Sixty per cent in Europe don’t know they are HIV positive
The latest data from the World Health Organisation (WHO) reveals that 60 per cent of people with HIV in Europe are undiagnosed and don’t know they have the disease.Dr Jens Lundgren, from Copenhagen, explained the shocking news at the European AIDS Clinical Society (EACS) conference held in Madrid in October.

In Britain the percentage of people who don’t know they have HIV is about a third but in Russia and Ukraine the percentage is as much as 90 per cent, he said.

WHO data also reveals that in 2005 over 80 per cent of people with HIV in Western Europe were on HAART (Highly Active Antiretroviral Therapy) but only 8 per cent in eastern Europe.“HIV is still the key public health problem across Europe,” Dr Lundgren said.

‘You can’t hide lipoatrophy’
Severe fat loss in the arms, legs, feet and face, known as lipoatrophy, is very stigmatising and affects both behaviour and psychological well being.

This was the stark conclusion of Dr Giovanni Guaraldi, speaking at the EACS Madrid conference. Dr Guaraldi runs a metabolic clinic for lipoatrophy in Modena in Italy and he explained that he tries to listen to his patients and treat the problem.

“You can’t hide lipoatropy,” he said, and it affects quality of life, anxiety and depression as well as sexual dysfunction.

A study of 350 HIV positive men at his clinic revealed over half had impairment of sexual function, body image and mental health problems.

“The higher your adherence the higher your chances of getting lipoatropy,” Dr Guaraldi said.A range of medical and psychological support services are now available in Italy for people with the side effect. “For some patients surgery was the cure for their depression.”

The Modena Clinic has produced a powerful video to explain the impact of lipoatrophy which can be viewed at www.lipodistrofia.info.
“We blamed protease inhibitors for lipoatrophy for a long time but this was not true.”

Dr Anton Pozniak, of the Chelsea and Westminster Hospital, said. Dr Pozniak explained that it is now possible to switch from the HIV drugs which lead to lipoatropy, the thymidine analogues such as AZT, ddI and D4T, onto drugs which can stop or even partially reverse the fat loss.“The thymidine analogues have now been eclipsed,” Dr Pozniak said.

UK activist Winnie Ssayu Sseruma, from the African HIV Policy Network (AHPN), said that a UK survey had revealed that two thirds of HIV positive people would be prepared to lose more than a year of life if they could avoid lipoatrophy.

Winnie explained her own 20 year battle with HIV and stressed the importance of building up a good relationship between doctors and patients.

She advised HIV patients to be proactive and to keep a patient journal, prepare for hospital appointments, take an interest in their health, get involved in their clinic, build up a relationship with their doctor, work with advocates and also get support from friends and family.HIV patients who have a good relationship with their doctors are more likely to adhere to treatments and get better outcomes, Winnie said.

Words from around the World
“The perception of people living with HIV and AIDS by the general public is still negative.”
Dr Bruno Spire, AIDES, France.

“Fifty per cent of new HIV infections are from people who are newly infected themselves. How can you blame someone who doesn’t know they are HIV positive?”
Dr Mark Wainberg, McGill University, Canada.

“We have a comfortable AIDS industry that supports itself and needs to become more accountable.”
Professor Helen Rees, South Africa.

“HIV disclosure is a moral act. ‘Don’t ask, don’t tell’ only increases stigma for people with HIV. There is a sense of duty to disclose.”
Dr Peter Keogh, Sigma Research, University of Portsmouth.

“Hepatitis C (HCV) is the big new elephant in the room. HCV is more stigmatised in the gay community than HIV. The fear of rejection and stigma is even worse than the disease itself. I felt grubby and skanky. There is a belief that dirty men get HIV or HCV.”
Michael Carter, NAM.

“Even in western countries large of people only find out their HIV positive status when they develop serious opportunistic infections.”
Dr Kevin de Cock, World Health Organisation (WHO).
Words from around the World continued

“TB is the biggest cause of death from a curable infectious disease.”
Dr Matteo Zignol, WHO Switzerland.

“The HIV and AIDS epidemic has taught us the value of solidarity, commitment and hope.”
Dr Teresa Robledo, secretary of the Spanish National Plan on AIDS.

“Treatments are currently started too late in Europe.”
Dr Jens Lundgren, Copenhagen.

“The NHS currently spends £200 million per annum on antiretrovirals.”
Robert Fieldhouse, treatment activist and writer.

“Far less progress has been made for children with HIV than for adults.”
Dr Valerie Stone, Harvard University Medical School.

“Twenty five per cent of HIV patients in Britain are starting treatments without resistance tests. If HIV treatment was a Smartie then everyone would start treatment as soon as they are diagnosed.”
Simon Collins, HIV i-Base.

“Within 10 days of HIV infection you lose all the lymphocytes in the gut and you never get them back.”

Dr Mark Nelson, Chelsea and Westminster Hospital.

USA STDs on the rise
The rates of three leading sexually transmitted diseases - chlamydia, gonorrhea and syphilis - rose again in the United States last year, worried public health officials have reported.

It was the second year in a row of increases for all three of these sexually transmitted bacterial infections, the Centers for Disease Control and Prevention said. The rate of chlamydia, the most common infectious disease reported to the CDC, increased 5.6 percent in 2006 from 2005.