Truly Equal

Such is the title of one of today’s New York Times op-ed:

In a paper published in the journal Science, researchers looked at health records from Kisumu, Kenya, a city of 200,000 with high levels of both diseases. They calculated that the interaction of the diseases increased AIDS cases by 8 percent and malaria by 13 percent. Over 25 years, that meant 8,500 additional AIDS cases and almost a million extra cases of malaria. The researchers drew on earlier findings that H.I.V.-positive people who get malaria experience a six- to eight-week spike in the level of the AIDS virus in their blood. During that spike, they are supercontagious, with double the usual chance of infecting a sexual partner. People with H.I.V. have also been proved more likely to catch malaria.

The scientific paper in question is titled, Dual Infection with HIV and Malaria Fuels the Spread of Both Diseases in Sub-Saharan Africa, by Laith Abu-Raddad.

From the paper’s abstract:

Mounting evidence has revealed pathological interactions between HIV and malaria in dually infected patients, but the public health implications of the interplay have remained unclear. A transient almost one-log elevation in HIV viral load occurs during febrile malaria episodes; in addition, susceptibility to malaria is enhanced in HIV-infected patients.

Also take a look at this article from Yahoo News.

Of course, the bigger picture here is not just an AIDS-Malaria connection. We know there are other factors involved, such as poverty and the lack of education, both basic education and more direct education regarding hygiene, disease, etc. Also, maternal education here is important, as a mothers’ malaria appears to enhance spread of AIDS virus (from the journal Science also):

For the first time, a study of HIV-infected pregnant women has found that coinfection with malaria significantly increased a mother’s risk of transmitting the AIDS virus to her baby before or during birth.

It’s great that the mainstream media is finally taking a good, hard look (albeit a brief one) at the existing global health problems - all the more reason why we, as future medical professionals and global health advocates, need to push hard and continue lobbying and informing people.

Now, if you have access to condoms, I do not suggest you go ahead with a circumcision… all joking aside, this finding - that circumcision significantly reduces men’s chances of acquiring HIV - is remarkably important.

However, it is NOT a substitute for condoms, proper sexual education, and yes, abstinence. I know that everybody wants doctors and scientists to come up with a vaccine, or even better a “wonder drug”, but in most parts of the world, especially in the African continent, a circumcision may be the only chance of maybe escaping, albeit 50% of the time, being infected by HIV.

I am not a fan of circumcision, but if it works… I rather people have access to microbicides instead.

Well, it was about damn time, don’t you think?

President Bush - in one of those rare, correct things he does from time to time - has just signed an executive order making it unnecessary for HIV visitors and tourists to obtain such a waiver.

For the uninitiated, people who are HIV/AIDS positive cannot enter the U.S. without a special waiver. Anyone who has filed for an immigrant visa (or knows someone who does) is quite familiar with this process. Part of the process is complete medical examination, complete with bloodwork. The results get sent straight to the U.S. embassy in question. If you are HIV/AIDS positive, the chances of getting your visa approved are zilch.

Imagine the following scenarios. If someone wants to lawfully immigrate to the U.S., but has AIDS, well then, he/she better pay a coyote anywhere from $2000-$5000 USD, because that visa is never going to get approved. If a woman is a victim of say, the rape and violence women experience during the conflict in Darfur, and requests political asylum, this request might get denied (notice I say might, as I’m not an immigration lawyer). So much for human rights!

And if some prominent HIV/AIDS activists would want to plan or attend an international AIDS conference in the U.S., those activists need waivers.

Because of the rule, organizers of the biannual International AIDS Conferences have not held a gathering in the United States since 1990, when San Francisco hosted the event.

And you wonder why there’s so much stigma against AIDS in the U.S.

By the way, this was actually started by Bill Clinton when he was president. It is a complete irony that the man that started this policy is now, literally, a global force against AIDS. And while President Bush deserves kudos for this, the one who deserves it even more is the new Global AIDS Coordinator, Dr. Mark Dybul, a gay physician who has treated AIDS patients in San Francisco. Yes, the one the religious right condemned because he not only had the guts to bring his homosexual partner, Jason Claire, to the swearing in ceremony by Secretary of State Condoleezza Rice, but brought Claire’s mother as well! Dr. Rice referred to Mr. Claire’s mother as “mother-in-law.”

Oh, and Laura Bush was there as well.