TREAT Asia Symposium Gathers Global and Regional Experts

  Confronting the increasing burden of cancer among people living with HIV/AIDS in Asia, TREAT Asia co-sponsored a two-day symposium in November bringing together regional and global experts with the aim of deepening understanding of cancer and its relationship to HIV.

  "People with HIV are living longer because of highly active antiretroviral treatment [HAART], but because they have a higher risk of developing certain cancers associated with other viral infections, they can still die younger," said TREAT Asia Director Annette Sohn, M.D. "The situation is amplified in Asia and other resource-limited regions where cancer is hard to diagnose and treat since medical resources are not usually available."

  Because of the strong association of human papillomavirus (HPV) with anal and cervical cancers, a number of presentations addressed current research into these two illnesses. Studies have shown that HIV-positive women and men who have sex with men (MSM) are much more likely to have HPV-associated cancers. In the US, HPV is now preventable through a childhood vaccine, but the cost is prohibitive in Asia. "We don't have the infrastructure in Asia for cervical cancer screening in the general population, but it's desperately needed among women with HIV given the much higher risk," said Liesl Messerschmidt, TREAT Asia's director of research.

  High rates of HPV-related anal dysplasia have been identified by the Thai Red Cross AIDS Research Centre in Bangkok via a screening program supported by TREAT Asia through a grant from the US National Institutes of Health's IeDEA (International Epidemiologic Databases to Evaluate AIDS) program.

  The Thai study has raised significant concerns about the extent of anal cancer risk among MSM, according to principal investigator Nittaya Phanuphak, M.D. The study is now looking at proteins associated with anal cancer in order to determine if men who are more likely to progress to cancer can be more accurately identified. The Thai Red Cross's research is rapidly advancing the understanding of anal cancer risk, progress that is leading to opportunities to collaborate with other US and Australian investigators.

  Another area of growing interest in Asia is liver cancer associated with viral hepatitis infection. Many of the local HIV epidemics in the region are connected with injection drug use and studies show that upwards of 90 percent of IDUs in Asia can also be infected with hepatitis C, which puts them at risk for liver cancer; this risk is even greater in the context of HIV infection. But because the costs of treating hepatitis B and C are prohibitively high, local clinicians lack the tools to help patients who may have more problems with liver disease than with their HIV infection.

  The symposium, which was supported by the IeDEA program, brought together 61 participants from nine countries to hear presentations from the World Health Organization's International Agency for Research on Cancer; the US National Institutes of Health's National Cancer Institute; regional medical centers and universities; and Australia's National Centre in HIV Epidemiology and Clinical Research, which co-sponsored the symposium.

Weblink: http://www.amfar.org/world/treatasia/article.aspx?id=9682&tr=y&auid=8379954

Organization: TREAT Asia

TREAT Asia研讨会集结地区和全球专家

     在亚洲,由于越来越多的艾滋病患者面临癌症的威胁,TREAT Asia于去年11月召开了一个为期两日的研讨会,召集区域和全球专家共同商讨如何加深我们对艾滋与癌症之间的关系的理解。

     "由于接受高效抗逆转录病毒治疗(HAART),艾滋病患可以存活更久,但由于他/她们患癌症或其它病毒感染的风险更高,较早期死亡仍有可能发生。" TREAT Asia主任、医学博士Annette Sohn表示:"在亚洲以及其它一些资源有限的地区,由于通常情况下很难获得医疗资源,所以很难对癌症进行诊断和治疗。"


   因为通常情况下人类乳头瘤病毒(HPV)与肛门癌、宫颈癌共生,本次研讨会上有很多针对这两种疾病的研究陈述。研究显示携带艾滋病毒的妇女与男男性行为者(MSM)更容易患与HPV相关的癌症。目前在美国HPV可以通过在孩童时期注射疫苗来预防,但在亚洲来说这种疫苗的价格过于高昂。TREAT Asia研究总管Liesl Messerschmidt 表示:"在亚洲我们并缺乏对公众进行宫颈癌普查的基础医疗设施。但由于感染艾滋的妇女患病风险较高,我们对这种检测的需求极为迫切。"

     TREAT Asia通过美国国家健康研究所的国际艾滋评估流行病学数据库(IeDEA)项目资金支持位于曼谷的泰国红十字会艾滋研究中心开展研究,结果显示与HPV相关的肛门癌发生比率相当高。

  该研究的首席研究人员、医学博士Nittaya Phanuphak表示,该研究引起了相关人士对MSM群体患肛门癌的风险程度的高度关注。这项研究目前正在观察与肛门癌相关的蛋白值,以便确定能否更加准确地鉴别患癌症可能性较大的男性。泰国红十字会所开展的研究迅速的提高了人们对肛门癌风险的认识,这一进步将吸引来自美国和澳大利亚的研究人员共同开展合作研究。





Asia Report 翻译


机构: TREAT Asia



HANOI, 9 May 2011 (IRIN) - International health experts criticize Vietnam's estimated 70 compulsory drug treatment centres.

The centres are part of a government strategy aimed at "correcting the illegal behaviours of drug use and sex work", according to UNAIDS.

They are believed to hold 20,000-70,000 drug addicts and/or former sex workers, said a Hanoi-based health expert familiar with Vietnam's drug treatment procedures.

Vietnam's compulsory treatment centres "are counterproductive on every single level," said Simon Baldwin, a former senior technical officer for HIV and drugs, at the US NGO Family Health International, which is working on drug treatment in Vietnam.

More than 90 percent of injecting drug users held at these centres relapse into drug addiction upon release, according to UNAIDS.

Beneficiaries at the centres, which began opening in the mid-2000s, are supposed to receive counselling, health checks, and vocational training to assist recovery and prevent relapse. But according to health experts, employees are not trained to treat drug addiction, and the fear of being sent to the centres encourages drug users to go underground.


When Vietnamese heroin addicts leave compulsory treatment centres, they face a "palpable and substantial" societal stigma against drug use, said Robert Ali of the World Health Organization's (WHO) Collaborating Centre for Research into the Treatment of Drug and Alcohol Problems.

Vietnam has made significant drug policy reforms since the mid-1990s, but most Vietnamese citizens and officials still see drug addiction as a "moral weakness" or "social evil" rather than a medical disease with a social dimension, Ali said.

Health experts say compulsory treatment centres coupled with widespread social stigma around drugs make it difficult for outreach workers to access the most vulnerable drug-user populations.

"The people who use drugs are a very marginalized and vulnerable population," said Ali. "One of the challenges for Vietnam is recasting and understanding what drug addiction is and being more accepting of people in the [drug-using] community."

Nguyen Thi Huynh, former chief of the Harm Reduction Department, Vietnam Administration of HIV/AIDS Control, said tolerance for drug addiction in Vietnam had improved over the last 20 years as a result of government interventions: "We have done a lot of outreach on television programmers, and the understanding of Vietnamese citizens about HIV and drug-use issues has changed a lot. The stigma is not as bad as it was before."
Methadone clinics opened
In the shadow of its controversial compulsory treatment centres, Vietnam has since 2008 opened 13 methadone clinics for heroin addicts.

The clinics will not replace the treatment centres but health experts hope Vietnam will move away from the compulsory treatment model towards a holistic drug treatment model which includes voluntary methadone treatment.

Methadone, a substitution therapy used to treat opioid dependence, helps assuage withdrawal symptoms for heroin addiction and prevent the spread of HIV among injecting drug users.

"Methadone treatment in Vietnam appears to be modelled on best practices," said WHO's Ali. "Individuals can determine whether they want to be in treatment, and they're provided with good clinical support and guidance."

Health experts commend Vietnam's methadone clinics as a positive step forward in drug-treatment policy, but the government's motives for introducing the clinics remain controversial.

"The government has rolled them out more out of concern over HIV/AIDS than for the lives of drug users themselves," said a Hanoi-based methadone expert who preferred anonymity.
Roughly a quarter of a million people are HIV-positive in Vietnam, and the figure is rising, according to a 2010 presentation by Kevin P. Mulvey, a substance abuse treatment adviser at the US embassy in Hanoi. Health experts say Vietnam's rate of HIV infection among injecting drug users, which UNAIDS reports is 57 percent, is among the highest in South Asia.

Vietnam's methadone clinics receive support from the US President's Emergency Plan for AIDS Relief (PEPFAR).

More than 2,000 patients were receiving methadone treatment across Vietnam in September, according to a 2010 presentation by Nguyen Thi Minh Tam, deputy head of the Harm Reduction Department, Vietnam Administration of HIV/AIDS Control.

Roughly 80,000 patients will receive methadone treatment at a minimum of 245 sites by 2015, according to a November decree by the Vietnamese health minister, Nguyen Quoc Trieu.

Hong Kong and Thailand implemented methadone treatment programmes in the 1970s. China and Malaysia followed suit in the mid-2000s, and Cambodia opened a pilot methadone clinic in September.

Weblink: http://www.irinnews.org/report.aspx?reportID=92599

Organization: Family Health International (FHI)




    来自美国非政府组织国际家庭健康(Family Health International)的艾滋病与毒品前高级技术官员Simon Baldwin表示,越南强制戒毒治疗中心对戒毒工作在越南国内开展"在每一个层面上都起到了反作用"。根据联合国艾滋规划署资料显示,90%以上的注射吸毒者在结束治疗后又再度复吸。



    世界卫生组织(WHO)毒品与酗酒问题治疗研究协调中心的Robert Ali称,在离开强行戒毒所后越南海洛因成瘾者面临"明显的、大量的"社会对毒品成瘾者的污名化。Ali表示尽管在上世纪90年代中期越南进行了卓越的毒品政策改革,但大多数越南民众和官员仍对吸毒人员持有"道德堕落"或"邪恶"这一类的偏见,而非把吸毒问题看作为社会层面的医学疾病。


    越南艾滋防治管理局减害部(the Harm Reduction Department)前任首席执行官Nguyen Thi Huynh表示,在过去20年中,由于政府的持续干预,越南对毒品成瘾的社会宽容度已有明显提高。他说:"我们在电视上做了大量宣传,越南民众对艾滋病和毒品问题的理解已发生了很多改变,目前社会污名化已不像过去那么严重了。"



    美沙酮作为阿片类物质依赖(opioid dependence)治疗的替代疗法,能够帮助减缓海洛因成瘾的脱瘾症状,并预防艾滋病毒在毒品注射者间传播。来自世卫组织的Ali表示:"在越南美沙酮治疗被视为最佳疗法。病人可以决定是否需要治疗,他们能够获得良好的临床服务和指导。"


    根据河内美国大使馆药物滥用治疗专家Kevin P. Mulvey在2010年的陈述,越南大约有25万艾滋病毒携带者。健康专家指出根据联合国艾滋规划署报告显示,越南毒品注射者的艾滋感染率高达57%,居南亚之首。

    越南美沙酮诊所受美国总统防治艾滋病紧急救援计划(PEPFAR)的支持。越南艾滋防治管理局减害部首席执行官Nguyen Thi Huynh在2010年的一次报告陈述中指出,2010年9月越南全国超过2000名患者接受了美沙酮治疗。根据越南健康部部长Nguyen Quoc Trieu颁布的11月法令,至2015年底,大约8万名患者将在全国245个治疗点接受美沙酮治疗。


Asia Report 翻译


机构:国际家庭健康(Family Health International)

The time is now

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Thanh Nien News

Young director finds meaning in confronting social prejudices, says no need to delay getting rid of them For a long time, Bui Nhu Lai shared the "normal" prejudices, a sense of loathing, against homosexuals and HIV/AIDS afflicted people.

Then his close friend began dying in front of his eyes. "Since I was a student, I'd boarded with him" Lai recalled.

"Then he became a drug addict, and caught the disease (AIDS). He deteriorated rapidly, and I decided to find out more about the disease.

"People are usually scared of what they do not understand. What I learnt about HIV/AIDS gave me a lot of insights, and I want to use my work to tell the community that HIV/AIDS is not as scary as we thought."

The 29-year-old director has since made a name for himself with art projects highlighting the plight of homosexuals and HIV-infected people. He also pulled off a coup of sorts recently by casting an HIV-infected person to act in his play.

A stage actor turned director, Lai's interactive drama series Dung doi den ngay mai (Don't wait until tomorrow) has won high praise. It was first conceived by Lai and script-writer Le Hung to fight against the social stigma of HIV/AIDS last October, and funded by the US President's Emergency Plan for AIDS Relief (PEPFAR) program.

The project featured three short plays centering on the lives of HIV-infected people as well as their families who have to endure unfair discrimination by the community.

In free performances held last year, the plays reached out to students at Hanoi and HCMC universities. This year, the project is being funded by the Philippines Educational Theater Association (PETA) and the plays were scheduled to be performed at Kon Tum, Nghe An and Thanh Hoa provinces' universities from March 28 to April 8.

Lai said that these provinces were chosen because of the high prevalence of HIV infections.

"The idea for a play about HIV/AIDS came to mind after reading articles and seeing the footage of the segregation that the people, especially their children, had to suffer. In my plays, there are emotionally strong stories about an HIV-infected schoolgirl who is fiercely objected to by other parents and a brokenhearted woman finding out after a long time that her ex-boyfriend had left her after finding out he was HIV positive."

The interactive play allows audiences to share their ideas and talk with the cast as well as HIV-infected people during the play.

Impressed by the project's effectiveness, the Kon Tum Youth Union has invited Lai to train their staff in making and performing interactive plays.

Magic can happen

Lai's use of a real HIV-infected person has been a master stroke.
Hung, a student of HCMC's University of Technology (HUTECH) said that his mind changed after the performance.

"Do we need to wait until tomorrow to start living better or wipe out all the social bias and give them our hand? I was impressed by Hoang, the HIV-infected actor who was brave and confident enough to perform on stage and tell us his story. His answers to some of our questions really made things clear," Hung said.

At the performances, some members of the Vi ngay mai tuoi sang (For a brighter future), a organization established in 2002 in Hanoi to bring together HIV-infected people and get them involved in many social activities, especially in helping others sharing their plight, were also present and revealed their own stories.

"They really touched the audience and after some performances, many, mostly students and young people, went on the stage and hugged them," said Lai.

Lai said that Bui Tran Hoang, the HIV-infected actor, was not only chosen for his acting skills but also for his knowledge of the disease and ability to answer the audience's questions.

"The artists have the understanding, but it is those who are attached to HIV for years who know their status best. They are very confident and like to participate in social activities. The members of Vi ngay mai tuoi sang club have also invited me to arrange a play for them to perform. Because of some outstanding individuals, those HIV-infected people who treasure their lives in words and deeds are gaining more and more social respect," Lai said.

Lai said he would like others to carry his message, but limited sponsorship prevented him from inviting famous artists or holding more performances.

"I think my team and I have to be more dynamic and find more support to maintain the show. If the local enterprises give us just 10 per cent of their annual budget for entertainment shows or football, magic will happen."

The Stereo Man

Lai achieved fame in 2006 as an actor in a drama series called "Stereo Man," produced by the Hanoi Youth Theater. Changing themes annually, the series explores many social issues like gender discrimination, sex, HIV/AIDS and violence through stories inspired by the lives of real people. It uses a lot of body language and very little dialogue.

For instance, a pair of shoes and a pair of woman's slippers are placed on the stage. The character approaches them. There is joy and fear when he looks at the slippers and utter weariness when he considers the men's shoes. Finally, he wears the slippers, and although they do not fit him, he is truly happy.

The series paved the way for other works including Dung doi den ngay mai.

Lai said he is trying to explore the other functions of art, not just entertainment.

"Local artists now just focus on entertaining the audience, instead of evoking their emotions. I enjoy what I am doing now, it's very meaningful, and I am not afraid of criticism. I know I am doing the right thing and supported by many good people."

Weblink: http://www.thanhniennews.com/2010/Pages/20110410161211.aspx

Organization: PETA- Philippines Educational Theater Association


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    很久以来Bui Nhu对同性恋者和艾滋病毒携带者都带有一种"正常的"偏见,一种厌恶的感觉。然而,当他亲眼目睹了好友的死亡之后,态度开始有所改观。"我从学生时代起就和他一起住校生活,然后他开始吸毒,之后就感染了艾滋。看着他的病情迅速恶化,我决定开始了解这种疾病。"他说,"人们通常害怕他们自己不了解的东西。通过学习我对艾滋病毒有了深入的了解,我希望通过我的工作向大家传达一个思想:艾滋病毒并不是我们想象中的那么可怕。"


    Lai通过舞台剧《Dung doi den ngay mai》(《不要等待明天》)从舞台剧演员向导演成功转型。去年10月,受来自美国总统防治艾滋病经济救援计划(PEPFAR)的资金支持,Lai和编剧Ke Hung将这部戏的最初构想定位为反抗社会对艾滋病的污名化。


    昆蒿青年联盟(the Kon Tum Youth Union)对该项目给予高度评价,并邀请Lai对该协会员工进行交互式表演的培训。


    在演出中,来自河内NGO Vi ngay mai tuoi sang (为了更美好的未来)的成员也向观众讲述了他们自己的故事。该机构成立于2002年,主要致力于帮助艾滋感染者重回社区,参与社会活动。

    Lai表示选择患艾滋病的演员Bui Tran Hoang并不仅仅因为他的表演技巧,更是因他对该疾病相关知识有着全面的了解,能够回答观众的任何问题。Lai希望能够让更多人加入演出,但由于有限的资金他无法邀请著名的艺术家出演,在演出的场次方面也有所保留。"我希望整个工作团队能够积极地寻求更多资金来支持演出。如果本土企业能够拨出10%投入在娱乐演出或足球赛的年预算给我们,奇迹将会发生" Lai说。

原文链接: http://www.thanhniennews.com/2010/Pages/20110410161211.aspx

Asia Report编译



The Open Society Foundations

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  投资家和慈善家George Soros1984年成立开放社会基金会(The Open Society Foundations)。项目活动遍及美洲、欧洲、亚洲、非洲和南美洲。基金会通过推动建立完善的政治、法律和经济系统来塑造健全的公共政策。





Open Society Foundations
400 West 59th Street
New York, NY 10019, U.S.A.
Tel. 1-212-548-0600
Fax. 1-212-548-4600

ND protest 4.jpg

Source: APN+




位于尼泊尔的 亚太艾滋病感染者网络(APN+)代表Rajiv Kafle表示:"我们的生命依赖着印度生产的廉价药物。我们不想回到从前,那时候我们的朋友和爱人因无力购买所需的药物而死去。我们今天来到新德里,走上街头,仅仅对印度政府提出一个简单的要求:不要拿我们的生命换取欧盟-印度自由贸易协定"

 联合国健康与权力问题特别报告员Anand Grover也作出表率:"经证明自由贸易协定所规定的数据独占权对别国公共健康带来严重损害。在印度实施数据独占这一法令更是一个巨大的错误。因为世界各地的患者都依赖着作为'发展中国家的药房'的印度。"

 德里艾滋患者网络代表Loon Gangte也表示:"印度的专利权早就惹恼了众多国际制药公司,诺华(Novartis)和拜尔(Bayer)两公司甚至在法庭上试图推翻该法案。虽然未获得成功,但这两家公司现正游说欧盟政府维护制药利润。"

 印度成瘾者论坛代表Abou Mere表示:"由于在印度药物受专利权保护,我们目前还是无法得到治疗丙型肝炎的非专利治疗方案,而丙型肝炎是毒品成瘾者和艾滋病毒携带者的主要病症。我想在印度没有人能够承受70万卢比(超过1.5万美元)的治疗。"

 癌症病人援助联盟一直提倡在印度实施香烟控制措施,此次也加入到抗议队伍当中。联盟负责人Y.K. Sapru表示:"菲利普莫里斯公司正在用瑞士-乌拉圭自由贸易协定起诉乌拉圭在香烟包装上放置更大更形象的'吸烟有害健康'的警示。印度政府和世界卫生组织应该从这个事件上觉醒过来,香烟管理条例也受到自由贸易协定的打击。"



Sheila Shettle: +91.98.7180.0723

Shailly Gupta: +91.98.9997.6108

Asia Report 翻译



亚太艾滋病感染者网络 (APN+)


癌症病人援助联盟 (CPAA)

Watch videos of the Asia-Pacific Regional Dialogue, held on 17 February 2011 in Bangkok, Thailand, using the player below. Video segments are broken down as follows:

Part 1 - Welcome and Context
Part 2 - Transgender people
Part 3 - Sex work
Part 4 - Men who have sex with men
Part 5 - Injecting drug users
Part 6 - Laws and practices that mitigate or sustain violence and discrimination lived by Women
Part 7 - Laws and practices that facilitate or impede HIV-related treatment access
Part 8 - Discrimination and legal aid responses
Part 9 - Law and HIV pertaining to children
Part 10 - Wrap-up


Watch the video:http://vimeo.com/channels/aprdglobalcommission#20590948

Orgnization: MSMGF

【视频】 亚太区域对话

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Asia Report翻译



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