Publications

There are various risk factors that can affect young people, such as living in a neighbourhood where drug dealing and drug abuse are taking place and where out-of-school activities are not available. Economic strain on families where parents struggle to meet living costs can influence family relationships negatively, while spending time with peers who are involved in drugs or delinquency while seeking adventure puts young people at higher risk of falling prey to drug abuse. As a consequence of these kinds of risk factors, young people may suffer from mental health problems, making them even more vulnerable to substance abuse.

Within the GMS the need for joint action for HIV prevention and better access to treatment, care and support is increasingly articulated at national and provincial (border provinces) levels, especially in contexts where migrants and mobile populations face barriers to accessing services in destination countries. In 2004, the six countries in the GMS signed a Memorandum of Understanding (MoU) for Joint Action to Reduce HIV Vulnerability Related to Population Movement and, following the expiration of this MOU in 2009, an amended MoU was signed during the 4th GMS Summit in Myanmar in 2011. Accompanying the 2011 MOU is a draft Joint Action Program (JAP) that identifies priority areas for bilateral and multilateral cooperation. Drawing guidance from both the MoU and its attached draft JAP, the Asian Development Bank (ADB) and the UNDP Asia-Pacific Regional Centre jointly convened this 2012 Consultation on the Memorandum of Understanding to Reduce HIV Vulnerability Associated with Population Movement, in order to formulate concrete national, bilateral and subregional activities to address the challenges faced by migrants and mobile populations in this area.

Sex workers have the same sexual and reproductive rights as anyone else – such as to choose who to have sex with and to have sexual relations free from violence. They also share many of the same needs for SRHR information, support, commodities and services – such as advice about family planning. This brief specifically focuses on the importance, but also challenges, of HIV/SRHR integration for sex workers. It is based on the experiences of a growing number of groups working with such communities to put integration into practice in a range of setting. These have given important insights into ‘what works’. But they also highlight that everyone is still learning and questions remain about what constitutes good practice. This issue brief promotes integration as a desirable goal in the long-term. However, it also emphasizes that organizations must work in a way and at pace that is appropriate and feasible for them – to ensure that the joining of HIV and SRHR services and systems enhances, rather than compromises, support for sex workers.

The Global Commission on HIV and the Law is an independent body, established at the request of the Programme Coordinating Board of the Joint United Nations Programme on HIV/AIDS (UNAIDS) and supported by a Secretariat based at the United Nations Development Programme (UNDP). This report reflects the views and conclusions of the Commission, as well as its recommendations to countries, civil society actors, the private sector and the United Nations.

Now is a critical time to ensure widest possible access to ART: a landmark scientific breakthrough in 2011 showed that treatment with antiretroviral medicines (ARVs) not only saves lives, but can also stop HIV from being transmitted by up to 96%. In response to this evidence, in 2012 the World Health Organization (WHO) issued guidance supporting immediate treatment – regardless of a person’s immune system’s status or CD4 count – for HIV-positive people who have HIV-negative partners, in order to help prevent transmission of the virus.5 At the same time, guidance was also issued suggesting the possibility of offering full antiretroviral therapy for life to all pregnant women living with HIV for prevention of mother-to-child transmission of the virus (PMTCT).

Although researchers and public health organisations in most low and middle income countries have not collected any recent data on the prevalence of HIV in female sex workers, the data that do exist are alarming, the 19th International AIDS Conference (AIDS 2012) heard on Thursday. Pooling the data available for 50 countries, female sex workers have a 14-fold higher risk of infection as women of a similar age in the general population. Rates are especially elevated in some countries, including Bangladesh, Benin, Cambodia, China, Guinea, Guyana, India, Indonesia, Malaysia, Mauritius, Mexico, Nepal and Senegal.

Violence against women (VAW) is a global problem that crosses cultural, geographic, religious, social and economic boundaries and is a violation of human rights. Violence against women deprives women of their right to fully take part in social and economic life. It causes a myriad of physical and mental health issues and in some cases results in loss of life. A lack of understanding of the magnitude of VAW, its causes and consequences, and the trends and patterns across cultures and countries, including the Pacific, hinders the development of efforts to address it. The National Study on Domestic Violence against Women in Tonga consisted of two separate components: a quantitative study based on the methodology developed for the WHO Multi-Country Study on Women’s Health and Domestic Violence against Women; and a qualitative study based on Tongan methodology of Talanoa and Nofo (see below). The use of qualitative and quantitative components was to seek results that complemented each other.

In 2010, an estimated 34 million people were living with the human immunodeficiency virus (HIV), around 70% of them in sub-Saharan Africa. By the end of 2010, 6.6 million people, or 47% of those in need (CD4+ cell count <350 cells/mm3), were on antiretroviral therapy (ART), and an estimated 7.5 million people were still in need of treatment. While considerable progress has been made in extending ART coverage, there continue to be critical gaps. In the same year, coverage for children was reported to be less than 23%, there were 2.7 million new infections and more than 20 million people were not yet treatment-eligible (as most of them did not know their HIV status). There were an estimated 1.1 million new cases of HIV-associated tuberculosis (TB), which led to 24% of HIV-related deaths. HIV is the strongest risk factor for developing TB, and people living with HIV have a 20–37 times higher risk of developing TB than those who do not. ART has a significant secondary prevention benefit for both HIV and TB, and expanded access to ART has probably averted millions of HIV infections and cases of TB.  The World Health Organization (WHO) has introduced the concept of HIV elimination through the use of combination prevention and prevention of mother-to-child transmission (PMTCT) of HIV. Additionally, WHO and the Joint United Nations Programme on HIV/AIDS (UNAIDS) launched Treatment 2.0 to look at ways to provide better services to a larger number of persons at lesser cost, and in a way that helps to retain them on lifelong ART. This would also greatly benefit HIV prevention efforts.

Migrant health issues have risen on the agenda of policymakers in the Asia-Pacific region in recent years, generating momentum at the very highest levels of government. The challenge now is how to translate this momentum into visible changes on the ground. Despite progress on both policy and programmatic fronts, Asian migrant workers continue to face challenges in accessing health facilities and services at all stages of migration – before departure, while in transit, at destination and upon return. Moving the policy discourse on migrant health issues forward and ensuring changes on the ground first require disentangling myths from realities. There is a persistent public perception that labour migrants are carriers of diseases or that they are a burden to the health systems of the countries that receive them. The reality, however, is different. Labour migrants are generally young and healthier than the native population and they tend to under-utilize health services at destination. Labour migrants’ vulnerability to ill health, however, increases during the migration process due to various risk factors such as lack of adequate health insurance, poverty and uncertain legal status.

The worldwide use of our data for entry and residence regulations makes it vital for us to update this overview regularly, in order to be able to provide PLHIV with access to the most current information at all times. This new issue is based on the results of a new worldwide survey of the foreign representatives of 200 countries, made between November 2007 and June 2008 with the support of the German foreign ministry. All changes that have occurred since then are integrated in this update. This new edition of the Quick Reference guide contains all the changes we have become aware of up to the beginning of 2012.