Publications

Mr. Nun (a pseudonym) is one of many Cambodians who suffer from AIDS. What is unique about Mr. Nun is that his physical condition is better now than it was last year and that his improvement happened after receiving HIV care and treatment from a local hospital. Mr. Nun is the beneficiary of a new collaborative initiative in Moung Russey Operational District (OD) between the district health services, the National Center for HIV/AIDS, Dermatology and STD (NCHADS), communities, people living with HIV/AIDS (PLHA), and international and local non-government organizations. These partners have worked together to improve health services for PLHA by instituting a continuum of care (CoC) for HIV/AIDS clients that provides complementary health care services in both the hospital as well as in the clients’ homes. In less than six months, with a strategic set of inputs, this partnership has implemented specially designed services in the Moung Russey Referral Hospital (RH) that prevent HIV infection, provide testing and counseling for suspected HIV cases, and make available diagnostic and treatment services for PLHA suffering from HIV-related illnesses such as opportunistic infections (OIs) and TB, including the provision of INH preventive therapy (IPT) for PLHA.

Unions in South Pacific countries face many threats and in many instances have weak or fragile capacities and infrastructures. Programs that respond to the needs of members and non-union workers in relation to HIV and sexual health can assist in building unions as effective civil society (or “non-state”) actors. Discrimination does not appear to be a major problem in most countries and has been resisted by unions when it has occurred. As cases grow, union policies will need to be in place to counter discrimination that will inevitably occur due to fear and ignorance. Issues of voluntary testing and confidentiality have not been widely debated or considered in most countries. Union leaders and their members need to be well informed and convinced of these key issues in order to protect the rights of workers and to counter demands for involuntary testing and keeping HIV status confidential. Apart from Australia, New Zealand, and French territories, other South Pacific unions have yet to develop plans of actions to deal with HIV/AIDS. Unions require assistance to develop workplace policies and education programs in line with the ILO Code of Practice.

The United Nations-led process of updating the 1998 international guidelines related to infant feeding and the prevention of maternal-to-child-transmission (pMTCT) of HIV called for a review of recent programmatic experience in addition to a review of the new scientific and medical evidence. This document represents an attempt to compile and synthesise reports on a wide variety of relevant programmes conducted since the 1998 guidelines were issued. The programmes presented here range in scale from small community research projects to national programmes. The compilation addresses numerous controversial topics and constraints, including human resources (inadequately trained and insufficient counsellors); confused mothers; stigma and discrimination; spillover of replacement feeding; free or subsidised infant formula; family economics; and the difficulty in providing integrated HIV testing, informed-choice counselling, community support, logistics, and follow-up care for mothers and infants.

With rapid and steady economic growth since the mid 1980s, the South Korean work force is increasingly avoiding the so-called 3D (difficult, dirty, and dangerous) jobs, causing an imbalance in the supply and demand of labor. This situation has attracted a great number of migrant workers to the Republic of Korea since the late 1980s.

In response to the HIV threat in the military, the Royal Cambodian Armed Forces, in partnership with local and international non-governmental organizations and international agencies, developed a comprehensive strategy for reducing HIV vulnerability in the military through education, empowerment and capacity-building as part of a larger national HIV prevention strategy. This case study documents the Cambodian defence sector's effort in building HIV resilience and reflects both constraints as well as lessons learned on factors contributing to an effective HIV prevention programme in the military.

The United Nations Regional Taskforce on Prevention of Mother-to-Child Transmission of HIV met from 11-13 May 2004 in Bangkok, involving countries from East and South Asia and the Pacific. The meeting aimed to strengthen communication and cooperation among those working on PMTCT in Asia and the Pacific through sharing country experiences and technical updates from global experts. Specific attention was also given to issues related to increasing access to antiretroviral treatment. On the future of the Regional PMTCT Taskforce it was agreed to continue the representation of the East Asia, South Asia and Pacific regions, to meet approximately three times every two years and to ensure that other UN agencies and NGOs are involved in planning and attending meetings, as well as representatives of women affected by and living with HIV/AIDS.

Interactions between antiretroviral therapy (ART) and food and nutrition can affect medication efficacy, nutritional status, and adherence to drug regimens. Drug-food interactions consist of the effects of food on medication efficacy, the effects of medication on nutrient utilization, the effects of medication side effects on food consumption, and unhealthy side effects caused by medication and certain foods. As ART interventions scale up in resource limited settings, addressing food and nutrition implications becomes a critical component of care and support programs and services. This technical note summarizes the types of ARVs commonly used; offers a framework for understanding drug-food interactions; describes key issues and steps for managing ARV-food interactions; identifies areas where knowledge gaps exist; and lays out the specific food and nutrition implications of ARVs commonly used in resource limited settings. This information aims to support program design and service provision.

Nepal's first cases of HIV/AIDS were reported in 1988. At the end of 2003 it was estimated that 62,000 people were living with HIV/AIDS. The epidemic assessments reveal a low prevalence among the general population and that so far HIV/AIDS is still concentrated among certain groups like Female Sex Workers (FSW), Intravenous Drug Users (IDUs) and labor migrants. However as shown by global experience and specific studies conducted in Nepal the young people remain highly vulnerable to the disease. In an effort to strengthen its national response to HIV/AIDS, Nepal established a National Center for AIDS and STD Control (NCASC) and a National AIDS Council that in October 2002 endorsed the National HIV/AIDS strategy. Prevention of new infections among young people is one of the 5 key priority areas identified in the strategy and therefore young people shall receive greater attention in future HIV/AIDS-related programming.

Indonesia, the world’s largest archipelago, with a population 214,8 million is now the forth most populated country in the world. Young people age 15-24 represent approximately 30% of the population (UNICEF, WHO, UNAIDS 2002). The HIV epidemic in Indonesia is concentrated, with still-low HIV infection rates in the general population, but high rates among certain populations. As of March 2004, the MoH reported 2,746 HIV and 1,413 AIDS cases, bringing to a total 4,159 reported HIV/AIDS cases and 493 AIDS related deaths in Indonesia. The number of Indonesians living with HIV/AIDS is estimated by the Government at 90,000 to 130,000, the majority of whom are unaware of their seropositive status. It is estimated that unless behaviour changes, another 80,000 Indonesians will have become newly infected in 2003.

Young people are under threat from HIV/AIDS. Of the estimated 40 million people in the world now living with HIV/AIDS, more than a quarter are aged 15 to 24. Half of all new infections occur in young people. In addition over 10 million children have been orphaned by AIDS and face life without parental protection and guidance, poverty, and social inequality.