HIV/AIDS around the Globe The Big Picture There over 42 million people living with HIV/AIDS today Over 19 million of those infected are women Everyday, there are 14,000 new infections http://www.until.org/statistics.shtml HIV – A “disease of young people” 2.5 million of those newly infected each year are between the ages of 15-24 UN estimates 14 million children have been orphaned by AIDS In just 3 years, that number is estimated to reach 25 million http://www.until.org/statistics.shtml HIV/AIDS in Latin America By 2006, 1.6 million people were living with AIDS in Latin America – While this is lower than Africa or India, these numbers are continually increasing and only expected to get worse Half of all those infected reside in the 4 largest countries of Latin America: Brazil, Argentina, Columbia and Mexico. – However – the most severe cases are where there is a higher prevalence, in smaller countries such as Belize and Honduras. http://www.avert.org/aidslatinamerica.htm Living with HIV/AIDS Deaths due to Country All people Adult (15-49) AIDS during 2005 rate % Argentina 130,000 0.6 4,300 Belize 3,700 2.5 <500 Bolivia 7,000 0.1 <500 Brazil 620,000 0.5 14,000 Chile 28,000 0.3 <500 Colombia 160,000 0.6 8,200 Costa Rica 7,400 0.3 <100 Ecuador 23,000 0.3 1,600 El Salvador 36,000 0.9 2,500 Guatemala 61,000 0.9 2,700 Guyana 12,000 2.4 1,200 Honduras 63,000 1.5 3,700 Mexico 180,000 0.3 6,200 Nicaragua 7,300 0.2 <500 Panama 17,000 0.9 <1,000 Paraguay 13,000 0.4 <500 Peru 93,000 0.6 5,600 Suriname 5,200 1.9 <500 Uruguay 9,600 0.5 <500 Venezuela 110,000 0.7 6,100 Total 1,600,000 0.5 59,000 http://www.avert.org/southamerica.htm Key Affected Groups: – Men who have sex with men (MSM) – Sex workers – Intravenous Drug Users (IDS) – Migrants http://www.avert.org/aidslatinamerica.htm Religion and HIV/AIDS Prevention Catholicism Says “NO!” to Condoms The Roman Catholic Church has been morally opposed to contraception for as far back as one can historically trace. Approximately 70% of people living in Latin American countries identify themselves as Catholic This predominantly Catholic population has remained both uninformed on safe sex practices and resistant to the use of condoms Homosexuality is a Sin Homosexuality is illegal in many Latin American countries – Homosexuals and bisexuals are often “underground” activities, increasing their likelihood of participating in high risk behaviors. – Bisexuality among married men is common, and studies have shown that while wives may be aware of their husbands’ other partners, they are generally not comfortable asking their husbands to wear condoms. Social and Political Stigma Colombia – Ongoing war between left-wing guerrilla groups and right-wing paramilitaries – FARC (the Revolutionary Armed Forces of Colombia) is known to have forced residents of areas they control to take HIV tests – Gay men forced to wear signs around neck – Displacement and migration to other countries may have impact on epidemic – 86% infected are men….leaving little access to healthcare for women infected Social and Political Stigma Guatemala – Mayans may be 3x more likely to develop HIV – Stigmatized population with less access to healthcare Nicaragua – Stigma around using condoms – One study showed that of adolescents who had been sexually active in past 3 months, only 21% used condom – Insufficient HIV Testing available Barriers to Overcoming the Crisis Regardless of differences in how each country handles this issue, there is consistent evidence of structural violence across the board: Poverty Migration Homophobia HIV-related discrimination BEADS FOR LIFE “Eradicating Poverty One Bead At a Time” Beads for Life Ugandan – North American partnership to eradicate poverty Sustainable income generation as the core of its mission – 501c3 organization. Over 75% of the proceeds go directly to supporting their mission. “4 pillars” of community development- Health, Education and Vocational Training, Life Skills and Affordable Beads for Health… Impoverished people often the victims of poor health. 43% of the BFL’s are HIV+ Beads for Life provides: – access to diagnosis and treatment services – HIV testing for BFL’s children – reproductive health services – health education – critical health products Meet Alice Aduna “Time for Hope for Young People” (PROTEJA) A social mobilization program for and by youth to promote healthy lifestyles Program implemented in the Dominican Republic PROTEJA Target: – Adolescents and young people between 10 to 19 years old, living in 10 communities, including poor communities of sugar cane cutters Objective: – Promote safe and healthy practices based upon values such as abstinence, delay of first sexual intercourse, sexual fidelity, and the correct use of condom. . Methodology – Forty-five young leaders were trained as peer-educators in sexual and reproductive health (SRH), gender, effective communication, and self- esteem issues. Each one trained15 other youth, who in turn trained 10 others until more than 10 thousand young people involved. Main Concepts and Components Demystification of local taboos about sexuality and SRH Increased amounts of adolescents and young people who realize the risk of HIV/STI infection Adolescents and young people receive systematic information through a quarterly bulletin de-signed and produced by community reporters, who have been trained by the project Forty teachers have graduated from a qualified course called “diplomado.” They are now giving information on SRH in schools. A total of 6,750 trained young people currently promote healthy SRH practices Fifty thousand youths and adults have been informed through information campaign using multi-media, e.g., bulletins, brochures, etc. A Youth-Friendly Care Center directed and conducted by young people was established.- Ten thousand adolescents and youths using at least two AIDS prevention measures PROTEJA What they have learned from organizing this project is: Youth-friendly communication requires broad-based consultation with the community, e.g. church leaders, teachers and parents. With minimal inputs, thousands of youth could be reached through a “ladder strategy”. Training programs with professional credits are attractive incentives to involve teachers. Youth must plan and design youth-targeted programs, so that they act as owners and protagonists and process builders Proteja Conclusion The PROTEJA project, with a minimum investment of about US $50,000, has positively impacted more than 10,000 adolescents. Youth are a window of opportunity for HIV prevention. They must not only be targeted, they must own programs that affect them. Creative activities and value-centered education are major points of attraction to youth programs European Community Project 1997-1999 Educational Program in the Colombian cities of Bogotá, Cali, and Bucaramanga. School-based peer education program Main goals – HIV/STI-related education for adolescents and young adults – promote risk awareness and safer sexual behavior – build the capacity of local nongovernmental organizations responding to HIV/AIDS and improve national networks of HIV/AIDS NGOs. European Community Project Information and education sessions for teachers (focused on classroom communication skills relevant to reproductive health and using information/education/communication training materials). Training of teachers, students, and peer educators on HIV/STI prevention, reproductive health and the importance of safer sex. Peer educator-led campaigns among community groups. Lessons Learned There is a need to develop and conduct widespread school-based programs for sexual and reproductive health, including HIV/AIDS prevention. Trained teachers and peer educators can achieve high coverage in implementing HIV/AIDS prevention activities. Enhanced project success is associated with participant involvement in project design. Activities should be culturally sensitive and relevant to the needs of intended beneficiaries. The participation of national health authorities is important for the sustainability of HIV/AIDS education and prevention activities. AID for AIDS Aid for AIDS New York City Medicine Recycling Program Donating to Latin America since 1996 Drug donations from HIV/AIDS patients in United States who don't need them anymore for various reasons Partners with activists/organizations in countries to help lobby government for AIDS awareness- Brazil has developed national drug program Conferences in Latin America Our Plan Comprehensive approach to tackle all angles of the epidemic – Education, Education, Education – Removing the stigma – Help create sustainable income – Utilize local resources – Lobby for financial and legislative government support and funding – Utilize the crafts and talents of the people to foster motivation and empowerment References and Resources AID for AIDS: http://www.thebody.com/atn/348/recycling.html www.AidforAids.org AmfAR, The Foundation for Aids Research: http://www.amfAR.org AVERT: http://www.avert.org/aidslatinamerica.htm Beads for Life: http://www.beadsforlife.org/ Colombia: http://ipsnews.net/interna.asp?idnews=13360 European Community Project http://www.rho.org/html/hiv_aids_progexamples.htm#colombia Proteja: A Time for Hope for Young People: http://www.visionmundial.org Until There’s a Cure: http://www.until.org/statistics.shtml UN Aids: www.unaids.org HIV/AIDS in Lithuania Irma In the Baltic states, as in another East European countries, the spread features of the HIV/AIDS pandemic are quite similar, but the spread of HIV in Lithuania has some peculiarities. HIV/AIDS Epidemiological situation in Lithuania In 1988 – 2007 1213 HIV infection cases and 126 AIDS cases were reported. Lithuania is surrounded by countries where HIV is widely spread. Nevertheless, Lithuania is still a country with a low HIV prevalence. HIV prevalence according to the way of transmission The main ways of HIV/AIDS transmission in Lithuania are: intravenous drug using (933 persons); heterosexual intercourses (136 persons); homosexual intercourses (79 persons); unknown (65 persons). HIV prevalence according to the age and gender HIV has been mostly reported in the age groups of 25 – 29 and 30 – 34. Up to the 1st of January in 2007, 1052 male and 161 female HIV cases were reported. It is important to notice that number of female cases is increasing. The prevention of HIV/AIDS in Lithuania. The prevalence of HIV depends on human interrelationships and their behaviour. So the main tool which can stop it is prevention. Systematic and methodical prevention of HIV infection and AIDS in Lithuania started in 1989, when Lithuanian AIDS Center was established. The main functions of the Center are: thedevelopment and promotion of HIV/AIDS prevention and control; performance and monitoring of testing and treatment in Lithuania; implementation of the national AIDS prevention programmes; cooperation with institutions involved in HIV/AIDS prevention; coordination of efforts with other related programmes; advocacy and lobbying, including legislative framework. The key strategical document on HIV/AIDS prevention and control in Lithuania is the National AIDS Prevention and Control Programme. This program has set the target to keep the country of a low HIV prevalence up to 2010. Key objectives of this programme are: 1. To reduce transmission of HIV/AIDS and related infections in Lithuania. 2. To mitigate negative consequences of HIV and related infections to an individual and society. 3. To provide appropriate health care services to people with HIV and AIDS. 4. To improve HIV/AIDS surveillance system. Decentralized actions – from the national level to the district and community levels are characteristics of the Lithuanian HIV/AIDS programme. The role of the municipal health programmes is very important to stimulate health promotion and local participation in design of the health policy. Other ways of HIV/AIDS prevention in Lithuania Issues on HIV/AIDS are integrated into various school curricula topics. Youth Health Centres take care of informal sexual education of young people. Non-governmental sector has been actively taking part: in organising of commemoration of the World AIDS Day; in actions “Get tested on HIV for free”; in implementation of the “Peer education” programmes; in organizing national contest for the schoolchildren on knowledge about HIV/AIDS; in organizing international Schoolchildren Drawing Competition “School Children Against AIDS”; in organising of debates of youth and policy makers in the municipalities; in organizing of a club “Journalists against AIDS”. Organisations trying to help people living with HIV/AIDS “PositiveLife” – an independent, non-governmental organization founded by HIV positive people, their family members and other individuals that deal with the problems encountered by people living with HIV/AIDS (PLWHA) in Lithuania. DrugUsers’ Social Rehabilitation Community where people dependent on drugs and psychotropic substances can get the Community’s support. The priority is given to drug users infected with HIV. Stigmatized HIV infected people Pervasive stigma has surrounded HIV/AIDS since the beginning of the pandemic. HIV infected people in Lithuania are not an exception too. In 2003 there the research was performed which examined the HIV related stigma among HIV infected prisoners. Research has shown that respondents feel personalized stigma. Another survey of the public opinion about vulnerable groups in 2003 has proved significant increase in tolerance towards the people with HIV in the last 13 years. Negative attitude of the society towards HIV infected people is determined by: the lack of information on HIV infection; preconcepion and stereotypes; fear of the desease which is incurable; irresponsibility of mass media; the attitudes about sexual life. The only way to overcome HIV/AIDS pandemic is to change the shame into solidarity and the fear into hope. This is what I wish for all of us. REFERENCES: www.aids.lt www.stophiv.lt Čaplinskas, S. (2004) HIV/AIDS policy of Lithuania. 6- th Nordic-Baltic Congress on Infectious Diseases. Abstract, p. 61. Čaplinskienė, I. (2004) Lithuanian population’s tolerance towards vulnerable groups. Abstract book, Vol. 1, p. 522, Čaplinskas, S., Stonienė, S. (2004) Schoolchildren against AIDS – a national contest in Lithuania. Sexual health exchange, No. 4, p. 7 – 8. Čaplinskas, S., Stonienė, L. (2004) Self-government and HIV/AIDS prevention in Lithuania. 6-th Nordic-Baltic Congress on Infectious Diseases. Abstract, p. 72. The Zontian. (2007, January) Volume 87, Number 4.