VIH/Sida en la red

[Texto publicado en el Boletín de Información Sexológica nº 55 de la Asociación Estatal de Profesionales de la Sexología (AEPS)]

VIH/Sida en la red

Cuando un buscador de internet arroja 52 millones de páginas relacionadas con el término sida en español, se hace más necesario que nunca filtrar los resultados y ofrecer tan solo unos pocos enlaces fiables y contrastados.

A modo de mapa simplificador, pueden dividirse las páginas sobre sida en tres tipos. Las pertenecientes a asociaciones u ONGs, en contacto directo con el terreno y las dificultades diarias, de tono didáctico y muy actualizadas; las de índole médica, con mucha información científica y bibliográfica, pero más asépticas y desapegadas de lo político-social y las reivindicaciones; y las institucionales, que aspiran a ser un punto de partida válido, con información general, que redirige a páginas más específicas.

Una de las páginas más útiles, de esas de consulta diaria, es la del Grupo de Trabajo sobre Tratamientos del VIH. Es un portal perteneciente a una asociación sin ánimo de lucro con multitud de materiales. Cuenta con una sección educativa (“aprende”), una de noticias (”actualízate”), un foro, edita una revista gratuita (“Lo+Positivo”) y ofrece un servicio de consulta.

De menor alcance, aunque proporciona toda la información necesaria, Stop Sida es una organización catalana que se dirige especialmente al colectivo homosexual. Son muy útiles sus guías de salud, prácticas seguras para gays y lesbianas, profilaxis post-exposición, etc.

África, Occidente y la lucha contra el sida

From The Times Literary Supplement
March 5, 2008
AIDS and evangelists in Africa
There is no single answer to the problem of HIV/AIDS, but solutions cannot be imposed from the outside
Steven Epstein

Helen Epstein
THE INVISIBLE CURE
Africa, the West and the fight against AIDS
326pp. Viking. £16.99.

On one of her many trips to Africa in recent years to investigate the state of the AIDS epidemic, Helen Epstein (no relation) visited the main hospital in a district known for its tea plantations, about 200 miles from Uganda’s capital, Kampala. There was one doctor at the facility, and on occasion some nurses. The X-ray machine could be powered up for an hour a day at best. Those patients not sleeping on the floor were sharing beds. The bathrooms had been gutted and served “as aviaries for the finches that made their nests in the porcelain scraps on the floor”. Some patients had AIDS; others, suffering from onchocerciasis, or “river blindness”, had long parasitic worms that formed wriggly lumps beneath the skin.

To write about AIDS in Africa for a Western audience is to confront a sharp narrative dilemma. How do you tell stories – often painful, sometimes overwhelming – without re-inforcing a sense of awful inevitability about Africa’s many problems? How do you convey the startlingly different logic by which life operates there, without trafficking in myths and stereotypes, and without solidifying a perception of Africa as radically “other”, and thus unknowable and unreachable? Epstein, a scientist turned essayist, has been piecing this account together for more than a decade in a series of lucid articles published in the New York Review of Books. Collecting that material between the covers of a single volume is a tremendous service – even if, as so often is the case for books with such origins, she has failed to eliminate distracting repetition across chapters or solve some basic problems of exposition. (Why are elementary facts about AIDS treatment and testing in Africa relegated to an appendix?) But her keen eye for detail, suspicion of conventional wisdom, and compelling prose carry the reader along. She does not shy away from telling horror stories about East and Southern Africa, home to about 40 per cent of the world’s cases of HIV infection. There are stories not just of deplorable conditions, tragic missteps and profound institutional failures, and sometimes of the hideous things that people do to one another – like the case of the South African teenage boys who stoned to death their neighbour, an HIV-positive AIDS counsellor, because she had brought “shame on the community”. But Epstein also juxtaposes failures with impressive accomplishments. Though her portraits are vividly painted, her desire is not to describe but to explain. And if she succeeds better than most in avoiding the standard portrayal of Africa as unfathomable and unchangeable, it is because she interweaves her storytelling with careful analysis. She shows how human efforts to control disease often fail but sometimes succeed, and by placing outcomes and actions squarely in their historical and cultural context – including, not incidentally, the long historical ripple effects of Western colonialism that continue to promote the spread of disease while hindering its containment – she shows us why people believe what they believe or do what they do. Finally, by linking what happens in Kampala and Pretoria to what goes on in Geneva, Washington, DC, and elsewhere, Epstein shows how the intractable dilemmas that come to seem quintessentially “African” are often caused, or compounded, by forces and agendas that originate elsewhere and over which Africans themselves exercise limited control.

VIH, preservativos y abstinencia

Leyendo el nuevo artículo de Ana Belén Carmona en El Confidencial sobre los preservativos y las actitudes ante la prevención del VIH, me ha encocorado ver luego dos comentarios tipo de las huestes conservadoras. Uno, que el preservativo falla y que no hay nada mejor que una pareja monógama y fiel. Porque como la gente solo tiene una pareja en toda su vida, que a su vez no ha tenido ninguna otra pareja, y se mantienen siempre fieles, qué mejor alternativa, ¿verdad? Suena increíble, pero todavía se esgrimen estos argumentos.

El segundo comentario es más elaborado y ya lo he visto tergiversado varias veces: el caso de Uganda. Lo primero que habría que mencionar es que el contexto social de ese país es tan distinto del de España que no tiene mucho sentido calcar las propuestas de prevención que allí funcionaron. De hecho, es justamente esa ignorancia del contexto lo que les anima a defender impúdicamente la abstinencia como clave para el descenso notable de nuevas infecciones por VIH en Uganda. Lo cierto es que fue una mezcla del aumento del uso de condones, así como la restricción en el número de parejas (en Uganda abundan las relaciones concurrentes y eso multiplica las probabilidades de contagio) lo que llevó a ese descenso.

Para un recuento más elaborado de este planteamiento con cifras y por expertos que han trabajado en la zona, recomiendo especialmente el libro de Helen Epstein The Invisible Cure: Africa, the West, and the Fight Against AIDS o alguno de sus artículos en la New York Review of Books o el New York Times. Otra buena fuente a la que acudir son los informes del Instituto Guttmacher, como por ejemplo éste.

Cómo parar el SIDA en África

Volume 54, Number 13 · August 16, 2007

Review
How, and How Not, to Stop AIDS in Africa
By William Easterly
The Invisible Cure: Africa, the West, and the Fight Against AIDS
by Helen Epstein
Farrar, Straus and Giroux, 326 pp., $26.00

One of the classic works of journalism of the last couple of decades was Randy Shilts’s And the Band Played On[1] about the sluggish response to AIDS in the 1980s in the United States, which indicted both the Reagan administration and the leaders of the gay community. I still remember the sense of outrage I felt when reading Shilts’s book; it struck just the right note, leaving one both horrified about the tragic incompetence of so many and yet also hopeful that someone, somewhere could do things better next time.

Yet after reading Helen Epstein’s masterful new book, the response to AIDS in America now looks in retrospect like a model of courage, speed, and efficiency by comparison with the response in Africa. In the US, the government publicized the threat and funded research, the gay community reduced its infection rates by encouraging less risky sexual behavior, the dreaded breakout into the heterosexual population never happened, and AIDS receded to become a disease that, while still tragic, could in most cases be kept under control with expensive new antiretroviral drugs (ARVs).

The opposite is true in every respect of AIDS in Africa, which was anticipated as a looming crisis already in the 1980s, yet governments, foreign aid agencies, and even activists reacted with denials and evasion. The disease rampaged through the heterosexual population and is still rampaging, ARVs were too late, too costly, and available to too few, and Africa is still in the midst of an epic disaster without a solution in sight. As of the latest figures in 2006, 25 million Africans are HIV-positive, 2.1 million die from AIDS every year, and 2.8 million are newly infected each year.[2]

Epstein’s book lays all this out in courageous and thought-provoking detail, describing the maddening complexity of the AIDS crisis in Africa, and the reprehensible and simplistic evasions of nearly everyone involved. It is not only a book that should be required reading for people concerned in the least with AIDS or with Africa; it is also compulsively readable.

Lavarse tras el coito aumenta el riesgo de VIH

August 21, 2007
Washing After Sex May Raise H.I.V. Risk
By LAWRENCE K. ALTMAN

A study in Uganda has come up with a surprising finding about sex and H.I.V. Washing the penis minutes after sex increased the risk of acquiring H.I.V. in uncircumcised men.

The sooner the washing, the greater the risk of becoming infected, the study found. Delaying washing for at least 10 minutes after sex significantly lowered the risk of H.I.V. infection, Dr. Fredrick E. Makumbi reported on July 25 at an International AIDS Society Conference in Sydney, Australia.

The researchers do not have a precise explanation for the findings, which challenge common wisdom and the teaching of many infectious disease experts who urge penile cleansing as part of good genital hygiene. Health experts have suggested that washing the penis after sex could prevent potentially infectious vaginal secretions from entering the body through the uncircumcised penis.

Washing the penis after sex is common in Africa. To determine whether washing could be recommended as an alternative to male circumcision, Dr. Makumbi’s team from the Makerere University Institute of Public Health studied 2,552 uncircumcised men in the Rakai district of Uganda.

Educación sexual en India

The great Indian sex debate
The Indian government’s recent attempt to introduce sex education for school children has provoked a vigorous debate. In the first of two articles, the BBC’s Jyotsna Singh considers the case in favour of a more open discussion of sex in schools.

“Who says discussing sex is against Indian culture? I don’t think this is a point worth debating any more,” Naina Kapoor, Director of the NGO, Sakshi, told the BBC.

“We are simply in denial when we say things like it is against our culture,” she says.

Sakshi is a leading Delhi-based NGO, trying to create sexuality awareness in India.

Needless to say their job has not been easy.

“Parents, teachers, students none of them are comfortable talking about the subject initially,” says Smita Bhartia, a programme co-ordinator at Sakshi.

“But we don’t just barge in and start talking about the subject. We organise seminars, workshops to try and get people talking about it.”

Taboo

India is world famous for its ancient manual on sex - the Kamasutra - and temples with erotic structures in Khajuraho in central India.

So, many ask, how come sex has become a taboo subject in modern India?

Prostitución masculina en Madrid

El 20% de los hombres que ejerce la prostitución en Madrid son seropositivos, según un estudio

El primer informe de este tipo hecho en España revela que el riesgo de infección del VIH es 25 veces mayor que en las meretrices

AGENCIAS - Madrid
ELPAIS.com - España - 15-06-2007

El 19,8% de los hombres que ejercen la prostitución en Madrid y se hacen la prueba del VIH son seropositivos frente al 0,8 de las trabajadoras sexuales. Éste es uno de los datos “inaceptables” que arroja el estudio Trabajadores masculinos del sexo: aproximación a la prostitución masculina en Madrid 2006, la primera investigación de estas características que se desarrolla en España y que tiene como fin buscar soluciones sanitarias e informativas para evitar riesgos entre este colectivo. El pionero informe también revela que la prostitución masculina se ejerce principalmente en la zona centro y también en Internet, que ofrece un mayor anonimato. Son jóvenes de 25 años, inmigrantes en el 87% de los casos y el 100% vende su cuerpo porque quiere. Según ha explicado durante la presentación del estudio Iván Zaro, coordinador del programa de atención a los trabajadores del sexo de la Fundación Triángulo, el generalizado desconocimiento social y la “invisibilidad” de los chicos que ejercen la prostitución “que no son tan reconocibles ni localizables como las mujeres prostitutas” dificultan las labores de actuación y prevención tanto de las ONG como de los servicios sociales de la Comunidad de Madrid. Y el problema no es pequeño, ya que el riesgo de infección del VIH es 25 veces mayor en hombres que ejercen la prostitución que en mujeres.
El trabajo, que cuenta con la colaboración de la Consejería de Sanidad y el Ministerio de Sanidad, muestra que el perfil del trabajador masculino del sexo es el de un joven de unos 25 años, inmigrante en el 87% de los casos y que ejerce durante una media de 12 meses, normalmente con fines económicos puntuales como “obtener dinero para comprarse una casa o montar un negocio”, ha indicado Zaro. El ámbito de la Puerta del Sol y algunas calles localizadas del barrio de Chueca son las zonas de la capital que concentran la mayor parte de la prostitución masculina de calle.

Expansión del sida y mujeres

AIDS

The not-so-fair sex
Jun 28th 2007 | KIGALI, RWANDA
From The Economist print edition

Women may be more responsible for spreading HIV than has been suspected

IN AIDS epidemiology, one orthodoxy—particularly in Africa, where things are at their worst—is that the main route of transmission is male promiscuity. Of course, in this most political of diseases, political correctness is de rigueur, so it is not put quite like that. But the assumption is that men give it to women. Men give it to other men. And to the extent that women give it to men, it is because they have acquired it in the first place in unequal partnerships, such as prostitution, based on male power or male patronage.

There is a lot of truth to this, of course. But perhaps not quite as much as orthodoxy would have it. For work by Vinod Mishra of Macro International, a research firm under contract to the American government, suggests women are not always the innocent vessels that HIV epidemiology takes them for. And that, in turn, means the models that epidemiology relies on may be wrong.

VIH y relaciones heterosexuales

 

La primera causa de infección por VIH en Europa es la relación heterosexual

La UE presenta el primer informe que recoge datos de 17 países, salvo España e Italia

EMILIO DE BENITO  -  Madrid

EL PAÍS  -  Sociedad - 19-03-2007

 

El VIH se expande en Europa empujado, sobre todo, por las relaciones heterosexuales sin protección. Es uno de los datos dados a conocer por primera vez por el Centro Europeo para el Control de Enfermedades (ECDC), vinculado a la Unión Europea y fundado hace un año. En 2005, último año con datos, el ECDC registró 20.000 nuevas infecciones por VIH, aunque la cifra real será mayor, según advierte la directora del organismo, Zsuzsanna Jakab. La UE destaca también que sólo quedan dos países que carecen de un registro de transmisiones: España e Italia. La tendencia a la heterosexualización de la epidemia comenzó en 1999, de acuerdo con los datos de nuevos infectados de los 17 países que tenían entonces registro, que el ECDC ha conseguido recopilar ahora por primera vez. Ése fue el primer año en el que los casos de transmisión heterosexual superaron a los de hombres que tienen sexo con hombres (unos 3.000 en ambos casos). Actualmente, los cálculos son que en Europa viven alrededor de 1,1 millones de personas con VIH, y cada año se infectan unas 32.000, es decir, uno de cada tres nuevos casos no queda registrado. El país que más nuevos casos registra es Portugal (251 por millón de habitantes), seguido de Rusia (247) y Ucrania (243). En España, extrapolando las estimaciones del Plan Nacional contra el Sida, salen unos 70 nuevos casos por millón.

Perspectivas psicológicas sobre la sexualidad humana

Journal of Sex Research Nov, 2001

Book review

Psychological Perspectives on Human Sexuality.

Beatrice E. Robinson

Edited by Lenore T. Szuchman and Frank Muscarella. New York: John Wiley & Sons, 2000, 682 pages. Cloth, $69.95.

 

This is a long and dense book–the kind that can cause carpel tunnel syndrome in book reviewers who attempt to lift and read it. It is the kind of book that editors fear will not be reviewed because the reviewer will never finish reading it. I was tempted to read selective chapters of the book and write the review based on a representative sampling of the content. However, I soon found myself caught up in each chapter I read, unable to decide which chapters to read. I tried several strategies–random selection, picking those chapters I knew the most about–always unhappy about giving up reading the chapters that were cut out by any particular strategy. I finally recognized that I wanted to read this book, all 682 pages, and so I did. This fact, more than anything else I will say during the rest of this review, speaks to the quality of this compendium.

Psychological Perspectives on Human Sexuality is an ambitious book, an edited overview of the field of human sexuality. The danger with edited volumes is that the quality of the volume can vary dramatically, all depending on the contributor of each chapter. This volume showed a consistently high level of quality, largely due to the seemingly judicious selection of authors who were experts in their assigned areas.

Vacuna realista contra el sida

January 14, 2007

A Real-World AIDS Vaccine?

By TINA ROSENBERG

Last month, scientists invented the AIDS vaccine. Missed it? Perhaps that’s because you were still seeking the vaccine fantasy: the magic bullet, the impenetrable shield that finally pitches this disease into the trash bin, the shot that will end not only the AIDS epidemic but our anxiety about the AIDS epidemic as well.

The vaccine thunderbolt didn’t strike — and might never. Drearily, the real AIDS vaccine is likely to be imperfect: one more tool in our arsenal, to be used along with condoms and all our other tools. It will most likely avert millions of infections and save millions of lives. But it will not end the Age of AIDS.

The vaccine that arrived last month was not actually a vaccine. It was, instead, a confirmation of what scientists had long suspected: circumcision helps protect men from AIDS infection. For years, AIDS researchers have observed that many African tribes that circumcise boys or young men had lower AIDS rates than those that don’t, and that Africa’s Muslim nations, where circumcision is near universal, had far fewer AIDS cases than predominantly Christian ones. The first research proof came in 2005, when a study in South Africa was stopped early in the face of evidence that the men who had been randomly assigned to be circumcised were getting 60 percent fewer H.I.V. infections than the men assigned to the control group. Last month, ethics boards halted two similar studies, in Uganda and Kenya, when they found similar results. In both, the circumcised men caught the AIDS virus half as often as the uncircumcised control group.

Circuncisión y sida

HALLAZGO DE GRAN IMPACTO

Dos estudios confirman el papel de la circuncisión para prevenir la infección por VIH

• Menos del 20% de los hombres del sur de África están circuncidados

MADRID.- El papel de la circuncisión masculina a la hora de reducir el riesgo de contagio del VIH, algo que muchos estudios habían sugerido hasta ahora, se ha confirmado. Tan positivos son los resultados sobre esta técnica obtenidos en dos ensayos clínicos en Kenia y Uganda, que los investigadores han decidido finalizarlos antes de tiempo para ofrecer la circuncisión a todos los participantes.

El Instituto Nacional de Alergia y Enfermedades Infecciosas de Estados Unidos, parte de los Institutos Nacionales de Salud (NIH), ha anunciado el cierre prematuro de ambos estudios, que comenzaron en septiembre de 2005 y tenían que durar hasta mediados de 2007, ante los datos de un informe interno que señalan que “la circuncisión bien realizada reduce de manera significativa el riesgo de que los hombres contraigan el VIH a través de relaciones heterosexuales”.

La protección ofrecida por la circuncisión ronda el 50%, mientras que con los ensayos con vacunas experimentales contra el virus, cuya viabilidad todavía no está clara, el horizonte de protección al que se aspira ronda el 30%.

Riesgo diferencial de contraer el VIH

For some, safe sex might not be safe

Blacks had high HIV risk even if their usual behavior was low risk, study finds

BY TAMMIE SMITH

TIMES-DISPATCH STAFF WRITER

Monday, December 11, 2006

To prevent HIV and other sexually transmitted diseases, practice safe sex, limit partners and don’t mix drugs, alcohol and sexual activity.

Do those things and you’re good to go, right?

Most of the time, it’s true. But research suggesting low-risk behavior on the part of young black adults does not translate into lower risk for HIV and sexually transmitted diseases has experts rethinking some prevention messages.

A study by a North Carolina researcher looking at risk behavior in young black adults and white adults found that young black adults were at high risk for HIV and other sexually transmitted diseases regardless of whether their usual behaviors were high risk or low risk.

The same was not true for young white adults: Low-risk behavior meant low risk for HIV and sexually transmitted diseases.

Píldora que elimina la regla

La píldora que logra eliminar un año la regla es segura

Además de eficaz contra los embarazos, un trabajo confirma que un año de uso continuado de esta contracepción quita el sangrado menstrual sin riesgos.

PATRICIA MATEY

El sueño de muchas mujeres: un método anticonceptivo eficaz que, a su vez, elimine las tediosas menstruaciones, parece que se está haciendo realidad.

En las últimas cuatro décadas, los científicos han intentado modificar el patrón de consumo de las píldoras anticonceptivas (tradicionalmente su ingesta es de 21 días consecutivos y siete de descanso) sin apenas lograr cambios, mientras que las encuestas constatan que cada vez son más las mujeres que desearían que sus ciclos menstruales finalizaran o, al menos, se redujeran.

Ahora un nuevo trabajo, publicado en la última edición de la revista Contraception, constata que es posible disminuir el número de menstruaciones e, incluso, eliminarlas de forma segura mientras que se logra una protección eficaz contra el embarazo no deseado.

 

Condón líquido

ESTUDIO PRELIMINAR

Un ‘condón’ líquido para proteger a las mujeres del virus del sida

12/12/2006

ELMUNDO.ES

MADRID.- Hasta dentro de cinco años no comenzarán las pruebas en humanos y tendrá que pasar al menos una década para que se utilice de manera generalizada, pero los primeros ensayos en el laboratorio con el llamado ‘condón molecular’ son esperanzadores. Los artífices de esta nueva herramienta contra el sida son unos científicos de la Universidad de Utah (Estados Unidos), que han desarrollado un líquido que se aplica en la vagina y libera fármacos contra el VIH.

“Hemos fabricado un nuevo gel vaginal que llamamos ‘condón molecular’ porque está compuesto de moléculas que son líquidas en la temperatura ambiente pero que cuando se aplican en la vagina se extienden y adquieren una textura de gel capaz de cubrir el tejido”, explica Patrick Kiser, profesor de bioingeniería y participante en el estudio, que se publica en ‘Journal of Pharmaceutical Sciences‘.

“El gel está pensado para que libere fármacos antisida cuando entra en contacto con el semen durante una relación sexual. El objetivo es que esta tecnología proteja a las mujeres y a sus futuros bebés de la infección por el virus de la inmunodeficiencia humana”, añade este investigador.

Arabia Saudí y el sida

November 27, 2006

Saudi Arabia More Open About AIDS

By THE ASSOCIATED PRESS

Filed at 1:42 p.m. ET

JIDDAH, Saudi Arabia (AP) — The 35-year-old mother of six flinched when asked if she has told her children that she and her husband were diagnosed with AIDS four months ago.

She never will, she said. ”Can you imagine what their reaction will be? We’ll be treated like pariahs,” said Umm Muhammad, a Jiddah resident who declined to use her full name to protect her privacy.

Saudi Arabia’s government has become more open about AIDS in recent years, publishing statistics about the number of infected Saudis, providing them with free medical care and urging compassion.

But in this deeply conservative kingdom, social stigma is still attached to the disease — which most people link, correctly or not, to acts forbidden by their religion and sometimes punishable by death: premarital or gay sex and adultery.

That complicates the job of health workers and activists who advocate spreading awareness about protective measures. How, they ask, can an activist educate people about safe sex in a culture that demands men and women abstain from premarital sex?