Older and Wiser

By Rachel Albone, HIV and AIDS Policy Advisor (HelpAge International, United Kingdom)

HelpAge International has been implementing programmes addressing the needs of older people affected by HIV for 10 years. As the work of HelpAge initially focussed on mitigating the impact of the epidemic on older carers, Rachel Albone, HIV and AIDS Policy Advisor, gives her perspective on the changing importance for supporting older people living with HIV:

While supporting older carers remains central to HelpAge International’s work, we like others, have been witnessing a shift in the epidemic with an increasing number of older people living with HIV. In 2005, UNAIDS estimated 7 per cent of people living with HIV worldwide were aged 50 and over. While a more up to date global estimate is not available due to the focus on 15-49 year olds, where data is being collected, significant increases are being seen. Recent data shows 14 per cent of people living with HIV in sub-Saharan Africa are aged 50 and over. By 2015 at least 50 per cent of those with HIV in the US will be in this age group.

Despite these increases, the response to HIV remains largely restricted to the 15-49 year age group. Policies and programmes rarely include older people or their need for access to services and support. HelpAge is working in east and southern Africa to raise awareness of the impact of HIV in and on older people and to support older people to live positively.

Prevention, treatment, care and support programmes must be age sensitive and address older people’s specific needs. Our approach is one of peer education and support. We establish peer support groups for older people living with HIV, providing psycho-social support, advice on adherence, and support to mitigate the impact of epidemic. We also recognize the need for improved access to bespoke counselling services for older people. With an ever increasing number of older people living with HIV, what we need and want to see is a policy and programme response that is fully inclusive of the needs of older people.

For more information on HelpAge International: http://www.helpage.org 


Article from IPPF HIV Update newsletter - Issue 27: http://www.ippf.org/en/Resources/Newsletters/HIV+Update+Issue+27.htm

David Kato Vision & Voice Award

By Tewodros Melesse (Director General of IPPF) 

On 26 January 2011, the world was deeply shocked and saddened by the news of David Kato’s murder. As the Litigation & Advocacy Officer with Sexual Minorities Uganda (SMUG), David campaigned tirelessly for human rights and particularly for the rights of lesbian, gay, bisexual, transgender and intersex (LGBTI) people across Africa. And this campaigning work had lead him to work on a number of initiatives with the HIV team at IPPF on a number of occasions.

In recognition of his life and courage, and the continued struggle of LGBTI individuals around the world, I am pleased to announce the call for nominations for the David Kato Vision & Voice Award. IPPF - along with other partners - established this award to be presented annually to an individual who demonstrates courage and outstanding leadership in advocating for the sexual rights of LGBTI individuals, particularly in environments where they face continued rejection, marginalization, isolation and persecution. Nominations for the award can be submitted until 1 November 2011 and are accepted for any individual whose leadership and life work has directly contributed to addressing the sexual rights of LGBTI people in their community. The award recipient will be announced on Human Rights Day (10 December 2011) and will be invited to attend part of the IPPF Donors’ Meeting at the end of January 2012 to collect the award.

If you know someone in your community who is particularly deserving of this award, I strongly encourage you to submit a nomination. For further information and to submit a nomination, please visit the award website: http://www.visionandvoiceaward.com/.  

 

50 Plus – the experiences of older people living with HIV

By Lisa Power, Policy Director (Terrence Higgins Trust, United Kingdom)

As treatments for HIV improve in both quality and accessibility, people are living longer with the virus. In some countries, provided their HIV is diagnosed in good time and treatment provided, people can now hope to live well into old age. The over 50s is the fastest growing group of people living with HIV. But what quality of life can they look forward to, and how can it be improved?

The UK’s 50 Plus research, done by Terrence Higgins Trust (THT), MBARC and Age UK for the Joseph Rowntree Foundation, surveyed 410 older adults with HIV – one in twenty of all those with HIV in the UK. They found that HIV systematically disadvantages those infected across their lifetime in three key areas – health, financial and social wellbeing. Older people with HIV, as a group, have twice as many other long term conditions (on top of their HIV); they are less economically active and less likely to have savings for old age; they are less likely to have their own home; they have significant levels of social isolation and poor mental health and considerable fears for the future. Not everybody ends up alone and in poverty, by any means, but some do and many others are disadvantaged across their lifetime in ways that could be changed, with proper planning and support.

These findings echo similar research in the US and the Netherlands, which suggests that whatever your health and social care systems, some of these problems will occur. For all these studies, people over 50 with HIV were a mixed group of the long term and more recently diagnosed. Obviously, those diagnosed longer ago - when everyone expected to die and many stopped work and spent their savings, and when many people saw their friends and partners die - had the greatest problems with health, wellbeing and poverty but even those more recently diagnosed were often disadvantaged in comparison with their peers.

With HIV, however well you start off, you may encounter stigma and ill-health that leads to broken relationships, lessens employment opportunities and damages your ability to provide for the future. At THT, we believe this means we need to change our services, not only to support those currently over 50 who are in greatest need, but also to work with younger people and those more recently diagnosed to minimise the problems they may face as they age with HIV. We need to help people stay in work or get back to it; manage their money and plan for the future; guard against social isolation and poor mental health; live healthy lives to reduce co-morbidities and improve quality of life.

One of the important aspects of this research is that it was undertaken at every stage with the close involvement of older people with HIV; on the advisory panel, as community researchers, as writers and as communicators of the findings. In the West, our elders are often neglected and survey respondents reported experiencing as much stigma around age as HIV. But older people with HIV are an enormous resource for the future.

The full report of A national study of ageing and HIV (50 Plus) is available at: http://www.tht.org.uk/binarylibrary/peoplesexperienceofhiv/50-plus-final-report.pdf

Article from IPPF HIV Update newsletter - Issue 27: http://www.ippf.org/en/Resources/Newsletters/HIV+Update+Issue+27.htm

HIV Update: Ageing with HIV

By Kevin Osborne (IPPF)

With increasing availability and options of effective antiretroviral treatment, people living with HIV are living longer and the population of people who are HIV positive is steadily growing older. Ageing is an inevitable process for us all, but what are the consequences of long-term HIV infection and treatment?


The face of HIV has altered dramatically over the past decade. A combination of earlier diagnosis, ART treatment adherence, and awareness of healthier lifestyle options translates into a drastically increased life expectancy for many people living with HIV. Globally, many people have now been living with the virus for over twenty years – some because they were born with HIV and others because they are long-term survivors of the epidemic. This unchartered territory raises many new and important issues about how long-term HIV infection and treatment affects the natural ageing process.

As people living with HIV grow older, they will have a unique set of clinical and psycho-social needs that need to be addressed in a more sustained and systematic manner. In the United Kingdom a recent study specifically investigated the needs, concerns and characteristics of people aged 50 and over who are living with HIV. Beyond health-related issues, a number of other challenges including financial and social wellbeing should increasingly be taken into consideration.

Many questions related to how older age affects the natural progression of HIV infection and the body’s response to long term treatment still remain unanswered. Clinicians and health practitioners are increasingly confronted by additional issues - from managing the expected and routine issues facing the over 50s living with HIV to dealing with some of the consequences of long-term ART use and resistance. It is clear that both providers and clients are entering a new phase in holistic health for people living with HIV.

As more people are living longer and healthier lives with HIV, IPPF Member Associations will have to find creative and innovative ways of meeting their sexual and reproductive health needs - from providing additional psycho-social support; strengthened integration with other health and care services for older adults to forging new partnerships with organizations specifically working with older adults.

Download the September issue of the IPPF HIV Update newsletter: http://www.ippf.org/en/Resources/Newsletters/HIV+Update+Issue+27.htm

New release: Love, Life and HIV Toolkit

The Love, Life and HIV Toolkit – developed by IPPF, UNFPA, Young Positives and the Global Coalition on Women and AIDS – aims to develop a greater understanding of some of the issues facing young people living with HIV today. It is available in English, French and Spanish and includes:

• A 28 minute film. Young people living with HIV from the Dominican Republic, India, Mexico, Russia, South Africa and Swaziland talk about a host of issues that affect their lives. The film is split into six themes: 1. facing stigma; 2. accessing services; 3. finding love; 4. having a family; 5. being supported; and 6. getting involved.
• A session plan to accompany each of the films themes. Each session includes adaptable discussion starters and activities, take home points summarizing the session, and links to further resources to enable users to maximize the potential learning in the stories shared in the film.
• Handouts with further information on each of the themes. These can be used by educators and trainers when preparing to lead sessions or can be given to participants as resource materials.

Limited hard copies of the film can be ordered from info@ippf.org. The resource pack is available from http://bit.ly/lovelifehiv.  

World Hepatitis Day

Today, the 28th of July, is World Hepatitis Day to recognize the need to further raise awareness of chronic hepatitis B and C around the globe and to advocate for policy change to improve health outcomes for people affected by viral hepatitis. Together, hepatitis B and C affect one in 12 people worldwide and approximately one million people die from these viruses every year (World Health Organization).

The 2011 theme for World Hepatitis Day is ‘This is hepatitis... Know it. Confront it. Hepatitis affects everyone, everywhere.’ This inclusive theme emphasizes the scale of viral hepatitis and helps combat the stigma often associated with hepatitis B and C by conveying the fact that these viruses do not discriminate.

Hepatitis simply means inflammation of the liver and can be caused by a wide range of things. One of the most common causes of chronic (long-term) hepatitis is viral infection, which can be transmitted sexually. Hepatitis B and C are two such viruses and approximately 500 million people around the world are currently infected with chronic hepatitis B or C. Unlike hepatitis C, hepatitis B can be prevented through effective vaccination.

As viral hepatitis is transmitted in similar ways as HIV, coinfection is a growing concern. In people living with HIV, infection with viral hepatitis can lead to more serious complications, such as more rapid liver damage. Coinfection can also complicate the treatment of HIV infection. It is important for people living with HIV to be tested for viral hepatitis and take steps to prevent infection.

Hepatitis is a global problem and by working together we can deliver change in prevention and access to testing and treatment.

For more information about HIV and hepatitis, including prevention, diagnosis and treatment: http://www.aidsmap.com/Hepatitis-and-HIV/cat/1508/

For more information about World Hepatitis Day, including campaign materials in different languages: http://www.worldhepatitisalliance.org/Home.aspx

UN HLM on AIDS: IPPF Key Message 04

Renew the political commitment to HIV

Recognizing the long-term benefits that have accrued from investing in HIV programmes, governments, international donors and the private sector need to re- commit to meeting the international targets, goals and accountability. Nuanced political commitment to HIV for this new millennium needs to be prioritized.


Rationale: In the last decade the HIV response has been transformed by increased political commitment and a dramatic increase in resources. Progress has been made towards the Millennium Development Goal (MDG) target for HIV, which is to have halted and begun to reverse the epidemic by 2015. At a global level, the epidemic is stabilizing. According to the 2010 UNAIDS Global Report, the number of new HIV infections declined by 16 per cent from an estimated 3.1 million in 2001 to 2.6 million in 2009. Improved access to services to prevent mother-to-child transmission has reduced the number of infants infected with HIV from 500,000 in 2001 to 370,000 in 2009. New interventions and emerging technologies, including male circumcision and pre-exposure prophylaxis, have the potential to further enhance HIV prevention efforts, if implemented at sufficient scale.

Current gaps to address:

• Close the funding gap: The funding gap - the difference in the amount of money needed and the amount actually allocated - was $7.7 billion in 2009, compared to $6.5 billion in 2008. Funding is a shared responsibility. Donor and recipient countries must meet their commitments and be held accountable. International donors should ensure full funding for the Global Fund to Fight AIDS, Tuberculosis and Malaria, and develop additional innovative financing mechanisms to ensure the long-term sustainability of the response. 
• Continue to scale up access to treatment: An estimated 10 million people who need treatment do not have access to ART. In 20 African countries, more than 80 per cent of treatment depends on donor funding. A recent survey showed that eight countries already face shortages of antiretroviral drugs and a further 22 countries - accounting for more than 60 per cent of people on treatment worldwide - expected an adverse impact on treatment programmes in the future. 
• Commit to a sustainable long-term response: HIV continues to be an exceptional epidemic and thus require an exceptional response. It is still a major threat to health and development and an effective response to HIV is critical to achieving all of the other MDGs. HIV spending is a down payment on a healthy future, yielding immense benefits for future generations, reducing human suffering and averting the large economic and development costs associated with the epidemic.
• Plug the condom gap: Condoms are a critical element of any HIV prevention strategy and are the only dual protection method available for the prevention of HIV, STIs and unplanned pregnancies. Yet, the gap between the number of condoms needed and the number of condoms available for HIV prevention and family planning is high.

Read all of IPPF's key messages for the 2011 UN High Level Meeting on AIDS in the June issue of the HIV Update newsletter: http://www.ippf.org/en/Resources/Newsletters/HIV+Update+Issue+26.htm