The 4th Global Forum on Children Affected by HIV and AIDS, taking place in Dublin, has called for a package of social welfare services to tackle child poverty and assist households in developing countries affected by HIV and AIDS.

The forum, attended by 200 delegates from 42 countries, is co-hosted by Irish Aid, the Government’s overseas aid programme, and UNICEF.

The Forum will attempt to secure commitments for children affected by HIV and AIDS to realise their right to health, education and welfare. The provision of social services is key to ensuring that children living in households affected by HIV and AIDS are not forced to drop out of school to care for sick relatives or to engage in paid work when a breadwinner falls ill.

Cash transfers and other social welfare instruments may alleviate poverty, improve school attendance and nutritional intake, the Forum heard.  Delivering the key note speech, the Prime Minister of Ireland, Brian Cowen TD, re-affirmed the Government’s commitment to the world’s poorest children and said: “All the evidence points to broad social protection and welfare approaches as a means of mitigating the impact of HIV on children. Our own history of social policy and protection, with the introduction of pensions and allowances, demonstrates the importance of these instruments in responding to household and child poverty.”

The Executive Director of UNICEF, Ann M. Veneman joined the Taoiseach at the Forum.  Speaking about UNICEF’s work with children affected by HIV and AIDS, Veneman said: "For too long children have been the missing face of the aids pandemic. This conference, generously co-hosted by the Irish government, provides an important opportunity to discuss approaches for dealing with children impacted by HIV and AIDS.”

Singer and HIV/AIDS Campaigner Annie Lennox will also address the Forum. 

Additional Notes:
This is the fourth meeting of the Global Partners’ Forum, established to provide momentum in fulfilling global commitments for children affected by HIV and AIDS as enshrined in the Millennium Development Goals and the 2001 United Nations Declaration of Commitment on HIV and AIDS. The forum brings together leaders in Government, civil society and the United Nations to review progress, set priorities, and make commitments for children affected by HIV and AIDS. 

Ireland has made a high-level political commitment to the global HIV/AIDS pandemic. With over €100 million being spent annually on HIV and other communicable diseases, the Government is investing in programmes that are benefiting those most in need, with a particular emphasis on supporting children. Resources are channelled through a range of organisations working at global, regional, country and community levels.

About UNICEF:
UNICEF works on the ground in more than 150 developing and transitional countries to help children survive and thrive. The world’s largest provider of vaccines for poor countries, UNICEF works to advance the Millennium Development Goals by supporting child health and nutrition, quality basic education for all boys and girls, access to clean water and sanitation, and the protection of children from violence, exploitation and AIDS.

UNICEF 

If you live along the main highway linking Abidjan, Côte d'Ivoire's economic hub, with Lagos in Nigeria, it is almost impossible to ignore the many AIDS awareness messages along the route, travelled by 47 million people each year.

"A few years ago I would never have believed it was so easy to get tested [for HIV], since it's so difficult to talk about AIDS in our communities," said Madeleine Abboh, a hairdresser in Hillacondji, a town in Benin near the border with Togo.

Abboh was attending the 'Caravane pour la vie' (caravan for life), an annual travelling HIV/AIDS awareness campaign organised for the third successive year by the Abidjan-Lagos Corridor Project in the five countries - Côte d'Ivoire, Ghana, Togo, Benin and Nigeria - that the road goes through. She took advantage of the event to be tested for HIV, as 79,000 other people between 2005 and 2007 have also done.

This regional project, launched in 2003 by the World Bank and funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria since 2007, has focused on often neglected border areas between countries and groups of people who depend on the 825km road and are particularly vulnerable to HIV: truck drivers, sex workers, security forces, traders and communities.

Around 800,000 people have been reached by the awareness campaign since the project began. According to an audit report at the end of 2007, more than 18 million condoms had been distributed.

Radio – a preferred form of media

All available means of communication were used to reach target groups: more than 5,900 radio and 50 television commercial spots were produced and broadcast on the project's partner stations, as well as programmes aimed at vulnerable groups.

"The programmes scared people," said Jean Discipline Adjomassokou, mass media officer of the Corridor Project. "In Hillacondji, sex workers abandoned their trade as they no longer had any clients, and brothel owners were forced to close down."

Partner radio stations were encouraged to broadcast programmes as often as possible, so that the "target groups could have the opportunity to listen to them at any time of the day, depending on their jobs," Adjomassokou added.

Sometimes the results were immediate. A young motorist, who asked not to be named, said he was parked near the border between Benin and Nigeria one day, in the middle of having casual sex, when a radio programme started on which the presenters and guests were emphasising the importance of wearing a condom when having risky sex.

"I was ashamed and I couldn't carry on with the act, [I] lost my erection," he told IRIN/PlusNews. "A few days later I started having problems with my penis. When I went to the hospital, the doctor [told] me that it was gonorrhoea [a sexually transmitted infection].

"I knew I had been lucky, and that I could have caught HIV if my casual partner had had the virus. Since then I no longer have unprotected sex with casual partners," he said.
The Corridor Project originally covered eight areas, but now operates in 22 and has expanded its work to non-border areas. "Lots of people criticised us a few years ago because we limited our work to border regions," said Harvey de Hardt-Kaffils, the project's information, education and communications officer.

"They asked us to expand our range, which we've done, but it still isn't enough; we need to do more."

PlusNews 

Bellissima, on bustling Gabon Street in the Ethiopian capital, Addis Ababa, could be just another upmarket café, except that each order comes with a packet of 'Sensation' condoms, and is served in 'Sensation' cups by staff wearing 'Sensation' T-shirts.

"I wanted to link business with a message for sexually active people," Bellissima's owner, Hayat Ahmed, 26, told IRIN/PlusNews. "I am the brand ambassador for 'Sensation' condoms in Ethiopia, and I want to spread the message that condoms can protect you from HIV/AIDS."

Hayat, a former beauty queen, has been involved in HIV/AIDS campaigns since she was crowned Miss Ethiopia in 2003 and subsequently named an HIV/AIDS ambassador.

Her face adorns billboards and she regularly appears on Ethiopia's only television station promoting condom use. "When I walk down the road even children recognise me," she said. "But they do not call me Hayat; they call me 'Sensation'."

Modelled on 'condom bars' in Asia, Bellissima handed out six boxes of condoms, each containing 48 packets of three-in-a-pack, within two days of opening its doors.

The free condoms have elicited mixed reactions, with older patrons tending not to like the idea, while younger ones love it and sometimes ask for a second packet.

"We have had young people come in and ask 'Is it true that you actually give free condoms?' and when we say, 'yes', their faces brighten up and they quickly order," said one waiter. "But we have also had people who get shocked when we bring the bill with a condom, some saying we are promoting immorality."

Guests do not have to take the packs home when they leave the restaurant. "It is your choice to take it or leave it," Hayat said. "We also plan to set up condom vending machines in the toilets."

Her campaign is supported by social marketing groups such as the non-profit organisation, DKT-Ethiopia, which sold almost 60 million condoms in 2007 and also launched a coffee-flavoured version of Sensation condoms. Ethiopia is widely thought to be the birthplace of coffee and it is very popular.

Hayat intends to open more cafés in the capital and other towns, and continue promoting various anti-HIV strategies, including abstinence and faithfulness. She might even expand the 'condom bars' concept to other African countries.
"A lot of people in Ethiopia are ashamed of talking about or using condoms," said. "Yet some companies put condoms in their toilets and when you go to look, each day, the boxes are empty. I don't care if the condoms are used behind closed doors or in public – as long as many people use them."

Ethiopia's HIV prevalence is estimated at over two percent among sexually active people aged 15 to 49. A report by the Federal HIV/AIDS Prevention and Control Office in March noted that between 2000 and 2005, condom use among males increased from 30.3 percent to 51.9 percent, and among females from 13.4 percent to 23.6 percent.

According to Ethiopian government data, half the public sector institutions and 20 percent of private businesses have mainstreamed HIV/AIDS prevention in their operational policies.

However, Philopos Petros, head of the Ethiopian Civil Service College's HIV/AIDS management unit, noted that "There are still educated people exposed to HIV and dying of AIDS," and said greater awareness was necessary.

"One person cannot change the world, but I want to make a contribution," Hayat said. "I have a name and the will, and I will use that."

PlusNews

While researchers and advocates at the International AIDS Conference this week urged donors and governments to rapidly scale up male circumcision programmes, others raised concerns about what this would mean for women.

In March 2007, the World Health Organisation and UNAIDS issued recommendations that gave the green light to male circumcision as an HIV prevention strategy, after studies in Kisumu, Kenya and the township of Orange Farm in South Africa showed that it could reduce the risk of infection by up to 60 percent.

But the recommendations also stressed that not enough is known about whether male circumcision reduces sexual transmission of HIV from men to women, making the intervention "highly problematic" according to Marge Berer, editor of the London-based journal Reproductive Health Matters. "From a public health perspective, we are told that 60 percent protection [for circumcised men] is far better than nothing. But is male circumcision good enough for women?" she wondered.

A study of almost 3,000 men between the ages of 18 and 24 in Kenya, compared sexual function between circumcised and uncircumcised men, assessing sexual satisfaction over a two-year period. The researchers found that the circumcised group had no higher rates of sexual dysfunction than the uncircumcised men.

According to John Krieger of the University of Washington, Seattle the men that had been circumcised reported more sexual pleasure post-circumcision, and that they found condoms easier to use.
In addition, new results from a male circumcision initiative implemented by Population Services International in Zambia suggest that cultural resistance may not pose as serious a barrier as previously thought, and that it is possible to do the procedures safely and effectively in poor settings, using nurses and clinical officers.

Delegates heard that circumcision also lowers the risk of men getting the human papilloma virus (HPV) that causes genital warts, and trichomoniasis, another common sexually transmitted disease.

What about women?

"All I'm hearing [at the conference] is about what it will do for men, the sexual satisfaction of men...but what about the women? What is their involvement?" commented Siphiwe Hlope, a founder of Swazis for Positive Living (SWAPOL), an AIDS support organisation.

Nicolai Lohse a research officer at UNAIDS said mathematical modelling showed women would benefit from male circumcision as long as it did not result in condom use dropping by more than two-thirds. Women's risk of acquiring HIV would also be reduced if circumcision programmes led to fewer HIV-positive men in the population. The risk to women of HIV acquisition would decline by 2 percent if only 5 percent of men were circumcised, and by 20 percent if half the men in a population were circumcised.

While Berer told delegates on Thursday that the potential benefits of male circumcision were "too large a gamble" for women, many countries in Southern Africa are already in the process of developing national policies on the procedure.
"We have to support these programmes, I don't think we have a choice. But one would really argue that these programmes have a responsibility to women," Berer told IRIN/PlusNews.

She called for campaigns expanding male circumcision to involve couples and not to focus solely on men. Women health advocates also had a role to play in drafting national policies. "No one is going to pull out the red carpet for women's involvement in male circumcision ...it is up to women to stop being victims," Berer added.

PlusNews 

Experience has shown that it is possible to run successful paediatric HIV programmes in rural African settings, yet less than 10 percent of patients on life-prolonging antiretroviral (ARV) drugs are children, field officers of the international medical NGO, Médecins Sans Frontieres (MSF), have said.

"Studies show that without treatment, 50 percent of children with HIV will die within the first two years of their lives," Fernando Parreno, who has worked for MSF's ARV programme in Bulawayo, Zimbabwe's second city, said at the recent International AIDS Conference in Mexico City. "It is imperative that all children are diagnosed and started on treatment as early as possible after diagnosis, or too many children will continue to die."

Children in rural Africa are rarely taken to hospital for HIV testing and accurate testing facilities for children are few and far between, so they are often diagnosed too late to benefit from treatment programmes.

MSF has more than 10,000 paediatric patients in more than 50 projects in poor countries around the world. An analysis of all child patients under five who started taking ARVs in 2002 found that by January 2008, 79 percent were still on treatment.

"In Rwanda, where MSF has over 300 children on ARVs, we decided to increase testing by proposing to all patients that they bring their children in for testing," said Johan Van Griensven, of MSF's programme in Rwanda. "We faced reluctance from the nurses, who were uncomfortable disclosing the HIV status of children, and from parents, who feared a positive result and its implications."

Van Griensven said after training the nurses were better able to disclose a child's status to them in a sensitive and informative way. Parents whose children test positive are actively encouraged to disclose their children's status to them.

"We have developed child-adapted tools to talk to children about HIV in ways they can understand," he added. "But as kids get older their perceptions change, so it is important to keep supporting them as they grow into adolescence; support groups have been very helpful in enabling children to talk openly about their experiences."

Helen Huerga, who is with MSF Kenya, said it was crucial for the family to be involved in the child's treatment, so programmes encouraged parents to attend children's clinic days; she also noted that community support was crucial to follow-up.

Need for suitable ARVs

However, support at the community and health centre level was not being matched with the same commitment by large drug manufactures, according to Karen Day, a pharmacist from MSF's Campaign for Access to Essential Medicines.

"Although there are 13 ARV formulations specifically developed for children, they are not adapted for use in resource-poor settings. Most of them are liquid, and come as three, often unpalatable, separate drugs that are difficult for children to take; others are in powder form and need to be reconstituted. In many cases there may not be an adequate supply of clean water to do this," she said.

"What we need from the drug companies are small, scored – and therefore easy to halve – tablets that are chewable and stable at high temperature and high humidity," Day suggested. "They must also develop fixed-dose ARVs for children; so far, only one fixed-dose exists, and none for second-line treatment."

She said there was a need to reach children earlier with treatment in order to improve their chances of survival. New guidelines by the UN World Health Organisation recommend that children under 12 months be diagnosed as early as six weeks and be started on treatment immediately, regardless of CD-4 count (which measures the strength of the immune system) or clinical signs.

PlusNews 

In an attempt to stem the spread of the virus, African countries are increasingly passing legislation that criminalises HIV exposure and transmission. But these laws could do more harm than good, delegates attending the International AIDS Conference in Mexico, heard on Wednesday.

"Africa has burst into this whole frenetic spasm of criminalising HIV," said South African Justice, Edwin Cameron.

Laws that make HIV transmission an offence are nothing new in the developed world. In Switzerland, a man was sent to jail this year for infecting his girlfriend with HIV, even though he was unaware of his HIV status and a Texas court recently sentenced a man living with HIV to 35 years in prison for spitting on a police officer, although the chances the officer was exposed to the virus were virtually zero.

Now African governments - particularly in West Africa - are jumping on the bandwagon.

Four years ago, participants from 18 countries met at a regional workshop in N'djamena, Chad, to adopt a model law on HIV/AIDS for West and Central Africa. But the law that they came up with was far from "model", in fact Cameron described some of its provisions as "frankly terrifying".

According to Richard Pearshouse, director of research and policy at the Canadian HIV/AIDS Legal Network, the model law's broad definition of wilful transmission could be used to prosecute HIV-positive women for transmitting the virus to their babies during pregnancy.

The law also makes provision for compulsory HIV testing for accused rapists and for the settling of marital disputes; empowers healthcare workers to disclose a patient's HIV status to their spouse or sexual partner; and requires people with HIV to tell their partners as soon as possible or within six weeks of learning their diagnosis.

Worryingly, at least seven countries in West and Central Africa have already used the model as the basis for their national HIV legislation, while at least six others are in the process of developing similar laws.

Some countries have chosen to adopt the "model" law word for word, while others have attempted to simplify it, making the legislation "profoundly human rights unfriendly and human rights regressive", according to Pearshouse.

Southern Africa, where the burden of HIV is the highest, has a mix of effective and ineffective HIV laws, but very few countries have so far introduced legislation that criminalises HIV transmission.

However, Michaela Clayton, executive director of the AIDS and Rights Alliance of Southern Africa, told delegates that in Malawi, a bill with very broad provisions for criminalising transmission, including from mother-to-child, is currently being debated. If found guilty under the proposed law, an HIV-positive person could face imprisonment of up to 14 years. Mozambique is considering passing similar legislation.

"Bad laws can spread the virus"

Speakers agreed that the intentional and malevolent infection of another person is a criminal offence, but warned about the difficulty of drawing a line between criminal and non-criminal transmission.

Julian Hows, from the Global Network of People living with HIV/AIDS, urged delegates to consider the effect of criminalisation laws on HIV-positive people. He said they created "fear and confusion" and made people living with the virus feel like criminals.

"Criminal law is simply the wrong framework for dealing with HIV transmission," Cameron commented. "Everywhere it has been tried, it has been counterproductive and applied unjustly."

Instead of preventing HIV, criminalisation fuels stigma and discourages people from getting tested, disclosing their status to partners or accessing treatment.

Criminalisation is often positioned as a way of protecting women, but Clayton pointed out that because women test for HIV in greater numbers than men, it is women who were more likely to be arrested and prosecuted. She also warned that the laws would create mistrust between people living with HIV and health care providers.

"Just like faulty condoms or unsafe medical supplies, bad laws can spread the virus," Cameron said.

PlusNews

There is a growing belief among men in Swaziland that circumcision provides complete protection against HIV, a perception that worries non-governmental organisations (NGOs) battling the highest HIV prevalence rate in the world.

In recent years circumcision has been lauded by Swazi public health officials as a procedure that reduces the rate of HIV transmission by about 50 percent, but it is far from the silver bullet solution some men see it as.

"The problem is not with the procedure, but the way it is abused by men, so that men think they are now immune from HIV contagion," said Siphiwe Hlope, an HIV-positive woman and founder of the support group, Swazis for Positive Living (SWAPO).

Hlope said SWAPO members were becoming increasingly aware of an attitude that circumcision protected men from HIV infection, while also providing an excuse not to use condoms; something Swazi men have long loathed doing.

Joy Magongo, a mother of two whose husband moved out to live with his second wife after the couple discovered they were both HIV-positive, told IRIN: "Men say, 'I've been circumcised. I don't have to wear a condom.' They get infected, and they give us HIV.
"He [my husband] was circumcised and felt he didn't have to wear a condom. When we found we had HIV after testing, he blamed me. He said, 'You brought HIV into this house.' It was because I tested first, when I was pregnant with my second child," she said.

"My husband did not believe he could be HIV-positive because he was circumcised. I did all I could to convince him to test, and he finally did. That was the end. He took another wife and left us," Magongo said. Polygamy is legally recognised in Swaziland.

"AIDS in Africa has a woman's face," Hlope said. "People think the disease originates with women. Why? Because it is the women who are tested first, when they are about to give birth."

She said Magongo's story was an unintended consequence of the circumcision campaign by the country's health ministry and AIDS NGOs. "Families blame women when HIV comes into the house, and it results in all sorts of abuse, from physical abuse to denial of spousal and child support, and loss of property rights."

While not disputing the advantages of male circumcision in reducing the rate of HIV transmission, Hlope said the gender dynamics of Swaziland's culture should be taken into account. The incorrect belief that circumcision was a panacea for the disease was making life more difficult and dangerous for women.

Law of unintended consequences

"It's the law of unintended consequences," said a Zambian doctor who treats HIV/AIDS patients at government hospitals, and who declined to be named. "Introducing the procedure, there was insufficient attention given to cultural factors, attitudes and human psychology.

"Many of the men I speak with think circumcision is like an AIDS vaccine. It's not. It's a useful tool to reduce chances of infection at a time and place where few other tools are available, but you can still contract HIV and pass it onto a partner," he said.
Jackson Dlamini, 25, a strapping man taking a break from weight training at a local gym, told IRIN he was considering circumcision as a way to protect himself from HIV. "This AIDS is bad. Nobody admits they are HIV [positive], but so many people are dying. I don't want to give up sex, so I am getting circumcised," Dlamini said.

When told that counsellors at Mbabane Government Hospital would advise him to carry on using condoms even after the operation, Dlamini said, "It is painful to get circumcised. If I have to wear a condom anyway, what is the point?"

HIV counsellor Henry du Pont is used to hearing men express similar sentiments. "The problem with male circumcision is not the procedure, but communications," he told IRIN. "We always end up against men's stubborn dislike of condoms."

A recent study by the UN Development Programme found only 20 percent of Swazi men consistently used condoms, which Hlope said probably indicated that circumcised men did not stop using condoms after circumcision, but had never used them in the first place.

Education about circumcision should stress a clear and consistent message that the procedure should be part of the HIV prevention measures, she said. "Until that happens, women will be infected with HIV this way, and ... male circumcision may do more harm than good if it is misused to deny women full protection."

IRIN

No one expected that the reaction to empty condom dispensers on São Tomé and Príncipe would be so angry.

"I thought the country had run out of condoms - you people are fouling up too much," Palmira Torres, the owner of Alfa Restaurant, complained to Almerindo Ferreira and Desinela Barros, who work as peer educators for the Italian non-governmental organisation, Alisei.

Condom dispensers were installed throughout the archipelago off the coast of Gabon at the beginning of the year, as part of an initiative by the National Programme for the Fight Against AIDS (known by the Portuguese acronym PNLS), assisted by Alisei.

Alfa Restaurant, near the port in the city of São Tomé, capital of the largest island in the group, was one of the 376 restaurants, night clubs and stores to be equipped with a dispenser.

But a month-long interruption in supply occurred when the vehicle that distributes the condoms broke down. This, combined with a lack of personnel, left the dispensers empty in a number of districts.

"Last Sunday a young woman came in here, all nervous, looking for condoms, but there weren't any. Who knows what happened to her?" said Torres.

The restaurant, frequented by government workers, sailors and sex workers, is one of the condom distribution points Alisei considers "hot": it only takes two weeks for a bulk package of 144 to run out.

The demand for condoms, which has been triggered by the placement of the dispensers, is a new phenomenon for São Tomé and Príncipe.

The estimated 1.5 percent HIV prevalence among the country's 160,000 inhabitants is considered low for the African continent, but health officials say the number of people becoming infected is rising.

With funding from the United Nations Population Fund (UNFPA) and the Global Fund to Fight AIDS, Tuberculosis and Malaria, each establishment with a dispenser receives a monthly supply of 432 condoms, which are available to the public free of charge. Nearly a million condoms were dispensed between January and June 2008.
Life savers

Early one morning at the beginning of July, the Alisei pickup truck brought a box of condoms to the Boca Loca restaurant, the first delivery in a month.
Nuno Santos, 25, who was eating breakfast, didn't wait to finish his meal. "The life savers have arrived," he joked, taking two packets from the dispenser.

"It was hard to function without the condoms," commented the Boca Loca barman, Valdemar Paquete. "All of the clients asked us a lot of questions because of the lack of them."

Also considered a "hot spot", the restaurant is open 24 hours a day, seven days a week. Business reaches its peak on Saturday and Sunday nights, when people leaving night clubs in the central part of the capital make a last stop at the Boca Loca.

"The condoms are sought after by everyone, but I think that younger customers are the ones who take the most. Girls also come here to get them," Paquete told IRIN/PlusNews.

PNLS Director Alzira do Rosário is heartened by the uptake, but said it remained to be seen whether people were actually using them. Nevertheless, the health authorities have applied to the Global Fund for additional funds to ensure they keep the demand for condoms supplied.

Alisei will also begin installing condom dispensers in more restaurants, stores and night clubs this month. The health authorities intend to have 400 distribution points set up by the end of the year, with the goal of guaranteeing greater access to condoms for the entire population.

PlusNews

With its white sand and sunny blue skies, Miramar Beach in the port city of Beira, Mozambique, has all the right ingredients to draw tourists from all over the world.

But that is not all this idyllic coastline attracts. "The beach is fertile ground for the spread of the [HI] virus, because so many people's paths cross there," said Victoria Machava, who works for the Beira municipal health department.

Miramar Beach is in Sofala Bay, close to the main Indian Ocean shipping routes and the largest airport in Mozambique's central region; it is not only ideally situated for tourism but also for the sex trade.

The explosion in both has led Beira's municipal government and local non-governmental organisations to launch HIV/AIDS awareness-raising campaigns in areas like Miramar to reach tourists, most of whom are European, as well as locals, including sex workers and fishermen.

Billboards along the beach warn people about the dangers of HIV, while a group of 15 activists from the city council provides prevention information and distributes condoms. "The environment entices people to have sex, but we've noticed that many of those who come to the beach don't bring condoms with them," said Zito Lazaro, 23, one of the activists.
High prevalence, high risk

An HIV infection rate of 35 percent - more than double the national average - means Beira is the worst-affected city in Sofala, Mozambique's worst-affected province. According to official figures, half of all new HIV infections identified in Sofala Province in 2007 were reported in Beira - a total of 11,242 cases.

The city's high prevalence can partly be attributed to its location at one end of the corridor linking Mozambique to Zimbabwe, Malawi and Botswana: countries with HIV infection rates that are among the highest in the world.

Truck drivers, sex workers, fishermen and street children, some of the groups most vulnerable to HIV infection, mingle with tourists, other visitors and locals on Miramar Beach.

Virgínia M.*, a 31-year-old sex worker, thinks she became infected with HIV during an unprotected sexual encounter at an eating establishment near the beach. Despite being aware of the risks, she said money sometimes talks louder: sex with a condom costs about US$4, but she can charge $10 for unprotected sex.

With support from the province's AIDS unit, 14 community-based AIDS organisations in the region have joined forces with the Beira municipal government to carry out campaigns in areas with the highest risk. At the weekends, they give lectures and screen educational films on the beach, in shops and in night clubs.

"Behind the high infection rate are high risk factors," said Machava of the city's health department. "That's why we're fighting not to allow a breeding ground for the spread of the virus."

*not her real name

PlusNews 

A new study shows that a variation in a gene known as the Duffy antigen receptor for chemokines, or simply DARC, may introduce an unknown vulnerability that could lead to a 40% greater risk of contracting HIV, the precursor to AIDS. The genetic variation is found in two-thirds of sub-Saharan Africans.

This particular variation on the gene, in which a single genetic letter is flipped, is thought to be a defense mechanism against malaria. It stops the growth of the malaria-causing parasite Plasmodium vivax. Concurrently, it also causes chemokines (proteins secreted by cells) to avoid red blood cells, an opposite behavior of the typical Duffy gene.

An on-going study of African American Airmen has found that the group infected with HIV was more likely to lack red blood cells that host the Duffy gene. The study, published in Cell Host & Microbe, does not identify why the absence of the chemokine receptor in red blood cells increases susceptibility to HIV, but the occurrence of the virus in such people is beyond the levels of chance.

The study also found that those carrying the DARC variant lived longer with HIV/AIDS. While this comes as good news to those already infected, it also means that the window for the unwitting spread of HIV is now known to be wider, since infected individuals with the gene mutation can take an average of two years longer to show symptoms. In terms of numbers, the two years of unknowingly being a source for infection translates into as much as 11% of AIDS cases in Africa.

Wikinews 

http://creativecommons.org/licenses/by/2.5/