Dearest,
I'm pasting below the link to the part of the conference relating to vaccines.
If anyone would like to learn more about this topic, they can do so:
www.kaisernetwork.org/health_cast/hcast_index.cfm?display=detail&hc=2869
This seems to be the day of minorities: this morning the plenary meeting addressed among others the topic of sex between men and some very interesting things came out.
A group of US researchers did their own research and discovered that there are many types of MSM, that MSM is an acronym that identifies a behavior and not an identity, that sexual orientation includes heterosexuality, bisexuality, and homosexuality, that the MSM group includes gay men and men who do not identify as gay, bisexuals, those in "situational" homosexual relationships (prisons, military schools, barracks, etc.), prostitutes, and even some transgender people, in addition, of course, to a wide range of locally defined terms.
In the HIV context, it has been identified that MSM have certain unique factors that increase their risk of infection: unprotected anal sex, frequent changes of partners both daily and in life, and injecting drugs. Other factors that influence the risk and vulnerability of MSM include human rights violations, the criminalization of sexual orientation, stigma and discrimination, and homophobia. For example, there are countries where even carrying a condom in your pocket is risky (Nepal), and in India, laws against sodomy certainly do not help prevention; in fact, it is one of those cases where the laws themselves create a risk to public health.
86 countries around the world still have laws that criminalize sexual relations between adult men. and consenting, this is the case in more than half of African countries, coincidentally precisely in those where the prevalence of AIDS cases is among the highest in the world. For completeness of information, 10 states provide the death penalty for the crime of homosexuality (Pakistan, Saudi Arabia, Iran, Nigeria, Sudan, etc.).
Very touching was the testimony of a HIV-positive gay activist from Senegal. Being a gay activist in Senegal, he explains, is against the law (!!); those who do it like him can't say it openly. Things like socializing, meeting other people, must be done clandestinely, in places that the police often close down. When we leave gay bars, the activist tells us, we have to do it in small groups, taking different routes to return home to our wives and children. Yes, wives and children, because in Senegal the only way to have a socially acceptable life is to get married and have children. In short, an absurd law forces gay men to live a shitty life and women to marry men who are secretly gay.
But there is some good news: maybe I forgot to write to you that the conference started with the first international march against homophobia, and just being able to do this in a country like Mexico is a big step forward, but there's more.
Organizers had long declared that the march would focus on the government of Panama, the only Latin American country still maintaining laws criminalizing homosexuality. Two days after the march, the laws were amended.
The research's conclusions are brief but clear: HIV continues to infect MSM at a very high rate worldwide; exclusion from surveillance systems and/or the lack of targeted prevention, and the difficulty in accessing treatment and healthcare remain a major limitation to the global response to HIV/AIDS; and, above all, the final conclusion: we have failed to reduce HIV incidence among MSM because, with a few exceptions, we have NOT tried.
Still regarding MSM in the HIV context, this morning they insisted a lot on two points:
a significant impact, at a global level, of injecting drug use and the increase
very worrying cases of tuberculosis very, very often related to HIV.
Don't think that these are things that only concern the third world, just take a tour of Italian hospitals to realise at a glance the significant return of tuberculosis in
Italy. Regarding the first point, several research presentations around the world have highlighted how harm reduction is an essential tool for significantly slowing the spread of HIV.
Unfortunately, these very concrete possibilities are being thwarted by conservative governments, by religions (as we well know), and by economic interests.
All the research has highlighted how there are still many countries in the world that prefer to punish those who use substances rather than promote control and harm reduction systems that, as research shows, have a serious potential to limit HIV.
Research has identified three key barriers that hinder access to antiretroviral therapy and related adherence:
socio-political:
social marginalization, criminalization, sanctions, finances, prison;
individual:
fear of side effects, psychiatric illnesses, homelessness, lack of self-confidence;
causes beyond their control due to the inexperience of healthcare personnel, bureaucratic procedures such as, as has been reported, the difficulty in making an appointment.
A slide titled A tale of two countries: USA and Australia was very revealing: the USA bans harm reduction, 33% of HIV-positive people inject drugs, and 40% of people who inject drugs are HIV-positive.
In Australia, where harm reduction techniques are used, 6% of HIV-positive people inject drugs and 2% of people who inject drugs are HIV-positive.
Everyone insisted on the need to put health at the center and not substance control policies.
The day continued with a beautiful symposium on public health policies and why, instead of relying on scientific evidence, they rely on the delusions of various governments or priests.
The first meeting of the symposium focused on the work an American researcher has done to demonstrate that ABC (Bush's theory for stopping AIDS, an acronym for abstinence, fidelity, and condoms) doesn't work.
The study was conducted on groups of students from several US states and showed that the ABC program did not lead to appreciable results (no decrease in sexual intercourse, no increase in condom use), while comprehensive sex and HIV programs worked very well, much to the chagrin of Bush's followers who put religious ideology before reality, forcing skilled scientists to spend money on studies that are useless to anyone with a shred of common sense. Meanwhile, Who knows how many young Americans have been infected because their mother or father are fervent Baptists?.
I think the parallel with the Italian specific is quite clear, so I won't say anything else.
Last but not least, in another symposium some research data were presented which demonstrate the need for increase the use of HIV testing. Much has been achieved in this area, with many countries implementing strategies to improve access to testing. However, the challenges of implementing testing and the associated data protection and combating discrimination and stigma, particularly among marginalized groups, remain largely unresolved. The need to find common ground in public health systems to promote testing and counseling has been emphasized by all. There is a strong emphasis on requiring testing only with informed and specifically declared consent from the person being tested, especially if they belong to groups at risk of discrimination, such as sex workers, gay men, and even women, who, if tested positive, in many countries face very serious measures, mostly social ones.
There are even countries that do not promote testing for fear that it will increase healthcare spending on drugs.
Everyone insisted that the test cannot be required regardless of the country's human rights situation. Collaboration between associations and the public is therefore essential.
I insist on this point because today, the CDC in Atlanta released a statement calling for all sexually active gay men to be tested, regardless of whether they are at risk or not.
In my opinion, this is a serious matter that demonstrates once again how far the USA is from the very meaning of the word democracy.
I hope the message from that statement is clear to everyone: that gay people, as such, are at risk of seroconversion even if they don't have sex or only masturbate, even if they've been in a monogamous relationship for decades. Who cares, they're gay and therefore spreaders of the virus.
I ended the day by watching a mini-festival of videos about sex workers around the world.
You kiss
Sandro