ARVs Side Effects: Some Men Developing Breasts

BLANTYRE: The National Aids Commission says is planning to engaging science experts for an explanation on why some men on Anti-Retroviral Therapy in the country are developing feminine-like physical structures. The matter has arisen following an incident in Mangochi in which a man on ART is said to have developed female breasts and people suspect the development may be linked to the treatment.

This comes after Digitas International of Mangochi and Machinga district hospitals HIV coordinator Christopher Kandionamaso told journalists that there are strong suspicions that the physical changes taking place in men on ART could be a side effect of the therapy regime they are receiving.

Chairperson of the NAC Ms Mara Kumbweza Banda told Zodiak Online that the current developments and suspicions about the ART require a scientific investigation and subsequent explanation.

“As a commission we have taken on board the concerns by the organizations. We are going to present the matter to scientists to determine what is really happening,” said Ms Banda.

However, Mangochi District Health Officer Dr. William Peno was non-committal on the matter saying, although he has personally seen a deformed male on ART, he would not link that to the ART.

“We are not the only district that is administering the new regimen of Anti Retrovirals…so it is better to wait until something scientifically concrete comes out on the same,” said Dr. Peno.

According to Kandionamaso, about 20 males on the new regime of ART have been affected in this way.

Mc Loud Piringu, HIV/Aids coordinator for Mangochi district hospital says he knows of three such cases of males on the new ART regimen which is composed of three drugs.

“The patients take Tenofovir, Lamivudine and Favirnz, it is Favirnz, that is causing men to grow female breasts, but once we observe that, we remove Favirnz and replace it with Neverapine,” he said.—Zodiak Online

NAC engages with the media sector

HIV first emerged in the 1980s. Since then the global HIV pandemic has rarely been out of the news for long. It is still one of the most pressing health challenges facing the world. In the early days of the epidemic little was known about the virus. There was a great deal of fear about how it was spread and many people died from HIV-related illnesses. Today, treatment has revolutionised what it means to live with HIV. 

Someone with HIV who gets tested, is diagnosed early and is treated effectively will not go on to develop AIDS and instead can live a long life, work, exercise, even have a family if they choose. Despite advances in treatment, social attitudes are changing much more slowly. Evidence shows public knowledge of HIV in Zimbabwe is declining and there is a worrying lack of understanding about HIV. The media play an important role in communicating to the public what exactly it means to live with HIV today.

 

The media is incredibly powerful in influencing people's attitudes and understanding of HIV. 

 

Stories in the media can have a positive effect in increasing people's awareness of HIV and what it means to live with HIV. However media reports about HIV are often stigmatising or inaccurate. Many stories contribute to a culture of blame about HIV transmission, focusing on so-called irresponsible sexual activity, use judgmental language and stereotype people living with HIV.

Improving the media's coverage of HIV issues is vital to tackle discrimination experienced by people living with HIV, improve people's knowledge and help prevent the spread of the virus.The National Aids Council (NAC) today held a media HIV/AIDS update to media practitioners in Bulawayo in a bid to engage the media in the halt of HIV/AIDS in Zimbabwe. This initiative is driven by the national multi- sectoral approach employed by NAC. The goal is one of the fundamental ways of improving the media's reporting of HIV. 

Working with journalists

 

NAC has produce a number of resources to help journalists ensure that the articles they write contain accurate information about HIV, are not misleading and do not encourage negative perceptions about HIV.

"Today we as NAC have initiated a quarterly meeting with the media sector in Bulawayo as part of our multi-sectoral strategy in combating HIV/AIDS in the country. The media as an industry is not immune to HIV. Hopefully, maybe on the third quarter we could establish a media committee responsible for co-coordinating such activities," said Douglas Moyo, monitoring and evaluation officer.

Way forward 

 

If you are living with HIV then you can help us challenge inaccurate and stigmatising media coverage and provide a human face to NAC or the or  author of this blog. NAC could possibly establish a group of people living with HIV working together with support from NAC to improve how the media portrays HIV and people living with HIV. In this group, members will be alerted to stigmatising coverage and given advice on contacting journalists, making a complaint, getting a letter to the editor published and sharing the story.

As far as improving reportage amongst other things, NAC can craft up a toolkit or a guideline for journalists reporting on HIV.  These guidelines would be intended for journalists working in Zimbabwe. They would enable journalists and editors to check the facts and ensure that the final story is accurate.  At the end of it  all, NAC will be always on hand to advise journalists to report accurately on these issues.

More importantly, NAC can work directly with the media and with journalism colleges to improve journalists' knowledge and understanding. NAC can do so by producing a DVD or communication materials for journalism students, as part of their work to challenge stigma and improve reporting of HIV in the Zimbabwean media.  If NAC does it well, maybe a curriculum that focuses on HIV reporting could be introduced in journalism schools (eg NUST doesn't offer that module). It must be understood that the future of reporting HIV is as important as the present media coverage, and this DVD  or communication material would provide information for students on HIV including facts and myths, real stories, ethics of HIV reporting and advice on how to report on HIV without prejudice.

To warp it up, accurate reporting benefits public health, dispells myths, undermines prejudice and increases understanding. It contributes positively to the way HIV is addressed around the world.We know that reporting accurately on HIV has always been – and still is – a challenge. HIV and its ramifications are complex to report and to be able to end HIV/AIDS in 2030, the media sector can never be ignored.


Aluta continua

The media is incredibly powerful in influencing people's attitudes and understanding of HIV.

Stories in the media can have a positive effect in increasing people's awareness of HIV and what it means to live with HIV. However media reports about HIV are often stigmatising or inaccurate. Many stories contribute to a culture of blame about HIV transmission, focusing on so-called irresponsible sexual activity, use judgmental language and stereotype people living with HIV.
Improving the media's coverage of HIV issues is vital to tackle discrimination experienced by people living with HIV, improve people's knowledge and help prevent the spread of the virus.
NAT works in a number of ways to improve the media's reporting of HIV.

Working with journalists

NAT has produce a number of resources to help journalists ensure that the articles they write contain accurate information about HIV, are not misleading and do not encourage negative perceptions about HIV.

NAT worked with the National Union of Journalists (NUJ), Society of Editors and Press Complaints Committee (PCC)  to produce new Guidelines on Reporting HIV which provide practical information on how to report on HIV in an accurate and non-stigmatising way.  In addition to including current facts and stats on HIV, this updated version of Guidelines on Reporting HIV (June 2010) from the original produced in April 2007  also contains more detailed information for journalists on HIV testing, and the risks of transmission from spitting, biting and discarded needles - the topics most commonly mis-reported.

We also work directly with the media and with journalism colleges to improve journalists' knowledge and understanding.
NAT has produced a DVD for journalism students, as part of our work to challenge stigma and improve reporting of HIV in the UK media.  We understand that the future of reporting HIV is as important as the present media coverage, and this DVD provides information for students on HIV including facts and myths, real stories, ethics of HIV reporting and advice on how to report on HIV without prejudice. 

Watch NAT's video guide for journalists reporting on HIV 

Challenging poor reporting

NAT works behind the scenes to change how journalists report HIV.
We monitor the press daily and if we see reports that are inaccurate or stigmatising towards people living with HIV then we intervene to achieve lasting improvements. By writing to editors, challenging poor reporting, providing information for journalists and working with the Independent Press Standards Organisation we have successfully achieved lasting changes in the approaches a number of national and local newspapers take to reporting HIV.

How you can help

If you are living with HIV then you can help us challenge inaccurate and stigmatising media coverage and provide a human face to HIV in the UK by joining Press Gang.
Press Gang is a group of people living with HIV working together with support from NAT to improve how the media portrays HIV and people living with HIV.
As a member of Press Gang you will be alerted to stigmatising coverage and given advice on contacting journalists, making a complaint, getting a letter to the editor published and sharing your story.
- See more at: http://www.nat.org.uk/Media-and-Blog/Influencing-the-media.aspx#sthash.IjLzOvd0.dpuf

FIRST HIV Vaccine Trial On the cards in Zim

Zimbabwean scientists, in collaboration with a global consortium of researchers, are preparing to conduct the country's first ever HIV vaccine trial as part of the global effort to find a lasting solution to the spread of HIV. "The vaccine to be tested in Zimbabwe is a preventive vaccine that will be administered to HIV-negative people," according to clinical trials coordinator Dr Portia Hunidzarira.

"Those already taking antiretroviral treatment (ART) are not eligible," she explained, referring to the drug used to suppress the virus among people who are already living with HIV.

Focus on HIV-negative people

Hunidzarira said the trial aimed to determine whether the vaccine could prevent HIV-negative people from contracting the virus. It will also gauge the safety of new vaccine products and regimens while measuring the immune response among trial subjects. Dr Lynda Stranix-Chibanda, a paediatrician at the University of Zimbabwe, is leading the initiative on behalf of the HIV Vaccine Trials Network (HVTN) in conjunction with the University of Zimbabwe and University of California San Francisco (UZ-UCSF) Collaborative Research Programme.

The HVTN is a publicly funded multi-disciplinary global consortium of scientists tasked with facilitating the development of HIV vaccines. Stranix-Chibanda said the trials would likely be conducted in June 2015 at the Seke South Clinic in the town of Chitungwiza, located about 30km south of Zimbabwe's capital Harare.
The vaccine to be tested is based on one used in Thailand's RV144 trial which was moderately successful at preventing new HIV infections among vaccinated adults.

Stranix-Chibanda added that RV144 had been modified for a sub-strain of the virus called Clade CHIV which is found in southern Africa. She went on to note that the HVTN107 vaccine, which will be tested in Zimbabwe and other southern African countries, had seen the addition of another booster, including an adjuvant (a pharmacological and/or immunological agent that modifies the effect of other agents) to test the response as compared to RV144.

RV144 had a six-month vaccination schedule while HVTN107 will have a 12-month schedule.
The trials in Thailand, which were reportedly administered to 16,000 adults, were 60 per cent effective at one year and 31 per cent effective at three years.

"The next phase of the programme will involve the selection of the best candidates, further research to assess the effectiveness of the drug, and - if successful - licensure for use," Stranix-Chibanda said.
According to Emilder Chihota, a community educator participating in the UZ-UCSF Collaborative Research Program, 26 people will take part in the first phase of the vaccine trials. Stranix-Chibanda said that Zimbabwe had been selected to join the initiative because the country's research environment was conducive to intense clinical trials.

Lasting solution to new infections

Stranix-Chibanda was moved to take part in the project because of the problems HIV has caused in Zimbabwe and the region. "As a paediatrician, I have long worked in Zimbabwe with mothers and babies trying to stop the spread of HIV," she said.

According to Dr Nyaradzo Mgodi, co-principal investigator at the UZ-UCSF, the rate of new HIV infections in Zimbabwe remains alarming. "A vaccine will benefit the population," she said. "We do not have a vaccine for HIV like we do for polio or measles. Due to human nature and behavioural changes, other preventive measures cannot be fully relied on. But a vaccine would be a stop-gap measure against new HIV infections."

Hunidzarira, the clinical trials coordinator, agreed. She noted that, due to poor logistical support in sub-Saharan Africa, only eight male condoms were available each year for each sexually active person.

SOURCE

Primary MTN 003 (VOICE) Study Results OUT

MTN 003 (VOICE) primary study results have now been published in the 5 February 2015 issue of the New England Journal of Medicine (NEJM). Initially presented in 2013 at the 20th Conference of Retroviruses and Opportunistic Infections (CROI), greater details of those findings are now presented through this peer-review journal publication.

Primary study results of VOICE indicated that none of the three products tested was effective among women enrolled in the study. “What we’ve learned from VOICE has been extremely valuable. It’s been eye-opening for all of us involved in HIV prevention, particularly on trials focused on meeting the needs of women. We need to better understand women’s perceived motivations for participating in a trial, but more importantly, what products they will want to use,” commented Jeanne Marrazzo, M.D., M.P.H., from the University of Washington in Seattle, who led the study with Zvavahera Mike Chirenje, M.D., from the University of Zimbabwe-University of California San Francisco (UZ-UCSF) in Harare.

Photo Credit: Microbicide Trials Network, University of Pittsburgh and Magee-Womens Research Institute

MTN 003 was a major HIV prevention trial designed to evaluate whether antiretroviral (ARV) medicines commonly used to treat people with HIV are safe and effective for preventing sexual transmission of HIV in women. The study focused on two ARV-based approaches: daily use of an ARV tablet and daily use of a vaginal microbicide containing an ARV in gel form. Specifically, the study sought to determine the safety and effectiveness of three different products: an oral tablet containing tenofovir (known by the brand name Viread); an oral tablet that contained both tenfovir and emtricitabine (Truvada); and tenofovir gel, a vaginal microbicide formulation of oral tenofovir. VOICE began in September 2009 and was completed in August 2012. A total of 5,029 women were enrolled across 15 sites in South Africa, Uganda, and Zimbabwe. 630 women were enrolled locally at our clinics in Harare and Chitungwiza.

Tenofovir gel reduced the risk of HIV by only 14.7% compared to a placebo gel, a finding that is not statistically significant. Estimates of effectiveness for both oral tenofovir and Truvada were less than zero (-49% for tenofovir and -4.4% for Truvada). The study’s cohort analysis revealed a persistent pattern of non-adherence which began nearly at the study’s start, with a women’s nonuse early in the trial largely predictive of low adherence to product use throughout. Drug was detected in less than 40% of the samples of women from the cohort three months into the study. Most of these women had no drug detected in blood samples from later quarterly visits either, which was the case for 70% of women in the Truvada group, 83% in the tenofovir group, and 72% in the tenofovir gel group.

Further analysis found that women in the tenofovir gel arm who had drug detected in the sample taken at their first quarterly visit were 66 percent less likely to acquire HIV than those who did not have drug detected, a result that was statistically significant. In contrast, there was no association between product use and HIV protection with either of the two tablets.

“Although the numbers are quite small, and there are other inherent limitations with this kind of analysis, we are nonetheless very encouraged to see an association between tenofovir gel use and HIV protection, especially as we await the results of the FACTS 001 study,” said Dr. Chirenje, referring to the Phase III confirmatory trial of tenofovir gel used before and after sex, the results of which are expected to be reported at the upcoming CROI conference at the end of February.

SOURCE

Life As a Young Girl With HIV in Zimbabwe

Telling a child that they have HIV can be a long and delicate process.

In Epworth, near the Zimbabwean capital, Harare, Médecins Sans Frontières (MSF) has set up HIV support groups where adolescents can meet others living a similar reality. Through sharing their stories, and connecting with one another, their newfound solidarity gradually helps them to become more self-confident.
Chido is an 11-year-old girl, but she looks much younger. Her big brown eyes shine bright, and she smiles and laughs aloud as she plays with the other children. It's hard to imagine what she has been through.

Chido is HIV positive, and because of her status most of her family-her grandmother, step-father and three step-siblings-shunned her at home. Yet she didn't know why. Her mother had told her that she had asthma, which is why she was sick and had to take the tablets, so she couldn't understand why her family ignored and avoided her. And because she didn't feel sick, she stopped taking her tablets regularly.

"Living with HIV can be confusing and difficult for young children, and is often particularly tough for those orphaned by HIV who are also HIV positive. They can be badly treated at home, encounter increased stigma and feel extremely isolated. Many of them never tell anyone what is happening to them and suffer in silence," says Ann Sellberg, a medical doctor working with Médecins Sans Frontières in Epworth.

As Chido continued to grow, her adherence to the life-saving antiretrovirals deteriorated to the point that the doctors referred her to MSF's HIV support group. Only then did she finally learn about her status.
"Finding out about HIV was a great relief for Chido, but also for her mother, who hadn't felt able to tell her daughter what she really had," explains Ann. "Now that she better understands the disease she has, she is doing a lot better emotionally, plus also adhering better to her medication plan."
Disclosure is always a delicate thing. Parents are often afraid to tell their children because they fear the consequences of stigma. Mothers who have passed the virus to their unborn children can feel very guilty. But there are additional issues according to Joseph Alick, a Médecins Sans Frontières mental health officer.
"Sometimes women themselves don't know their own status until their first pregnancy. Pregnant women often don't show symptoms so they get a terrible shock when they discover that they are HIV positive," he says.
After a positive test for HIV, a pregnant woman is immediately started on antiretroviral therapy (ART).

"However, it is difficult for a newly diagnosed woman to go home and tell her husband about her status, because of the blame game," Joseph says, pointing out that the Zimbabwean society is very patriarchal. "Many people still think that being HIV positive is a sign for sleeping around, and that the woman is guilty."
According to the World Health Organization, Zimbabwe remains one of the countries that is most affected by HIV/AIDS, with nearly 15 per cent of the adult population infected by the virus. Zimbabwean Ministry of Health and Child Welfare estimates that ART coverage had reached almost 80 per cent in 2013, whereas the rate of access treatment for adolescents was only half.

"At school, children learn that HIV is passed from one person to another by sexual intercourse, so when they find out that they are positive they are shocked and confused," Alick says, explaining that it is often the HIV counsellors who inform the children about transmission from mother to child.
Teenagers frequently refuse medication because they fear disclosing their condition or that others will expose them, worried about the lack of guarantee that their condition won't become known. Though there is no guarantee, the counselling teams encourage the children to undertake responsible disclosure, and not to be ashamed of their status.

But the HIV support group in Epworth is about more than counselling. It becomes a safe haven where they are all treated equally, where they can play, sing, dance and just be themselves without fear of stigma.
Chido has a role in a theatre play about sexual abuse. She looks confident, she looks happy. "At home things are better now," she says. It makes a great difference that she can now exchange frankly with her mother about her disease. Ann adds "It's rewarding to see how strong they become together-not forgetting how much fun they have!"

In 2014, a total of 165 HIV positive patients aged under 20 years received ART through MSF's project in Epworth. Eight percent of these patients were under 15 years of age. This year, MSF will continue to advocate for increased access to HIV testing and treatment for children and adolescents.

SOURCE

Global Fund Zim Financial Information

They say information is power - true. But I would like to believe that information is right. Everyone has the right to information. Today our major focus is to know how much money has been set aside to curb HIV/AIDS in Zimbabwe. It has been known for some time that the National Aids Levy is not the only contributor in the funding model to halt the pandemic. There are other key players like Global Fund. Actually, it is the major contributor.

For those who didn't know yet, a grant has been disbursed to Zimbabwe. Before I get into much detail. It must be noted that the Global Fund is a financial mechanism aimed at fighting AIDS, Tuberculosis and Malaria. Owing to this background, the grant has to cover those three diseases.

Below is a table that highlights the financial information for Zimbabwe.

	Signed	Committed	Disbursed
HIV/AIDS	US$ 1,081,866,745	US$ 803,049,798	US$ 729,395,077
Tuberculosis	US$ 100,262,381	US$ 83,539,550	US$ 70,943,940
Malaria	US$ 163,682,428	US$ 144,855,669	US$ 113,809,965
Health Systems Strengthening	US$ 75,713,833	US$ 75,713,832	US$ 75,713,832

In overall, the estimated number of people currently on ART are 670 000 while 25 200 are the new smear - positive TB cases detected and treated. A total of about 4,9 million nets have been distributed that is Insecticide Treated Mosquito Nets (ITNS) and Long-lasting Insecticide-treated Nets (LLINS).

So now you know! It is up to the relevant stakeholders to ensure that the money put aside for fighting HIV/AIDS, TB and Malaria is used accordingly. With such kind of information, we are now in a position to hold the receipients accountable. We are empowered to ask questions related to the above information. Now you know why I say "Information is right."

Aluta continua!
 

Press Release: Zero Discrimination Day

GENEVA — Discrimination continues to affect the lives of millions of people around the world. On 1 March, Zero Discrimination Day, people from all corners of the world will unite under the theme of Open Up, Reach Out in order to celebrate diversity and reject discrimination in all its forms.

The support garnered for Zero Discrimination Day has created a global movement of solidarity to end discrimination, which remains widespread. Millions of women and girls in every region of the world experience violence and abuse and are unable to exercise their rights or gain access to health-care services, education or employment. Discrimination at work, school and health-care and other settings reduces people’s ability to participate fully and meaningfully in societies and provide and care for themselves and their families. Globally, there are almost 80 countries that still have laws criminalizing same-sex sexual relations. Some 38 countries, territories and areas impose some form of restriction on the entry, stay and residence of people living with HIV. Furthermore, legal and social environments are still failing to address stigma and discrimination against people living with HIV and those most vulnerable to HIV infection.

“Discrimination is a violation of human rights and must not go unchallenged,” said United Nations Secretary-General Ban Ki-moon. “Everyone has the right to live with respect and dignity.”

For this year’s Zero Discrimination Day people have been invited to Open Up, Reach Out, using social media channels to tell the world what zero discrimination means to them. People have shared songs, poems, thoughts and activities inspired by the butterfly, the transformative symbol of the campaign. People are also calling on their governments to make greater efforts to realize and protect human rights and eliminate discrimination.

“Some of the world’s most challenging problems can be solved simply by eliminating stigma and discrimination,” said Michel Sidibé, Executive Director of UNAIDS. “As we collectively strive for a fairer world we can be encouraged by the enthusiasm for achieving zero discrimination.”

Among celebrities supporting the campaign are UNAIDS International Goodwill Ambassador David Luiz, who posted a special message on standing up to racism, UNAIDS Goodwill Ambassador Toumani Diabaté and his son, Sidiki Diabaté, as well as the Sri Lankan cricketing star Kumar Sangakkara, whose message is being played on screens at venues hosting the Cricket World Cup in Australia and New Zealand. Governments, lawmakers and business leaders have also pledged their support to the campaign.

Events to mark Zero Discrimination Day include photo exhibitions in China, dancing in Gabon, concerts in Madagascar, a storytelling event for children in Mongolia and special film screenings in Nepal. Seminars and workshops to discuss issues relating to stigma and discrimination will take place in more than 20 countries worldwide, from Colombia to Uzbekistan.

Zero Discrimination Day was first celebrated on 1 March 2014.

SOURCE