Dear Dr. Roach: 

I read on the internet that you should take your blood-pressure medicine at night. I just recently started taking medicine for my blood pressure and my instructions were to take it first thing in the morning. So, when is the best time to take it?

A study published last October showed that, as a group, people who were told to take all their high blood pressure medicines at night had surprisingly fewer bad events (heart attack, heart failure, stroke, procedure to open heart blood vessels or death due to cardiovascular causes) than people who were told to take their medicines in the morning. Subjects in the study could be taking any of the major types of blood-pressure medicines that are normally given once daily.

The reason those who took their medicines at night did so much better might be related to normal physiology. During sleep, the blood pressure normally dips down. In some people, there is a diminished “dip” or even the opposite occurs — a rise in blood pressure. Taking blood-pressure medicine at nighttime restored or enhanced the normal response. In addition, blood pressure normally rises around 6 in the morning, timed with an increase in the blood levels of the hormone cortisol. This is the peak time for heart attacks. It’s possible that having protection from high blood pressure at this time from taking it at night could help prevent heart attacks. That’s opposed to those taking it during the day; at 6 a.m., the medicine is wearing off and protection is at its lowest.

The findings in the study are dramatic. There was a 45% relative risk reduction in the number of people who had any of the bad outcomes studied. This translates to about one person in 18 over the six years of the study not getting an event, or an absolute risk reduction of just over five per cent.

Some of my colleagues have already started telling their patients to change the time they take their blood pressure medicines to nighttime. I would caution against doing so without talking to your doctor. I would also add that taking diuretics at bedtime can cause some people to have to get up during the night.

Dear Dr. Roach: I had a skin blemish removed by burning at a dermatologist office. One wouldn’t seem to heal and a follow-up to the dermatologist with a biopsy found it to be a keratoacanthoma. I am not scheduled for a return visit as there was treatment during the time of the biopsy. What is the prognosis for this type of condition?

A.A.

Experts argue whether keratoacanthoma is a benign tumour (which can sometimes go away by itself) or a skin cancer that can rarely spread to other locations. However, since it can be difficult or impossible to tell the difference between keratoacanthoma and squamous cell cancer of the skin, I think surgical removal is the most appropriate treatment.

If the tumour was completely removed during biopsy, then your prognosis is excellent. However, 3% to 8% of keratoacanthomas recur after biopsy. You should definitely see your dermatologist immediately if you see signs of regrowth at the site of biopsy.

Otherwise, I would recommend a return visit to the dermatologist in six months for a complete skin exam as well as to let the dermatologist look at the biopsy site.

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Global gains made in AIDS fight are under threat due to declining political commitment and funding, Tedros Adhanom Ghebreyesus, director general of the World Health Organization (WHO), said here on Monday.

At an international AIDS conference, the WHO chief said in 2018, 770,000 people died from HIV and 1.7 million people were newly infected and the vast majority of these cases and deaths occurred in Africa.

An AIDS-free world can be achieved with “innovation, community engagement and political leadership,” he told the opening ceremony of the International Conference on AIDS and Sexually Transmitted Infections in Africa (ICASA) that runs in Dec. 2-7 in Kigali.

HIV pandemic will remain a global challenge in the foreseeable future, said ICASA president John Idoko.

He called upon the governments to seek domestic solutions for a sustainable response against HIV/AIDS in Africa.

Rwanda’s President Paul Kagame said at the opening ceremony that stigma and silence are “real killers” for sexually transmitted infections, as they hinder people from learning and accepting their status.

“Open dialogue saves lives,” the president said.

The conference held under the theme “AIDS-free Africa” drew nearly 8,000 participants including leaders, activists, scientists and researchers from across the world to discuss the role of political leadership, collaboration and innovation in advancing efforts to end AIDS by 2030.

More than 37 million people were living with HIV worldwide in 2018, where Africa accounted for about one in every 25 adults infected with the virus, according to the WHO.

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Since the beginning of the response to the HIV epidemic, communities have been at the forefront of the fight to end the disease. Community health workers, key populations, people living with or affected by HIV, peer educators, civil society organizations and grassroots activists have mobilized to step up the fight while ensuring no one is left behind.

This year’s World AIDS Day theme honors these incredible advocates and leaders: “Communities make the difference.” Around the world, community-led organizations and activists are breaking down stigma and discrimination, connecting vulnerable populations to lifesaving health services and bringing all of us closer to our shared goal of a world without HIV. Their stories inspire each of us to make a difference in our own way, in our own communities.

Loyce Maturu was born with HIV and lost both her parents and brother to the disease before the age of 10. Loyce struggled to accept her HIV status, faced verbal and emotional abuse from relatives, missed school due to ill health, and nearly committed suicide. With the support of community health clinics and local nongovernmental organizations, Loyce began receiving antiretroviral treatment and psychological counseling. “That’s when I told myself, I would not remain silent,” Loyce said. “I want to share my story so that people can have an understanding of how it is like living with HIV.” Since 2009, Loyce has been a peer counselor and advocacy officer for people living with HIV, helping deliver anti-discrimination campaigns in schools and communities throughout Zimbabwe.

Sepi Maulana Ardiansyah, known to his friends and followers as Davi, was sexually abused as a teenager, trafficked into sex work, and infected with HIV. This harrowing experience altered the trajectory of his life. But once diagnosed, Davi took control. He started on treatment, left sex work and became an advocate for the rights of young people like himself. Now Davi uses his large social media following to push back against stigma and discrimination. He reaches young people in Indonesia with information about HIV, the importance of knowing your status and adhering to treatment. “I wanted to contribute because I saw my friends die from the blatant stigma and discrimination, which seemed to make them reluctant to undergo treatment.”

In Ulaanbaatar, Mongolia, Delgerzaya M. (left) and Usukhbayar D. (right) help connect sex workers with the Perfect Ladies, a nongovernmental organization offering HIV prevention training, outreach, testing, stress management resources and counseling for sex workers. As a former sex worker, Delgerzaya said: “We are the same women. I understand their challenges better than others.” Community organizations like Perfect Ladies help sex workers access the tools and skills to protect their health.

Every day, Sandrine Kouadio visits about 40 sites in her community, known as “smoking rooms”, to keep an eye on the health of women she considers her “sisters”. Sandrine is a former drug user, and now provides counseling services, information on HIV, TB prevention and sexual and reproductive health to other women who use drugs in Abidjan, Côte d’Ivoire. Women are at a higher risk of violence and face greater stigmatization than men for using drugs. “When you are a female drug user, you are denigrated and rejected because the use of drugs is tainted with prostitution and loss of virtue,” said Sandrine. “Every woman has the right to health. This is my battle. Being able to support them feels like being born again.”

Altaf Sheikh (right) is a transgender community activist living with HIV in Mumbai, India. India’s transgender community, or Hijras, are a marginalized group with very high HIV infection rates, more than 15 times higher than the general adult population in India. As a former sex worker, Altaf remembers suffering discrimination and stigma. “I was alone when I found out I had HIV. Nobody was there with me.” Today Altaf is a peer educator and outreach worker for the Vihaan Care and Support Program, a community-led initiative that works with India’s national HIV program. Altab visits homes and accompanies hijras to take HIV tests. “They are not alone anymore.”

Martha Clara Nakato was 14 years old when she learned she had been born with HIV. At first gripped by fear, she fought to overcome the misconceptions in her community. “Having people call you all these ugly words, having people judge you, having people blame you for living with HIV has been the hardest thing in my life,” she said. Today, Martha is a community advocate and volunteer with the Uganda Network of People Living with HIV. Her mission is to remove the shame surrounding HIV. “I believe that we cannot fight HIV, we cannot end it, if we do not address the shaming of people living with HIV.”

Connie Mudenda lost three children to HIV. “AIDS took all three of my children. I lost all three of my children because I was unlucky.” After learning her status, Connie considered herself lucky to be able to access lifesaving treatment and find counseling and support. With the help of community health organizations, Connie gave birth to an HIV-free daughter in 2012. Today she is a proud mother, a fierce advocate in the fight against the disease, and an ambassador for (RED), an organization that partners with the world’s biggest brands to raise money and awareness to end AIDS. At the Global Fund’s Sixth Replenishment Conference in Lyon, France, in October 2019, Connie called French President Emmanuel Macron, heads of state and global health leaders to action. “We need to take luck out of the equation and put justice in its place,” she said.

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Wound healing events in mucous tissues — part of the body’s defense against germs — during early infection by Simian Immunodeficiency Virus (SIV) guard some primate species against developing AIDS, a study has found.

Aspects of this wound-healing immune response could become targets for developing new therapies to prevent AIDS in people with HIV infections, according to the researchers from the University of Washington School of Medicine in the US. The research, published in the journal Nature Communications, looked at why certain species can carry the virus throughout their lives, and still avoid disease progression.

SIV is closely related to the Human Immunodeficiency Virus and is used as a laboratory model for many studies seeking AIDS and HIV cures and preventions.

Despite effective treatments to manage HIV, the virus remains a major global health threat, the researchers said.

Nearly 37.9 million people in the world are living with an HIV infection. Each year about 770,000 people die of AIDS, they said.

There are no clinically available vaccines against HIV, or cures for the infection, till now.

New study

In the latest study, scientists sought to uncover, in natural hosts, successful virus-fighting tactics that could inform the design of better antiviral drugs to treat HIV in people.

They found that the biological events involved in wound healing of mucosal tissues create an environment inside the body that protects against the destructive consequences of SIV infection.

The researchers compared virus-host interactions and immune response to SIV, including gene expression profiles, from the African green monkey — a natural host for HIV — with those from an AIDS-susceptible species, the rhesus macaque.

Similar data from human HIV infections was also evaluated.

“The use of public datasets were a key component of this research and highlights the importance of the scientific community sharing their data in public forums,” said Fredrik Barrenas from the University of Uppsala, Sweden.

The researchers explained that both HIV and SIV infect immune cells called T helper cells. These cells are abundant in the intestine and in specialised tissues elsewhere in the body.

The HIV infection provokes an immune response that injures tissues surrounding the intestine, the researchers said.

This injury allows the bacteria that normally reside in the gut to penetrate the tissue and invade other sites in the body, they said.

This causes further inflammation and damage. The situation attracts more immune cells, some of which get infected with HIV, according to the researchers.

Others undergo a programme of spontaneous cell death. Deterioration of the immune system and further decline of infection-fighting T cells can follow, they said.

If the infection progresses to AIDS, the syndrome lowers the ability to resist opportunistic pathogens and fend off cancer.

The researchers found that, in contrast, African green monkeys in the early stages of SIV infection quickly activate and maintain regenerative wound healing mechanism in their mucosal tissue.

For example, in the monkeys, a white-cell mediated remodelling of tissue occurs.

Some of the repair mechanisms, the researchers said, are evolutionarily conserved.

The green monkey’s ability to activate mucous tissue wound healing, the research team found, interrupts the course of the disease such that the onset of AIDS is avoided.

“We think the regenerative wound healing process likely preserves the tissue integrity, and could prevent the inflammatory insults that underlie immune exhaustion, cell death and AIDS that happen due to SIV or HIV infection,” said Michael Gale, a professor at the University of Washington School of Medicine.

“This maintenance of tissue integrity would be a valuable therapeutic strategy to avoid systemic immune activation and progression to AIDS.

“Our findings indicate that the use of therapies that stimulate the wound healing response during early infection could have a protective effect against disease from HIV infection,” he said.

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The rapid increase in HIV infection among the gay population in China has been brought primarily under control due to improved education and intervention measures in recent years, a leading expert at the Chinese Center for Disease Control and Prevention said.

However, Wu Zunyou, chief epidemiologist at the center, said the number of new HIV cases among heterosexuals is still rising rapidly, posing a major threat to overall HIV/AIDS prevention and control in China.

About 6.9 percent of gay men who received tests through the National Sentinel Surveillance Program last year were HIV positive, down from a peak of about 8 percent in 2015.

In 2005 the rate was less than 2 percent, he said.

“We can draw the conclusion that the HIV epidemic among the MSM (men who have sex with men) group has initially been brought under control,” Wu said, adding that risks of HIV transmission in the group may continue to fall.

Although most new HIV cases reported each year in China are still heterosexual, the rapidly rising number of HIV cases among the MSM population in many big cities in China has worried health authorities and experts in the past few years.

In Beijing, for example, MSM has been responsible for the majority of newly reported HIV/AIDS cases in recent years. Of the more than 2,800 cases reported between January and October last year in the capital, nearly 70 percent were transmitted through sex between men, according to the city’s health authority.

Compared with other groups, MSM have much higher chances of HIV transmission.

It is estimated that 1.25 million people were living with HIV in China by the end of last year, though about 30 percent of them were not diagnosed and therefore unaware they had the virus, according to the National Health Commission.

The commission estimates that every year about 80,000 people in China are infected with HIV.

Wu, from the Chinese CDC, said constant publicity and education efforts targeting the MSM group in recent years, especially improved community-based services, have played a key role in containing HIV transmission.

In addition, recent advances in early diagnosis have contributed to improved HIV prevention and control in communities, he said.

“The number of HIV/AIDS cases among heterosexuals in China is still rising,” he said. “The group will be a key for HIV/AIDS prevention and control in the long run.”

Last year, heterosexuals accounted for 71 percent of the total number of new HIV/AIDS cases in China, up from 69.6 percent in the previous year, he said.

Improved diagnosis is urgent for effective control and prevention so new cases can be identified in a timely manner, Wu said.

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Nov. 16 through to Nov. 22 marks National HIV Testing Week 2019. Charities like the Terrence Higgins Trust have spent decades destigmatising HIV, supporting people who live with it, and educating people to practice safe sex. In 2019 getting diagnosed with HIV is not what it was a few decades ago. People live happy full lives with a positive diagnosis. So, here’s how you can get involved this National HIV Testing Week. Getting a HIV test is a super simple step in getting an STI test and is over within seconds. However, knowing your status is so important when it comes to your sex life.

National HIV Testing Week was created to encourage people to get tested and normalise conversations around HIV and sexual health. Getting tested and prioritising your sexual health should be second nature and this includes being tested for HIV. Treatments have developed so much that they work by reducing the amount of the virus in the blood to undetectable levels. This means that the levels of HIV become so low that the virus cannot be passed on.

This National HIV Testing week a number of famous faces have joined forces with the Terrence Higgins Trust to raise awareness for what happens when you go for a HIV test and how easy it actually is. E4’s The Sex Clinic nurse Sarah Mulindwa and This Mornings Dr Ranj are among the people raising awareness. Dr Ranj said in a statement, “getting tested is nothing to be worried about – I’ve been tested in the past and it’s quick and easy. You’ll be in a better situation knowing your status than not knowing. With effective treatment, people living with HIV can not only live long healthy lives but they can’t pass it on to others.”

According to Public Health England and estimated one in 14 people in the UK with HIV are living with it and remain undiagnosed. The Terrence Higgins Trust recommends that you go and get tested at least once a year, if not more.

Charities, campaigners, and celebrities have fought tirelessly to open up conversations on HIV and showing how easy it is to get tested. Former Welsh Rugby Captain Gareth Thomas has been praised by so many people, including Prince Harry, after speaking so openly about his own HIV diagnosis. The pair sat down for a chat in a video made by the Terrence Higgins Trust and Thomas said, “we do so much around our health – going to the dentist, going to the doctor. But when it comes to sexual health testing there’s the stigma and fear around it.” He continued:

“We need to re-educate people to know that where we are now with HIV it is not a death sentence, it’s not and I am living proof.”

Taking control of your sexual health is so important. Knowing your HIV status is crucial and there’s absolutely nothing to be embarrassed about when you go to get tested. If you want to get tested you can either book to see your GP, or go to a walk in-centre. Alternatively, the Terence Higgins Thrust offers HIV self-testing kit for those most at risk of HIV.

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Cure for HIV/AIDS is still not found as there are so many types of virus which makes it difficult to make a vaccine. Since every strain of HIV requires a separate method to eliminate them, epidemics such as AIDS and Cancer are still incurable. But for the first time in 19 years, Scientist has discovered a major new strain of HIV which could be a big breakthrough for finding the HIV/AIDS cure.

The latest strain uncovered is part of the HIV-1 version, Group M and the same family of viruses is mainly responsible for spreading the disease all over the world. Abbott Laboratories and the University of Missouri, Kansas City conducted the research together and are now working on a possible solution to kill the HIV strain and cure the deadly disease.

HIV generally has many different types of strains and the virus can mutate over time which makes the use of simple drugs ineffective in killing them. The first Group M HIV strains were discovered in 2000 and now a new type has been found which means that the test to detect AIDS is effective.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases has said that the biggest problems lie with identifying the cause of HIV and discovering the new strains will help them understand how the viruses evolve. Fauci also assured people not to panic as there are very rare chances of someone getting affected by it and they are also working on a cure based on the discovery.

Treatment to Eliminate the HIV Strain

The Scientists at Abbott and the University of Missouri have been searching for new types of HIV strains for years and it was like looking for a needle in the haystack. The sample HIV strain was fully sequenced and they now have a clear structure and it was found out that it was subtype L from the M Group.

The latest discovery is an indication that to cure HIV/AIDS one must learn how it develops and functions. The virus is constantly changing and hence they develop a treatment that can also evolve and keep up with HIV and eliminate it at the end.

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Bernie Sanders became the first 2020 presidential candidate to come out in support of finding a global cure for AIDS. Scientists and researchers have been working toward a cure, but they insist that full support and additional resources from the government is necessary to find the solution. With his announcement, Sanders told the Research Foundation to Cure AIDS that “the U.S. can lead the world in finding the global cure for AIDS,” Block Toro reported.

Since Sanders’ announcement, almost every other presidential hopeful followed suit, supporting a cure for HIV/AIDS.

“We have all of the technology needed to end AIDS-related deaths and stop HIV transmission and develop a working cure for AIDS,” Sanders said. “All we need now is the political will to do it.”

In a series of questions asked by the Research Foundation to Cure AIDS (RFTCA), Sanders said that as president he would form a team of the top U.S. scientists, researchers and doctors to find a cure for HIV/AIDS, make sure every citizen had access to affordable treatment, work with the international community to help find a cure, as well as provide affordable medicine and hold Big Pharma accountable.

Sanders’ leadership and support of the cause won him praise by Kambiz Shekdar, Ph.D., RFTCA president.

“The cure for HIV/AIDS has been proven possible but the main struggle is to raise the funds needed to make it happen in real life,” Shekdar said. “We would need a presidential leadership like Bernie’s for developing the cure for all the patients in need.”

According to a transcript, Sanders “introduced curing AIDS as a new pillar” to his comprehensive AIDS address.

“Bernie believes that we can and we must end the AIDS epidemic in the United States and abroad, and we can lead the world by developing a cure for AIDS. Bernie will invest significant federal resources and convene experts, advocates, scientists, and researchers to ensure this goal is met. The United States has before come together to achieve things once thought impossible. What we need is a grassroots political movement that will stand up to the greed of the pharmaceutical industry and take the steps necessary to ensure we end the AIDS epidemic by 2025 and ensure no person in America dies because they cannot afford medication or health care. Bernie is proud to say he will, alongside a political movement, rise to this challenge.”

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Last year I marked 10 years since I became HIV positive. It has been a long journey, from the fear of acceptance and today, advocacy, knowing that my treatment keeps me healthy and prevents HIV being passed on to any partner.

With the developments in pre-exposure prophylaxis (PrEP), a daily tablet which can stop a person from getting HIV, we have a real chance of ending HIV transmissions.

Robust scientific evidence has shown that PrEP is highly effective at preventing HIV. Yet, England is the only place in the UK where access to PrEP is restricted. Organisations including Terrence Higgins Trust and the British HIV Association are clear that this needs to change. England has lagged behind on PrEP for far too long

The PrEP Impact Trial was launched across England in October 2017 with 10,000 places available. Due to soaring demand, the trial places were increased by an extra 3,000 in September last year.

In January, the secretary of state Matt Hancock committed the UK Government to end new HIV transmissions by 2030. To assist this aim he promised to double the number of places on the PrEP Impact Trial, with NHS England agreeing to fund the cost of the drug for these extra places.

The trial comes to an end in September 2020. Demand remains high, and we must ensure that while the trial remains in place no one is turned away from accessing PrEP.

The Government must also now turn their efforts to ensuring that PrEP has a permanent home within sexual health services. In the past few months NHS England, Public Health England, local authorities and even the Department of Health and Social Care have said there must be a smooth transition between the trial and routine commissioning of PrEP.

A national PrEP programme needs to be introduced by April 2020 to ensure that those currently on the trial don’t face a cliff edge in September 2020.

We all are aware of the budgetary pressures faced by councils as a result of continued cuts to public health budgets. The tension around funding is tricky. The reality is that NHS England are funding the PrEP drug, but it’s local authorities that fund sexual health clinics.

When the Impact Trial started, only the branded PrEP drugs were available. Now it’s available as the generic version – at a fraction of the price. But the reality of creating more sexual health appointments when the funding has been cut is a very real challenge. However, this cannot justify the withholding of a tool that we know can prevent HIV.

We now know that at least 15 men have contracted HIV while waiting for a place on the trial. And this is likely to be the tip of the iceberg. This is the reason why I am urging the Department of Health and Social Care, NHS England, Public Health England and local authorities to work together to find a viable and stable future for PrEP as a national programme.

If we are to have a smooth transition, the challenges facing routine commissioning must be ironed out and resolved sooner rather than later.

As Phil Samba, a PrEP activist puts it: “PrEP means that I can finally feel completely in control of my sexual health for the first time. No one should be turned away from this HIV game-changer and it must be routinely available.”

PrEP works. PrEP saves the NHS money in treatment costs. PrEP will help us end HIV transmissions. PrEP transforms the lives of people at risk of HIV. So why the hell are we still waiting for full access to this game-changing drug?

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David Austin was diagnosed with HIV while living in London in 1993.

In a television interview, the journalist talks about how her family was unable to bring his body back home for burial because of his condition.

Her story is part of a new documentary in which County Antrim actor Matthew Cavan talks about living with HIV and the abuse he endured.

True North: Cherrie, Me and HIV is narrated by Matthew, who also talks about living as a gay man in Northern Ireland and the prejudices he encountered.

He was diagnosed as HIV positive 10 years ago – something he says changed his life and had a huge impact on those closest to him.

The documentary focuses on what has changed since the Aids epidemic first came to the public’s attention in the 1980s and how close scientists are to finding a cure, if at all.

During the programme, Matthew visits Wendy Austin and her daughter Kerry.

The veteran broadcaster said her brother broke the news of his illness to her during a visit to London.

“He [David] got in touch with me one day and said: ‘I’ve got some really bad news for you – I’m an alcoholic and I’m HIV positive’.

“He did start to go downhill very quickly and the next time I saw him in London I thought that, really, mum and dad needed to come over.

‘Sad journey’

“So we went over for the weekend, the three of us, and we saw him then. I have to say he looked beyond dreadful.

“Actually, I think that was the last time I saw him and the last time mum and dad saw him.”

She spoke about how the family had to make the “sad journey” to London for his funeral.

“One of the things that we discovered was there was no question of being able to bring his body back here because he had died from Aids, ” she said.

“He was zipped up in a bag and taken away and that was that. He had to be cremated.

“People would stop me in the street and say: ‘I’m sorry to have read that about your brother, but good for you for talking about it.'”

During the programme, Matthew Cavan also returns to his family home.

In a poignant discussion, he explores with his parents how his sexuality and diagnosis impacted on them and their strong religious faith.

He also meets people who are helping prevent further cases of the condition and talks to those who understand the stigma around HIV.

Matthew also speaks to the doctors who treat his condition and finds out more about how, with the right medical help and support, men and women with HIV can expect to live a healthy, happy life.

During the documentary, Matthew introduces his colourful drag alter-ego, Cherrie Ontop, who brings sparkle and fun into his life and helps him cope with the pressure of living with HIV.

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THIRUVANANTHAPURAM: In the fight against HIV/AIDS, Kerala has set a new record at the national level. In the last four and a half years, the state has reported zero cases in HIV transmission due to injecting drug use (IDU). According to the Kerala State AIDS Control Society (KSACS), the achievement is nothing short of a challenge as they had to fight theft, intimidation, threat to kill and others from the drug mafia. 

IDU is an important route in HIV transmission and it is spread through risk behaviours related to the sharing of contaminated needles and syringes as well as through high-risk sexual behaviour and sex for the exchange of drugs.

“This is a remarkable achievement. When the state reported zero IDU cases, the prevalence rate at the national level is 6.6 per cent,” said Dennis Joseph, joint director, KSACS. 
“It was because of the successful implementation of the Needle Syringe Exchange Programme (NSEP), Opioid Substitution Therapy (OST) and constant monitoring that the state emerged as a model in containing HIV transmission via IDU,” he added. 

According to him, through the intervention programmes that include five projects across 10 OST centres in the state, the prevalence rate has been brought down to zero from 9.57 per cent in 2006. “For that, we had to face several challenges. NSEP is about providing sterile needles and syringes to drug users. But we get ridiculed for promoting drug use. When the importance of the same was understood by the critics, they extended their wholehearted support for the same. The major threat for IDU-targeted interventions now comes from the drug mafia,” said Dennis. 

It is learnt that to sabotage it, the drug mafia is using various strategies. Other than intimidation techniques, registering themselves as patients at OST centres and providing false inputs to authorities and media, stealing methadone (used in OST as a substitute drug in the treatment of morphine and heroin addiction) are some of the other strategies being followed by them. 

“The drug mafia is desperate to sabotage our targeted intervention. Thus, they step up surveillance at OST centres. They target those who come here for treatment. By providing them with drugs free of cost, they persuade patients to discontinue treatment. They also issue death threat to peer educators and outreach workers who help us identify new drug users and the shooting galleries (the place where intravenous drug users rent or borrow needles and syringes),” said Dennis. 

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SAMBALPUR: HIV positive people under the banner of ‘Network of Positive People, Sambalpur’ have come out in support of VIMSAR dental surgeon PK Swain, accused of performing surgery on an afflicted patient without following protocol. The people on Saturday submitted a memorandum to the District Collector, addressed to Chief Minister Naveen Patnaik demanding to end the inquiry going on against Swain. 

On October 28, Swain had conducted the surgery of an HIV positive patient at the dental wing of the hospital. However, he was accused of not following set protocols for the surgery. Following the incident, on October 30, a five-member team was formed to probe the alleged violations. Hospital sources informed that the inquiry is in progress and the team is yet to submit is report.

Founder member and secretary of ‘Network of Positive People, Sambalpur’ Amarendra Behera said, “I have been witnessing cases where HIV positive patients are denied any kind of surgery in VIMSAR. The doctors here usually refer such patients to other hospitals. The HIV positive patients are also being subjected to discrimination since they are afraid to disclose their identity owing to social stigma associated with the disease.” 

Under such circumstances, the surgeon, who performed surgery on an HIV positive patient on humanitarian grounds, deserves to be commended for his act. But instead, some people are trying to malign his image and the hospital authorities have initiated an inquiry against him which is unjust, he said.

Behera said the surgeon had taken all precautions while operating upon the patient. Besides demanding termination of inquiry against the doctor, the organisation asked the government to act against those who hatched a conspiracy to blame the surgeon. Moreover, they have urged the Chief Minister to take steps to felicitate the surgeon at the state capital on World AIDS Day for his noble act.

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She is one of about 20 children aged 18 and under living in Wales with the disease.

Jessica – not her real name – told BBC Wales Live she wept as jokes about the condition went unchallenged.

Campaigners said there should be a new education drive about HIV and how medicine has revolutionised treatments.

Jessica said myths about the disease persist – that touching or sharing a cup or even a hat can pass on the virus, and people with HIV will die of AIDS.

But drugs introduced more than 20 years ago mean those living with HIV can control the infection so effectively it is undetectable and cannot be passed on to another person, even through sexual activity.

Antiviral treatments used since 1996 also mean those with the virus will enjoy the same life expectancy as those without the condition.

• ‘Just a little illness’
• ‘Why Gareth Thomas’ example is important’
• HIV – The facts

Jessica said she sat through lessons in school where incorrect information was shared with other pupils and jokes about the illness were allowed.

“I was sat at the back of that classroom and I cried my eyes out. But I had to hide it at the same time, because these were people that I wanted to potentially tell,” she said.

“I’ve never been so shocked and ashamed of myself in my entire life – I shouldn’t have been upset in that way.”

Consultant pediatrician Dr Jennifer Evans said this was not a surprise.

“If people have a serious diagnosis of cancer there’s huge amount of sympathy – this diagnosis is still met with a lot of suspicion,” she said.

“That transmits itself into feeling bad about yourself.”

Jessica agreed: “If there was less stigma, I would 100% be the person out there talking to all my friends.

“I feel like those conversations would’ve been a lot easier if in school it was educated properly.”

Abi Carter, an participation officer with the charity Chiva – Children’s HIV Association – said the lack of education about the disease could hold people back.

“We need another public information campaign about HIV, which is updated with all the revolutions that have happened in medicine over the last 20 to 30 years. There’s a lot of misinformed people out there.

“It’s time that we really busted some of these myths.”

A Welsh Government official said the new education curriculum included guidance on learning how to find information from trusted sources to inform decisions and “challenging harmful social influences”, including stigma.

“We recognise how HIV has changed in terms of risk and disease profile in the last decade and think it is important that teachers should have the most up-to-date information on HIV available to them.”

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HRSA’s Ryan White HIV/AIDS Program will be critically important in a number of ways. Not only will it reduce HIV transmission by improving access to HIV treatment and antiretroviral medication, but it will also give those living with HIV access to a better state of health. This is significant, as many who have HIV and daily medication as prescribed (and who maintain an undetectable viral load) have effectively no risk of sexually transmitting the virus to a partner without HIV.

The following is a breakdown of how the funds were allocated, and for which initiatives:

A sum of $628.3 million was awarded to 52 metropolitan areas to provide core medical and support services to people with HIV. These grants were awarded to 24 eligible areas and 28 transitional grant areas with the highest concentration of people with HIV and AIDS and that see emergency care needs.

A sum of $1.3 billion was awarded to 59 states and territories to improve the quality, availability, and organization of the HIV health care and support services and for the AIDS Drug Assistance Program (ADAP). In addition, 16 states received Emerging Community grants based on the number of AIDS cases over the most recent five-year period, and an additional $11.2 million was awarded for an initiative for minority individuals living with AIDS.

Approximately $181.8 million was awarded as a part of the Early Intervention Services (EIS) to 349 local, community-based organizations. This sum aims to provide core medical and support services to people with HIV. Also, 76 organizations were awarded approximately $10.2 million in other Capacity Development grants.

Another part of the program allocated $69.7 million to 115 local community-based organizations to provide family-centered comprehensive HIV care and treatment for women, infants, children, and youth with HIV.

A sum of $66.7 million was awarded to support clinical training, oral health services, quality improvement, and the development of innovative models of care through several different programs.

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