Girls, Women Trafficked In Asia For Commercial Sex Work Emerging As HIV/AIDS Risk Factor, Report Says

Young women and girls in Asia who are trafficked for commercial sex work are emerging as an HIV/AIDS risk factor, according to a report released by the United Nations Wednesday at the 8th International Congress on AIDS in Asia and the Pacific, the AP/PR-Inside reports (Nessman, AP/PR-Inside, 8/22). The conference brings together more than 2,500 delegates from Asian countries to discuss fighting the spread of HIV/AIDS, as well as providing treatment and support to people living with the disease. An estimated 8.6 million people living in the Asia-Pacific region are HIV-positive (Kaiser Daily HIV/AIDS Report, 8/23).

The report, titled "Human Trafficking and HIV," focused on the estimated 150,000 to 200,000 people from South Asia trafficked and forced into labor annually, usually as sex workers. According to the AP/PR-Inside, the number represents only 50% of the people who are trafficked in all of Asia. The report examined the intersection between HIV and trafficking in Afghanistan, Bangladesh, India, Nepal, Pakistan and Sri Lanka, the AP/PR-Insider reports.

Although there are few reliable statistics about HIV among trafficked people, one study estimated that 25% of trafficked women in Mumbai, India, are HIV-positive, Caitlin Wiesen-Antin, United Nations Development Programme regional HIV/AIDS coordinator in Asia and the Pacific, said. She added that another study found 60% to 70% of 218 trafficked sex workers from Nepal who were later rescued in Mumbai were HIV-positive. According to Wiesen-Antin, the increase in the number of infrastructure projects across the region, as well as the sex work that accompanies project workers, has the potential to further spread HIV across the Asia-Pacific.

The report recommended that governments work to merge their anti-trafficking and HIV prevention efforts. It also called for a renewed focus on issues that make women more vulnerable to both trafficking and HIV transmission, including gender inequality, violence, poverty and a lack of education (AP/PR-Inside, 8/22).

"Both human trafficking and HIV greatly threaten human development and security," Wiesen-Antin said, adding, "Neither HIV/AIDS nor human trafficking have been integrated or mainstreamed adequately, either at policy or programmatic levels" (Sirilal, Reuters, 8/22). Wiesen-Antin said that it is "absolutely critical that we take action now" (AP/PR-Inside, 8/22).

Conflict, Stigma Hindering Fight Against HIV/AIDS in Region, UNAIDS Official Says
Increasing conflict, stigmatization of HIV-positive people and conservative social attitudes are hindering efforts to fight the virus in the region, Prasada Rao, UNAIDS Asia-Pacific regional director, said at the conference. "The harsh reality is that the grim march of the epidemic in our region continues unabated," Rao said.














According to Rao, recent international HIV/AIDS efforts have focused on India and Thailand, but Bangladesh, China, Indonesia and Pakistan could be the next front lines in the fight against the disease. "These are large countries, and they have the potential of an epidemic to take root, so they need a strong program," he said. Rao added that although there have been some successes in the region, there also are alarming trends, such as efforts from people who oppose condom use and sex education. In addition, increasing conflict in the Asia-Pacific region is hindering HIV prevention and treatment efforts, according to Rao. During the last regional conference two years ago, Nepal was the only Asia-Pacific country experiencing significant conflict, Rao said. He added that eight additional countries currently are experiencing political instability and conflict (Nessman, AP/Guardian, 8/22).

Compulsory Licensing
Rao at the conference also praised Thailand's decision to issue compulsory licenses for two antiretroviral drugs. "Thailand has made a strong statement by invoking a compulsory license for the production of second-line antiretroviral drugs," Rao said. He added, "I urge countries in Asia and the Pacific region to use" World Trade Organization "flexibilities to do more and show more commitment to AIDS responses" (Sathitphattarakul/Treerutkuarkul, Bangkok Post, 8/23).

Colombo Declaration
Representatives at the close of the ICAAP conference on Thursday signed and released the Colombo Declaration, Xinhua/People's Daily reports. The declaration said that countries in the Asia-Pacific have a mix of low and high HIV/AIDS prevalences, adding that countries with low prevalences should work to maintain their statuses by:
Addressing the disease as a development issue;

Employing community-based organizations and residents living with HIV/AIDS to campaign against the disease; and

Implementing specific strategies for prevention.

Countries also should promote voluntary HIV testing and counseling and provide universal access to antiretroviral treatment, according to the declaration. The document also calls on governments and policymakers to address poverty, gender inequality, social marginalization of vulnerable populations and stigmatization, Xinhua/People's Daily reports.

Conference participants said governments should recognize the rights of women, adding that countries should work to strengthen sexual and reproductive education and reduce mother-to-child HIV transmissions, child marriage and gender violence (Xinhua/People's Daily, 8/23).

Samlee Plianbanchang, WHO's Southeast Asia regional director, said, "In the Asia-Pacific region, we are at high risk of a massive spread of HIV," adding, "This is not only due to the large size of the population and the high burden of sexually transmitted infections, but also due to the prevailing risk behaviors and vulnerabilities as well as inherent social stigma." Experts at the close of the conference said that safeguarding the rights of vulnerable groups -- including sex workers, injection drug users, and trafficked women and children -- is vital and should be done in conjunction with prevention efforts. Conference Chair A.H. Sheriffdeen said, "Governments should recognize rights and listen to the voice of women," adding, "They ... should stop treating drug use as a criminal offence and treat it as [a] public health issue" (Sirilal, Reuters, 8/23).

"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Consultant, Former Member of FDA Advisory Panel Resigns Over Handling of Plan B Application

A consultant and former member of FDA's Nonprescription Drug Advisory Committee, Frank Davidoff, has resigned in protest of the agency's action to indefinitely postpone a decision on Barr Laboratories' application for nonprescription sales of its emergency contraceptive Plan B to women ages 17 and older, the AP/San Jose Mercury News reports. Davidoff, editor emeritus of the Annals of Internal Medicine, was a member of the advisory panel when it voted to recommend approval of Plan B for nonprescription sales in 2003 (AP/San Jose Mercury News, 10/6). FDA in May 2004 issued a "not approvable" letter in response to Barr's original application to allow Plan B to be sold without a doctor's prescription and in January delayed a ruling on Barr's revised application, which would allow EC to be sold without a doctor's prescription only to women ages 17 and older. Former FDA Commissioner Lester Crawford at a press conference in August opened a 60-day public comment period on Barr's application and said that science supports giving nonprescription access to Plan B to women ages 17 and older but added that the application presented FDA "with many difficult and novel policy and regulatory issues," including how to keep girls age 16 and younger from obtaining the drug (Kaiser Daily Women's Health Policy Report, 9/26). Davidoff said that FDA is favoring politics over science in delaying approval of the drug for nonprescription sales, adding, "There wasn't any observable scientific or procedural reason for them to first decline and then further delay the decision. ... [I]t seemed to me that [this] was unacceptable." Davidoff, who resigned in September, had served as a consultant to the committee since his term ended earlier this year. He is the second person to publicly leave FDA over the Plan B decision (AP/San Jose Mercury News, 10/6). Former FDA Assistant Commissioner for Women's Health Susan Wood in late August resigned her position (Kaiser Daily Women's Health Policy Report, 9/1).


"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

10 Tips For Breast Cancer Prevention

Throughout October, National Breast Cancer Awareness Month, experts from Fred Hutchinson Cancer Research Center and its clinical care partner, the Seattle Cancer Care Alliance, are offering a series of weekly research-based tip sheets regarding a variety of topics related to breast cancer, including breast cancer prevention, screening and early detection, treatment, and survivorship.


The series launches today with "10 Tips for Breast Cancer Prevention" provided by Anne McTiernan, M.D., Ph.D., director of the Hutchinson Center's Prevention Center, a member of the Center's Public Health Sciences Division, and author of "Breast Fitness" (St. Martin's Press).


Other upcoming tip sheets will include:


Oct. 8 - "10 Tips for Breast Cancer Screening and Early Detection" by Constance Lehman, M.D., Ph.D., director of Breast Imaging and medical director of Radiology at the Seattle Cancer Care Alliance.


Oct. 15 - "10 Tips for Breast Cancer Patients During Treatment" by Julie Gralow, M.D., director of Breast Medical Oncology at the Seattle Cancer Care Alliance and co-author of "Breast Fitness" (St. Martin's Press).


Oct. 22 - "10 Tips for Breast Cancer Survivors" by Karen Syrjala, Ph.D., director of Biobehavioral Sciences and co-director of the Survivorship Program at Fred Hutchinson Cancer Research Center.


The first of four tip sheets in the series follows:


10 Tips For Breast Cancer Prevention


1. Avoid becoming overweight. Obesity raises the risk of breast cancer after menopause, the time of life when breast cancer most often occurs. Avoid gaining weight over time, and try to maintain a body-mass index under 25 (calculators can be found online).


2. Eat healthy to avoid tipping the scale. Embrace a diet high in vegetables and fruit and low in sugared drinks, refined carbohydrates and fatty foods. Eat lean protein such as fish or chicken breast and eat red meat in moderation, if at all. Eat whole grains. Choose vegetable oils over animal fats.


3. Keep physically active. Research suggests that increased physical activity, even when begun later in life, reduces overall breast-cancer risk by about 10 percent to 30 percent. All it takes is moderate exercise like a 30-minute walk five days a week to get this protective effect.


4. Drink little or no alcohol. Alcohol use is associated with an increased risk of breast cancer. Women should limit intake to no more than one drink per day, regardless of the type of alcohol.


5. Avoid hormone replacement therapy. Menopausal hormone therapy increases risk for breast cancer. If you must take hormones to manage menopausal symptoms, avoid those that contain progesterone and limit their use to less than three years. "Bioidentical hormones" and hormonal creams and gels are no safer than prescription hormones and should also be avoided.


6. Consider taking an estrogen-blocking drug. Women with a family history of breast cancer or who are over age 60 should talk to their doctor about the pros and cons of estrogen-blocking drugs such as tamoxifen and raloxifene.


7. Don't smoke. Research suggests that long-term smoking is associated with increased risk of breast cancer in some women. Need help quitting? Consider participating in WebQuit, the Hutchinson Center's online smoking-cessation study.


8. Breast-feed your babies for as long as possible. Women who breast-feed their babies for at least a year in total have a reduced risk of developing breast cancer later.


9. Participate in a research study. The Hutchinson Center is home to several studies that are looking at ways to reduce the risk for breast cancer. Check our website periodically for studies that might be appropriate for you. Just go here and click on "How You Can Help."


10. Get fit and support breast cancer research at the same time. Regular physical activity is associated with a reduced risk of breast cancer. Ascend some of the world's most breathtaking peaks while raising vital funds for and awareness of breast cancer research by participating in the Hutchinson Center's annual Climb to Fight Breast Cancer.


Source:

Fred Hutchinson Cancer Research Center

Dozens Of Women In Southwest China Say They Underwent Forced Abortions, Government Investigation Finds Claims Fabricated, NPR Reports

Dozens of women in Southwest China recently have reported being forced to undergo abortions as late as nine months into their pregnancies, NPR's "Morning Edition" reports. Some women from the region's Guangxi Province say they were forced to have abortions because they were unmarried, while other women were married and pregnant with their second child (Lim [1], "Morning Edition," NPR, 4/23). China's one-child-per-family policy seeks to keep the country's population, now 1.3 billion, at about 1.7 billion by 2050. Ethnic minorities and farmers are the only groups legally exempt from the rule nationwide. Methods of enforcing the policy, such as fines and work demotions, vary among Chinese provinces and cities (Kaiser Daily Women's Health Policy Report, 3/2). According to NPR, Liang Yage and Wei Linrong, a married couple from Baise City with one child, last week contacted a Christian group based outside of China after they said Liang was forced to have an abortion at seven months' gestation. Other unnamed individuals have reported that several dozen women underwent similar procedures at Youjiang District Maternity Hospital in Baise City last week, NPR reports. A Baise City family planning official named Nong said forcing women to undergo abortions against their will would be against the law. He said that an investigation into the reports had already been concluded and that officials determined the reports of forced abortions were fabricated. According to NPR, reports from China's Xinhua News Agency show that the Baise City government last year missed its family planning target by a fraction of 1%. The figures "shed some light on why a forced abortion campaign might be judged necessary," NPR reports (Lim [2], "Morning Edition," NPR, 4/23). Audio and a partial transcript of the segment are available online.

"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.