ICASA Conference Attendees Debate Abstinence Education as Prevention Method for HIV

Experts last week said the subject of teaching abstinence to prevent HIV/AIDS led to debate among many attendees at the 14th International Conference on AIDS and Sexually Transmitted Infections in Africa, which took place in Abuja, Nigeria, Agence France-Presse reports (Agence France-Presse, 12/9). About 7,500 representatives, primarily from African nations, attended the six-day conference, which had the theme "HIV/AIDS and the Family" (Kaiser Daily HIV/AIDS Report, 12/7). Winnie Madizikela-Mandela, ex-wife of former South African President Nelson Mandela, was "the most outspoken proponent" of abstinence, according to Agence France-Presse. She said, "We are starting to say, as mothers in Africa, 'There is a remedy for AIDS after all,'" adding, "We must simply tell our children to abstain." However, groups "at the other end of the spectrum" criticized abstinence-only education and the five-year, $15 billion President's Emergency Plan for AIDS Relief for "attach[ing] ideological strings to money for fighting HIV/AIDS," according to Agence France-Presse (Agence France-Presse, 12/9).

Affordable Second-Line Treatments Needed To Prevent 'New Crisis'
Medecins Sans Frontieres presented research at the ICASA conference showing that approximately 16% of HIV-positive patients in the organization's clinics switch their antiretroviral drug regimens by their fourth year of treatment, emphasizing the importance of making second-line treatments affordable in developing countries to prevent a "new crisis," Toronto's Globe and Mail reports. While prices for first-line antiretrovirals have come down to $200 per patient annually because of lobbying and competition from generic drugs, once a patient becomes resistant to those drugs, they must be placed on second-line drugs, which often cost "thousands of dollars," according to the Globe and Mail. MSF, which is one of the primary treatment providers in Africa, said that placing 2.5% of its patients on second-line drugs would use up to 30% of the group's drug budget. Daniel Berman, who coordinates MSF's Campaign for Access to Essential Medicines, said at the conference, "We need to get this information out so we can lean on the [pharmaceutical companies] like we did with the (first-line) drugs." He added that for most HIV-positive Africans, considering second-line drugs is a "premature" concern because less than 10% of Africans are receiving treatment, but it is an important issue for countries that have gotten thousands of HIV-positive individuals on the older, less-expensive drugs (Nolen, Globe and Mail, 12/12).