The singer Amy Winehouse was found dead in her apartment in London yesterday.

She was growing in popularity in the world of music, but was also struggling with the use of drugs. The police do not think of her death as homicide.

Her European tour which started in Serbia recently had to be cancelled in the last-minute when she could not perform due to influence of drugs.

She will be missed by fans and family.

API sends condolences to her family and loved ones.

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KENYA: More cervical cancer screening for HIV-positive women urged

Photo: Kate Holt/IRIN

Cervical cancer is one of the biggest killers of women in he developing world

KISUMU,  – The Kenyan government is taking steps to incorporate screening for cervical cancer – one of the biggest killers of women of child-bearing age – into HIV care, but health workers say low awareness means the uptake of this vital service is low.

Studies show that HIV infection increases women’s risk of human papillomavirus (HPV) infection, a leading cause of cervical cancer.

“When we as health workers talk to many women, you realize that HIV-negative women believe cervical cancer only affects those who are HIV-positive and they miss the opportunity for screening because they believe they are not at risk, while HIV-positive women will at times decline screening because they fear they will be found to be positive for the disease,” Collins Wambasa, a clinical officer at western Kenya’s Nyanza Provincial General Hospital, told IRIN/PlusNews.

Cervical cancer screening is included as part of routine care for HIV-positive women under the country’s national guidelines for HIV care. However, screening levels remain low; according to the UN World Health Organization, just 3.2 percent of Kenyan women aged 18-69 are screened for cervical cancer every three years, compared with 70 percent of women in the developed world.

In 2007, the government began rolling out cervical cancer screening at selected HIV care centres using a method known as visual inspection with acetic acid, which studies say is an efficient and cost-effective method of screening. The test is performed by a trained health worker who washes a woman’s cervix with acetic acid – a key ingredient in vinegar – and gauze; any pre-cancerous lesions turn white and can be seen with the naked eye under a halogen lamp.

The more common Pap smear test requires more highly trained health providers, access to equipment and supplies, a cytology laboratory, arrangements for communicating results to screened women and a facility for confirming diagnosis.

Joyce Ndisi, a 33-year-old HIV-positive mother of two, recently visited the Nyanza Provincial Hospital for her routine care, where clinicians told her she would require another cervical cancer screening. “It was very simple – I didn’t even feel any pain because they didn’t put that metal spoon [spatula] inside me… Now I won’t fear coming for it because it is very easy,” she said.

Awareness issues

“The main limitation to cervical cancer screening is the lack of awareness of cervical cancer as a significant health threat to women in the general public and in the healthcare sector,” said Elizabeth Bukusi, a senior research officer at the Kenya Medical Research Institute and co-author of a 2011 article on cervical cancer screening for HIV-positive Kenyan women.

The main limitation to cervical cancer screening is the lack of awareness of cervical cancer as a significant health threat to women

According to a 2011 study conducted in Eldoret, in Kenya’s Rift Valley Province, on the perceptions of risk and barriers to cervical cancer screening, 35 percent of the participants did not think they were at risk of cervical cancer and felt no need to screen for the condition. In this study, 22.1 percent of the respondents mentioned fear of abnormal results as the reason they would not want to be screened for cancer while 11.4 percent mentioned cost. Just 12.3 percent of the participants reported having been screened at least once before.

Bukusi cautioned that health workers needed to emphasize the importance of repeat screening. “No currently available screening technique is 100 percent sensitive, and women are at risk of cervical cancer throughout their lives, so screening at regular intervals is necessary,” she said.

Charles Okal, the Provincial AIDS and STI Coordinator in Nyanza, says the use of simple techniques for cancer screening and the integration of screening in HIV care settings had seen the number of women screened and treated rise over time.

“Making cervical cancer screening part of routine HIV care for women has made it easy to get more women to screen and get treated for the disease,” he said. “But it is also important to note that HPV prevalence within the population will decline over time so long as we step up our efforts to make people take up such prevention methods such as condom use, male circumcision and reduction in sexual partners.”

According to WHO, cervical cancer ranks as the second most frequent cancer among women in Kenya; about 39 percent of women in the general population are estimated to harbour a cervical HPV infection at any given time.

ko/kr/mw source www.irinnews.org

HIV/AIDS: Survey reveals gaps in HIV programming for MSM

Photo: Flickr Creative Commons/Spec-ta-cles

Just 36 percent of MSM surveyed reported having easy access to HIV treatment

NAIROBI, ) – A new global survey of more than 5,000 men who have sex with men (MSM) reveals a marginalized group of people with little access to basic HIV prevention tools such as condoms and few means to learn about HIV.

Conducted by the Global Forum on MSM & HIV between 24 June and 17 August 2010, the survey sought to highlight key gaps in global efforts to provide MSM with evidence-informed HIV prevention services. More than 1,000 of the study participants – drawn from all over the world – were health workers; 22 percent reported being HIV-positive.

The authors recommend expanding access to HIV prevention services for MSM across the globe, more focus on promoting awareness of emerging HIV prevention interventions and more robust and sustained stigma-reduction efforts. Some of the major findings of the survey include:

Access to health services – Fifty-three percent of participants said they could easily access testing for sexually transmitted infections, while 51 percent said they had easy access to HIV counselling; 47 percent found STI treatment easily accessible.

Just 36 percent of MSM surveyed reported having easy access to HIV treatment, while 27 percent said it was available but difficult to access, was not available or had never heard of HIV treatment.

Access to HIV prevention – Free condoms were easily accessible only to 44 percent of participants, while just 29 percent could obtain lubricant.

Just 30 percent of participants reported easy access to each of the basic HIV prevention services, including behavioural HIV/AIDS interventions, HIV education materials, mental health services, free or low-cost medical care, media campaigns focused on reducing HIV, and laws/policies to ensure access to HIV prevention.

Just 25 percent said they had access to sex education.

Stigma - Africa reported the highest levels of stigma and external homophobia, followed by the Middle East, Asia-Pacific, Central/South America and the Caribbean, which all reported similar levels of stigma. Australia and New Zealand reported the lowest levels of stigma and external homophobia.

MSM from Africa and the Asia-Pacific region reported the highest levels of internalized homophobia.

MSM-specific services – Some 52 percent of respondents reported that MSM health facilities were not available or unknown.

Media campaigns to reduce homophobia were rare, with 30 percent of the survey’s participants reporting that anti-homophobia campaigns were not available and another 20 percent saying they were “unheard of”.

Knowledge of and access to emerging HIV prevention strategies – Fifty percent of respondents said medical male circumcision was easily accessible and just 10 percent had not heard of circumcision as a biomedical strategy for HIV prevention.

Post-exposure prophylaxis (PEP) was described as easily accessible by only 18 percent of respondents, with 35 percent reporting that they had never heard of PEP.

Thirty-nine percent of partiszcipants had never heard of pre-exposure prophylaxis for HIV prevention, while 44 percent of MSM had never heard of topical microbicides.

kr/mw source www.irinnews.org

KENYA: Outrage over “cash for contraception” offer to HIV-positive women

Photo: Dogs and music/flickr

The project gives Kenyan women US$40 to undergo long-term contraception

KAKAMEGA,  – The Kenyan government and rights groups have expressed outrage at a project in western Kenya that is paying HIV-positive women to undergo long-term contraception.

Project Prevention, a US-based NGO, offers cash to drug addicts in the US and the UK to undergo long-term contraception or permanent sterilization. In 2010, the project started offering HIV-positive women in western Kenya US$40 to be fitted with intrauterine devices (IUDs), which can prevent pregnancy for over a decade.

The project uses a medical practitioner in the western Kenyan town of Kakamega to insert the IUDs for $7 per woman; so far, 22 women have undergone the procedure.

“There are two issues here; one is using incentives to push women into taking up birth control, and the second is pushing women with HIV to take up long-term birth control irrespective of their reproductive needs,” said Agnes Odhiambo of New York-based Human Rights Watch. “All women, including women with HIV, have the right to make informed choices about their reproductive health and that effectively means to use a contraceptive method of their choice, whether long or short term – the key word here is informed choice.

“Giving economic incentives to women with HIV, or any woman for that matter, to undertake long-term contraception is a form of coercion and violates women’s reproductive rights and choices,” she added.

“Illegal”

According to James Kamau, coordinator of the Kenya Treatment Access Movement, the project was “wrong, immoral and unethical”.

Someone, somewhere is sleeping on the job because a project like this cannot and should not be allowed to practise in Kenya

He noted that it contradicted provisions against discrimination in the country’s HIV and AIDS Prevention and Control Act of 2006. Ministry of Health officials say Project Prevention did not seek the government’s authority before beginning its operations, making its activities illegal.

“Someone, somewhere, is sleeping on the job because a project like this cannot and should not be allowed to practise in Kenya,” Kamau said.

South African media reports in May said Project Prevention planned to start similar operations in South Africa.

Defence

Willice Okoth, coordinator of the Kenyan operation, argued that the project’s aim was to fill family planning gaps, prevent HIV-related infant deaths and lower the number of orphans in the country.

“HIV has been the longest disaster and only birth control amongst HIV-positive women provides an opportunity to end it,” he said. “Why should you give birth to a child who will remain an orphan, or who is likely to die before his or her fifth birthday because the mother had infected them… prevent the suffering before it occurs,” Okoth told IRIN/PlusNews.

According to the US Health Policy Initiative, there is an unmet family planning need of almost 20 percent among married Kenyan women. The government is working to reduce this gap, and the prevalence of contraceptive use has increased from 39 percent in 1998 to 46 percent a decade later.

The country is also increasing access to services for prevention of mother-to-child HIV transmission (PMTCT); an estimated 72 percent of HIV-positive pregnant women receive antiretroviral prophylaxis to reduce the risk of HIV transmission to their babies, while more than 3,300 health facilities around the country offer PMTCT services.

“Fine, one would argue that PMTCT has reduced cases of HIV-positive babies but statistics from government show that just 44 percent of deliveries occur in health facilities,” said Okoth. “It means many more HIV-positive mothers who do not deliver at the hospital stand the risk of infecting their unborn children. When you look at the intentions of PMTCT, prevention of unintended pregnancies is one of the key pillars.”

Poverty, ignorance

Yunia*, a 31-year-old mother of six, says she would have chosen to stop having children as soon as she was diagnosed with HIV four years ago, but had no access to contraceptives. “I didn’t want to have a child, but here in the rural area, people cannot advise you because they also don’t know. I have had two children since, and one of them died,” she told IRIN/PlusNews.

Photo: Edgar Mwakaba/IRIN

Government officials say cash incentives are the wrong way to fill the gap in women’s access to contraceptives

Yunia was happy to take the one-off payment of $40, which she says will help her family income. “I have six children and I could still give birth to more because I am fertile but have nothing to buy food or clothes for them; now if you can get some small money to start a business plus you are helped also to stop giving birth – why not take it?”

Project Prevention gives the money to groups of 10 women for income-generating projects; Yunia and her group have not yet decided on a business venture.

“Wrong way to go”

Senior government officials say, however, that cash incentives targeting a particular group of women is the wrong way address family planning gaps.

“We can’t say as a government we have been good at providing family planning needs of women or even men but we are putting measures in place. But it is important to stress that even HIV-positive women have the right to have children if and when they desire. HIV doesn’t take that right way, not at all,” said Peter Anyang’ Nyong’o, Minister for Medical Services.

“Women need reproductive health services – including family planning – but before you give those services, you must educate them and give them a range of choices and then they voluntarily agree to take the one they feel best suited for their case, but to flash money and say take this – no, that is not how to do it,” he added.

*Not her real name

ko/kr/mw source www.irinnews.org