By, Sarah Krouse, ajc.com, March 31, 2008
HIV-positive women often do not reveal their diagnosis to current or possible sexual partners, to close friends, or to potential employers because of the stigma attached to the disease, according to a survey released Monday.
"Despite 25 years of progress in diagnosing and treating the disease, one in five Americans would not be comfortable with having an HIV-positive woman as a close friend," said Susan Blumenthal, senior policy and medical adviser for the American Foundation for AIDS Research, or amfAR.
Factors such as fear of contracting the disease, the belief that HIV/AIDS is a result of promiscuity or moral fault, and the severity of the disease all contribute to the stigma associated with HIV/AIDS, participants at a news conference said. Shame and blame were identified as two major obstacles for the 15.4 million HIV-positive women and girls worldwide.
"Women are the ones living in secret," said Regan Hofmann, editor in chief of POZ Magazine, a publication for people living with or affected by HIV/AIDS. "Women are terrified, women of all colors, of all socio-economic statuses."
Laura Nyblade, senior social scientist for the International Center for Research on Women, said, "Women are extremely vulnerable in social circles." She said because society has "an irrational fear of contracting AIDS from everyday contact," women often do not share their diagnosis for fear of being rejected by their friends and peers.
The amfAR survey revealed that a majority of Americans are uncomfortable with having an HIV-positive woman as a health-care or child-care provider. The panel discussed the importance of education and reaching out to policy makers to help remove the stigma associated with HIV/AIDS.
Hofmann said sex education must also be changed in order to reduce this stigma.
"The federal government prevents sexual education other than abstinence in some states, which is fine, but many young people think vaginal sex is the only real kind of sex. We need to redefine what this abstinence is. We have a lot of re-educating to do," she said.
An important part of preventing more women from contracting HIV is discussing the disease, according to Hoffman. "We did it with breast cancer, no one talked about it for so long. We can do it with HIV," she said.
"Women often times don't want to hear about heterosexual women with HIV because it then becomes something real that they have to worry about," said Hoffman. She stressed the importance of dialogue, especially the promotion of protected sex and discussing HIV status with future sexual partners.
Source: http://www.ajc.com/health/content/health/stories/2008/03/31/HIV_WOMEN01.html
Monday, March 31, 2008
Sunday, March 30, 2008
Women's Rights are human rights - The right to adequate health care
By, Jamaica Gleaner, March 31, 2008
Many women and girls in Jamaica who are infected with HIV face discrimination. Some children living with HIV/AIDS report that they cannot trust caregivers for fear that their personal information will be revealed to others.
Some 20,000 children in Jamaica are affected by HIV/AIDS and young women in the Caribbean between 15 and 24 are up to six times more likely to be infected with HIV than men.
CEDAW recommends that the Jamaican Government target adolescents to combat HIV/AIDS, adopt measures or get rid of discrimination against women and girls infected with HIV, and raise awareness of issues related to women's health, including their sexual and reproductive health and rights.
The August 2006 report on Jamaica of the Committee on the Elimination of Discrimination against Women noted that while the Government of Jamaica was to be commended on its work on HIV and AIDS prevention and improvement of women's sexual health and reproductive rights, the Committee noted, with concern, the increasingly high rates of HIV/AIDS infection in adolescent girls.
The committee called on the Jamaican Government to monitor, systematically, women's access to health care, including primary and secondary health-care services, and to desegregate such data by urban and rural areas, and by age, and use such data as a basis for planning health-care delivery.
Noting that abortion is one of the five leading causes of maternal mortality, and noting the existence of the 1975 Ministry of Health policy on abortion, the committee expressed concern that the policy is not widely known or implemented, and services for the provision of safe abortions may not be available.
The committee also requested that the state adopt measures to eliminate discrimination against women and girls infected with HIV/AIDS.
Excerpted from 'CEDAW for Jamaicans', produced by the Women's Resource and Outreach Centre, Kingston, and the August 2006 report on Jamaica of the Committee on the Elimination of Discrimination Against Women 36th session. Email wroc@cwjamaica.com.
Source: http://www.jamaica-gleaner.com/gleaner/20080331/flair/flair2.html
Many women and girls in Jamaica who are infected with HIV face discrimination. Some children living with HIV/AIDS report that they cannot trust caregivers for fear that their personal information will be revealed to others.
Some 20,000 children in Jamaica are affected by HIV/AIDS and young women in the Caribbean between 15 and 24 are up to six times more likely to be infected with HIV than men.
CEDAW recommends that the Jamaican Government target adolescents to combat HIV/AIDS, adopt measures or get rid of discrimination against women and girls infected with HIV, and raise awareness of issues related to women's health, including their sexual and reproductive health and rights.
The August 2006 report on Jamaica of the Committee on the Elimination of Discrimination against Women noted that while the Government of Jamaica was to be commended on its work on HIV and AIDS prevention and improvement of women's sexual health and reproductive rights, the Committee noted, with concern, the increasingly high rates of HIV/AIDS infection in adolescent girls.
The committee called on the Jamaican Government to monitor, systematically, women's access to health care, including primary and secondary health-care services, and to desegregate such data by urban and rural areas, and by age, and use such data as a basis for planning health-care delivery.
Noting that abortion is one of the five leading causes of maternal mortality, and noting the existence of the 1975 Ministry of Health policy on abortion, the committee expressed concern that the policy is not widely known or implemented, and services for the provision of safe abortions may not be available.
The committee also requested that the state adopt measures to eliminate discrimination against women and girls infected with HIV/AIDS.
Excerpted from 'CEDAW for Jamaicans', produced by the Women's Resource and Outreach Centre, Kingston, and the August 2006 report on Jamaica of the Committee on the Elimination of Discrimination Against Women 36th session. Email wroc@cwjamaica.com.
Source: http://www.jamaica-gleaner.com/gleaner/20080331/flair/flair2.html
Granny, 73: My life with HIV
By, Carolyn Kissoon, Trinidad News, March 29, 2008
Great-grandmother, Cynthia Pascal, has been living with the deadly HIV virus for five years. And although her lifestyle has changed, Pascal has not allowed the virus to control her daily routine.
She still cares for her seven children, 16 grand children and six great grand children. And she is still an active member of the community church.
Pascal, 73, stood smiling before an audience at City Hall, Harris Promenade, San Fernando yesterday and spoke about living with the HIV virus.
"I did not know I had the virus. I was getting slimmer and slimmer and I thought it was my kidney. Doctors could not tell me what was happening until I collapsed one day and was taken to the San Fernando General Hospital. There I was diagnosed with the virus. AIDS is not a nice thing to be living with. But I did not allow it to control my life," she said.
Pascal, of Siparia, pleaded with youths to have only one sexual partner. "I want to warn young people to stick to one partner. Don't go jumping from here to there it does not pay," she said.
Pascal said the greatest pain for people with the virus was discrimination. "I have not really experienced discrimination, but I know what it can do -it can kill you," she said.
Pascal was speaking at a symposium hosted by the Ministry of Social Development to commemorate International Women's Day. The symposium was titled "Keeping the Promise: An Agenda for Action on Women and HIV".
Dr Amery Browne, Minister of Social Development, applauded Pascal, for speaking about living with the disease. "It is not easy to step forward and reveal one's status before a large national audience. Ms Pascal you are extremely courageous and you still have so much to contribute to our nation," he said.
The function was attended by Central and South staff of the ministry.
Browne said there were currently some 20,000 to 30,000 people in Trinidad and Tobago living with HIV. The majority of the new infections occur among individuals in their reproductive years, 15 to 44, he said. Browne added that national statistics also indicated that women account for 45 per cent of new HIV cases.
Browne challenged his staff to take on the responsibility to pass out information to the men and women of the nation. "As minister I will not tolerate any ill-treatment or hostility from my staff towards any persons living with HIV," he said.
Browne said researchers have found that the root causes of HIV/AIDS were violence, poverty, inequality and violations of economic, legal, educational and health rights.
He said if Trinidad and Tobago was to win the battle against the spread of HIV, the first step should be to show compassion for all those infected by HIV and Aids.
Source: http://www.trinidadexpress.com/index.pl/article_news?id=161300431
Great-grandmother, Cynthia Pascal, has been living with the deadly HIV virus for five years. And although her lifestyle has changed, Pascal has not allowed the virus to control her daily routine.
She still cares for her seven children, 16 grand children and six great grand children. And she is still an active member of the community church.
Pascal, 73, stood smiling before an audience at City Hall, Harris Promenade, San Fernando yesterday and spoke about living with the HIV virus.
"I did not know I had the virus. I was getting slimmer and slimmer and I thought it was my kidney. Doctors could not tell me what was happening until I collapsed one day and was taken to the San Fernando General Hospital. There I was diagnosed with the virus. AIDS is not a nice thing to be living with. But I did not allow it to control my life," she said.
Pascal, of Siparia, pleaded with youths to have only one sexual partner. "I want to warn young people to stick to one partner. Don't go jumping from here to there it does not pay," she said.
Pascal said the greatest pain for people with the virus was discrimination. "I have not really experienced discrimination, but I know what it can do -it can kill you," she said.
Pascal was speaking at a symposium hosted by the Ministry of Social Development to commemorate International Women's Day. The symposium was titled "Keeping the Promise: An Agenda for Action on Women and HIV".
Dr Amery Browne, Minister of Social Development, applauded Pascal, for speaking about living with the disease. "It is not easy to step forward and reveal one's status before a large national audience. Ms Pascal you are extremely courageous and you still have so much to contribute to our nation," he said.
The function was attended by Central and South staff of the ministry.
Browne said there were currently some 20,000 to 30,000 people in Trinidad and Tobago living with HIV. The majority of the new infections occur among individuals in their reproductive years, 15 to 44, he said. Browne added that national statistics also indicated that women account for 45 per cent of new HIV cases.
Browne challenged his staff to take on the responsibility to pass out information to the men and women of the nation. "As minister I will not tolerate any ill-treatment or hostility from my staff towards any persons living with HIV," he said.
Browne said researchers have found that the root causes of HIV/AIDS were violence, poverty, inequality and violations of economic, legal, educational and health rights.
He said if Trinidad and Tobago was to win the battle against the spread of HIV, the first step should be to show compassion for all those infected by HIV and Aids.
Source: http://www.trinidadexpress.com/index.pl/article_news?id=161300431
Thursday, March 27, 2008
61% of new HIV/AIDS infections are women
By, Inalegwu Shaibu, Vanguard, March 27, 2008
Nigeria: The National Agency For The Control of AIDS (NACA) has revealed that an estimated sixty one percent of Nigerians that are newly infected with HIV/AIDS are women and young girls.
The Director General of NACA, Professor Babatunde Oshotimehin who gave the information in Abuja at a One-day workshop organised by the agency to strengthen its relationship with the National Council of Women Societies (NCWS), said the country stands the risk of losing an important part of her population to the scourge of HIV if the situation is not quickly addressed.
He said, “We have to appreciate why it is important for women to be in the fore front of the battle against the spread of HIV/AIDS. Today, Africa houses seventy percent of HIV/AIDS infections, with sixty-one percent of new infections in Nigeria being women and young girls.
“Today, the burden of the disease in terms of care and support of those living with the virus, is the responsibility of the women, across our continent. So when you look at the statistics and you look at how the disease affects our women, it is important that we put women at the centre of the control of this virus.”
He called on women all over the country to take up the fight against the spread of HIV/AIDS, while decrying the gender distance between men and women even though majority of the transmission of the HIV virus occur between men and women.
The NACA boss said women are getting more infected than men because of their inability to speak out against some of sexual practices that has put them in disadvantaged positions.
His words, “It is also important to note before we forget that most of the transmission of the virus occurs between women and men. We also appreciate that with the gender distance between our men and our women, it is difficult for our women to protect themselves or to ensure that they will not get infected.”
“In our culture, it is hard for a wife to say no to our husband. We are talking here to women of substance who are enlightened. But when we go down to our homestead, where these women don’t have the education you have, it becomes even more difficult to negotiate safe sex.”
He added that the spread of the disease could be easily tamed if women are giving more right to negotiate sex with their partners.
The national president of NCWS Mrs. Ramatu Bala Usman in her remarks said the involvement of the women in the fight against HIV/AIDS would help reduce the spread of the disease.
She said, “It is in our collective interest to fight the spread of HIV/AIDS because we are the most infected and affected. We have about 250 groups that are affiliated to us and with all of them we will carry the campaign to the grassroots.
The Society is not just composed of educated elites but the also include the uneducated women in the rural areas. It is easier for us to penetrate the rural areas because we speak their language and they understand us
more.”
Source: http://www.vanguardngr.com/index.php?option=com_content&task=view&id=5481&Itemid=47
Nigeria: The National Agency For The Control of AIDS (NACA) has revealed that an estimated sixty one percent of Nigerians that are newly infected with HIV/AIDS are women and young girls.
The Director General of NACA, Professor Babatunde Oshotimehin who gave the information in Abuja at a One-day workshop organised by the agency to strengthen its relationship with the National Council of Women Societies (NCWS), said the country stands the risk of losing an important part of her population to the scourge of HIV if the situation is not quickly addressed.
He said, “We have to appreciate why it is important for women to be in the fore front of the battle against the spread of HIV/AIDS. Today, Africa houses seventy percent of HIV/AIDS infections, with sixty-one percent of new infections in Nigeria being women and young girls.
“Today, the burden of the disease in terms of care and support of those living with the virus, is the responsibility of the women, across our continent. So when you look at the statistics and you look at how the disease affects our women, it is important that we put women at the centre of the control of this virus.”
He called on women all over the country to take up the fight against the spread of HIV/AIDS, while decrying the gender distance between men and women even though majority of the transmission of the HIV virus occur between men and women.
The NACA boss said women are getting more infected than men because of their inability to speak out against some of sexual practices that has put them in disadvantaged positions.
His words, “It is also important to note before we forget that most of the transmission of the virus occurs between women and men. We also appreciate that with the gender distance between our men and our women, it is difficult for our women to protect themselves or to ensure that they will not get infected.”
“In our culture, it is hard for a wife to say no to our husband. We are talking here to women of substance who are enlightened. But when we go down to our homestead, where these women don’t have the education you have, it becomes even more difficult to negotiate safe sex.”
He added that the spread of the disease could be easily tamed if women are giving more right to negotiate sex with their partners.
The national president of NCWS Mrs. Ramatu Bala Usman in her remarks said the involvement of the women in the fight against HIV/AIDS would help reduce the spread of the disease.
She said, “It is in our collective interest to fight the spread of HIV/AIDS because we are the most infected and affected. We have about 250 groups that are affiliated to us and with all of them we will carry the campaign to the grassroots.
The Society is not just composed of educated elites but the also include the uneducated women in the rural areas. It is easier for us to penetrate the rural areas because we speak their language and they understand us
more.”
Source: http://www.vanguardngr.com/index.php?option=com_content&task=view&id=5481&Itemid=47
Wednesday, March 26, 2008
Why tuberculosis matters to women’s health
By, Chief K.Masimba Biriwasha, Zivizo.com, March 24, 2008
Tuberculosis (TB) has a major impact on women’s sexual reproductive health and that of their children.
For pregnant women living in areas with high TB infection rates, there are increased chances of transmission of TB to a child before, during delivery or after birth.
The disease, especially if associated with HIV, also accounts for a high incidence of maternal and infant mortality.
Unfortunately, there is little to no attention about women’s vulnerability in the current discussion and media blitz of a resurgent TB internationally, and in particular, sub-Saharan Africa.
In sub-Saharan Africa, TB is threatening to unravel public health developments gains around increased HIV awareness yet the solutions are not easy, particularly where they concern the well-being of women.
There is need for huge financial, human, research and technological investments to fight the problem, but such investments will work only if they radically put women’s health needs at the core.
More importantly is the need to align TB services and sexual reproductive health services, so that men and women know about the implications of the disease to their sexual lives and households.
In sub-Saharan Africa, however, there are pervasive systemic factors driving TB and drug resistance which cannot be ignored in the search of an effective solution to the problem.
A myriad of social and economic factors, as well as weaknesses in the health care system, inadequate laboratories combined with high HIV infection rates are fueling the resurgence of the TB in the region. Food insecurity, poor sanitation and overcrowding also contribute to the easy spread of the disease.
According to WHO, although Africa has only 11% of the world’s population, it accounts for more than a quarter of the global TB burden with an estimated 2.4 million TB cases and 540,000 TB deaths annually.
Governments in the region are grappling with inadequate infrastructure and the increasing threat of drug-resistant strains and co-infection with HIV.
HIV infection increases the likelihood of active TB more than 50-fold. An estimated one-third of the 24.5 million people living with HIV (PLHIV) in sub-Saharan Africa also have TB.
For women in the region, the prospect of a growing TB epidemic is harrowing, but discussion about the disease rarely sheds light nor seeks to address women’s specific needs.
Given the high rates of HIV infection among women in the region - the majority of people living with HIV in sub-Saharan Africa (61% or 13,1 million) are women – it is clear that they are the largest group at threat to develop active TB, and more likely drug resistance.
Even with the availability of TB drugs women’s socio-economic status and gender roles including child-bearing and caring puts them at high risk of both HIV and TB infection.
For many women in the region, the costs required to access health care centers for TB treatment are usually out of reach due to poverty and undermined socio-economic positions.
The social stigma associated with a TB diagnosis and its association with HIV forces both men and women to delay going to get tested for the disease. In some cases, when men in marital relationships test positive for TB, they are likely to withhold the information, thereby increasing the likelihood to spread the disease to both their partner and children.
Moreover, women in the region are largely responsible for the upkeep of the family, including looking after children, which may also affect consistent uptake of TB drugs. When a woman is infected with TB, the likelihood of spreading the disease to young children is very high.
An additional concern for women is that the uptake of TB drugs interferes with contraceptive use, pregnancy, and fertility.
According to researchers, Rimfampicin, a key component of TB treatment can reduce the effectiveness of oral contraceptive pills and possibly other hormonal methods, such as implants, injectables and emergency contraception.
TB in pregnant women not only increases the rate of maternal mortality, but is also a major factor contributing to the risk of mother-to-child transmission of the disease.
A study conducted in South Africa revealed mother-to child-transmission of TB in 15% of infants born to a study cohort of pregnant women in which 77% were HIV-infected. Maternal HIV/TB coinfection also increases the risk of mother-to child transmission of HIV.
Screening and treatment for TB in pregnant women at antenatal clinics must therefore be a major public health priority in the region. Information about TB needs to be an integral component of sexual reproductive health services.
To be precise, women infected with TB need to be empowered so that they can take control of their own care and lives.
Source: http://zivizo.com/2008/03/24/why-tuberculosis-matters-to-women%e2%80%99s-health/
Tuberculosis (TB) has a major impact on women’s sexual reproductive health and that of their children.
For pregnant women living in areas with high TB infection rates, there are increased chances of transmission of TB to a child before, during delivery or after birth.
The disease, especially if associated with HIV, also accounts for a high incidence of maternal and infant mortality.
Unfortunately, there is little to no attention about women’s vulnerability in the current discussion and media blitz of a resurgent TB internationally, and in particular, sub-Saharan Africa.
In sub-Saharan Africa, TB is threatening to unravel public health developments gains around increased HIV awareness yet the solutions are not easy, particularly where they concern the well-being of women.
There is need for huge financial, human, research and technological investments to fight the problem, but such investments will work only if they radically put women’s health needs at the core.
More importantly is the need to align TB services and sexual reproductive health services, so that men and women know about the implications of the disease to their sexual lives and households.
In sub-Saharan Africa, however, there are pervasive systemic factors driving TB and drug resistance which cannot be ignored in the search of an effective solution to the problem.
A myriad of social and economic factors, as well as weaknesses in the health care system, inadequate laboratories combined with high HIV infection rates are fueling the resurgence of the TB in the region. Food insecurity, poor sanitation and overcrowding also contribute to the easy spread of the disease.
According to WHO, although Africa has only 11% of the world’s population, it accounts for more than a quarter of the global TB burden with an estimated 2.4 million TB cases and 540,000 TB deaths annually.
Governments in the region are grappling with inadequate infrastructure and the increasing threat of drug-resistant strains and co-infection with HIV.
HIV infection increases the likelihood of active TB more than 50-fold. An estimated one-third of the 24.5 million people living with HIV (PLHIV) in sub-Saharan Africa also have TB.
For women in the region, the prospect of a growing TB epidemic is harrowing, but discussion about the disease rarely sheds light nor seeks to address women’s specific needs.
Given the high rates of HIV infection among women in the region - the majority of people living with HIV in sub-Saharan Africa (61% or 13,1 million) are women – it is clear that they are the largest group at threat to develop active TB, and more likely drug resistance.
Even with the availability of TB drugs women’s socio-economic status and gender roles including child-bearing and caring puts them at high risk of both HIV and TB infection.
For many women in the region, the costs required to access health care centers for TB treatment are usually out of reach due to poverty and undermined socio-economic positions.
The social stigma associated with a TB diagnosis and its association with HIV forces both men and women to delay going to get tested for the disease. In some cases, when men in marital relationships test positive for TB, they are likely to withhold the information, thereby increasing the likelihood to spread the disease to both their partner and children.
Moreover, women in the region are largely responsible for the upkeep of the family, including looking after children, which may also affect consistent uptake of TB drugs. When a woman is infected with TB, the likelihood of spreading the disease to young children is very high.
An additional concern for women is that the uptake of TB drugs interferes with contraceptive use, pregnancy, and fertility.
According to researchers, Rimfampicin, a key component of TB treatment can reduce the effectiveness of oral contraceptive pills and possibly other hormonal methods, such as implants, injectables and emergency contraception.
TB in pregnant women not only increases the rate of maternal mortality, but is also a major factor contributing to the risk of mother-to-child transmission of the disease.
A study conducted in South Africa revealed mother-to child-transmission of TB in 15% of infants born to a study cohort of pregnant women in which 77% were HIV-infected. Maternal HIV/TB coinfection also increases the risk of mother-to child transmission of HIV.
Screening and treatment for TB in pregnant women at antenatal clinics must therefore be a major public health priority in the region. Information about TB needs to be an integral component of sexual reproductive health services.
To be precise, women infected with TB need to be empowered so that they can take control of their own care and lives.
Source: http://zivizo.com/2008/03/24/why-tuberculosis-matters-to-women%e2%80%99s-health/
How menstruation curses young girls to the margins
By, Chief K.Masimba Biriwasha, Zivizo.com, March 25, 2008
The natural process of menstruation comes as a big problem to women and girls in many parts of Africa, contributing to both disempowerment and health risks. For young girls, menstruation is an addition to the heap of gender disparities they have to face in life.
In order to stem the flow of monthly periods, the women and girls use anything from rags, tree leaves, old clothes, toilet paper, newspapers, cotton wool, cloths or literally anything that can do the job. Most girls from poor, rural communities do not use anything at all.
Menstruation is perhaps one of the most regular individual female experiences, but in sub-Saharan Africa, the experience impacts general society negatively due to the absence of products required by women and girls to cope with menstrual flow.
To state it bluntly, menstruation has become like a curse not only to the women and girls but to society in general on the continent. Because menstruation is largely a private act, the social damage is hidden and never makes the news headlines. Also, there are cultural and social attitudes that render discussion of menstruation almost impossible.
Affordable and hygienic sanitary protection is not available to many women and girls in Africa, and governments have done very little to address this reproductive health issue which has serious public health consequences.
In sub-Saharan Africa, millions of girls, in particular, that reach the age of puberty are highly disempowered due to the lack of access to sanitary wear. Many of the girls from poor families cannot afford to buy sanitary pads.
Hence they resort to the use of unhygienic rags and cloths which puts them at the risk of infections. Some of the girls engage in transactional sex so that they can raise the money required to buy sanitary pads, putting themselves at the risk of HIV and STI infection.
Alternatively, young girls are forced to skip school during the time they experience monthly periods to avoid both the cost of pads or use of cloths.
UNICEF estimates that one in 10 school-age African girls either skips school during menstruation or drops out entirely because of lack of sanitation.
“Less-privileged girls and women who represent substantial percentage in our contemporary Africa will continue to suffer resulting to school absenteeism and also compromising their right to health care,” says Fredrick W. Njuguna, Program Director of Familia Human Care Trust in Kenya.
A girl absent from school due to menstruation for 4 days in 28 days (a month) loses 13 learning days equivalent to 2 weeks of learning in every school term.
It is estimated that within the 4 years of high school the same girl loses 156 learning days equivalent to almost 24 weeks out of 144 weeks of learning in high school.
Consequently, a girl child potentially becomes a “school drop out” while she is still attending school. In addition, the girl child has to deal with emotional and psychological tension associated with the menstrual process.
To make matters worse, according to Familia Human Care Trust, many schools in underprivileged areas lack sufficient sanitation facilities which are vital not only during a girl’s period but at all times generally such as water, adequate toilet facilities and appropriate dumping facilities for sanitary wear.
As a result, menstruating girls opt to stay at home due to lack of facilities to help them manage their periods than go to school.
For orphaned girls, the prospect of coping with bodily changes can be a significant challenge because they have no-one to turn to for information or advice. In addition, due to the use of improper methods to contain their menstrual flow, young girls may develop bodily odors that will lead to social exclusion within peer groups thereby impacting negatively on the young girl’s confidence.
The need for affordable sanitary wear for women and girls in Africa is indeed a major public health issue that governments need to prioritize in their planning.
On the other hand, there is need for social innovation around this issue because the need for sanitary wear among girls and women will forever be there, at least in the long term future.
The bottom line is that no girl child must be disadvantaged by the natural process of menstruation, and governments, civil society organizations and other players need to work together to ensure that the appropriate services are made available.
As it is, menstruation has becomes the undeclared basis for the social exclusion of young girls. Sanitary protection is an urgent need among women and girls and needs to be made affordable so that poor and marginalized groups can have access.
Global alliances between women in the rich and poor worlds can be a key solution to the problem of access to sanitary wear. But governments also need to recognize that ensuring women and girl’s access to sanitary wear has positive public health implications.
Access to affordable, sanitary is human right but one that is never discussed in our male dominated world. Whatever the case, the fact remains: every woman should be able to have access to the right products which can enable them to happily experience menstruation.
No woman should be cursed to disempowerment by the natural act of monthly periods.
Source: http://zivizo.com/2008/03/25/how-menstruation-curses-young-girls-to-the-margins/
The natural process of menstruation comes as a big problem to women and girls in many parts of Africa, contributing to both disempowerment and health risks. For young girls, menstruation is an addition to the heap of gender disparities they have to face in life.
In order to stem the flow of monthly periods, the women and girls use anything from rags, tree leaves, old clothes, toilet paper, newspapers, cotton wool, cloths or literally anything that can do the job. Most girls from poor, rural communities do not use anything at all.
Menstruation is perhaps one of the most regular individual female experiences, but in sub-Saharan Africa, the experience impacts general society negatively due to the absence of products required by women and girls to cope with menstrual flow.
To state it bluntly, menstruation has become like a curse not only to the women and girls but to society in general on the continent. Because menstruation is largely a private act, the social damage is hidden and never makes the news headlines. Also, there are cultural and social attitudes that render discussion of menstruation almost impossible.
Affordable and hygienic sanitary protection is not available to many women and girls in Africa, and governments have done very little to address this reproductive health issue which has serious public health consequences.
In sub-Saharan Africa, millions of girls, in particular, that reach the age of puberty are highly disempowered due to the lack of access to sanitary wear. Many of the girls from poor families cannot afford to buy sanitary pads.
Hence they resort to the use of unhygienic rags and cloths which puts them at the risk of infections. Some of the girls engage in transactional sex so that they can raise the money required to buy sanitary pads, putting themselves at the risk of HIV and STI infection.
Alternatively, young girls are forced to skip school during the time they experience monthly periods to avoid both the cost of pads or use of cloths.
UNICEF estimates that one in 10 school-age African girls either skips school during menstruation or drops out entirely because of lack of sanitation.
“Less-privileged girls and women who represent substantial percentage in our contemporary Africa will continue to suffer resulting to school absenteeism and also compromising their right to health care,” says Fredrick W. Njuguna, Program Director of Familia Human Care Trust in Kenya.
A girl absent from school due to menstruation for 4 days in 28 days (a month) loses 13 learning days equivalent to 2 weeks of learning in every school term.
It is estimated that within the 4 years of high school the same girl loses 156 learning days equivalent to almost 24 weeks out of 144 weeks of learning in high school.
Consequently, a girl child potentially becomes a “school drop out” while she is still attending school. In addition, the girl child has to deal with emotional and psychological tension associated with the menstrual process.
To make matters worse, according to Familia Human Care Trust, many schools in underprivileged areas lack sufficient sanitation facilities which are vital not only during a girl’s period but at all times generally such as water, adequate toilet facilities and appropriate dumping facilities for sanitary wear.
As a result, menstruating girls opt to stay at home due to lack of facilities to help them manage their periods than go to school.
For orphaned girls, the prospect of coping with bodily changes can be a significant challenge because they have no-one to turn to for information or advice. In addition, due to the use of improper methods to contain their menstrual flow, young girls may develop bodily odors that will lead to social exclusion within peer groups thereby impacting negatively on the young girl’s confidence.
The need for affordable sanitary wear for women and girls in Africa is indeed a major public health issue that governments need to prioritize in their planning.
On the other hand, there is need for social innovation around this issue because the need for sanitary wear among girls and women will forever be there, at least in the long term future.
The bottom line is that no girl child must be disadvantaged by the natural process of menstruation, and governments, civil society organizations and other players need to work together to ensure that the appropriate services are made available.
As it is, menstruation has becomes the undeclared basis for the social exclusion of young girls. Sanitary protection is an urgent need among women and girls and needs to be made affordable so that poor and marginalized groups can have access.
Global alliances between women in the rich and poor worlds can be a key solution to the problem of access to sanitary wear. But governments also need to recognize that ensuring women and girl’s access to sanitary wear has positive public health implications.
Access to affordable, sanitary is human right but one that is never discussed in our male dominated world. Whatever the case, the fact remains: every woman should be able to have access to the right products which can enable them to happily experience menstruation.
No woman should be cursed to disempowerment by the natural act of monthly periods.
Source: http://zivizo.com/2008/03/25/how-menstruation-curses-young-girls-to-the-margins/
Tuesday, March 25, 2008
The tragedy of mother-to-child HIV transmission
By, Courtenay Bartholomew, Trinidad and Tabago Express, March 26, 2008
The most biologically intimate association between two individuals is that of a mother and the foetus developing within her womb. Indeed, one of the most tragic consequences of HIV infection in women, who become pregnant is the transmission of that deadly virus to their unborn offsprings.
Alarmingly, more than 60,000 babies worldwide inherit HIV from their mothers every year. Can you really fathom the dimension of this tragedy? It is indeed a tragedy when the mother does not know that she is HIV-infected at the time of her pregnancy as is frequently the case, but it is a felony when she knows that she is HIV-infected and still becomes pregnant while neither on treatment nor taking other precautions.
Now, without treatment, the overall risk of transmission from an infected mother to her infant is around 30 per cent but there are wide variations. In the early stages of infection and in the more advanced stages with severe immuno-suppression, the viral load is greater than at other times and transmission from mother to child is therefore considerably higher during these periods.
Infection may be transmitted in utero or during the delivery process (intrapartum) as the baby moves down the birth canal and is bathed with the mother's blood.
Infection may also be acquired after birth (postpartum) by breast feeding and so, we advise all HIV-positive mothers not to breast feed their babies and milk formulae are given free of charge. About 23 per cent of infections occur in utero and as early as the first trimester of pregnancy, however, most transmissions occur at the time of delivery or during the birth process.
Antibodies to a virus are a legacy of and a response to previous infections and remain in the blood indefinitely even when the virus has disappeared. These antibodies then protect the individual from being re-infected with the same virus. Not so with the retrovirus of AIDS. Viruses and antibodies co-exist in these patients because the antibodies are not powerful enough to suppress or kill the virus. Therefore, to test for the presence of HIV, we only need to test for the antibodies, which is much simpler and less dangerous than testing for the virus itself (much cheaper also).
All babies of infected mothers, whether the mother's virus is transmitted to the child or not (and remember, as I said above, only about 30 per cent of mothers transmit their HIV virus to their babies), carry "passively" the antibodies of the mother through the cord blood.
However, these harmless passively-acquired maternal antibodies may take up to 18 months in some cases to be cleared from the baby's blood and it is only then that one can say with certainty that the baby does not carry the virus. However, for the past two years we now have more sophisticated equipment in our MRF laboratory and use the ultra-sensitive polymerase chain reaction (PCR) technique, which can identity viral infection within two months.
Because of the ridiculously high price of antiretroviral drugs, which third world countries could not afford and about which history will have a lot to say in years to come, there was a time when we were only able to prevent the baby from being HIV infected by giving the mother a short course of a single drug treatment (AZT) from 28 or 32 weeks of her pregnancy, during labour, and for a week to the baby after delivery. This reduced the percentage of HIV-positive babies drastically from about 30 per cent to about 6.8 per cent.
Unfortunately, therapy was then stopped and so, while many of the babies survived, the mother was not able to get long-term treatment. The tragedy of this is not worth recalling.
Now, all mothers attending the antenatal clinics of hospitals are tested for HIV antibodies (with their consent). This being so, we have found that 8 per cent of the mothers first became aware of their HIV positivity this way. This is interesting. Once they are tested positive they are then referred to the Medical Research Centre where we assess the immunological status of the mothers (CD4 counts) and their viral loads. Depending on those levels, we then treat the mothers at a certain time in their gestation period and treatment continues during labour, after labour and onwards. In other words, we now treat both mother and child. We use the World Health Organisation's (WHO) therapeutic recommendation for mother to child transmission. To date we have treated 203 mothers and only 7 (3.4 per cent) of their babies have been infected. But even that is not good enough.
We are now considering a more aggressive approach by treating the mothers with triple therapy earlier in their pregnancy although we are very concerned that since non-compliance of therapy increases with time, we may theoretically be putting the mothers at risk of developing drug resistance in time to come the earlier we begin treatment. Whether our concern is valid would only be determined in comparative long-term studies. In the meanwhile, we are aiming for a zero transmission of virus from mother to child without compromising the mother in the long-term.
- Prof Bartholomew is the Executive Director of the Medical Research
Source: http://www.trinidadexpress.com/index.pl/article_opinion?id=161298516
The most biologically intimate association between two individuals is that of a mother and the foetus developing within her womb. Indeed, one of the most tragic consequences of HIV infection in women, who become pregnant is the transmission of that deadly virus to their unborn offsprings.
Alarmingly, more than 60,000 babies worldwide inherit HIV from their mothers every year. Can you really fathom the dimension of this tragedy? It is indeed a tragedy when the mother does not know that she is HIV-infected at the time of her pregnancy as is frequently the case, but it is a felony when she knows that she is HIV-infected and still becomes pregnant while neither on treatment nor taking other precautions.
Now, without treatment, the overall risk of transmission from an infected mother to her infant is around 30 per cent but there are wide variations. In the early stages of infection and in the more advanced stages with severe immuno-suppression, the viral load is greater than at other times and transmission from mother to child is therefore considerably higher during these periods.
Infection may be transmitted in utero or during the delivery process (intrapartum) as the baby moves down the birth canal and is bathed with the mother's blood.
Infection may also be acquired after birth (postpartum) by breast feeding and so, we advise all HIV-positive mothers not to breast feed their babies and milk formulae are given free of charge. About 23 per cent of infections occur in utero and as early as the first trimester of pregnancy, however, most transmissions occur at the time of delivery or during the birth process.
Antibodies to a virus are a legacy of and a response to previous infections and remain in the blood indefinitely even when the virus has disappeared. These antibodies then protect the individual from being re-infected with the same virus. Not so with the retrovirus of AIDS. Viruses and antibodies co-exist in these patients because the antibodies are not powerful enough to suppress or kill the virus. Therefore, to test for the presence of HIV, we only need to test for the antibodies, which is much simpler and less dangerous than testing for the virus itself (much cheaper also).
All babies of infected mothers, whether the mother's virus is transmitted to the child or not (and remember, as I said above, only about 30 per cent of mothers transmit their HIV virus to their babies), carry "passively" the antibodies of the mother through the cord blood.
However, these harmless passively-acquired maternal antibodies may take up to 18 months in some cases to be cleared from the baby's blood and it is only then that one can say with certainty that the baby does not carry the virus. However, for the past two years we now have more sophisticated equipment in our MRF laboratory and use the ultra-sensitive polymerase chain reaction (PCR) technique, which can identity viral infection within two months.
Because of the ridiculously high price of antiretroviral drugs, which third world countries could not afford and about which history will have a lot to say in years to come, there was a time when we were only able to prevent the baby from being HIV infected by giving the mother a short course of a single drug treatment (AZT) from 28 or 32 weeks of her pregnancy, during labour, and for a week to the baby after delivery. This reduced the percentage of HIV-positive babies drastically from about 30 per cent to about 6.8 per cent.
Unfortunately, therapy was then stopped and so, while many of the babies survived, the mother was not able to get long-term treatment. The tragedy of this is not worth recalling.
Now, all mothers attending the antenatal clinics of hospitals are tested for HIV antibodies (with their consent). This being so, we have found that 8 per cent of the mothers first became aware of their HIV positivity this way. This is interesting. Once they are tested positive they are then referred to the Medical Research Centre where we assess the immunological status of the mothers (CD4 counts) and their viral loads. Depending on those levels, we then treat the mothers at a certain time in their gestation period and treatment continues during labour, after labour and onwards. In other words, we now treat both mother and child. We use the World Health Organisation's (WHO) therapeutic recommendation for mother to child transmission. To date we have treated 203 mothers and only 7 (3.4 per cent) of their babies have been infected. But even that is not good enough.
We are now considering a more aggressive approach by treating the mothers with triple therapy earlier in their pregnancy although we are very concerned that since non-compliance of therapy increases with time, we may theoretically be putting the mothers at risk of developing drug resistance in time to come the earlier we begin treatment. Whether our concern is valid would only be determined in comparative long-term studies. In the meanwhile, we are aiming for a zero transmission of virus from mother to child without compromising the mother in the long-term.
- Prof Bartholomew is the Executive Director of the Medical Research
Source: http://www.trinidadexpress.com/index.pl/article_opinion?id=161298516
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