‘With Liberty And Travel For All’; Obama Lifts HIV Travel Ban

 

More information on the lifted travel ban:

November 2, 2009 at 10:34 AM | by JetSetCD | 0 Comments

Although the travel health focus right now is on the Swine Flu, it’s nonetheless important to remember that Swine Flu isn’t the end-all, be-all of dangerous diseases right now. After all, millions of people in the world don’t have it, unlike HIV and AIDS. Up until this weekend, those with HIV were banned from traveling to the United States due to an archaic law which was just lifted by Obama in response to a UNAIDS request for all countries to end such discriminatory travel bans: “Placing travel restrictions on people living with HIV has no public health justification. It is also a violation of human rights,” said UNAIDS executive director Michel Sidibe.

Although the ban won’t be fully lifted until next year, those who have HIV and haven’t been able to visit the US and make their dreams come true of going to Graceland and eating a slice of New York pizza now can start booking their flights.

The HIV travel ban was passed way back in 1987, when the public was very afraid of and confused about the human immunodeficiency virus (HIV) and misinformation ran rampant. These days, people have returned to not freaking out about sharing water fountains and not giving wide berths to anyone wearing a red ribbon, so it’s about time that all can travel as equals, even in first class.

For a list of seven diseased you really ought to be afraid of during travel, checking out this article at The Olympian.

President Obama lifts ban for those with HIV/AIDS

President Obama lifted the ban that makes it illegal for those living with HIV to enter the United States.  Check out the article from The Examiner below:

November 1, 4:09 PMSeattle HIV and AIDS ExaminerLisa Onstot

The world is making progress.

Last week President Obama signed an extension of the Ryan White HIV/AIDS bill. The legislation provides care, treatment and support services to nearly half a million people, most of whom are low-income.  Thousands of people use these services on a daily basis. 

This is actually the fourth extension of this bill since its original passing in 1990, but Obama said that this was the first time that the bill was not controversial and passed with bi-partisan support.

In another move toward achieving equality and eliminating the stigma associated with HIV/AIDS, President Obama also invalidated a 22-year-old restriction on the entry of HIV infected people into the United States. Our country has had one of the most restrictive policies on the immigration and travel of HIV-positive people in the world. In addition, non-citizens living long-term in the United States were denied permanent resident categorization solely on the basis of their HIV-positive status.

Sadly, this restriction has remained in affect all these years, despite the ignorance that is was created under.  The original restriction was enforced when it was thought that HIV could be transmitted through the respiratory system.   It is common knowledge that HIV cannot be transmitted casually.

“If we want to be a global leader in combating HIV/AIDS, we need to act like it”, Obama said.  Beginning in January, those living with HIV/AIDS are no longer banned from our country. 

Dear Mr. President,

Thank you for taking another step closer to ending discrimination.

Signed,

A grateful citizen

PR group tests syringe vending machine for addicts

SAN JUAN, Puerto Rico — A needle exchange program in Puerto Rico is testing a vending machine that provides drug users with clean syringes after-hours to fight the spread of HIV and hepatitis C.

Dr. Jose Vargas Vidot is the founder of Community Initiative, the U.S. island territory’s only needle-exchange group. He says a single machine will make clean syringes available at night outside the group’s office in Hato Rey.

Vargas said Tuesday that drug counseling offices that distribute syringes are open only during daylight hours.

The vending machine program targets young addicts reluctant to seek help.

Drug users can get syringes, cookers, cotton filters, gauze and sterile water to prepare drugs for injection by inserting a special card.

Proposed legislation to end written consent for HIV testing in Mass. sparks controversy

Two bills pending in the Massachusetts Senate that would eliminate informed, written consent before administering HIV tests continue to stir debate. Supporters say the proposed legislation would increase the chances of treating the virus in its early stages. Opponents, on the other hand, maintain written consent is crucial in building trust between doctor and patient.

The Centers for Disease Control issued a non-binding recommendation in 2006 that written consent for HIV testing is no longer needed. The CDC concluded general consent for medical care should be considered sufficient.

Only eight states currently still require written consent before a patient undergoes an HIV test. Besides Massachusetts, they are Alabama, Michigan, Nebraska, New York, Pennsylvania, Rhode Island and Wisconsin.

The Massachusetts bills, sponsored by state Sens. Patricia Jehlen and Robert O’Leary, both Democrats, would replace written consent with requirements health care providers verbally discuss the test, outline treatment options if it comes back positive, recommend patients who test negative but remain at-risk undergo periodic testing in the future and advise them they have the right to decline the test.

O’Leary’s bill also would require the state’s Department of Public Health to undertake a study on how to best reach those who are at increased risk for contracting the HIV virus, but are not getting tested.

In making the case for eliminating written consent, Jehlen’s office reported 20 percent of Massachusetts residents with HIV/AIDS are unaware of their status because they have not been tested. It also
referenced the fact HIV testing rates at San Francisco General Hospital rose by 44 percent after administrators eliminated its written consent regulation. The number of positive test results increased by 67 percent.

The Boston Globe recently endorsed the proposed legislation in an editorial. And many healthcare providers and activist organizations support it. They include Gary Daffin, executive director of the Multicultural AIDS Coalition.

Fenway Health, a Boston-based provider that treats LGBTs and has been at the forefront of HIV/AIDS treatment and prevention since the early days of the epdemic, also maintains believes it is time to end what many believe is an outmoded policy.

“We’re very supportive of moving in this direction,” Fenway president Dr. Stephen Boswell told EDGE in a phone interview.”The goals of the CDC are to help identify as many of the people who are HIV positive in the country, but don’t know it, as possible. Study after study has shown that the current testing paradigm for HIV is interfering with making testing readily available in some of the sites where the largest number of people who are positive, but don’t know it, are going for care.”

But some Massachusetts LGBT and HIV/AIDS service organizations remain opposed the bill. Gay & Lesbian Advocates & Defenders opposed it during a state house hearing last week. The AIDS Action Committee also remains opposed..

Bennett Klein, director of GLAD’s AIDS Law Project, testified before the Joint Committee on Public Health on Oct. 6 he feels written consent provides important protections to those HIV/AIDS. He further argued there is no evidence to suggest it is a barrier to people getting tested.

“Solving this problem requires a comprehensive public health solution, including determining how to reach populations, such as the homeless or immigrants, who may not make contact with the traditional healthcare system,” Klein told the panel. “If we could solve a difficult social and public health problem by simply getting rid of a piece of paper, we would be very lucky. But that is not the case.”

In a phone interview, Klein further contended the bills leave open the possibility some people will be tested without knowing it or without believing the test was voluntary and that they were in control of the situation.

“There are also larger repercussions in terms of the public response to the epidemic, such as creating a sound and trusting relationship between provider and patient, and patients being able to talk frankly about risk behaviors,” he explained. “This is particularly important in adherence to medication. If people are distrustful of the healthcare system, you are much less likely to ensure that there is a patient-provider relationship that can address those issues.”

The AAC told EDGE in a statement that while it welcomes efforts to eliminate barriers to HIV testing and supports the goals of the proposed legislation, it cannot endorse the bills as they currently are written.

The organization said it could support proposals that required documentation of verbal informed consent and imposed enforceable penalties for failure to document consent and for violations of patient confidentiality.

AIDS Action further called for a statute to require a funded study of the reasons people with HIV often enter treatment late and to propose solutions.

“Because written informed consent is perceived to be a barrier to testing in medical settings, moving to verbal consent with appropriate documentation and confidentiality protections can be an important first step toward increasing the number of HIV tests offered and ensuring routine HIV testing in medical settings,” the statement read.

The organization added it feels the full integration of routine HIV testing in medical practices will help reduce the stigma still associated with the virus because of its association with sex and drug habits.

“HIV/AIDS disproportionately impacts gay men and women of color,” AIDS Action said. “People at risk for HIV should not have to seek out extra services or special sources of care to be screened for a medical condition that disproportionately impacts them. HIV screening and testing should be available everywhere in the Commonwealth.”

The Massachusetts Department of Public Health has not taken a position on the legislation, but it noted in a statement it has long supported routine screening.

Among its initiatives are pilot routine screening projects in urban areas, a public information campaign promoting knowledge of HIV status and guidance to providers about how to reduce the administrative burden of obtaining consent under current law.

“We are invested in reducing barriers to HIV screening for both patients and providers while preserving the strict confidentiality of individual medical information,” Kevin Cranston, director of the agency’s Bureau of Infectious Disease, said.

No Place at School for Vietnam AIDS Orphans

Justin Mott for The New York Times

Children from the Mai Hoa AIDS Center in An Nhon Tay, Vietnam played in between classes.

By SETH MYDANS

Published: October 13, 2009

AN NHON TAY, Vietnam — The first day of school was a special one last month for the 15 children from the Mai Hoa orphanage here. They are infected with H.I.V., the virus that causes AIDS, and for the first time they would be allowed to attend the local primary school.

“The children were so excited,” said Sister Nguyen Thi Bao, who runs the orphanage and had been lobbying for three years to enroll them in the government school. “They had been wishing for this day to come.”

But when they arrived, they found an uprising by the parents of the other students, who refused to let their children enter the school together with the infected orphans. Some of the parents hastily backed away when the orphans walked past.

After a short standoff, the principal, who had agreed to accept the orphans, told Sister Bao that their papers were not in order and that they could not stay.

The children returned to the orphanage, just a short walk down a country road, where they continue to study in small classrooms, still exiled from the uninfected world.

“I was so happy to go to the school,” said a 12-year-old fourth-grader for whom Sister Bao insisted on anonymity to keep her from the spotlight. “But then I saw that some parents wouldn’t let their children go to school with me because they are scared of my disease.”

The girl said she understood their reaction.

“If I were a normal child, I would be afraid, too, because I wouldn’t understand,” she said. “I would feel the same way. But I wouldn’t have acted the way they did.”

Sister Bao and officials of the district and the school, the An Nhon Dong Elementary School, have met with the parents since then, but they remain adamant.

“I don’t want my child to be with the AIDS children,” Nguyen Thi Thuy, 36, said the other day as she brought her 8-year-old son to school. “He could be injured, and it’s easy to transmit the disease through blood. And once you’re sick, it’s difficult to become a normal person again.”

One after another, parents who arrived with their children on small motorbikes raised their voices in agreement. If the orphans came back, said a man who gave his name only as Tam, he would pull his 6-year old son out again.

The story is not surprising, said Eamonn Murphy, country director in Vietnam for Unaids, the United Nations’ AIDS-fighting agency.

“You go to any rural environment in Asia, and you are going to have similar reactions,” he said. “The general lack of understanding leads to this inappropriate reaction and fear.”

Most of the parents here are farmers with little education, but the prejudice seemed to extend to city folk as well.

“I don’t know why we don’t isolate people with AIDS,” said a civil servant in Ho Chi Minh City, about 20 miles southeast of the village. “Even with swine flu we isolate people, and this disease is much more dangerous.”

There is no truth to these fears, Mr. Murphy said.

“You can’t contract it by sharing a workplace or going to school with people,” he said. “H.I.V. is not contagious from community contact, even if you are sharing cups and saucers and eating from a communal plate. You can’t get H.I.V. from that.”

In recent years, Vietnam’s prevention and treatment programs have been improving, Mr. Murphy said, although so far only 30 percent of people who need life-saving antiretroviral drugs receive them.

About 290,000 people in Vietnam, a country of 86 million, carry H.I.V. today, and Mr. Murphy said that although the rate of increase was slowing, the infection was spreading outside the high-risk groups such as intravenous drug users.

Among those infected, the government estimates that 5,100 are children. Although the law requires equal treatment, almost none of them have been accepted in schools because of the fears of other children’s parents, Nguyen Vinh Hien, the deputy minister of education, said last month.

He said the ministry would try to enroll at least half of these children in government schools by next year, but the experience of the Mai Hoa orphans suggests that this will not be easy.

Frightened and angry on that first day, some of the parents seemed heartless, Sister Bao said.

“They were saying the children were going to die anyway, so there’s no need for them to study,” she said. “ ‘If they are going to study, let them do it in the orphanage, and not put our children in danger.’ ”

The Mai Hoa AIDS Center, with its green and quiet grounds, was founded by a Roman Catholic order in 2003 as a hospice for patients in the final stages of the disease. It added the orphanage to care for children of people who died here.

The children are infected as well, Sister Bao said, but are receiving antiretroviral medication.

The buildings behind the classrooms are still a hospice, where a dozen emaciated patients lie on cots. Altogether, 250 people have died, Sister Bao said, including 90 whose unclaimed ashes are stored behind the hospice buildings.

Some of those are the remains of the children’s parents.

So the orphans of Mai Hoa live suspended between the death that fills the space behind their classrooms and the life of a world, just down the road, that still will not accept them.

“The children say they want to go to the other school because they want to have friends,” Sister Bao said.

But the 12-year-old fourth-grader seemed to have changed her mind.

“I don’t want to go to that school,” she said. “I already have enough friends here.”

H1N1 vaccine trials in HIV-infected people

BETHESDA, Md., Oct. 12 (UPI) — The first clinical trial of the H1N1 influenza vaccine in human immunodeficiency virus-infected pregnant women has begun, U.S. officials said.

Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, said a similar trial will begin in HIV-infected children and youth next week.

“These studies are important because HIV infection and pregnancy both increase the risk for a poor immune response to the normal 15-microgram dose of seasonal influenza vaccine given to the general population,” Fauci said in a statement. “Moreover, children, young people and pregnant women are at higher risk for more severe illness from the 2009 H1N1 influenza virus than other groups, and HIV-infected individuals in these populations may be particularly vulnerable.”

One trial will enroll 130 HIV-infected pregnant women ages 18-39, who are in their second or third trimester of pregnancy. The other trial will enroll 140 children and youth ages 4-24 infected with HIV at birth.

The Catholic church’s Lazarus complex over HIV-Aids

 More talk about the Catholic Church and condoms. 

So here we are again, talking past one another on the subject of condoms, Aids and Africa. Tanya Gold says the pope’s got it all wrong. Giuseppe Caramazza defends the pontiff, under the headline “the condom is no cure for Aids in Africa“.

Let’s get some facts straight. Condoms prevent HIV. And if we prevent HIV, then we prevent Aids, without having to put millions into the bank accounts of pharmaceutical companies. Caramazza toes the papal line, implying that African countries with higher rates of condom use have higher rates of HIV, and that condoms therefore don’t work in preventing HIV. Well, more people use insecticide-treated bed nets in west Africa than they do in Britain, and west Africa has far higher rates of malaria. Proof, by Caramazza’s logic, that treated bed nets don’t work as protection against malaria.

He also holds up the example of Uganda as a country that has promoted abstinence and seen HIV infections fall. I must correct him. Uganda aggressively promoted condoms as well as abstinence and fidelity from the early 1990s until the early 2000s. People began to wait on average a year longer before becoming sexually active. Once active, they were more faithful to their chosen partners, and used condoms much more frequently with the casual partners they did have.

All of this in combination did, indeed, cut the number of new infections. Then, around five years ago, Uganda started to receive vast slabs of money under the US government’s Pepfar (President’s Emergency Plan for Aids Relief) programme, which was driven by rightwing Christians. A good proportion of the money was spent on the abstinence-only sex prevention programmes, which have failed so miserably in the United States. Shortly afterwards, the slow slide in new HIV infections that we had measured in rural areas over the previous decade stopped, and there are indications that new infections are actually rising again.

The Ugandan data has been so badly tortured by both promoters and opponents of condoms that it has confessed to just about anything asked of it, so it’s not Caramazza’s confused interpretation that upsets me. What I object to (as a Catholic, and one who has worked, like him, in Kenya) is the Catholic church’s distorted approach to compassion, which his words shine a light upon. He rightly points out that “the church cares for the victims of Aids”, that many of the organisations caring for those infected and their families are Christian. Half of all Aids projects in Africa are run by Catholics. I’m prepared to bet that almost all of them deal with “victims”.

It seems it is absolutely fine to show compassion for people once they’ve become infected with HIV, to care for them, to provide fabulously expensive drugs to raise them off their deathbeds. But this Lazarus complex seems to me only half-Christian. Why can’t we extend our compassion to those who are not yet infected, and provide them with all the information and tools they need to stay uninfected? Whether the pope likes it or not, those tools include condoms.

Sex education for four-year-olds

Children as young as four are to become the youngest in Scotland to be given sex education lessons under a new curriculum from Glasgow City Council.

Lessons begin in P1 with children being taught about body parts and conclude in S6 with classes on sexually transmitted infection, especially HIV and Aids.

However, the Scottish Conservative Party said there would be “massive concerns” about the scheme.

It said parents would question the need to involve primary one pupils.

The new sexual health and relationships curriculum was piloted in 13 primary and two secondary schools.

The council said teachers, pupils and parents gave it “overwhelming support”.

Maureen McKenna, service director of education, said the programme was devised to build knowledge year-on-year.

“What we have is a broad curriculum which deals with emotions, friendships, self-esteem and respect as well as physical development and sexual health,” she said.

Many parents will question whether this is really the most appropriate priority in primary one classes – especially when there is yet more evidence published today that Scotland is performing poorly when it comes to teaching children to read, write and count Liz Smith MSP Scottish Conservatives

“From P1 onwards, topics and issues are introduced at an appropriate age and handled in an appropriate way. It is tailored to meet the needs and development of young people in Glasgow.

“Parents have a crucial part to play too and by keeping them involved through supporting their child’s learning they are prepared for any questions that may crop up at home.”

Following the pilot period in 2007/08, the curriculum was extended across other areas in the east end of Glasgow.

The roll-out is continuing in the north and west of the city during this academic year with plans now being put in place to extend the curriculum across the remaining areas of Glasgow.

Councillor James Coleman, who chairs Glasgow’s young person’s sexual health steering group, said the curriculum could be “a blueprint for others to follow”.

‘Significant step’

“Both parents and children made it very clear to us they wanted to be closer to one another on this issue and this curriculum allows for that to happen,” he said.

“Stronger bonds between parents and their child help to encourage young people to delay engaging in sexual activity until they are physically and emotionally equipped to deal with the consequences.

“What we are now rolling-out in Glasgow represents a significant step forward in the provision of sexual health and relationships education.”

The Scottish Conservative spokeswoman for schools, Liz Smith, said there would be “massive concerns” about the new curriculum.

“Children as young as four – and just out of nursery – will be involved in this new curriculum,” she said.

“Just how well can they be expected to cope with understanding even some of the more simple facts in what is a very complex and sensitive issue?

“Many parents will question whether this is really the most appropriate priority in primary one classes – especially when there is yet more evidence published today that Scotland is performing poorly when it comes to teaching children to read, write and count.”

New HIV cases set to increase

From tribune242.com:

By ALISON LOWE

Tribune Staff Reporter

alowe@tribunemedia.net

 

THE number of new HIV cases in The Bahamas is set to increase, health experts have revealed.

If trends recorded in the early part of this year hold until its end, this year will see a worrying rise, said Dr Perry Gomez, director of the National AIDS Programme.

From January to April 2009 Mr Gomez said 57 more people — 29 men and 28 women — were added to the list of people infected with the virus in The Bahamas.

Meanwhile, during the same period, 42 people with HIV saw their disease progress to the critical AIDS stage of the illness, resulting in 22 deaths during those four months.

“If we multiply 57 times four, we get 228. That would be more than we had last year. We’ll have to see how things pan out,” said Dr Gomez.

This potential rise in new HIV cases comes even as the National AIDS Programme has had impressive success in minimising the number of cases which are progressing to the critical AIDS stage of the disease, suggesting that while access to treatment and education in this regard has had an impact, people are still not getting the message about HIV prevention.

Dr Gomez disclosed the latest figures as he, with President of the AIDS Foundation Camille Barnett, and organisers of this year’s Red Ribbon Ball appealed to the public to continue to support the annual fundraising gala despite hard economic times.

Tickets are $200 each for the November 21 event, which has over the past 16 years raised $700,000 for the AIDS Foundation — a non-governmental organisation that assists in providing education, counselling, housing, medication and other basic necessities to people “infected and affected” by the virus.

Sandra Knowles, a director at major sponsor Colina Imperial Insurance Ltd and co-chair of the organising committee for the ball, reminded the public that “need knows no season” and now is not the time to give up on supporting the HIV/AIDS fight.

“We are hoping to raise at least $50,000…but if we could maintain what we got last year, that would be a miracle and God’s blessing,” said Mrs Knowles.

Mrs Barnett noted that within the next couple of months the AIDS foundation is embarking on a new outreach initiative which will cost a significant amount of money.

The programme, aimed at providing support to adolescents suffering from HIV/AIDS, is expected to see trained professionals connect with the young people, who often struggled to cope with their healthcare regimes, on a weekly basis.

“The foundations wants to assist these young people to achieve their right to health and right to life. We would like to empower these youths to truly believe they are accepted, safe and well,” said Mrs Barnett.

In this regard, Dr Gomez commented on the case of a 20-year-old man born with HIV as a result of his mother being infected who died in the last six weeks, “in short, because of neglect.”

“He had no support, he lived alone, aged 20, parents deceased, no help,” said Dr Gomez.

Despite advances made by the National AIDS programme and the AIDS foundation, the NAP director said the fight against HIV/AIDS still has a long way to go in The Bahamas and therefore still needs the support of members of the public and corporate donors.

Highlighting this, he noted that although The Bahamas has been described as a model of best practice for reducing mother-to-child HIV transmission, last year saw four babies born with HIV to HIV positive mothers.

“Stigma and discrimination remains a huge problem that keeps people away from care. In the mother-to-child programme we went for a few years with almost no transmission at all from mother to child in people who came for care.

“We normally have one or two (babies born with HIV each year). Last year we had four women who had no ante-natal care, so we had four children born with HIV last year.

“That’s the most we’ve had in ages and so there’s still a lot to do with maintaining the programme of awareness and care and making sure that people get in for care,” said Dr Gomez, who also noted that The Bahamas’ standout reputation for good ante-natal care for HIV/AIDS infected mothers has seen numerous women travel here in recent years from across the region seeking care in the country’s public clinics.

Providing a cumulative overview of the impact of HIV/AIDS in the Bahamas since it was first detected in this country, Dr Gomez said that up to the end of 2008 a total of 6,103 people in The Bahamas have contracted AIDS — 3,626 men and 2,477 women. Of these, “4,000 plus” have died already, or 66 per cent, while 2,078 are “alive and living well with AIDS.”

Meanwhile, up to the end of 2008 there was also a cumulative total of 5,387 people infected with HIV, 2,678 men and 2,726 women.

That means that there are around 7,400 people living in The Bahamas at the moment who are known to be infected with HIV/AIDS, with a current “one to one” male to female ratio — a change from the historically greater prevalence of HIV/AIDS in men than women.

Dr Gomez noted that there are also “certainly people who have HIV/AIDS and do not know because they have never been tested”, meaning that the actual rate may be much higher.

 

 

Helping couples cope with single HIV diagnosis

From TheStar.com:

 

Program helps Africa’s ‘discordant’ couples stay together and healthy through counseling, communication

Oct 05, 2009 04:30 AM

Global Voices
When Lucy Emmanuel learned her husband had tested positive for HIV, she cried.

After nine years of marriage, the 32-year-old from Arusha, Tanzania attempted to process her fears. Lucy tested as well. It came back negative but she found little relief. She worried about her own health and that of her two young children.

Mostly, she worried about her marriage.

An opportunistic infection brought Lucy’s husband, Emmanuel Ndolimana, to a clinic. It took him three weeks to tell his wife about the positive result. When he broke the news, he made a request – please stay with me, please be okay with it and please help find a way to work through this.

“I put myself in his place,” she says. “I thought, ‘What if it was me?’”

There is no greater test of the vow “in sickness and in health” than a single positive HIV test. Yet, discordant couples – where one partner is HIV-positive and the other negative – are prevalent throughout Africa.

Despite the fear of disclosure and the challenges of the disease, through counseling, couples like Lucy and Emmanuel are staying together, staying healthy and making their marriages work.

“We enforce a positive prevention strategy where we prevent them from infecting their partner,” says Cayus Mrina, project coordinator for the African Medical and Research Foundation’s (AMREF) Counseling Discordant Couples Project in Tanzania. “To be able to have the skills to disclose and bring up the issue of communication with them and other community members, these are the key things.”

Due to the stigma associated with HIV, many fear repercussions for disclosure. There is the risk of transmitting the disease to a loved one. There are also the social challenges. Women especially fear being thrown out of the home and ostracized by the community due to male-dominance in the culture.

For most couples involved, it is the woman who is HIV-positive. Pregnancy means women are more likely to get tested.

“Disclosure is especially low when there is no couple counseling,” says Dr. Florence Temu, AMREF’s Deputy Country Director. “The issue of fear is there.”

Despite their nervousness, Lucy and Emmanuel enrolled in AMREF’s program.

Emmanuel was determined to keep Lucy and their marriage healthy.

In their session, the focus was communication. They discussed prevention methods like sustained and proper condom use. At the same time, they talked about antiretroviral drugs and the importance of a nutritious diet.

From there, they learned how to strengthen their marriage and acceptance of their new marital status.

“Women are linked into peer support clubs,” says Mrina. “For the few men who are HIV-positive, we encourage them to create a forum for discussion at home.”

Through the practices they learned, Lucy has been able to stay HIV-negative. They have found others who share similar challenges. Their community even started a club. Emmanuel serves as its chair and members openly discuss stigma, prevention and health.

Most importantly, the couple says their love for each other has deepened.

“He takes good care of me,” says Lucy. “He loves me very much.”

The couple still faces challenges. The two have come to accept the positive test result, but others outside their marriage are less tolerant. Emmanuel left his job when he became ill. Now, he is concerned he won’t be able to find an employer who will hire an HIV-positive worker.

At the same time, Lucy worries their extended families will start questioning why she hasn’t produced any more children.

But, these are all issues Lucy and Emmanuel are slowly addressing with their counselor. Emmanuel describes his wife as kind and says he appreciates her acceptance of his status. Both say they love each other very much and that their marriage is strong.

Despite the challenges, their vow is to work through them together.

Marc and Craig Kielburger are children’s rights activists and co-founded Free The Children, which is active in the developing world. Their column appears Mondays online at www.thestar.com/globalvoices

Craig and Marc Kielburger