http://www.undp.org/ United Nations Population Fund (UNFPA) http://www.unfpa.org/ United Nations Office on Drugs and Crime (UNODC) http://www.unodc.org/odccp/index.html International Labour Organization (ILO) http://www.ilo.org/ United Nations Educational, Scientific and Cultural Organization (UNESCO)
http://www.unesco.org/ World Health Organization (WHO) http://www.who.int/en/ World Bank http://www.worldbank.org/
CRIS
Country Response Information System. Developed by UNAIDS, CRIS provides partners in the global response to HIV with a user-friendly system consisting of an indicator database, a programmatic database, a research inventory database and other important information. The indicator database provides countries with a tool for reporting on national follow-up to the United
Nations General Assembly Special Session on HIV/AIDS (June 2001) Declaration of Commitment on HIV/AIDS. The country-level CRIS will be complemented by a Global Response Information Database (GRID), which will support strategic analysis, knowledge-based policy formulation and subsequent programming. At country and global levels a Research Inventory Database (RID) is also being developed.
CULTURAL DOMINANCE
Familiar terms used in some cultures may not be appropriate in other cultural contexts e.g. seasons of the year—avoid “fall” or “autumn” and prefer instead last quarter of the year or instead of summer prefer mid-year. Similarly remember that different cultures celebrate the New Year at different times and that seasons in the northern and southern hemispheres are opposite to each other.
DESCRIBING AIDS
AIDS is often referred to as a “deadly, incurable disease”, but this creates a lot of fear and only serves to increase stigma and discrimination. It has also been referred to as a “manageable, chronic illness, much like hypertension or diabetes”, but this may lead people to believe that it is not as serious as they thought. It is preferable to use the following description: AIDS, the acquired immunodeficiency syndrome, is a fatal disease caused by HIV, the human immunodeficiency virus. HIV destroys the body’s ability to fight off infection and disease, which can ultimately lead to death.
Currently, antiretroviral drugs slow down replication of the virus and can greatly enhance quality of life, but they do not eliminate HIV infection.
DRIVER
The term relates to the structural and social factors, such as poverty, gender, and human rights abuses that can increase people’s vulnerability to exposure to HIV. It is often reserved to describe underlying determinants.
EPIDEMIC
In epidemiology, an epidemic is a disease that appears as new cases in a given human population (e.g. everyone in a given geographic area; a university, or similar population unit; or everyone of a certain age or sex, such as the children or women of a region) during a given period, at a rate that greatly exceeds what is “expected” based on recent experience. Defining an epidemic is subjective, depending in part on what is “expected”. An epidemic may be restricted to one locale (an outbreak), more general (an epidemic) or global (a pandemic). Common diseases that occur at a constant but relatively high rate in the population are said to be “endemic”. Widely known examples of epidemics include the plague of mediaeval Europe known as the Black Death, the influenza pandemic of 1918–1919, and the current HIV epidemic which is increasingly described as a pandemic (made up of distinct types of epidemics in areas across the globe).
EPIDEMIOLOGY
Epidemiology is the branch of medical science that deals with the study of the incidence, distribution and determinants of patterns of a disease as well as its prevention in a population.
EVIDENCE-INFORMED
This term is preferred to evidence based in recognition of the fact that several elements may play a role in decision making, only one of which may be evidence; others may include cultural appropriateness, cost, feasibility and concerns about equity and so on.
FAITH-BASED ORGANIZATIONS
Faith-based organization is the term preferred instead of e.g. church, synagogue, mosque or religious organization, as it is inclusive (non-judgmental about the validity of any expression of faith) and moves away from historical (and typically European) patterns of thought.
FEMINIZATION
Referring to the pandemic, feminization is now often used by UNAIDS and others to indicate the increasing impact that it has on women. It is often linked to the idea that the number of women
infected has equalled, or surpassed, the figure for men or that women and girls are bearing the brunt of the epidemic in many settings.
FIGHT
Avoid using words such as “fight” and other combatant language e.g. struggle, battle, campaign or war, unless in a direct quotation. Alternatives include: response to; management of; measures against; initiative; action; efforts; and programme. One rationale for this is to avoid a transference being made from the fight against HIV to a fight against people living with HIV.
GAY MEN
Write “men who have sex with men” unless individuals or groups specifically self-identify as
gay. The broader community of men and women and transsexuals should be described as lesbian, gay, bisexual and transgendered—the abbreviation LGBT is often used for such communities, but
UNAIDS’ general preference is to spell out all terms in full.
GENDER and SEX
The term “sex” refers to biologically determined differences, whereas the term “gender” refers to differences in social roles and relations between men and women. Gender roles are learned through socialization and vary widely within and between cultures. Gender roles are also affected by age, class, race, ethnicity and religion, as well as by geographical, economic and political environments. Since many languages do not have the word gender, translators may have to consider other alternatives to distinguish between these concepts.
GLOBAL FUND TO FIGHT AIDS, TUBERCULOSIS AND MALARIA
The Global Fund to Fight AIDS, Tuberculosis and Malaria, established in 2001, is an independent public-private partnership. Its purpose is to attract, manage and disburse additional resources to make a sustainable and significant contribution to mitigate the impact caused by HIV, tuberculosis and malaria in countries in need, while contributing to poverty reduction as part of the Millennium Development Goals. Since 2001, the Global Fund has attracted US$ 4.7 billion in financing through 2008. In September 2007, donors provided initial pledges to the Global Fund worth US$ 9.7 billion over three years. These pledges constitute the largest single financing exercise for health ever and they will allow the Global Fund to move towards annual commitments of US$ 6–8 billion by 2010. http://www.theglobalfund.org/en/
GIPA
An acronym for the “greater involvement of people living with HIV/AIDS”. In 1994, 42 countries prevailed upon the Paris AIDS Summit to include the Greater Involvement of People Living with
HIV/AIDS Principle (GIPA) in its final declaration. http://www.unaids.org/en/Issues/Affected_communities/gipa.asp
UNAIDS does not use the term “high-risk group” because it implies that the risk is contained within the group whereas, in fact, all social groups are interrelated. It may also lull people who don’t identify with such groups into a false sense of security. As well it can increase stigma and discrimination. It is often more accurate to refer directly to “higher risk of HIV exposure”, “sex without a condom”, “unprotected sex”, or “using non-sterile injection equipment” rather than to generalize by saying “highrisk
group”.
Membership of groups does not place individuals at risk, behaviours may. In the case of married and cohabiting people, particularly women, it may be the risk behaviour of the sexual partner that places them in a “situation of risk”. There is a strong link between various kinds of mobility and heightened risk of HIV exposure, depending on the reason for mobility and the extent to which people are removed from their social context and norms. UNAIDS prefers the term “key populations” because it emphasizes that these populations, while being important to the dynamics of HIV transmission in a setting, are equally essential partners for an effective response to the epidemic.
HIGHLY ACTIVE ANTIRETROVIRAL THERAPY (HAART)
This term is now infrequently used in favour of antiretroviral treatment or therapy (ART). It referred to treatment regimens recommended by leading HIV experts to aggressively suppress viral replication and slow the progress of HIV disease. The usual HAART regimen combines three or more different drugs such as two nucleoside reverse transcriptase inhibitors and a protease inhibitor, two nucleoside analogue reverse transcriptase inhibitors and a non-nucleoside reverse transcriptase inhibitor or other combinations. More recently, new drugs have been developed to prevent the virus from entering the cell. These treatment regimens have been shown to reduce the amount of virus so that it becomes undetectable in a patient’s blood.
HIPC INITIATIVE
The Heavily Indebted Poor Countries Initiative is a debt relief tool for increasing the funds that countries have available and for ensuring that they are channelled to core human development
priorities, such as basic health care. The HIPC initiative, created in 1996 by the World Bank and further enhanced in 1999, has already helped some of the poorest nations in the world to free up precious resources for human development that would otherwise have been spent on servicing debt.
Fully funded and implemented, the enhanced HIPC initiative has the potential to be an even more powerful tool to allow countries to devote more resources to combating infectious diseases.
HIV-RELATED DISEASE
Symptoms of HIV infection may occur both at the beginning of HIV infection and after immune compromise sets in, leading to AIDS. During the initial infection with HIV, when the virus comes
into contact with the mucosal surface, it finds susceptible target cells and moves to lymphoid tissue where massive production of the virus ensues. This leads to a burst of high-level viraemia (virus in the bloodstream) with wide dissemination of the virus. Some people may have flu-like symptoms at this stage but these are generally referred to as symptoms of primary infection rather than HIV-related disease. The resulting immune response to suppress the virus is only partially successful and some virus escapes and may remain undetectable, sequestered in reservoirs for months to years.
As crucial immune cells, called CD4+ T cells, are disabled and killed, their numbers progressively
decline. In this manner, HIV-related disease is characterized by a gradual deterioration of immune function. Eventually high viral turnover leads to destruction of the immune system, sometimes
referred to as advanced HIV infection, which leads to the manifestation of AIDS.
HIV-INFECTED
As distinct from HIV-positive (which can sometimes be a false positive test result, especially in infants up to 18 months of age), the term HIV-infected is usually used to indicate that evidence of
HIV has been found via a blood test.
HIV-NEGATIVE
Showing no evidence of infection with HIV (e.g. absence of antibodies against HIV) in a blood or oral fluid test. Synonymous with seronegative. An HIV-negative person can be infected if he or she is in the window period between HIV exposure and detection of antibodies.
HIV-POSITIVE
Showing indications of infection with HIV (e.g. presence of antibodies against HIV) in a blood or oral fluid test. Synonymous with seropositive. Results may occasionally be false positive.
HUMAN IMMUNODEFICIENCY VIRUS (HIV)
The virus that weakens the immune system, ultimately leading to AIDS. Since HIV means “human immunodeficiency virus”, it is redundant to refer to the HIV virus.
HUMAN IMMUNODEFICIENCY VIRUS TYPE 1 (HIV-1)
The retrovirus isolated and recognized as the etiologic (i.e. causing or contributing to the cause of a disease) agent of AIDS. HIV-1 is classified as a lentivirus in a subgroup of retroviruses. Most viruses
and all bacteria, plants and animals have genetic codes made up of DNA, which is transcribed into RNA to build specific proteins. The genetic material of a retrovirus such as HIV is the RNA itself. The viral RNA is reverse transcribed into DNA, which is then inserted into the host cell’s DNA preventing the host cell from carrying out its natural functions and turning it into an HIV factory.
HUMAN IMMUNODEFICIENCY VIRUS TYPE 2 (HIV-2)
A virus closely related to HIV-1 that has also been found to cause AIDS. It was first isolated in West Africa. Although HIV-1 and HIV-2 are similar in their viral structure, modes of transmission
and resulting opportunistic infections, they have differed in their geographical patterns of infection and in their propensity to progress to illness and death. Compared to HIV-1, HIV-2 is found primarily in West Africa and has a slower, less severe clinical course.
INCIDENCE
HIV incidence (sometimes referred to as cumulative incidence) is the number of new cases arising in a given period in a specified population. UNAIDS normally refers to the number of people (of
all ages) or children (0–14 years) who have become infected during the past year. In contrast HIV prevalence refers to the number of infections at a particular point in time (like a camera snapshot). In specific observational studies and prevention trials, the term incidence rate is used to describe incidence per hundred person years of observation.
INJECTING DRUG USERS (IDUs)
This term is preferable to drug addicts or drug abusers, which are seen as derogatory terms and which often result in alienation rather than creating the trust and respect required when dealing with
those who inject drugs. UNAIDS does not use the term “intravenous drug users” because subcutaneous and intramuscular routes may be involved. It is preferable to spell out in full and not use the abbreviation. An acceptable alternate phrasing is people who inject drugs.
INTERVENTION
This term conveys “doing something to someone or something” and as such undermines the concept of participatory responses. Preferred terms include programming, programme, activities, initiatives, etc.
MILLENNIUM DEVELOPMENT GOALS (MDGs)
Eight goals developed at the Millennium Summit in September 2000. Goal 6 refers specifically to AIDS but attainment of several goals is being hampered by the HIV epidemic. http://www.un.org/millenniumgoals/
MONITORING AND EVALUATION REFERENCE GROUP
Established by UNAIDS, the Monitoring and Evaluation (M&E) Reference Group (MERG) has a broad membership of national, bilateral agency and independent evaluation expertise, enabling it to assist in the harmonization of monitoring and evaluation approaches among collaborating organizations
and in the development of effective monitoring and evaluation of the response to the epidemic.
MSM
Abbreviation for “men who have sex with men” or “males who have sex with males”. This term is useful as it includes not only men who self identify as gay or homosexual and have sex only with other men but also bisexual men, and heterosexual men who may, nonetheless at times have sex with other men.
MTCT
Abbreviation for “mother-to-child transmission” (PMTCT is the abbreviation for “prevention of mother-to-child transmission”). Some countries prefer the term “parent-to-child transmission” to
avoid stigmatizing pregnant women and to encourage male involvement in HIV prevention.
OPPORTUNISTIC INFECTIONS
Illnesses caused by various organisms, some of which usually do not cause disease in persons with healthy immune systems. Persons living with advanced HIV infection may have opportunistic
infections of the lungs, brain, eyes and other organs. Opportunistic illnesses common in persons diagnosed with AIDS include Pneumocystis carinii pneumonia, cryptosporidiosis, histoplasmosis, bacterial infections, other parasitic, viral and fungal infections; and some types of cancers. Tuberculosis
is the leading HIV-associated opportunistic infection in developing countries.
ORPHANS
In the context of AIDS, it is preferable to say “children orphaned by AIDS” or “orphans and other children made vulnerable by AIDS”. Referring to these children as “AIDS orphans” not only stigmatizes them, but also labels them as HIV-positive, which they may not necessarily be. Identifying a human being by his/her medical condition alone also shows a lack of respect for the individual.
Contrary to traditional usage UNAIDS uses “orphan” to describe a child who has lost either one or
both parents.
PANDEMIC
A disease that spreads across an entire region, continent or the whole world. Preferred usage is to write “pandemic” when referring to global disease and to use “epidemic” when referring to country or regional level. For simplicity, UNAIDS often uses “epidemic”,
PATHOGEN
An agent causing disease.
PEOPLE LIVING WITH HIV
Avoid the expression “people living with HIV and AIDS” and the abbreviation PLWHA. With reference to those living with HIV, it is preferable to avoid certain terms: AIDS patient should only
be used in a medical context (most of the time, a person with AIDS is not in the role of patient); the term AIDS victim or AIDS sufferer implies that the individual in question is powerless, with
no control over his or her life. It is preferable to use “people living with HIV” (PLHIV), since this reflects the fact that an infected person may continue to live well and productively for many years.
Referring to people living with HIV as innocent victims (which is often used to describe HIV-positive children or people who have acquired HIV medically) wrongly implies that people infected in
other ways are somehow deserving of punishment. It is preferable to use “people living with HIV”, or “children with HIV”.
PREVALENCE
Usually given as a percentage, HIV prevalence quantifies the proportion of individuals in a population who have HIV at a specific point in time. UNAIDS normally reports HIV prevalence among adults, aged 15–49 years. We do not write prevalence rates because a time period of observation is not involved. “Prevalence” is sufficient, e.g. the Caribbean region, with estimated adult HIV prevalence of 2.3% in 2003, is an area to focus on in the future”. HIV prevalence can also refer to the number of people living with HIV as in “by December 2007 an estimated 33.2 million people were living with HIV worldwide.
PROSTITUTION
Use this term in respect to juvenile prostitution only. Otherwise for people of older ages use “commercial sex” “sex work” or “the sale of sexual services”.
PROVIDER-INITIATED TESTING
Under certain circumstances, when an individual is seeking medical care, HIV testing may be offered. It may be diagnostic—as when a patient presents with symptoms that may be attributable to HIV or has an illness associated with HIV such as tuberculosis—or it may be a routine offer to an asymptomatic person. For example, HIV testing may be offered as part of the clinical evaluation of patients with sexually transmitted infections and pregnant women. HIV testing may be offered to all patients where HIV is prevalent. Regardless of the type of testing and the location of the offer,
All HIV testing should always be carried out under conditions respecting the three Cs—confidentiality, informed consent and counselling. Testing without counselling has little impact on behaviour and is a significant lost opportunity for assisting people to avoid acquiring or transmitting infection.
RISK
Avoid using the expressions “groups at risk” or “risk groups”. People with behaviours which may place them at higher risk of exposure to HIV do not necessarily identify themselves with any
particular group. Risk refers to risk of exposure to HIV which may be high as a result of specific behaviours or situations. Examples of the latter include risk in discordant couples unaware of their
serostatus and recipients of unscreened blood or blood products. Behaviours, not memberships, place individuals in situations in which they may be exposed to HIV. Some populations may be at
increased risk of exposure to HIV.
RISK COMPENSATION or RISK ENHANCEMENT
A compensatory increase in behaviours which can result in exposure to HIV brought on by reduced perception of personal risk e.g. uptake of a 50% effective preventive HIV vaccine might tend to encourage abandoning condom use.
SAFER SEX
Use by preference the term safer sex because the term safe sex may imply complete safety. Sex is 100% safe from HIV transmission when both partners know their HIV-negative serostatus and
neither partner is in the window period between HIV exposure and appearance of HIV antibodies detectable by the HIV test. In other circumstances, reduction in the numbers of sexual partners and
correct and consistent use of male or female condoms can reduce the risk of HIV transmission. The term safer sex more accurately reflects the idea that choices can be made and behaviours adopted to reduce or minimize risk.
SEROPREVALENCE
As related to HIV infection, the proportion of persons who have serologic evidence of HIV infection, i.e. antibodies to HIV at any given time.
SEROSTATUS
A generic term that refers to the presence/absence of antibodies in the blood. Often, the term refers to HIV antibody status.
SEXUALLY TRANSMITTED INFECTION (STI)
Also called venereal disease (VD), an older public health term, or sexually transmitted disease (STD), terms that do not convey the concept of being asymptomatic in the same way that the term sexually transmitted infection does. Sexually transmitted infections are spread by the transfer of organisms from person to person during sexual contact. In addition to the “traditional” STIs (syphilis and gonorrhoea), the spectrum of STIs now includes HIV, which causes AIDS; Chlamydia trachomatis; human papilloma virus (HPV) which can cause cervical, penile or anal cancer; genital herpes; chancroid; genital mycoplasmas; hepatitis B; trichomoniasis; enteric infections; and ectoparasitic diseases (i.e.
diseases caused by organisms that live on the outside of the host’s body). The complexity and scope of sexually transmitted infections have increased dramatically since the 1980s; more than 20 diseasecausing organisms and syndromes are now recognized as belonging in this category.
SEX WORK
“Commercial sex work” is considered a tautology, which is saying the same thing twice over in different words. Preferred terms are “sex work”, “commercial sex”, and “the sale of sexual services”.
SEX WORKER
The term “sex worker” is intended to be non-judgmental, focusing on the conditions under which sexual services are sold. Alternate formulations are: “women/men/people who sell sex”. Clients of
sex workers may then also be called “men/women/people who buy sex”. The term “commercial sex worker” is no longer used, primarily because it is considered to be saying something twice over in different words (i.e. a tautology).
SHARING
When referring to injecting equipment UNAIDS does not use the word “sharing” in its publications. Instead, “use of contaminated injecting equipment” is preferred if referring to actual
HIV transmission and “use of non-sterile injecting equipment” if referring to risk of HIV exposure. This is because injecting drug users uncommonly “share” their needles in the usually understood
sense of the word—with the exception of sexual partners who inject together. In the absence of needle exchanges, people may use discarded needles (which are anonymous) or bargain away
drugs for a needle or are injected by professional injectors. They do not regard this as sharing.
Neither does “sharing” distinguish between needle borrowing and needle lending; this is important because (usually) different dynamics are at work. A person aware of his or her HIV-positive status may try to avoid lending, but may continue to borrow or vice versa. Also “sharing” has positive connotations in injecting drug use communities (and wider communities also), e.g. sharing a meal, which are not appropriate in writing about HIV risk.
STIGMA and DISCRIMINATION
As the traditional meaning of stigma is a mark or sign of disgrace or discredit, the correct term would be stigmatization and discrimination; however, “stigma and discrimination” has been accepted in everyday speech and writing, and may be treated as plural.
SURVEILLANCE
Continual analysis, interpretation and feedback of systematically collected data, generally using methods distinguished by their practicality, uniformity, and rapidity rather than by accuracy or
completeness.
VERTICAL TRANSMISSION
Sometimes used to indicate transmission of a pathogen such as HIV from mother to fetus or baby during pregnancy or birth but may be used to refer to the genetic transmission of traits. UNAIDS
primarily uses the term mother-to-child transmission.
ICAAP9: “Journalists can save more lives than doctors”
“Journalists can save more lives
than doctors”
Dr. Peter Piot
The Former Executive Director of UNAIDS
=================
Challenges facing by media
• Editors don’t prioritize HIV and AIDS stories, media need to find new angles on coverage to make it newsworthy
• Need for separate media strategies to reach different audiences (policy makers, PLHIV, youth)
* youth are currently underserved by current media outreach
* not enough new media is directed towards AIDS awareness, prevention and reduction of stigma and discrimination
• Not only report program, but also analyze the legal and policy issues
• Information needs to be more widely available in local languages
---------
Challenges faced by media
Standardized terms for discussing the issues that are non-discriminatory, nonambiguous and accessible
• Raising standards of ethics among journalists for covering PLHIV is necessary
• Coverage still tends to be sensational
• Coverage is still concentrated around World AIDS UNAIDS Day
--------
Possible roles for media
• Give a voice to affected communities
• Humanize affected and infected persons – portray consequences of stigma and discrimination, and reduce distance
• Focus on legal issues which are impediments
• Address fears and misconceptions through accurate information
• Discuss taboo topics
• Inspire partnerships
• Keep the AIDS issues alive – AIDS is not going to go away so soon
-------
Achievements by media
Coverage:
HIV kept visible and high in people’s minds
HIV kept on national and International agendas
Partnership:
• Multi-sectoral cooperation between government, media, NGOs, CSOs, and the
private sector for raising awareness,
* regional and sub-regional networks and alliances are empowering and effective
Involvement of PLHIV in media outreach for reducing
stigma
• Humanizing PLHIV through profiles and articles that focus on their personal stories and portrays them as productive and active members of society
* readers respond to stories that tug at the heartstrings
* coverage that gives voice to PLHIV decreases stigma
• Involvement of celebrities helps reduce stigma
than doctors”
Dr. Peter Piot
The Former Executive Director of UNAIDS
=================
Challenges facing by media
• Editors don’t prioritize HIV and AIDS stories, media need to find new angles on coverage to make it newsworthy
• Need for separate media strategies to reach different audiences (policy makers, PLHIV, youth)
* youth are currently underserved by current media outreach
* not enough new media is directed towards AIDS awareness, prevention and reduction of stigma and discrimination
• Not only report program, but also analyze the legal and policy issues
• Information needs to be more widely available in local languages
---------
Challenges faced by media
Standardized terms for discussing the issues that are non-discriminatory, nonambiguous and accessible
• Raising standards of ethics among journalists for covering PLHIV is necessary
• Coverage still tends to be sensational
• Coverage is still concentrated around World AIDS UNAIDS Day
--------
Possible roles for media
• Give a voice to affected communities
• Humanize affected and infected persons – portray consequences of stigma and discrimination, and reduce distance
• Focus on legal issues which are impediments
• Address fears and misconceptions through accurate information
• Discuss taboo topics
• Inspire partnerships
• Keep the AIDS issues alive – AIDS is not going to go away so soon
-------
Achievements by media
Coverage:
HIV kept visible and high in people’s minds
HIV kept on national and International agendas
Partnership:
• Multi-sectoral cooperation between government, media, NGOs, CSOs, and the
private sector for raising awareness,
* regional and sub-regional networks and alliances are empowering and effective
Involvement of PLHIV in media outreach for reducing
stigma
• Humanizing PLHIV through profiles and articles that focus on their personal stories and portrays them as productive and active members of society
* readers respond to stories that tug at the heartstrings
* coverage that gives voice to PLHIV decreases stigma
• Involvement of celebrities helps reduce stigma
Tuesday, 11 August 2009
Nuclear reactor in Kadapa district: 25 year dream come true for AP
Syed Akbar
Hyderabad, Aug 10: Andhra Pradesh is all set to enter the nuclear power map
of India by producing "clean energy", making powercuts a thing of the past.
And in the process it will fight climate change and global warming. Two sites
have been identified for nuclear reactors in the State and the Nuclear Power
Corporation of India has already cleared one of the sites.
The State has already emerged as the nuclear fuel hub of the country with
vast thorium and fairly large uranium reserves and the proposed nuclear
power reactors in Kadapa district and Srikakulam districts will further boost
its "nuclear" image. The State has heavy water plant at Manuguru and
Nuclear Fuel Complex and Atomic Minerals Directorate in Hyderabad. The
Kadapa plant is expected to generate 2000 mw of clean energy without
causing air pollution.
The Atomic Energy Commission had long ago drawn up ambitious plans to
commission nuclear reactors in the State. The Nuclear Power Corporation of
India had cleared the proposal for a nuclear reactor at Kovvada in Srikakulam
district five years ago. But things did not move an inch because of political
considerations.
With Chief Minister YS Rajasekhar Reddy renewing interest in nuclear
power plant at his native Pulivendula village, the NPCIL and APGenco have
started a rework on the project. The NPCIL is now expected to give its
clearance for the plant near Pulivendula in Kadapa district. "It takes at least
six months for us to give the necessary recommendations for the project
based on a number of factors including availability of water and seismic
conditions," says S Thakur, former NPCIL director.
A nuclear power plant is finally getting shape in the State, 25 years after a
silmilar plant was proposed near Nagarjunasagar. The Central government
had to back out amidst stiff opposition from politicians and environment
activists. The Kovvada project too has been hanging in balance for at least a
decade.
That the Kadapa reactor is going to become a reality can be assessed from the
fact that there has been no opposition to the power plant this time. While
environmentalists mobilised national support to oppose Nagarjunasagar
nuclear power plant two decades ago, this time there's only a murmur here
and there. Neither the Central nor the State governments has taken any
decision on the proposed plant at Kovvada so far.
A group of politicians, however, has opposed the Kadapa plant not because
of environmental reasons, but because of political considerations. The
proposed plant will draw water from the Somasila project and those opposed
to the Chief Minister, Dr YS Rajasekhar Reddy, do not want the nuclear plant
located in his native district to thrive on Krishna waters.
"The uranium mine and the mill, which are under construction at
Tummalapalle in Kadapa district will go on stream in 2013," says Atomic
Energy Commission chairman Dr Anil Kakodkar. Once the project is ready it
will supply uranium to various plants in the country.
The Nuclear Power Corporation of India has already inspected the proposed
site at Pulivendula and if things go as planned, the reactor will be ready in the
next five years. Chief Minister YS Rajasekhar Reddy has already instructed
GENCO to take up the project along with NPCIL.
The Sate government is ready to bear 50 per cent of the total cost of the
nuclear reactor near Pulivendula. The plant will add 2000 megawatt of power
to the national grid.
Somalsila Protection Committee leader Jakka Venkaiah said the proposed
nuclear plant will turn Nellore district dry. "The government should not go in
for political considerations. Already the Somasila reservoir is tapped to its
full capacity by supplying drinking water to Chennai through Telugu Ganga.
Any deviation of water will have a severe impact on the ecology of Nellore
district," he said.
The Central government wants to generate 20,000 mw of nuclear energy by
2020 and AP is all set to contribute 10 per cent of it. Andhra Pradesh has a
stalled capacity of 8000 mw of power generation by all means. "Though new
projects are going to be added next year, there's nothing like nuclear energy,
which is pollution-free and clean. Moreover, a small quantity of nuclear fuel
is required to generate large quantities of nuclear power. Electricity will
become cheaper and affordable if we generate nuclear power," said
environment scientist ChV Subbaiah.
Hyderabad, Aug 10: Andhra Pradesh is all set to enter the nuclear power map
of India by producing "clean energy", making powercuts a thing of the past.
And in the process it will fight climate change and global warming. Two sites
have been identified for nuclear reactors in the State and the Nuclear Power
Corporation of India has already cleared one of the sites.
The State has already emerged as the nuclear fuel hub of the country with
vast thorium and fairly large uranium reserves and the proposed nuclear
power reactors in Kadapa district and Srikakulam districts will further boost
its "nuclear" image. The State has heavy water plant at Manuguru and
Nuclear Fuel Complex and Atomic Minerals Directorate in Hyderabad. The
Kadapa plant is expected to generate 2000 mw of clean energy without
causing air pollution.
The Atomic Energy Commission had long ago drawn up ambitious plans to
commission nuclear reactors in the State. The Nuclear Power Corporation of
India had cleared the proposal for a nuclear reactor at Kovvada in Srikakulam
district five years ago. But things did not move an inch because of political
considerations.
With Chief Minister YS Rajasekhar Reddy renewing interest in nuclear
power plant at his native Pulivendula village, the NPCIL and APGenco have
started a rework on the project. The NPCIL is now expected to give its
clearance for the plant near Pulivendula in Kadapa district. "It takes at least
six months for us to give the necessary recommendations for the project
based on a number of factors including availability of water and seismic
conditions," says S Thakur, former NPCIL director.
A nuclear power plant is finally getting shape in the State, 25 years after a
silmilar plant was proposed near Nagarjunasagar. The Central government
had to back out amidst stiff opposition from politicians and environment
activists. The Kovvada project too has been hanging in balance for at least a
decade.
That the Kadapa reactor is going to become a reality can be assessed from the
fact that there has been no opposition to the power plant this time. While
environmentalists mobilised national support to oppose Nagarjunasagar
nuclear power plant two decades ago, this time there's only a murmur here
and there. Neither the Central nor the State governments has taken any
decision on the proposed plant at Kovvada so far.
A group of politicians, however, has opposed the Kadapa plant not because
of environmental reasons, but because of political considerations. The
proposed plant will draw water from the Somasila project and those opposed
to the Chief Minister, Dr YS Rajasekhar Reddy, do not want the nuclear plant
located in his native district to thrive on Krishna waters.
"The uranium mine and the mill, which are under construction at
Tummalapalle in Kadapa district will go on stream in 2013," says Atomic
Energy Commission chairman Dr Anil Kakodkar. Once the project is ready it
will supply uranium to various plants in the country.
The Nuclear Power Corporation of India has already inspected the proposed
site at Pulivendula and if things go as planned, the reactor will be ready in the
next five years. Chief Minister YS Rajasekhar Reddy has already instructed
GENCO to take up the project along with NPCIL.
The Sate government is ready to bear 50 per cent of the total cost of the
nuclear reactor near Pulivendula. The plant will add 2000 megawatt of power
to the national grid.
Somalsila Protection Committee leader Jakka Venkaiah said the proposed
nuclear plant will turn Nellore district dry. "The government should not go in
for political considerations. Already the Somasila reservoir is tapped to its
full capacity by supplying drinking water to Chennai through Telugu Ganga.
Any deviation of water will have a severe impact on the ecology of Nellore
district," he said.
The Central government wants to generate 20,000 mw of nuclear energy by
2020 and AP is all set to contribute 10 per cent of it. Andhra Pradesh has a
stalled capacity of 8000 mw of power generation by all means. "Though new
projects are going to be added next year, there's nothing like nuclear energy,
which is pollution-free and clean. Moreover, a small quantity of nuclear fuel
is required to generate large quantities of nuclear power. Electricity will
become cheaper and affordable if we generate nuclear power," said
environment scientist ChV Subbaiah.
Swine flu: What explains sudden spurt in H1N1 human influenza deaths in India
By Syed Akbar
Hyderabad, Aug 10: Scientists and health experts are baffled over the sudden swine flu deaths in the country, even as the National Institute of Virology has clarified that the novel H1N1 virus that causes human influenza has not mutated in India to become more aggressive.
Swine flu has been in existence in the country for the past five months without any fatalities. But in the last one week there have been six deaths, forcing scientists and health experts to think whether the virus had mutated in the country to take a virulent form. Some believe that the novel H1N1 virus is now in the second
phase of manifestation as the human influenza viruses normally do. The Spanish flu virus did the same in early 19th century killing millions of people worldwide.
"We have been monitoring the virus from different human samples. But so far we have not found any mutation or change in the virus. The virus currently present in the country is the same as found in Mexico, USA and other parts of the world," Dr Akhilesh C Mishra, director of NIV, Pune, told this correspondent.
Asked about the sudden swine flu deaths in the last one week, Dr Mishra attributed it to the "wide profiling system" now adopted by health authorities. "Earlier, we used to screen only those coming from other countries. Now we are screening the local public too. This has led to a sudden spurt in the number of cases.
And this explains the deaths too," he clarified.
But senior geneticist Dr M Khaja emphasises the need for a relook at the virus. "All through the history the influenza virus has been mutating. Even the present novel H1N1 virus is a mutant one. There are chances of it mutating further in a country like India with vast population. Swine flu virus is capable of leading to
secondary infection, both viral and bacterial," he said.
Even as local scientists differ on whether the virus has mutated or turned aggressive since temperatures have gone down because of monsoon, American researchers have unravelled the mechanism the human influenza
virus adopts to kill its host.
Swine flu virus is capable of binding deeper into the cells of lungs and stomach, unlike other influenza viruses. "There are slight differences in the way different flu proteins bind to receptors in lungs. Since the swine flu virus binds deeper in the lung's trachea, bronchi and bronchioles, it causes breathing problems,
which ultimately lead to death. The virus is also capable of replicating faster and causing more damage than other influenza viruses. Different patients react differently to the virus. This explains the death of some swine flu patients and survival by others," said US-based senior researcher Dr G R Reddy.
While other influenza virus do not touch the stomach, the novel human influenza virus binds with the stomach lining and intestines. This causes diarrhoea, vomiting and nausea in some patients suffering from swine flu.
Hyderabad, Aug 10: Scientists and health experts are baffled over the sudden swine flu deaths in the country, even as the National Institute of Virology has clarified that the novel H1N1 virus that causes human influenza has not mutated in India to become more aggressive.
Swine flu has been in existence in the country for the past five months without any fatalities. But in the last one week there have been six deaths, forcing scientists and health experts to think whether the virus had mutated in the country to take a virulent form. Some believe that the novel H1N1 virus is now in the second
phase of manifestation as the human influenza viruses normally do. The Spanish flu virus did the same in early 19th century killing millions of people worldwide.
"We have been monitoring the virus from different human samples. But so far we have not found any mutation or change in the virus. The virus currently present in the country is the same as found in Mexico, USA and other parts of the world," Dr Akhilesh C Mishra, director of NIV, Pune, told this correspondent.
Asked about the sudden swine flu deaths in the last one week, Dr Mishra attributed it to the "wide profiling system" now adopted by health authorities. "Earlier, we used to screen only those coming from other countries. Now we are screening the local public too. This has led to a sudden spurt in the number of cases.
And this explains the deaths too," he clarified.
But senior geneticist Dr M Khaja emphasises the need for a relook at the virus. "All through the history the influenza virus has been mutating. Even the present novel H1N1 virus is a mutant one. There are chances of it mutating further in a country like India with vast population. Swine flu virus is capable of leading to
secondary infection, both viral and bacterial," he said.
Even as local scientists differ on whether the virus has mutated or turned aggressive since temperatures have gone down because of monsoon, American researchers have unravelled the mechanism the human influenza
virus adopts to kill its host.
Swine flu virus is capable of binding deeper into the cells of lungs and stomach, unlike other influenza viruses. "There are slight differences in the way different flu proteins bind to receptors in lungs. Since the swine flu virus binds deeper in the lung's trachea, bronchi and bronchioles, it causes breathing problems,
which ultimately lead to death. The virus is also capable of replicating faster and causing more damage than other influenza viruses. Different patients react differently to the virus. This explains the death of some swine flu patients and survival by others," said US-based senior researcher Dr G R Reddy.
While other influenza virus do not touch the stomach, the novel human influenza virus binds with the stomach lining and intestines. This causes diarrhoea, vomiting and nausea in some patients suffering from swine flu.
Andhra Pradesh nuclear fuel advantage
* Uranium mines have been proposed at Lambapur and Peddagattu in Nalgonda district way back in 2005. Work on these mines is yet to start.
* Environmental clearance has been obtained for Lambapur-Peddagattu project. One open cut and three small underground mines have been proposed in the belt.
* Work on the underground mine and mill at Tummalapalle in Kadapa district has been going on and the project is expected to be ready by 2013.
* Uranium and thorium reserves have been identified in Nalgonda, Kadapa and Mahbubnagar districts. Further reconnaissance studies have to be taken up.
* Andhra Pradesh has the advantage of having nuclear reserves and processing units in the form of Nuclear Fuel Complex and the proposed mill at Tummalapalle. It has a heavy water plant in Khammam district. The Atomic Minerals Directorate, which conducts research on atomic mineral reserves, is also located in
Hyderabad.
* Environmental clearance has been obtained for Lambapur-Peddagattu project. One open cut and three small underground mines have been proposed in the belt.
* Work on the underground mine and mill at Tummalapalle in Kadapa district has been going on and the project is expected to be ready by 2013.
* Uranium and thorium reserves have been identified in Nalgonda, Kadapa and Mahbubnagar districts. Further reconnaissance studies have to be taken up.
* Andhra Pradesh has the advantage of having nuclear reserves and processing units in the form of Nuclear Fuel Complex and the proposed mill at Tummalapalle. It has a heavy water plant in Khammam district. The Atomic Minerals Directorate, which conducts research on atomic mineral reserves, is also located in
Hyderabad.
Nuclear reactor in AP: YSR scores a political point over rivals
By Syed Akbar
Hyderabad, Aug 10: Chief Minister YS Rajasekhar Reddy has scored a
political point over his rivals when he mooted the idea of a nuclear
power reactor in native Pulivendula in Kadapa district.
Though there have been proposals for a nuclear power plant in the
State in the last three decades, things did not much further as those in
power then did not evince keen interest. Moreover, there was a strong
opposition from political parties and environment activists. The chief
ministers then preferred to play a safe game by consigning the
proposals to dust bin.
But Rajasekhar Reddy, basking in the glory of recent victory in
Assembly elections, reopened the files and directed officials of
APGenco to study the feasibility of a nuclear reactor either at Kovvada
in Srikakulam or at Pulivendula. The Nuclear Power Corporation of
India Limited has already gave a green signal for the Kovvada site.
Since Rajasekhar Reddy is keen on the location of the reactor at
Pulivendula, NPCIL conducted a fresh study in Kadapa district.
Besides Pulivendula, the team inspected three other locations in the
district.
The Central government may not find it hard to fund the nuclear reactor
at Pulivendula since the State government has offered to bear half of
the total cost of the project. Once completed, it will generate 2000 mw
of power, 25 per cent of the present installed capacity in the State.
The Chief Minister may have the things going easy for him since a
nuclear mine and mill is already coming up near Pulivendula and the
uranium thus mined can be used for the proposed nuclear reactor.
Hyderabad, Aug 10: Chief Minister YS Rajasekhar Reddy has scored a
political point over his rivals when he mooted the idea of a nuclear
power reactor in native Pulivendula in Kadapa district.
Though there have been proposals for a nuclear power plant in the
State in the last three decades, things did not much further as those in
power then did not evince keen interest. Moreover, there was a strong
opposition from political parties and environment activists. The chief
ministers then preferred to play a safe game by consigning the
proposals to dust bin.
But Rajasekhar Reddy, basking in the glory of recent victory in
Assembly elections, reopened the files and directed officials of
APGenco to study the feasibility of a nuclear reactor either at Kovvada
in Srikakulam or at Pulivendula. The Nuclear Power Corporation of
India Limited has already gave a green signal for the Kovvada site.
Since Rajasekhar Reddy is keen on the location of the reactor at
Pulivendula, NPCIL conducted a fresh study in Kadapa district.
Besides Pulivendula, the team inspected three other locations in the
district.
The Central government may not find it hard to fund the nuclear reactor
at Pulivendula since the State government has offered to bear half of
the total cost of the project. Once completed, it will generate 2000 mw
of power, 25 per cent of the present installed capacity in the State.
The Chief Minister may have the things going easy for him since a
nuclear mine and mill is already coming up near Pulivendula and the
uranium thus mined can be used for the proposed nuclear reactor.
Saturday, 8 August 2009
Beware! Hair dye may induce jaundice
By Syed Akbar
Hyderabad, Aug 6: City health experts have come across a rare case of a woman developing jaundice after using a hair dye.
The 33-year-old woman, otherwise healthy, developed skin lesions and hepatitis (jaundice)two days after she used a new hair dye. She had abnormal liver profile after she used the dye.
Doctors at the city-based Asian Institute of Gastroenterology, who treated the woman, found that she had acute hepatitis. Further study by the AIG team led by Dr D Nageshwar Reddy revealed that she had developed drug-induced jaundice, which is quite a rare case in medical history.
Hair dye contains various mutagenic (that bring change in genetic setup) and carcinogenic (cancer-causing)chemicals and is examined as a risk factor for various malignancies. Though hair dye causes skin problems in some persons, it is rare that it induces jaundice.
--------------------------
THE FACTS ABOUT HAIR DYE
Hair dyes are of two types: Those made from natural materials and those prepared from chemicals. Hair dye containing natural material is comparatively harmless, though it may cause complications in certain cases.
Hair dye contains chemicals that damage the hair structure and scalp.
Hair dye contains substances that can bring about change in the genetic make-up
(mutations) or cause cancer (carcinogenic).
Hair dye generally causes contact dermatitis. Commonly available hair dyes contain
chemicals like Toluene-2, 5-diamine, resorcin, cetearyl alcohol and polyethylene glycol among others.
Chemicals present in the hair dye can be absorbed into the body through a wound, damaged skin or by aspiration of the spray during dyeing.
According to studies, about five per cent of permanent hair dyes users develop allergy. But only in rare cases the problem becomes severe.
It is better to undergo allergy sensitivity test every time.
Do not change the hair dye brand frequently. If you change, under allergy sensitivity patch test.
Women have sensitive skin than men. So women will have to be extra careful about the
sensitivity test.
Some of the precautions include applying hair dye for a few minutes without leaving it for longer periods; wearing gloves to protect the tender skin of palms; washing of hair after dyeing; and using of single hair dye without mixing different hair dyes.
------------------------------
"Hair dye-induced hepatitis is a rare condition. There is only one case of hair
dye-induced hepatitis reported in the literature," Dr Nageshwar Reddy said.
The AIG team conducted a number of tests to rule out various possibilities and finally arrived at a decision that the woman had developed jaundice because of the hair dye. "Because the patient had an allergic reaction, lymphocyte activation test was performed to study if the hair dye in question induced immune-mediated drug reaction leading to acute hepatitis," he said.
Results obtained in in vitro lymphocyte activity experiment strongly suggest that hair dye causes immune-mediated drug reaction in hypersensitive individuals.
Hair dye is a well-recognised cause of contact dermatitis. Routinely used hair dyes
contain multiple components viz Toluene-2, 5-diamine, resorcin, cetearyl alcohol, polyethylene glycol, etc. Chemicals of the hair dye can be absorbed into the body through a wound, damaged skin or by aspiration of the spray during dyeing.
The pathogenesis of drug-induced hepatotoxicity usually involves either the parent drug or its metabolite, which affects the hepatocytes directly or elicits an immune response, the AIG team noted in its study.
"The chronological course of the patient, allergic skin manifestations and in vitro
lymphocyte reactivity to hair dye supported hair dye-induced immune-mediated hepatitis. Liver biopsy was not performed as investigations supported
diagnosis and her liver functions improved after two weeks of cessation of hair dye."
Thursday, 6 August 2009
Swine flu: India to have its own human influenza H1N1 vaccine by December 09
Syed Akbar
Hyderabad, Aug 4: The Indian Council of Medical Research has swung into action following the first ever swine flu death in the country by hastening its plans to introduce by November-end an indigenously developed vaccine to contain novel human influenza virus.
India's first human influenza virus vaccine developed locally will be ready in about 100 days for phase-1 or phase-2 human trials to test its efficacy on the local population. The ICMR has invited letters of intent from research agencies
and major hospitals to carry out H1N1 or swine flu vaccine trials in the country on human beings.
"There's a necessity for development of an indigenous vaccine that suits the local population. Other countries including the USA are also busy developing similar vaccines. The USA too plans to introduce the vaccine before winter sets in there," senior scientist Dr MN Khaja told this correspondent.
Presently seasonal influenza vaccine is available in India but it does not give protection against the novel human influenza vaccine that claimed hundreds of lives world-wide. However, the new vaccine will not be a replacement to seasonal flu problems. Both the new vaccine as well as the existing seasonal flu vaccines will be available in the market.
High on the priority list of ICMR for the new vaccine trials are pregnant women, ayahs looking after children below six months, people between six months and 24 years of age, and those with health conditions associated with higher
risk of medical complications from flu.
The ICMR has received action plans for different types of vaccines like killed inactivated, live attenuated, and vaccine developed from virus like particles. Some of these vaccines are likely to be available for human trials by November/December, according to senior scientist Dr Harpreet Kaur of ICMR.
During the trials ICMR team will evaluate safety, immunogenicity and tolerability of the vaccine(s). The ICMR has fixed August 17 as the deadline for receipt of LoI from research groups and institutions.
Hyderabad, Aug 4: The Indian Council of Medical Research has swung into action following the first ever swine flu death in the country by hastening its plans to introduce by November-end an indigenously developed vaccine to contain novel human influenza virus.
India's first human influenza virus vaccine developed locally will be ready in about 100 days for phase-1 or phase-2 human trials to test its efficacy on the local population. The ICMR has invited letters of intent from research agencies
and major hospitals to carry out H1N1 or swine flu vaccine trials in the country on human beings.
"There's a necessity for development of an indigenous vaccine that suits the local population. Other countries including the USA are also busy developing similar vaccines. The USA too plans to introduce the vaccine before winter sets in there," senior scientist Dr MN Khaja told this correspondent.
Presently seasonal influenza vaccine is available in India but it does not give protection against the novel human influenza vaccine that claimed hundreds of lives world-wide. However, the new vaccine will not be a replacement to seasonal flu problems. Both the new vaccine as well as the existing seasonal flu vaccines will be available in the market.
High on the priority list of ICMR for the new vaccine trials are pregnant women, ayahs looking after children below six months, people between six months and 24 years of age, and those with health conditions associated with higher
risk of medical complications from flu.
The ICMR has received action plans for different types of vaccines like killed inactivated, live attenuated, and vaccine developed from virus like particles. Some of these vaccines are likely to be available for human trials by November/December, according to senior scientist Dr Harpreet Kaur of ICMR.
During the trials ICMR team will evaluate safety, immunogenicity and tolerability of the vaccine(s). The ICMR has fixed August 17 as the deadline for receipt of LoI from research groups and institutions.
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Mother's Care
Minnu The Cat & Her Kittens Brownie, Goldie & Blackie
Someone with Nature
Syed Akbar in an island in river Godavari with Papikonda hills in the background
Recognition by World Vegetable Centre
Under the shade of Baobab tree
At Agha Khan Akademi in Kenya
Gateway to the Southern Hemisphere
Convention on Biodiversity
Syed Akbar at the 11th Conference of Parties to the United Nations Convention on Biological Diversity