After AIDS (Volume 1) (French Edition)

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In , nine out of 10 new infections were among key affected populations and their sexual partners. HIV prevalence is also considerably higher among key affected populations. However, the populations most affected by HIV differ between countries. In the three Baltic countries Estonia, Latvia and Lithuania , most HIV transmission occurs through injecting drug use and heterosexual sex, including sex work. Although there is a general decline in new infections, among certain key affected populations new infections are rising. There are significant disparities by race.

It is estimated that 6. Limited regional data on transgender people suggests that prevalence among this population is high.

School of Aids - Légèreté explained

For instance, a study estimates there are 1 million transgender adults in the USA. Although acceptance of transgender people is increasing in some countries in the region, many transgender people remain socially, economically, politically and legally marginalised. These factors heighten their vulnerability to HIV in many ways. Its findings suggest that transgender women are almost twice as likely to experience sexual violence than other survivors of sexual violence and are seven times more likely to experience further physical violence when reporting IPV to the police.

Marginalisation leads many transgender people to stay away from health services. Some migrants will have acquired HIV in their home country, however there is evidence that a considerable proportion of infections are acquired post-migration. High prevalence among migrants has much to do with restrictive health policies, preventing access to treatment. Treatment has a public health benefit by reducing viral load and preventing further transmission of HIV - reducing long-term health costs.

African American men and women in the USA are most likely to be infected with HIV through unprotected sex with a man or by injecting drugs. Other factors, such as heightened levels of poverty, lack of access to adequate healthcare, and stigma surrounding men who have sex with men also increase this group's risk of HIV infection. While the vast majority of countries in the region have seen HIV prevalence decline or stabilise among people who inject drugs, a number of countries are facing a worsening epidemic among this group.

In the Czech Republic, where drug use is decriminalised and coverage of harm reduction services is relatively high, HIV prevalence among people who inject drugs is 0. For example, a study of sex workers in Portugal reported HIV prevalence of 7. High prevalence was found among female sex workers who also inject drugs in the Netherlands. Prevalence is also relatively high in Italy and Spain among migrant, street and transgender sex workers.

Studies conducted in Belgium, the Czech Republic, Germany and Spain between and suggest prevalence among male sex workers to be high. In , only three countries in Western and Central Europe - France, Norway and the UK - had laws and policies in place authorising self-testing. Saliva-based self-testing kits have been available in the USA since Half of all new infections in the region in occurred in the USA.

In Canada in , there was an A number of possibilities exist to explain this increase in cases including more testing due to the implementation of provincial testing initiatives. Most countries in the region adopt combination HIV prevention strategies, some of these are outlined below. Increases in the annual number of cases of sexually transmitted infections STIs such as gonorrhoea, syphilis and HIV diagnoses among men who have sex with men in the European Union and the USA suggest that condom use among this population has not improved.

Between and , more than million condoms were distributed. In stark contrast, sexuality education in Central European countries tends to reduce it to a basic anatomical study of the human body and the promotion of abstinence, traditional family values marriage and religious morality. If you are interested in becoming our Editorial Board member, please submit the following information to info benthamopen. We will respond to your inquiry shortly.

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Serodeconversion of HIV Antibody-Positive AIDS Patients Following Treatment with V-1 Immunitor

Open access journals offer a good alternative for free access to good quality scientific information. Available data for — from 18 countries in the region indicate that condom use at last sex with a non-marital, non-cohabiting partner was higher among men than among women. Delivering comprehensive sexuality education CSE in schools in West and Central Africa is hampered by the low levels of children and young people accessing education in the first place, with gender disparities widening as children advance through the education system.

For those in school, good quality CSE is rare due to resistance from parents, teachers and decision-makers, resulting from misunderstandings about the nature, purpose and effects of sexuality education. Children younger than 18 months who are born to HIV-positive mothers require virological testing yet there has been limited progress on this in the region.

Male circumcision is common West Africa. A study found countries that report on both the proportion of Muslim men who were circumcised and the proportion of the population who are Muslim show a close match.

The Open AIDS Journal

Male circumcision is less common in Central Africa. Despite the region having significant populations of people who use drugs, harm reduction interventions, which help prevent HIV transmission through injecting drug use, are scarce. The only government-run harm reduction programme in West Africa is in Senegal. The country implements small-scale, community-based needle and syringe programmes and opioid substitution therapy.

In , Ghana began collecting data on people who inject drugs to establish an evidence base for future programming. In , this programming was yet to be implemented. This means that around 4 million people living with HIV need treatment but are not receiving it. Coverage varies between countries. However, in Nigeria which is home to 3. Underlying factors such as the lack of national and international political will, weak health services, and lack of support for community organisations exacerbate the situation. Men are less likely than women to start treatment, and those who do begin ART are more likely to have advanced HIV progression.

This disparity is thought to be due, in part, to harmful gender norms that lead men to view seeking HIV testing and treatment as a sign of weakness.

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This is the lowest regional paediatric ART coverage rate of any region in the world. This is further compounded by second- or third-line ARVs being either scarce or unavailable. This region reflects the fact that global prevalence of HIV drug resistance HIVDR is rising, mainly due to resistance to first-line antiretroviral treatment regimes. Weak health systems and low levels of adherence are the main drivers. In West and Central Africa, many non-government organisations NGOs concerned with protecting the rights of people living with HIV have seen a decrease in funding since the global recession.

As a result, some have had to scale down or stop activities. Additionally, the fragmentation of civil society organisations into distinct language-speaking groups primarily English and French leads to constraints in exchanging experiences and support between countries in the region. The region remains a difficult place for key populations such as men who have sex with men. This hostile environment often prevents people from accessing HIV services.

For example, following the passage of the Same-Sex Marriage Prohibition Act in Nigeria in , a greater proportion of men who have sex with men in the country reported being afraid to seek healthcare.

HIV and AIDS in W & C Europe & N America regional overview | AVERT

In Mauritania and Northern Nigeria, the death penalty exists for men who have sex with men. Sex work is illegal in most countries in the region.

Male and transgender sex workers are not allowed to register. In addition to heavy regulations on legal sex work, Senegal retains criminal penalties for solicitation, brothel ownership, and procuring sex work. However, when sex workers register their files are sent to the police, which sex workers say facilitates harassment, abuse, and extortion at the hands of authorities. Sex work is also legal in Burkina Faso, although profiting from others engaging in sex work is illegal.

In many countries in the region there are laws criminalising people who expose others to HIV or transmit the virus sexually. This fuels HIV-related stigma, which can cause significant barriers to accessing HIV prevention, treatment and care services.