Safe sex

Marion Stevens, treatment monitor with the Health Systems Trust, reflects on adolescent sexual and reproductive healthcare during Youth Month.

With June being Youth Month, it's important to consider and reflect on the area of adolescent sexual and reproductive healthcare. This is an area that is often ignored as we grapple with the reality that adolescents are choosing tobe sexually active, but cultural practices often limit open communication about sex with our cllildren. As nurses we have a responsibility to provide care of adolescents' sexual health, which also includes the results of unplanned pregnancies,abortion, spread of sexually transmitted infections (STIs) including HIV and maternal mortality and morbidity.

The first anti-AIDS vaginal gel to make it through late-stage testing failed to stop HIV infection in a study of 6,000 South African women, disappointed researchers announced Monday.

The diaphragm contraceptive device does not help to prevent HIV infection, according to the results of a three-year trial published in the Lancet today.

28 MARCH 2007 PARIS/GENEVA -- In response to the urgent need to reduce the number of new HIV infections globally, WHO and the UNAIDS Secretariat convened an international expert consultation to determine whether male circumcision should be recommended for the prevention of HIV infection.

Circumcision can halve the risk of a man picking up the HIV infection that leads to Aids, scientists in the United States said on Wednesday night. Two major trials, in Kenya and Uganda, have confirmed what doctors and campaigners have suspected and hoped for several years. The results have major implications for the fight against the Aids pandemic raging in Africa and Asia.

This World AIDS Day - 1st December 2006 - marks the 18th anniversary of the first ever World AIDS day, held in 1988, where the theme was Communication. The age of 18 years is synonymous with coming of age, the rite of passage into adulthood where a person becomes legally responsible and accountable for their lives. Therefore, it is appropriate that the theme this year is Stop AIDS: Keep the Promise Accountability. With events marking this day across the world, perhaps we need to stop for a few moments and consider what the term accountability actually means, specifically in terms of HIV/AIDS.

Certain cultural factors in resource limited settings pose significant challenges to prevention efforts and must be addressed to make it possible for people (especially youth) to adopt behaviours such as abstinence, being faithful, and correct and consistent condom use (ABC) according to several presentations at the 2006 PEPFAR Implementers Meeting held mid-June in Durban, South Africa. Some PEPFAR-funded prevention programmes are attempting to change cultural norms around polygamy, cross-generational sex, male attitudes towards women, sexual coercion and violence, taboos surrounding discussing sex, economic pressures and social expectations to have sex. Failure to confront these challenges could lead to the failure of prevention programmes, and could also have extremely negative unintended consequences including, potentially, the rape of girls known to be abstinent.

More than 5 000 Durban women have volunteered for the world's largest microbicides clinical trials that will test the efficacy of the anti-HIV product which, if successful, could prevent at least 2,5 million new infections in the developing world over the next five years.

The use of HIV testing and information about HIV status as an HIV prevention tool remains a complex and controversial area of debate, largely due to issues of trust trust in confidentiality of information, trust that healthcare providers will not test without consent, and trust that partners are telling the truth about their status. For all these reasons prevention experts have shied away from addressing the topic in the developed world, despite the fact that HIV testing is considered an essential ingredient in the prevention mix in low-income countries. At last months Thirteenth Conference on Retroviruses and Opportunistic Infections in Denver, it was clear that the issue of HIV testings role in prevention cannot be avoided any longer.