Publications

Interactions between antiretroviral therapy (ART) and food and nutrition can affect medication efficacy, nutritional status, and adherence to drug regimens. Drug-food interactions consist of the effects of food on medication efficacy, the effects of medication on nutrient utilization, the effects of medication side effects on food consumption, and unhealthy side effects caused by medication and certain foods. As ART interventions scale up in resource limited settings, addressing food and nutrition implications becomes a critical component of care and support programs and services. This technical note summarizes the types of ARVs commonly used; offers a framework for understanding drug-food interactions; describes key issues and steps for managing ARV-food interactions; identifies areas where knowledge gaps exist; and lays out the specific food and nutrition implications of ARVs commonly used in resource limited settings. This information aims to support program design and service provision.

Nepal's first cases of HIV/AIDS were reported in 1988. At the end of 2003 it was estimated that 62,000 people were living with HIV/AIDS. The epidemic assessments reveal a low prevalence among the general population and that so far HIV/AIDS is still concentrated among certain groups like Female Sex Workers (FSW), Intravenous Drug Users (IDUs) and labor migrants. However as shown by global experience and specific studies conducted in Nepal the young people remain highly vulnerable to the disease. In an effort to strengthen its national response to HIV/AIDS, Nepal established a National Center for AIDS and STD Control (NCASC) and a National AIDS Council that in October 2002 endorsed the National HIV/AIDS strategy. Prevention of new infections among young people is one of the 5 key priority areas identified in the strategy and therefore young people shall receive greater attention in future HIV/AIDS-related programming.

Indonesia, the world’s largest archipelago, with a population 214,8 million is now the forth most populated country in the world. Young people age 15-24 represent approximately 30% of the population (UNICEF, WHO, UNAIDS 2002). The HIV epidemic in Indonesia is concentrated, with still-low HIV infection rates in the general population, but high rates among certain populations. As of March 2004, the MoH reported 2,746 HIV and 1,413 AIDS cases, bringing to a total 4,159 reported HIV/AIDS cases and 493 AIDS related deaths in Indonesia. The number of Indonesians living with HIV/AIDS is estimated by the Government at 90,000 to 130,000, the majority of whom are unaware of their seropositive status. It is estimated that unless behaviour changes, another 80,000 Indonesians will have become newly infected in 2003.

Young people are under threat from HIV/AIDS. Of the estimated 40 million people in the world now living with HIV/AIDS, more than a quarter are aged 15 to 24. Half of all new infections occur in young people. In addition over 10 million children have been orphaned by AIDS and face life without parental protection and guidance, poverty, and social inequality.

Over the last few decades, the eyes of much of the world have turned toward Asia and the Pacific. In many countries in the region, economic growth has taken off, poverty has decreased, and people are better educated and healthier than ever before. Not all of Asia has participated equally in these wide-ranging social and economic changes, but much of the region is moving ahead. Despite this picture of promise, however, HIV/AIDS poses a threat that cannot be ignored. In Asia and the Pacific, as in the rest of the world, the number of those infected with HIV is increasing rapidly, as is the number of people in whom the infection has progressed to the disease of AIDS. Treating AIDS is expensive, but not treating it—allowing it to spread even faster – may be even more so. In this way, too, the countries of Asia face an enormous challenge.

Mother-to-child transmission is the main way children become infected with human immunodeficiency virus (HIV) worldwide. To date, the primary approach to the prevention of mother-to child transmission (PMTCT) has been to identify HIV-infected pregnant women by voluntary counseling and testing (VCT) for HIV and then provide antiretroviral (ARV) drug prophylaxis to them during delivery and then to their newborn infants. Many HIV-positive births could be prevented, however, by simply preventing unintended pregnancies among infected women. Furthermore, increasing contraceptive use to prevent such pregnancies appears to be at least as cost-effective as providing nevirapine to HIV-infected mothers. Minimizing HIV-positive births likely will be best achieved through a combination of various approaches, including the prevention of HIV infection among women of reproductive age. The degree to which any one approach should be emphasized will depend on factors unique to particular settings, such as HIV prevalence, client needs, and service-delivery capacity. 

In Cambodia, AIDS is reaching the general population. With an HIV/AIDS prevalence reaching 3% (2003) of the adult population, Cambodia is the country with the highest infection rate in the Asia and Pacific region. Mobility of the population and in particular rural exodus is increasing vulnerability of the people. Although the AIDS epidemic is now well established into the general population, commercials sex workers and drugs users represent potential groups that can transmit the virus to their clients/partners. Prevention efforts targeting young people should therefore be reinforced and continued. That is the reason why UNICEF, together with UNESCO is supporting the Ministry of Education, Youth and Sports for the conduction of a Youth Risk Behaviour Survey carried out on a national scale. The survey will provide key information on risk behaviour taken by young people and will make a new baseline about Cambodian youth. 

The HIV epidemic in Bangladesh, from an epidemiological perspective, is evolving rapidly. While still a low prevalence country for overall HIV rates, a small pocket of IDU under second generation surveillance has shown an HIV prevalence increased from 1.4% to 4% to 8.9% (in one locality) in the past three years. Simultaneously recent Behavioral Surveillance Survey (BSS) data indicate an increase in risk behaviors such as sharing of injecting equipment and a decline in consistent condom use in sexual encounters between IDUs and female sex workers. BSS data also indicate that the IDU population is well integrated into the surrounding urban community, socially and sexually, thus raising grave concern about the spread of HIV infection.

This report is based on a mapping of HIV vulnerability along selected sections of secondary and tertiary feeder roads along National Road Number Six. This mapping was done as part of the preparatory phase of the World Bank Provincial and Rural Infrastructure Project (PRIP). This project aims at reducing rural poverty through economic and social development, thus facilitating the reintegration of the four target provinces into mainstream national development. The development objective of the PRIP is to provide sustainable and safe access to markets and essential services for people located in rural areas of Kampong Thom, Siem Reap, Odor Meanchey and Preah Vihear. The increasing prevalence of HIV takes away the benefits from rehabilitation and development of the road system. The ASEAN leaders recognized the importance of the Chiang Rai Recommendation, adopted in 1999, when they again reiterated the importance of regional cooperation in reducing HIV vulnerabilities related to population movement and development at the ASEAN summit in 2001.

This study was conducted in order to determine the prevalence of men having sex with men (MSM) and their HIV related behaviours and attitudes among Chinese men in Hong Kong. Methods: A large scale, random, population based, anonymous telephone survey of 14 963 men between the ages of 18–60 was conducted. The overall response rate was approximately 57%.