HIV/AIDS around the Globe HIV/AIDS around the Globe

The Big PictureThe Big Picture

There over 42 million people living with HIV/AIDS todayThere over 42 million people living with HIV/AIDS today

Over 19 million of those infected are womenOver 19 million of those infected are women

Everyday, there are 14,000 new infections Everyday, there are 14,000 new infections http://www.until.org/statistics.shtmlhttp://www.until.org/statistics.shtml

HIV – A “disease of HIV – A “disease of young people”young people”

2.5 million of those newly infected each 2.5 million of those newly infected each year are between the ages of 15-24year are between the ages of 15-24

UN estimates 14 million children have UN estimates 14 million children have been orphaned by AIDSbeen orphaned by AIDS

In just 3 years, that number is estimated In just 3 years, that number is estimated to reach to reach 25 million25 million

http://www.until.org/statistics.shtmlhttp://www.until.org/statistics.shtml

HIV/AIDS in Latin AmericaHIV/AIDS in Latin America

By 2006, 1.6 million people were living with AIDS in Latin By 2006, 1.6 million people were living with AIDS in Latin AmericaAmerica

– While this is lower than Africa or India, these numbers are While this is lower than Africa or India, these numbers are continually increasing and only expected to get worsecontinually increasing and only expected to get worse

Half of all those infected reside in the 4 largest countries of Latin Half of all those infected reside in the 4 largest countries of Latin America: Brazil, Argentina, Columbia and Mexico.America: Brazil, Argentina, Columbia and Mexico.– However – the most severe cases are where there is a higher However – the most severe cases are where there is a higher

prevalence, in smaller countries such as Belize and Honduras.prevalence, in smaller countries such as Belize and Honduras.

http://www.avert.org/aidslatinamerica.htmhttp://www.avert.org/aidslatinamerica.htm

Country

Living with HIV/AIDSDeaths due to AIDS during 2005All people Adult (15-49)

rate %

Argentina 130,000 0.6 4,300

Belize 3,700 2.5 <500

Bolivia 7,000 0.1 <500

Brazil 620,000 0.5 14,000

Chile 28,000 0.3 <500

Colombia 160,000 0.6 8,200

Costa Rica 7,400 0.3 <100

Ecuador 23,000 0.3 1,600

El Salvador 36,000 0.9 2,500

Guatemala 61,000 0.9 2,700

Guyana 12,000 2.4 1,200

Honduras 63,000 1.5 3,700

Mexico 180,000 0.3 6,200

Nicaragua 7,300 0.2 <500

Panama 17,000 0.9 <1,000

Paraguay 13,000 0.4 <500

Peru 93,000 0.6 5,600

Suriname 5,200 1.9 <500

Uruguay 9,600 0.5 <500

Venezuela 110,000 0.7 6,100

Total 1,600,000 0.5 59,000 http://www.avert.org/southamerica.htm

Key Affected Groups:Key Affected Groups:– Men who have sex with men (MSM)Men who have sex with men (MSM)

– Sex workersSex workers

– Intravenous Drug Users (IDS)Intravenous Drug Users (IDS)

– MigrantsMigrantshttp://www.avert.org/aidslatinamerica.htmhttp://www.avert.org/aidslatinamerica.htm

Religion and HIV/AIDS Religion and HIV/AIDS PreventionPrevention

Catholicism Says “NO!” to Catholicism Says “NO!” to CondomsCondoms

The Roman Catholic Church has been morally The Roman Catholic Church has been morally opposed to contraception for as far back as one can opposed to contraception for as far back as one can historically trace. historically trace.

Approximately 70% of people living in Latin Approximately 70% of people living in Latin American countries identify themselves as CatholicAmerican countries identify themselves as Catholic

This predominantly Catholic population has This predominantly Catholic population has remained both uninformed on safe sex practices and remained both uninformed on safe sex practices and resistant to the use of condomsresistant to the use of condoms

Homosexuality is a SinHomosexuality is a Sin Homosexuality is illegal in many Latin American Homosexuality is illegal in many Latin American

countriescountries

– Homosexuals and bisexuals are often Homosexuals and bisexuals are often “underground” activities, increasing their “underground” activities, increasing their likelihood of participating in high risk behaviors.likelihood of participating in high risk behaviors.

– Bisexuality among married men is common, and Bisexuality among married men is common, and studies have shown that while wives may be studies have shown that while wives may be aware of their husbands’ other partners, they aware of their husbands’ other partners, they are generally not comfortable asking their are generally not comfortable asking their husbands to wear condomshusbands to wear condoms..

Social and Political StigmaSocial and Political Stigma

ColombiaColombia– Ongoing war between left-wing guerrilla groups Ongoing war between left-wing guerrilla groups

and right-wing paramilitaries and right-wing paramilitaries – FARC (the Revolutionary Armed Forces of FARC (the Revolutionary Armed Forces of

Colombia) is known to have forced residents of Colombia) is known to have forced residents of areas they control to take HIV tests areas they control to take HIV tests

– Gay men forced to wear signs around neckGay men forced to wear signs around neck– Displacement and migration to other countries Displacement and migration to other countries

may have impact on epidemicmay have impact on epidemic– 86% infected are men….leaving little access to 86% infected are men….leaving little access to

healthcare for women infectedhealthcare for women infected

Social and Political StigmaSocial and Political Stigma

GuatemalaGuatemala– Mayans may be 3x more likely to develop HIVMayans may be 3x more likely to develop HIV– Stigmatized population with less access to Stigmatized population with less access to

healthcarehealthcare NicaraguaNicaragua

– Stigma around using condomsStigma around using condoms– One study showed that of adolescents who had One study showed that of adolescents who had

been sexually active in past 3 months, only been sexually active in past 3 months, only 21% used condom21% used condom

– Insufficient HIV Testing available Insufficient HIV Testing available

Barriers to Overcoming the Barriers to Overcoming the CrisisCrisis

Regardless of differences in how eachRegardless of differences in how eachcountry handles this issue, there iscountry handles this issue, there isconsistent evidence of consistent evidence of structural

violenceacross the board:across the board: PovertyPoverty MigrationMigration HomophobiaHomophobia HIV-related discriminationHIV-related discrimination

BEADS FOR LIFEBEADS FOR LIFE

“Eradicating Poverty One Bead At a Time”

Ugandan – North American partnership to eradicate povertyUgandan – North American partnership to eradicate poverty Sustainable income generation as the core of its missionSustainable income generation as the core of its mission

– 501c3 organization. Over 75% of the proceeds go directly to supporting their mission.501c3 organization. Over 75% of the proceeds go directly to supporting their mission. ““4 pillars” of community development- Health, Education and Vocational Training, Life Skills and 4 pillars” of community development- Health, Education and Vocational Training, Life Skills and

Affordable HousingAffordable Housing

Beads for LifeBeads for Life

Beads for Health…Beads for Health… Impoverished people Impoverished people

often the victims of often the victims of poor health. poor health.

43% of the BFL’s are 43% of the BFL’s are HIV+ HIV+

Beads for Life Beads for Life provides: provides: – access to diagnosis and access to diagnosis and

treatment servicestreatment services– HIV testing for BFL’s HIV testing for BFL’s

childrenchildren– reproductive health reproductive health

servicesservices– health educationhealth education– critical health productscritical health products

Meet Alice AdunaMeet Alice Aduna

““Time for Hope for Time for Hope for Young People” Young People”

(PROTEJA) (PROTEJA) A social mobilization program for A social mobilization program for and by youth to promote healthy and by youth to promote healthy

lifestyles lifestyles

Program implemented in the Dominican Program implemented in the Dominican RepublicRepublic

PROTEJAPROTEJA Target:Target:

– Adolescents and young people between 10 to 19 years old, Adolescents and young people between 10 to 19 years old, living in 10 communities, including poor communities of sugar living in 10 communities, including poor communities of sugar cane cutterscane cutters

Objective: Objective: – Promote safe and healthy practices based upon values such as Promote safe and healthy practices based upon values such as

abstinence, delay of first sexual intercourse, sexual fidelity, abstinence, delay of first sexual intercourse, sexual fidelity, and the correct use of condom.and the correct use of condom.

. . MethodologyMethodology– Forty-five young leaders were trained as peer-educators in Forty-five young leaders were trained as peer-educators in

sexual and reproductive health (SRH), gender, effective sexual and reproductive health (SRH), gender, effective communication, and self-esteem issues. Each one trained15 communication, and self-esteem issues. Each one trained15 other youth, who in turn trained 10 others until more than 10 other youth, who in turn trained 10 others until more than 10 thousand young people involved.thousand young people involved.

Main Concepts and Main Concepts and ComponentsComponents

Demystification of local taboos about sexuality and SRH Demystification of local taboos about sexuality and SRH

Increased amounts of adolescents and young people who realize the risk of Increased amounts of adolescents and young people who realize the risk of HIV/STI infectionHIV/STI infection

Adolescents and young people receive systematic information through a Adolescents and young people receive systematic information through a quarterly bulletin de-signed and produced by community reporters, who have quarterly bulletin de-signed and produced by community reporters, who have been trained by the projectbeen trained by the project

Forty teachers have graduated from a qualified course called “diplomado.” They Forty teachers have graduated from a qualified course called “diplomado.” They are now giving information on SRH in schools.are now giving information on SRH in schools.

A total of 6,750 trained young people currently promote healthy SRH practicesA total of 6,750 trained young people currently promote healthy SRH practices

Fifty thousand youths and adults have been informed through information Fifty thousand youths and adults have been informed through information campaign using multi-media, e.g., bulletins, brochures, etc.campaign using multi-media, e.g., bulletins, brochures, etc.

A Youth-Friendly Care Center directed and conducted by young people was A Youth-Friendly Care Center directed and conducted by young people was established.- Ten thousand adolescents and youths using at least two AIDS established.- Ten thousand adolescents and youths using at least two AIDS prevention measuresprevention measures

PROTEJAPROTEJA What they have learned from What they have learned from

organizing this project is:organizing this project is:

Youth-friendly communication requires broad-based Youth-friendly communication requires broad-based consultation with the community, e.g. church leaders, consultation with the community, e.g. church leaders, teachers and parents.teachers and parents.

With minimal inputs, thousands of youth could be reached With minimal inputs, thousands of youth could be reached through a “ladder strategy”.through a “ladder strategy”.

Training programs with professional credits are attractive Training programs with professional credits are attractive incentives to involve teachers.incentives to involve teachers.

Youth must plan and design youth-targeted programs, so that Youth must plan and design youth-targeted programs, so that they act as owners and protagonists and process buildersthey act as owners and protagonists and process builders

Proteja ConclusionProteja Conclusion

The PROTEJA project, with a minimum The PROTEJA project, with a minimum investment of about US $50,000, has investment of about US $50,000, has positively impacted more than 10,000 positively impacted more than 10,000

adolescents. adolescents. Youth are a window of opportunity for HIV Youth are a window of opportunity for HIV

prevention. They must not only be prevention. They must not only be targeted, they must own programs that targeted, they must own programs that

affect them. Creative activities and value-affect them. Creative activities and value-centered education are major points of centered education are major points of

attraction to youth programsattraction to youth programs

European Community European Community ProjectProject

1997-1999 Educational Program in the 1997-1999 Educational Program in the Colombian cities of Bogotá, Cali, and Colombian cities of Bogotá, Cali, and Bucaramanga.Bucaramanga.

School-based peer education programSchool-based peer education program Main goalsMain goals

– HIV/STI-related education for adolescents and HIV/STI-related education for adolescents and young adults young adults

– promote risk awareness and safer sexual promote risk awareness and safer sexual behavior behavior

– build the capacity of local nongovernmental build the capacity of local nongovernmental organizations responding to HIV/AIDS and organizations responding to HIV/AIDS and improve national networks of HIV/AIDS NGOs. improve national networks of HIV/AIDS NGOs.

European Community European Community ProjectProject

Information and education sessions for Information and education sessions for teachers (focused on classroom teachers (focused on classroom communication skills relevant to reproductive communication skills relevant to reproductive health and using health and using information/education/communication information/education/communication training materials). training materials).

Training of teachers, students, and peer Training of teachers, students, and peer educators on HIV/STI prevention, educators on HIV/STI prevention, reproductive health and the importance of reproductive health and the importance of safer sex. safer sex.

Peer educator-led campaigns among Peer educator-led campaigns among community groups. community groups.

Lessons LearnedLessons Learned There is a need to develop and conduct There is a need to develop and conduct

widespread school-based programs for sexual widespread school-based programs for sexual and reproductive health, including HIV/AIDS and reproductive health, including HIV/AIDS prevention. prevention.

Trained teachers and peer educators can achieve Trained teachers and peer educators can achieve high coverage in implementing HIV/AIDS high coverage in implementing HIV/AIDS prevention activities. prevention activities.

Enhanced project success is associated with Enhanced project success is associated with participant involvement in project design. participant involvement in project design.

Activities should be culturally sensitive and Activities should be culturally sensitive and relevant to the needs of intended beneficiaries. relevant to the needs of intended beneficiaries.

The participation of national health authorities is The participation of national health authorities is important for the sustainability of HIV/AIDS important for the sustainability of HIV/AIDS education and prevention activities. education and prevention activities.

AID for AIDSAID for AIDS

Aid for AIDSAid for AIDS New York City Medicine Recycling ProgramNew York City Medicine Recycling Program Donating to Latin America since 1996Donating to Latin America since 1996 Drug donations from HIV/AIDS patients in Drug donations from HIV/AIDS patients in

United States who don't need them anymoreUnited States who don't need them anymorefor various reasonsfor various reasons

Partners with activists/organizations in Partners with activists/organizations in countries to help lobby government for AIDS countries to help lobby government for AIDS awareness-Brazil has developed national drug awareness-Brazil has developed national drug programprogram

Conferences in Latin America Conferences in Latin America

Our PlanOur Plan

Comprehensive approach to tackle all Comprehensive approach to tackle all angles of the epidemicangles of the epidemic– Education, Education, EducationEducation, Education, Education– Removing the stigmaRemoving the stigma– Help create sustainable income Help create sustainable income – Utilize local resources Utilize local resources – Lobby for financial and legislative government Lobby for financial and legislative government

support and fundingsupport and funding– Utilize the crafts and talents of the people to Utilize the crafts and talents of the people to

foster motivation and empowermentfoster motivation and empowerment

References and ResourcesReferences and ResourcesAID for AIDS: AID for AIDS: http://www.thebody.com/atn/348/recycling.htmlhttp://www.thebody.com/atn/348/recycling.html

www.AidforAids.orgwww.AidforAids.orgAmfAR, The Foundation for Aids Research: AmfAR, The Foundation for Aids Research:

http://www.amfAR.orghttp://www.amfAR.orgAVERT: AVERT: http://www.avert.org/aidslatinamerica.htmhttp://www.avert.org/aidslatinamerica.htmBeads for Life: Beads for Life: http://www.beadsforlife.org/http://www.beadsforlife.org/Colombia:Colombia: http://ipsnews.net/interna.asp?idnews=13360http://ipsnews.net/interna.asp?idnews=13360European Community Project European Community Project

http://www.rho.org/html/hiv_aids_progexamples.htm#colomhttp://www.rho.org/html/hiv_aids_progexamples.htm#colombiabia

Proteja: A Time for Hope for Young People: Proteja: A Time for Hope for Young People: http://www.visionmundial.orghttp://www.visionmundial.org

Until There’s a Cure: Until There’s a Cure: http://www.until.org/statistics.shtmlhttp://www.until.org/statistics.shtmlUN Aids: UN Aids: www.unaids.orgwww.unaids.org

HIV/AIDS in HIV/AIDS in LithuaniaLithuania

IrmaIrma

In the Baltic states, as in another In the Baltic states, as in another East European countries, the East European countries, the spread features of the HIV/AIDS spread features of the HIV/AIDS pandemic are quite similar, but pandemic are quite similar, but the spread of HIV in Lithuania the spread of HIV in Lithuania has some peculiarities.has some peculiarities.

HIV/AIDS Epidemiological situation in HIV/AIDS Epidemiological situation in LithuaniaLithuania

In 1988 – 2007 1213 HIV infection cases In 1988 – 2007 1213 HIV infection cases and 126 AIDS cases were reported.and 126 AIDS cases were reported.

Lithuania is surrounded by countries Lithuania is surrounded by countries where HIV is widely spread. where HIV is widely spread. Nevertheless, Lithuania is still a country Nevertheless, Lithuania is still a country with a low HIV prevalence. with a low HIV prevalence.

HIV prevalence according to the HIV prevalence according to the way of transmissionway of transmission

The main ways of HIV/AIDS transmission The main ways of HIV/AIDS transmission in Lithuania are: in Lithuania are:

intravenous drug using (933 persons);intravenous drug using (933 persons); heterosexual intercourses (136 persons);heterosexual intercourses (136 persons); homosexual intercourses (79 persons);homosexual intercourses (79 persons); unknown (65 persons). unknown (65 persons).

HIV prevalence according to the age HIV prevalence according to the age and genderand gender

HIV has been mostly reported in the HIV has been mostly reported in the age groups of 25 – 29 and 30 – 34. age groups of 25 – 29 and 30 – 34.

Up to the 1st of January in 2007, Up to the 1st of January in 2007, 1052 male and 161 female HIV cases 1052 male and 161 female HIV cases were reported. It is important to were reported. It is important to notice that number of female cases is notice that number of female cases is increasing.increasing.

The prevention of HIV/AIDS in The prevention of HIV/AIDS in Lithuania.Lithuania.

The prevalence of HIV The prevalence of HIV depends on human depends on human interrelationships and interrelationships and their behaviour. So the their behaviour. So the main tool which can main tool which can stop it is prevention.stop it is prevention.

Systematic and methodical prevention of Systematic and methodical prevention of HIV infection and AIDS in Lithuania HIV infection and AIDS in Lithuania started in 1989, when Lithuanian AIDS started in 1989, when Lithuanian AIDS Center was established. The main Center was established. The main functions of the Center are:functions of the Center are:

the development and promotion of the development and promotion of HIV/AIDS prevention and control;HIV/AIDS prevention and control;

performance and monitoring of testing performance and monitoring of testing and treatment in Lithuania;and treatment in Lithuania;

implementation of the national AIDS implementation of the national AIDS prevention programmes;prevention programmes;

cooperation with institutions cooperation with institutions involved in HIV/AIDS prevention;involved in HIV/AIDS prevention;

coordination of efforts with other coordination of efforts with other related programmes;related programmes;

advocacy and lobbying, including advocacy and lobbying, including legislative framework.legislative framework.

The key strategical document on The key strategical document on HIV/AIDS prevention and HIV/AIDS prevention and control in Lithuania is the control in Lithuania is the National AIDS Prevention and National AIDS Prevention and Control Programme. This Control Programme. This program has set the target to program has set the target to keep the country of a low HIV keep the country of a low HIV prevalence up to 2010. prevalence up to 2010.

Key objectives of this programme are:Key objectives of this programme are:

1. To reduce transmission of HIV/AIDS 1. To reduce transmission of HIV/AIDS and related infections in Lithuania.and related infections in Lithuania.

2. To mitigate negative consequences of 2. To mitigate negative consequences of HIV and related infections to an HIV and related infections to an individual and society.individual and society.

3. To provide appropriate health care 3. To provide appropriate health care services to people with HIV and AIDS.services to people with HIV and AIDS.

4. To improve HIV/AIDS surveillance 4. To improve HIV/AIDS surveillance system.system.

Decentralized actions – from the Decentralized actions – from the national level to the district and national level to the district and community levels are characteristics of community levels are characteristics of the Lithuanian HIV/AIDS programme. the Lithuanian HIV/AIDS programme. The role of the municipal health The role of the municipal health programmes is very important to programmes is very important to stimulate health promotion and local stimulate health promotion and local participation in design of the health participation in design of the health policy.policy.

Other ways of HIV/AIDS Other ways of HIV/AIDS prevention in Lithuaniaprevention in Lithuania

Issues on HIV/AIDS are integrated into Issues on HIV/AIDS are integrated into various school curricula topics. various school curricula topics.

Youth Health Centres take care of Youth Health Centres take care of informal sexual education informal sexual education ofof young young people. people.

Non-governmental sector has been Non-governmental sector has been actively taking part:actively taking part:

in organising of commemoration of in organising of commemoration of the World AIDS Day;the World AIDS Day;

in actions “Get tested on HIV for in actions “Get tested on HIV for free”;free”;

in implementation of the “Peer in implementation of the “Peer education” programmes;education” programmes;

in organizing national contest for the in organizing national contest for the schoolchildren on knowledge about schoolchildren on knowledge about HIV/AIDS;HIV/AIDS;

in organizing international in organizing international Schoolchildren Drawing Competition Schoolchildren Drawing Competition “School Children Against AIDS”;“School Children Against AIDS”;

in organising of debates of youth and in organising of debates of youth and policy makers in the municipalities;policy makers in the municipalities;

in organizing of a club “Journalists in organizing of a club “Journalists against AIDS”.against AIDS”.

Organisations trying to help people Organisations trying to help people living with HIV/AIDSliving with HIV/AIDS

““Positive Life” – an independent, Positive Life” – an independent, non-governmental organization non-governmental organization founded by HIV positive people, their founded by HIV positive people, their family members and other family members and other individuals that deal with the individuals that deal with the problems encountered by people problems encountered by people living with HIV/AIDS (PLWHA) in living with HIV/AIDS (PLWHA) in Lithuania.Lithuania.

Drug Users’ Social Rehabilitation Drug Users’ Social Rehabilitation Community where people dependent Community where people dependent on drugs and psychotropic on drugs and psychotropic substances can get the Community’s substances can get the Community’s support. The priority is given to support. The priority is given to drug users infected with HIV.drug users infected with HIV.

Stigmatized HIV infected peopleStigmatized HIV infected people

Pervasive stigma has Pervasive stigma has surrounded HIV/AIDS surrounded HIV/AIDS since the beginning of since the beginning of the pandemic. HIV the pandemic. HIV infected people in infected people in Lithuania are not an Lithuania are not an exception too. exception too.

In 2003 there the research was In 2003 there the research was performed which examined the HIV performed which examined the HIV related stigma among HIV infected related stigma among HIV infected prisoners. Research has shown that prisoners. Research has shown that respondents feel personalized stigma.respondents feel personalized stigma.

Another survey of the public opinion Another survey of the public opinion about vulnerable groups in 2003 has about vulnerable groups in 2003 has proved significant increase in proved significant increase in tolerance towards the people with tolerance towards the people with HIV in the last 13 years.HIV in the last 13 years.

Negative attitude of the society towards Negative attitude of the society towards HIV infected people is determined by: HIV infected people is determined by:

the lack of information on HIV infection;the lack of information on HIV infection; preconcepion and stereotypes;preconcepion and stereotypes; fear of the desease which is incurable;fear of the desease which is incurable; irresponsibility of mass media;irresponsibility of mass media; the attitudes about sexual life.the attitudes about sexual life.

The only way to overcome The only way to overcome HIV/AIDS pandemic is to change the HIV/AIDS pandemic is to change the shame into solidarity and the fear shame into solidarity and the fear into hope. This is what I wish for all into hope. This is what I wish for all of us.of us.

REFERENCES:REFERENCES: www.aids.ltwww.aids.lt www.stophiv.ltwww.stophiv.lt Čaplinskas, S. (2004) HIV/AIDS policy of Lithuania. 6-Čaplinskas, S. (2004) HIV/AIDS policy of Lithuania. 6-

th Nordic-Baltic Congress on Infectious Diseases. th Nordic-Baltic Congress on Infectious Diseases. Abstract, p. 61. Abstract, p. 61.

Čaplinskienė, I. (2004) Lithuanian population’s Čaplinskienė, I. (2004) Lithuanian population’s tolerance towards vulnerable groups. Abstract book, tolerance towards vulnerable groups. Abstract book, Vol. 1, p. 522,Vol. 1, p. 522,

Čaplinskas, S., Stonienė, S. (2004) Schoolchildren Čaplinskas, S., Stonienė, S. (2004) Schoolchildren against AIDS – a national contest in Lithuania. Sexual against AIDS – a national contest in Lithuania. Sexual health exchange, No. 4, p. 7 – 8.health exchange, No. 4, p. 7 – 8.

Čaplinskas, S., Stonienė, L. (2004) Self-government and Čaplinskas, S., Stonienė, L. (2004) Self-government and HIV/AIDS prevention in Lithuania. 6-th Nordic-Baltic HIV/AIDS prevention in Lithuania. 6-th Nordic-Baltic Congress on Infectious Diseases. Abstract, p. 72.Congress on Infectious Diseases. Abstract, p. 72.

The Zontian. (2007, January) Volume 87, Number 4.The Zontian. (2007, January) Volume 87, Number 4.