12th World AIDS Conference
  
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LAST UPDATE: Thursday, 2 July, 1998 14:00 GMT        PRESS RELEASE                           ...all the news, as it happens

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BEHAVIOURAL AND SOCIAL SCIENCE TRACK 'D' HIGHLIGHTS


Human Rights, Political Obstacles to HIV Education and Services, the Psychological Impact of HIV, and the Global Economic Impact of HIV/AIDS Among the Focuses of 12th World AIDS Conference

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(GENEVA, SWITZERLAND) - Thursday, 2 July, 1998- Track 'D', the Behavioural and Social Science Track of the 12th World AIDS Conference, includes dozens of scientific presentations that examine the pressing behavioural and social issues that are key to understanding the epidemic and devastating global effects of HIV/AIDS.

Issues covered in Track D include the psychological impact of HIV and therapeutic advances, human rights and policy obstacles, social dynamics that affect control of sexual risk situations, and the legal and economic impacts of AIDS.

"Track D is rich in high quality social science that explores the core issues both of the international spread of HIV/AIDS, and the ways it can be stopped," said Track D Chair Dr. Geeta Rao Gupta of the International Centre for Research on Women. "In developing the Behavioural and Social Science programme, we worked closely with the chairs of Track C, Epidemiology, Prevention, and Public Health, to highlight the most significant research in each of these areas. The result is a rich and diverse programme that opens new doors in our understanding of the human response to HIV/AIDS."

"It is particularly important, in the age of therapeutic advances, to keep a strong focus on the social and behavioural issues that are central to HIV prevention," Dr. Gupta noted. "In most of the developing world, HIV transmission has only stabilised, not decreased. And in many parts of the developing world, HIV is still spreading unchecked."

Track D presentations will address a wide variety of social and behavioural issues, including gender roles, power dynamics, and their unmistakable impact in the HIV/AIDS epidemic. Also included, the increasing impact of HIV/AIDS on the world's youth and children, the ethical considerations of clinical trials, and the effect of government policies on HIV prevention efforts around the world. Track D presentations will also focus on economics, human rights, and psychological and sociological research. Speakers in Track D programmes include the Ministers of Health of France and Canada, and former director of the World Health Organisation's Global Programme on AIDS, Dr. Jonathan Mann.

Among many presentations of note in Track D are the following:

 

Overcoming Political Obstacles to HIV Education and Prevention

Several presentations in Track D will also examine strategies that facilitate effective policies for HIV control. Session D14, "Overcoming Obstacles to Action" (Monday, 13.00-14.30, Hall II) includes several research presentations on the relationship between AIDS education and religious and political systems. Papers include "A National Awareness Campaign in a Country Where Silence Rules," which focuses on Venezuela, and "The Role of Appropriate Policies in the Fight Against AIDS," which examines AIDS prevention efforts in Uganda, one of the countries hardest hit by AIDS, and once which has had notable success in curbing the spread of AIDS.

The response of political systems around the world to HIV/AIDS is also the subject of Session D15, "Politics Behind AIDS Policies" (Monday, 15.00-17.00, Hall I). And Jonathan Mann, former director of the WHO Global Programme on AIDS, will be the discussant for Bridging Session D26, "International Funding and Policy: Closing the Gap," (Tuesday, 13.00-17.00), which will include presentations by policy and economics experts from around the world, including the Ministers of Health for France and Canada and the Vice-President of the World Bank.

 

Resource Mobilisation

While the 12th World AIDS Conference focuses on the challenge of "Bridging the Gap" between worlds affected by AIDS, the very real issue of resource mobilisation is key to many of these discussions. How to move the money and expertise needed to stem the global AIDS crisis is the subject of Session D46, "Resource Mobilisation: Where Will the Money Come From" (Thursday, 15.00-17.00).

 

Gender and Power

Conference Session D13 "Male Sexuality" (Monday, 13.00-14.30, Session Hall I), and Session D22, "Gender and Power" (Tuesday, 11.00-12.30, Hall II) feature presentations that focus on the role of heterosexual men in the transmission of HIV and the unequal balance of power in heterosexual relationships that favours men. This session will discuss gender differentials in HIV/AIDS; women’s experience of violence and sexual coercion and the impact of the spread of the epidemic, as well as strategies for reducing the vulnerability of women. Presentations of note in this session include "Reducing Gender-Related Barriers in HIV-Prevention Efforts" and "Gender Issues in HIV Prevention for Heterosexual Men."

 

An Increasingly Young Epidemic

HIV/AIDS is increasingly becoming a disease of the young in both the developed and developing worlds, and the global rate of HIV infection is increasing most rapidly among youth. Session D16 "Youth and Vulnerability" (Monday, 15.00-17.00) includes research on HIV prevention and transmission among both male and female youth in several parts of the world, and highlights the vulnerability of young girls.

A Late Breaker paper, "Five to Tenfold Increase in Mortality in the Sexually Active Age Groups in Northern Thailand" (Friday, 08.30-10.30, Arena) documents a substantial increase in deaths among young Thais of both sexes, most of which is attributable to AIDS. The paper also discusses the need for AIDS sensitive socio-economic measures to prevent depopulation and sustain population growth. This is one of the first studies of this subject based on the actual demography of AIDS rather than mathematical models or projections.

 

Access to and Impact of HIV Therapy.

Both the developed and developing worlds are struggling with how to provide access to therapies in countries with minimal healthcare budgets, and with less developed support systems for people affected by HIV. Session D21, "Bridging Session: Implications of Therapies for Developing Countries" (Tuesday, 11.00-12.30, Hall I) addresses many of these issues.

A Late Breaker study, "The Cost Effectiveness of Successive Antiretroviral Therapeutic Drug Regimes for the Treatment of HIV/AIDS" (Friday, 08.30-10.30, Arena), presents a large British Colombian study of the cost-effectiveness of ERA-III ART regimens. The study found the regimens to be well within the range of currently funded/reimbursed therapies for the treatment of other diseases, and that triple combination therapy was more cost-effective than double therapy, given the number of years of life gained.

An additional Late Breaker on this subject, titled "HAART: One of the Most Cost-Effective Therapies of the Past Decade" (Friday, 08.30-10.30, Arena) examines the cost-effectiveness of the introduction of highly active antiretroviral therapy (HAART) into clinical practice. The study finds that HAART is arguably the most cost-effective major new medical technology that has been introduced in the past decade, providing both short-term cost-saving with a substantial improvement in clinical outcome, as well as a longer-term incremental cost-effectiveness ratio that the authors state is highly favourable compared to almost any other technology in the U.S.

Session D45, "Implications of New Treatments at Individual and Population Level" (Thursday, 15.00-17.00) looks at the implications of new therapies both for those who benefit from the therapies and for those who do not. The session also examines the impact of new treatments on attitudes towards HIV/AIDS and risk behaviour.

 

Clinical Trials - Ethical Issues

Few issues in HIV research are as complex or explosive as those surrounding the ethics of clinical trials of HIV drugs. These issues received international attention in a recent dispute over HIV vertical transmission trials, and are being debated in both the developed and developing world, as more and more clinical trials of HIV drugs and vaccines are undertaken.

Session D35, "Bridging Session: Ethics and Science" (Wednesday, 15.00-17.00, Hall I) includes a presentation by Peter Lurie, one of the most outspoken critics of the AZT vertical transmission trials, a reply by Hoosen Coovadia, and presentations by ethicists from North America and Africa.

 

Orphans

The global impact of AIDS may be most notable in the thousands of children orphaned every year, particularly in Asia and Africa. Conference Session D34, "Taking Care of the Future: Support for Orphans" (Wednesday, Session Hall II, 13.00-14.30) examines AIDS-affected children with research presentations from Brazil, Kenya, Uganda, and Zimbabwe.

A Late Breaker paper, "Should We Talk About Death to Children Concerned Directly or Indirectly by HIV/AIDS and How?" (Friday, 08.30-10.30, Arena) shows that actively discussing death with children affected by HIV/AIDS in an age appropriate manner reduced anxiety, particularly among boys.

 

HIV/AIDS and Mental Health

Conference session D44, "Mental Health and HIV" (Thursday, 13.00-14.30, Hall II) will examine the impact of psychological and neuropsychological predictors on health and disease in HIV infection, mental health aspects of IV education, and differences between cultures in the psychological approach to living with HIV.

A Late Breaker, "Behavioural Status in HIV-Positive Children as Perceived by HIV-Positive Mothers" (Friday, 08.30-10.30, Hall VI) explores the emotional and behavioural state of children aged four to twelve, using a standard child behaviour checklist. The study found that, though HIV-positive children were more withdrawn than HIV-negative peers, their scores in other psychological categories were within the normal range.

 

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