Some health workers and advocates in Kenya's North Eastern Province recently said that HIV/AIDS awareness campaigns face difficulties in the region because of its remote location and culture, IRIN/PlusNews reports. Ijara, a district in Kenya's North Eastern Province, has recorded the lowest number of people living with HIV in the province at 130. However, the "stigma associated with HIV/AIDS is very, very strong here," Mohamed Abdikadir Sheikh, Ijara's medical officer, said. According to Sheikh, HIV/AIDS still is associated with magic, witchcraft and evil spirits by many people in the region, leading them to seek ritualistic instead of medical treatment. The voluntary HIV counseling and testing center in Ijara "remains idle because the local community believe they cannot contract the disease," Sheikh said, adding, "We need an aggressive awareness campaign in these remote areas."According to IRIN/PlusNews, the remoteness of the area, cultural taboos and the transient nature of the population create difficulties for groups already working to create HIV/AIDS awareness. The group Isiolo Youths Against AIDS and Poverty said it is limited in its abilities to spread awareness in the region because of a lack of resources and ethnic conflicts. Ali Boru, an IYAP official, said open discussions of sex and sexuality are discouraged by the largely Muslim population, adding, "We have no picture or poster of a condom here -- we cannot take the risk." According to IYAP official Amina Abdullahi, the young age of the group's educators also hinders awareness efforts because the "culture does not allow me to advise or discuss any sexual matter with a woman who is older than me" (IRIN/PlusNews, 8/21).

A program that will provide employees in Namibia who work at sea with information on HIV/AIDS and focus on antiretroviral treatment is in an advanced stage of development, the New Era/AllAfrica.com reports. According to the New Era/AllAfrica.com, the program is needed to address this group's vulnerability to HIV/AIDS because of a lack of information and to ensure that HIV-positive employees do not miss scheduled doses of antiretrovirals. Representatives from the Ministry of Health and Social Services , fishing companies and other HIV/AIDS service providers met last week to create a committee that will oversee the program's implementation.According to assessments, the extended period of absence at sea can disrupt the antiretroviral regimens of employees living with HIV/AIDS because they often are unable to take the drugs at sea. Although the health ministry does make arrangements for HIV-positive employees to receive treatment, most employees are unaware of such arrangements, the New Era/AllAfrica.com reports.Immanuel Mwilima of the Walvis Bay Multi-Purpose Centre Trust , which will lead the program, said the initiative could be effective in addressing the vulnerability of sea-going employees to HIV/AIDS. "Such a program will cater for the very basic needs in form of information and education for seafarers when it comes to HIV/AIDS," Mwilima said, adding, "These people are very vulnerable, as most information does not reach them due to their extended length of stay at sea."Mwilima added that Namibia will pilot the program and that if successful, it could be rolled out to other countries. "We have very high expectations for this program and will do everything possible to make sure that it succeeds. If successful, Namibia could be used as a model for other countries facing the same scenario worldwide," Mwilima said (Tjatindi, New Era/AllAfrica.com, 8/21).

The Wall Street Journal on Monday examined a new trend for drugmakers marketing HIV/AIDS treatments to release ads that "tak[e] aim at rival HIV drugs, hinting at side effects and other drawbacks." Drug companies have "traditionally sold" antiretrovirals "with images of hope and by explaining the benefits of their treatments" and the "tough new tack has some patient groups unsettled, saying it could scare off patients," according to the Journal. A recent GlaxoSmithKline ad shows shark-infested waters with the message: "Don't take a chance -- stick with the HIV medicine that's working for you." According to the Journal, another GSK ad in the monthly magazine Poz promotes the drugmaker's protease inhibitor Lexiva and advises patients to ask their physicians, "Will the HIV medicine make my skin or eyes turn yellow?" Other protease inhibitors have been associated with such a side effect, the Journal reports.The AIDS Healthcare Foundation sent a letter to HHS last month expressing concerns about GSK's ads. The organization said it has not yet received a response, but a spokesperson for HHS said it has not received the letter. In addition, Bob Huff, antiretroviral project director at Treatment Action Group , said he complained to GSK about the shark-themed ad. Huff said the ad is offensive and intended to create fear among HIV-positive people.According to GSK, the ads are "educational" and appropriate. Marc Meachem, a spokesperson for the company, said in a statement, "While we acknowledge that some people may find the headline and imagery of the materials to be provocative, GSK stands firmly behind the ads and their underlying message: Patients considering changing HIV therapy ought to consult closely with their physician to fully understand the near and potential long-term health implications of such changes."Meachem said the ads are "just as likely to encourage a patient to stay with another medicine as it is one of our own, assuming that the medicine is working for a patient and is well-tolerated." Meachem said that he is aware of the concerns regarding the ads, adding that the shark-themed campaign "ends this September, and, as always, we will take all the community feedback we have received into consideration for future campaigns."A recent print ad from Bristol-Myers Squibb shows an image of a toilet and says, "Ask your doctor if there are HIV medications with a low risk of diarrhea." Diarrhea is a side effect associated with Abbott Laboratories ' Kaletra, but not BMS' Reyataz. BMS spokesperson Brian Henry said the ad is appropriate. Abbott spokesperson Melissa Brotz said, "Kaletra has a well-established side-effect profile and profound and sustained effectiveness in combating HIV."According to the Journal, part of the push behind the new "sharp-elbows advertising" is that the "market for HIV medicines has grown crowded and companies want to protect their market share." While GSK is one of the world's biggest sellers of antiretrovirals, its medicines are older and its share of the $11 billion global antiretroviral market has dropped from 39% in 2004 to 25% currently.Regan Hoffman, editor of Poz, said, "Treatments have become so comparable, so [companies] are really trying to split hairs to have a marketing advantage" (Whalen/Wang, Wall Street Journal, 8/25).

CDC on Friday announced that it will no longer fund an advanced HIV/AIDS monitoring system in eight states and Puerto Rico, the New York Times reports. The eight states are Georgia , Illinois, Maryland, Missouri, Ohio, Oklahoma, Pennsylvania and Tennessee. According to the Times, the system uses a new test that distinguishes recent HIV infections from old ones, which helps "epidemiologists track [infections] in something much closer to real time than was previously possible." Data from the advanced system were used in a recent report on new HIV infections in the U.S. based on 22 of the 34 states using the test, Terry Butler -- spokesperson at the National Center for HIV, STD and TB Prevention -- said. Butler added that future monitoring will include data from all 25 jurisdictions. The change in CDC funding will reduce the number of states using the advanced system from 34 to 25. Total funding for the advanced testing method will remain the same but the 25 states will receive a larger portion of funding, Butler said. Butler added that the 25 states that will continue using the advanced test have the most reliable systems and could help CDC produce the most accurate estimate of HIV infections in the U.S. Julie Scofield, executive director of the National Alliance of State and Territorial AIDS Directors , said that more extrapolations would be necessary to estimate HIV infections nationwide if fewer states use the advanced test.Scofield added that federal funding for HIV surveillance has decreased and that many states are struggling to meet CDC standards for HIV monitoring. She estimated that the eight states and Puerto Rico lost about $3 million in CDC funding with the announcement. "Surveillance funding is starving at the CDC," Scofield said, adding, "Their ability to say that they're going to have ongoing reliable reports of [HIV] incidence is somewhat questionable unless you have funding for that." NASTAD has called for a $35 million increase in funding for HIV surveillance efforts, the Times reports (Dewan, New York Times, 8/22).

CDC officials on Thursday confirmed that the agency has stopped funding for Georgia to participate in a "cutting-edge" surveillance program aimed at determining trends in HIV/AIDS nationwide, the Atlanta Journal-Constitution reports. The first results from the program about annual new HIV infections in the U.S. were announced by CDC earlier this month. Georgia had received more than $1 million in CDC funding to participate in the program, but CDC removed the state from its latest round of funding, which began in January and runs for five years. According to state officials, Georgia will still track and report HIV/AIDS cases, but it will not benefit from new technologies and methods available from the CDC program. For example, one of the new technologies available in the program is an HIV test that can determine if an HIV-positive person contracted the virus within the past five months, according to the Journal-Constitution. State officials have said that the CDC program estimated that 2,100 people in Georgia were newly infected with HIV in 2006, adding that they could not put this figure into perspective because they have no previous numbers for comparison. CDC officials said that the test can help determine "real time" trends about where HIV/AIDS is spreading and what groups it is affecting. "It's a setback," Carlos del Rio, co-director of the Emory Center for AIDS Research , said of Georgia being cut from the program. He added, "In order to have effective prevention, we need to know who is getting infected today, not 10 years ago." CDC officials would not discuss why Georgia was not included in the latest funding round but said that the state was not among the 25 areas that were selected following an application process. Irene Hall, chief of CDC's HIV/AIDS incidence and case surveillance branch, said that Georgia had provided "adequate" data during the program's first round. She added that CDC has reduced the number of areas funded under the program from 34 to 25 cities and states. CDC has increased funding for Georgia's basic HIV/AIDS surveillance by 70% this year to $726,257. According to Jennifer Taussig, state HIV/AIDS surveillance coordinator, the additional funding will be used to bolster reporting efforts. Some advocates said that Georgia never has been at the forefront of HIV surveillance, testing or prevention and that the loss of CDC funding worsens the situation. According to Jeff Cheek, local director of Georgia's Ryan White Program funding that is allocated to 20 counties in the Atlanta area, the state should increase its efforts to promote HIV testing and prevention (Schneider, Atlanta Journal-Constitution, 8/22).

A bill seeking to promote the development of microbicides to prevent HIV and other sexually transmitted infections has been introduced in the Philippines, the Philippines News Agency reports. The legislation was filed by Rep. Narciso Santiago and states that the Department of Health and its components should increase research into the initial mechanism of infection by STIs. The bill also mandates that the health department evaluate the safety and efficacy of microbicides in animal models; research the design of contraceptive and non-contraceptive microbicides; examine the development of a mucosal delivery system; and create clinical trials and behavioral research on the use, acceptability and compliance of microbicides. According to Santiago, the social, health and economic effects of STIs are particularly severe in developing countries such as the Philippines, where women ages 15 to 49 are most affected. Santiago said the STIs that could be prevented by the use of microbicides "impose high human costs in pain, diminished quality of life, disability and death," adding that STIs "substantially enhance susceptibility to HIV infection." According to Santiago, he hopes the legislation will "lessen if not totally stop" the spread and impact of STIs. Hepatitis B, herpes, HIV and human papillomavirus represent two-thirds of new STIs recorded in the country, Santiago said (Philippines News Agency, 8/21).

A team of researchers is examining how different perceptions of masculinity can influence HIV prevention messages in Central America, the Columbia State reports. The team, which is supported by USAID and Population Services International , has held focus groups with 1,200 men from El Salvador, Guatemala, Nicaragua and Panama to learn about different perceptions of masculinity and how the men see themselves. The men completed 11-point surveys on issues such as what motivates them, what is important in life and what word best describes them. Using the surveys, the researchers developed six primary categories to which HIV/AIDS prevention messages can be customized, according to the State. "It's another approach for behavioral change messages," Susana Lungo, program director for the initiative, said. The six primary categories are powerful, men to whom researchers should stress that they have the power to choose condom use; energetic, who can be reached by emphasizing that they can make a contribution to the fight against HIV/AIDS; protector, who should be given messages about fidelity and condom use for the sake of protecting their families; relaxed, who tend to be receptive to condom use because of generally open attitudes; searchers, to whom condom use has to be presented in interesting and engaging ways; and passionate, men who are receptive to fidelity and condom use messages out of respect for their partners. According to the researchers, although the categories were developed to promote HIV prevention, they also can be used for teenage pregnancy prevention and other health issues (Reid, Columbia State, 8/21).

Vietnam's General Department of Population and Family Planning under the Ministry of Health on Tuesday launched an HIV/AIDS awareness campaign that promotes safer-sex practices among young people in the country, the VNS/Viet Nam News reports. The campaign will focus on youth ages 15 to 24 in 15 provinces with large ethnic minority populations. It falls under the framework of a $20 million campaign funded by the Asian Development Bank and implemented by the population and family planning department between 2007 and 2011. The HIV/AIDS youth campaign is the largest of its kind launched in Vietnam, according to VNS/Viet Nam News. It aims to reduce HIV/AIDS prevalence to less than 0.3% by 2010, according to a population and family planning department official. In addition, the project will focus on implementing Vietnam's national HIV/AIDS strategy, which includes prevention and outreach programs at the provincial and district levels (VNS/Viet Nam News, 8/21).

IRIN/PlusNews on Wednesday profiled Bellissima, an Ethiopian cafe located in the capital of Addis Ababa that provides no-cost "Sensation" brand condoms with every order. Hayat Ahmed, 2003 Miss Ethiopia and owner of Bellissima, said that as the brand ambassador for "Sensation" condoms in the country, she "wanted to link business with a message for sexually active people." According to IRIN/PlusNews, the cafe's concept is modeled on "condom bars" in Asia. Within the first two days of business, the cafe handed out six boxes that contained 48 packets of three condoms each. The campaign is supported by social marketing groups like DKT Ethiopia , and Ahmed said she plans to open more cafes around the country and promote other HIV/AIDS prevention strategies, such as fidelity and abstinence. Ahmed said that many Ethiopians are "ashamed" to discuss condom use and that she wants to "spread the message that condoms can protect you from HIV/AIDS." According to IRIN/PlusNews, the no-cost condoms have "elicited mixed reactions, with older patrons tending not to like the idea, while younger ones love it and sometimes ask for a second packet." Ahmed added that she plans to set up condom vending machines in the cafe (IRIN/PlusNews, 8/20).

About 12,000 of the 50,000 HIV-positive children in Uganda who are in need of antiretroviral therapy are receiving the treatment, delegates said on Wednesday during the second annual national pediatric HIV/AIDS conference in Kampala, Uganda, the Monitor reports. According to the Monitor, there are currently 110,000 HIV-positive children living in the country (Kirunda, Monitor, 8/21).First lady Janet Museveni at the conference said that despite increasing access among adults to HIV prevention, care and treatment in Uganda, the number of children accessing the services remains low. "Access to care and treatment for children still falls far below that of adults," Museveni said, adding that out of Uganda's 310 antiretroviral clinics, only 174 provide the drugs for children. "The children also need psycho-social support, which is also limited," Museveni added (Bugembe, New Vision , 8/20). According to Museveni, "This horrendous scenario is something that we must address without flinching" (Monitor, 8/21).Kihumuro Apuuli, director-general of the Uganda AIDS Commission , also told the conference that efforts to reduce new HIV cases among children in the country should start with prevention of mother-to-child transmission (New Vision, 8/20). Every year, 22% of new HIV cases in Uganda -- or 25,000 cases -- are the result of MTCT, according to Apuuli, with 91,000 HIV-positive women becoming pregnant annually (Monitor, 8/21).Some people in Uganda were "born in an AIDS-free generation," Apuuli said, adding, "It is our moral responsibility to ensure that our children and grandchildren are born and remain free from HIV/AIDS" (New Vision, 8/20). In addition, Apuuli said it is possible for Uganda to reduce the number of HIV cases among children but added that "[p]olitical will needs to be re-energized." Conference Official Phillipa Musoke said that although there have been "pockets" of success in pediatric HIV/AIDS efforts, much progress still needs to be made (Monitor, 8/21).