aug08-3

Beijing (dpa) - The offer is prompt: "Sex?" asks the prostitute as she approaches the two foreign tourists from a side street in Beijing 's Sanlitun entertainment district.

"How much?" asks one of the foreigners, slightly taken aback. "500 yuan" comes the reply with a charming smile. That's about 75 dollars. "For the two of you together."

The attractive Chinese, in her late 20s or early 30s, looks self- confident and experienced. She takes one of the foreigners' hand and doesn't let go. "Come on." Back to the hotel? Her place? "Whatever."

Those who watch over the morality of Beijing's nightlife may have closed down some of the dingier bars in a pre-Olympics "purge", but the oldest profession is alive and well - only, not as open.

Normally every foreigner getting out of a taxi at the entrance to the street full of bars in Sanlitun is bombarded with offers of "lady bar", "massage" or "sex" from the girls and their pimps.

During the Olympics, business has been swept into the sidestreets and clubs. The red light district is not quite as sinful as normal, but it's still far from innocent.

Isn't she afraid to be out on the street alone? Isn't there someone protecting her? "I work alone," says the girl. "300 yuan," she adds, quickly lowering the price.

But aren't the police especially strict during the Olympics? asks the foreigner. "They only bother about the Chinese, not you foreigners," she says, still not letting go of the hand.

Just 20 metres away stand two soldiers guarding the entrance of the diplomatic compound. They look on but do nothing. Their job is to stand guard, not stop prostitution.

Masses of football fans throng the street with the bars after Argentina 's 3-0 defeat of Brazil in the football semi-final at the nearby Workers' Stadium.

Bands play in the clubs, beer bottles clink at the doors, the fans chant and shout. A big, broad foreign bouncer blocks the entrance to the China Doll club, ordering the rich and beautiful back into an orderly queue.

"200 yuan, please," says a friendly Chinese woman at the cash desk - 30 dollars - for the men to get in. At the weekend the price can go up to 500 yuan. Attractive women get in for free.

Also allowed in free as Olympic medal-winners, and there have been quite a few sightings of them, too. Many of the guests also wear one of the Olympic family ID tags. And the music throbs.

Girls in short, turquoise-and-black dresses serve Qingdao beer for 50 yuan (7.5 dollars) - prices only the affluent night-clubbers can afford, or their expensive girlfriends, or the mistresses of wealthy Chinese all too aware of their market value.

In fact, prostitution is illegal in China . The girls - and their customers - face being sent to re-education camps. Occasionally the police will detain foreigners for a few days if they are caught in raids on brothels or massage salons.

However, the big danger is not from the police - who often look the other way - but from AIDS. After the disease was ignored for a dangerously long time, ignorance and a frequent change of partners have meant a strong increase in the number of people infected.

"Where's the Suzie Wong?" asks an Olympic tourist seeking the expensive bar by Chaoyang Park with more than its share of attractive women.

"You chat up three and score with one," laughs an insider. "Semi- professionals", perhaps - beauties with a daytime job financing their Gucci handbags and designer outfits. Or perhaps looking for the big catch - a rich Chinese or foreigner.

It's a dangerous game. Today there are an estimated 700,000 Chinese infected with AIDS, and it would be an achievement if this were only to double in the next two years. UN estimates say the number could rise to several million.

It's why several hundred thousand free condoms have been provided for the more than 10,000 athletes in the Olympic Village and guests in Beijing 's hotels.

Every second infection in Beijing today can be traced to unprotected sex. There is little "playing safe" in the Chinese capital, where a growing number of foreign students and business people are also becoming infected after a careless "adventure".

"I get more and more of these cases," says a doctor at one of the city's clinics for foreigners.

Chinese gay bars open, activism slowed during Olympics

The first paragraph of the Aug. 9 entry on John Amaechi’s blog could have been written by any Olympic tourist guilty of staying up too late to take in the local culture.

“I had to wake up at 6 a.m. this morning, which was not fun considering I had been up until 3 a.m., watching the opening ceremony and hanging out at ‘Destination’ again,” he wrote. “I have to say that it got busy very late — I am officially too old for bars that close at 5 a.m.”

Only Amaechi isn’t just any tourist, and Destination isn’t just any bar. Last year, Amaechi made worldwide headlines when he became the first NBA player to come out as gay, three years after retiring from professional basketball. And Destination is the most popular, contemporary gay bar in Beijing, which some activists had fretted would face closure as the Chinese government tried to strictly manage the city’s image during the Olympic Games.

Now, Amaechi, who once feared being ostracized in the sports world, is in Beijing to broadcast Olympic basketball games for the BBC. And the party at Destination continues, drawing a mix of Chinese citizens, ex-pats, and tourists.

“It is a sizeable club, very pleasant staff, which is not a given in every gay bar,” Amaechi told the Blade.

Amaechi noted a lack of racial diversity — “Not many black people about in Beijing outside of the athletes” — and a lack of dancing on weeknights, but otherwise found Destination to be similar to many high-end Western gay bars.

Destination’s Edmund Yang confirmed that the club, which recently expanded from one floor to two, is open and thriving with the Olympics underway.

“So far we have seen more foreign visitors coming to Destination,” he said. “We had a large crowd on the dance floor on Aug. 9, Saturday. The highlight of the night was most of them singing along to the chorus of ‘YMCA’ when I played this oldie towards the end of my set.”

But while gay nightlife has continued in Beijing during the Olympics, Chinese activists acknowledge that the Games have impacted their work.

“There are many new regulations on security, such as Internet censorship, travel, migrant workers in Beijing,” said Bin Xu, who leads an organization for lesbian and bisexual women based in the Chinese capital. “We have to be careful with our work to avoid intriguing safety concerns.”

The heightened security and general restrictions in place during the Games make activist work almost impossible, agreed Damien Lu, a volunteer with Aibai Culture & Education Center, which operates two gay centers and a gay library.

“Most LGBT groups, particularly those in Beijing and surrounding areas, have completely suspended their work during the Olympic period, partly because of logistic reasons (transportation problems, etc), partly because the Beijing public security has become hysterical and closed down many entertainment venues, gay or otherwise,” said Lu, who lives in Los Angeles but travels to China frequently for gay rights work and maintains constant contact with activists there.

“Since many of these groups’ work consists mainly of conducting outreach at these venues, it effectively made it impossible for them to continue,” he said.

‘Homosexuality and AIDS’

Olympic visitors to Beijing will also see another familiar symbol: the ubiquitous red ribbon that has come to recognize the fight against HIV.

According to reports in state-run Chinese media, the Red Cross Society of China plans to pass out thousands of copies of “Together for HIV and AIDS Prevention: A Toolkit for the Sports Community” during the Games, while also stressing HIV awareness at Chinese universities.

The Olympic effort focuses generally on preventing HIV transmission and discrimination, but as in the United States, the fight for increasing visibility for gay people in China has been inextricably linked to the fight against HIV.

Today, an estimated 700,000 Chinese are HIV-positive. Some 11.1 percent contracted the virus through male-male sexual contact, according to a report from the Chinese Ministry of Health, UNAIDS, and the World Health Organization.

The Chinese government did not issue its first research on HIV and gay men until 2004. But since then, outreach efforts, ranging from targeted prevention campaigns to free health clinics for gay men, have been frequent subjects of matter-of-fact news reports from state-run media like the Xinhua News Agency.

“In recent years, the government has made a lot of effort to involve the LGBT community in the fight against HIV/AIDS. Toward that end, the health branch of the government approves of LGBT work and has good relationship with us as well,” said Lu, the Aibai Culture & Education Center volunteer.

Although the government works openly with gay groups in efforts to stem a growing AIDS epidemic, criticism of its efforts from within may meet with a far different response.

Dr. Wan Yanhai, founder of the AIDS-related Aizhixing Institute, has twice been arrested for speaking out against the government’s response to AIDS. In 2002, he went public with information about blood-contamination that may have led to hundreds of thousands of infections; he was arrested again in 2006 for claiming the government was asleep at the wheel in AIDS prevention efforts.

And for Chinese gay activists, being linked with HIV is a double-edged sword — a dilemma familiar to those in the West. On one hand, the fight against HIV has helped bring gay issues into the forefront, increasing the visibility of gay men and forging alliances between activists and government health workers.

But the two issues now run the risk of being not only related, but conflated in the eyes of both government and the general public.

Western exports

Along with stereotypes about homosexuality and pressure from families, gay Chinese face an additional hurdle, Bin noted. Despite the fact that homosexuality has been documented in the country as far back as the Chinese dynasties, where emperors’ male liaisons were accepted, Bin and her fellow activists must also battle the idea that being lesbian or gay is “something bad imported from the West,” she said.

There is something bad being imported from the West, but it isn’t gay visibility, according to Lu of Aibai Center.

“I think we need to alert our friends here about two relatively recent developments in China, because both are partly the result of U.S. ‘exports’ and we need everyone’s help to stop them,” he said.

The two unwelcome exports are religious fundamentalism and ex-gay therapy, Lu said.

“Many of the religious fringe elements, having been kept at bay in the U.S. by the LGBT community, are seeing China as a new territory,” he said. “There’s been a huge surge of various religious extremist groups entering in to China.”

Lu cited James Dobson’s Focus on the Family, a well-known foe of American gay rights groups that now has chapters in China. Dobson, whose name is translated as “Dr. Du Busen” on Focus on the Family’s Chinese website, also appears regularly on Chinese state-run radio.

Focus on the Family did not respond to interview requests about their Chinese chapters.

Homosexuality was officially removed from China’s list of mental disorders in 2001, but Lu said “ex-gay” therapy is also common. “Many religious conservatives from the West, mainly the U.S., go to China as mental health experts, and continue to spread lies,” he said. “In the past two years, Aibai has twice organized activists in successfully defeating two events billed as seminars or conferences on sexuality while in reality, they were venues for ‘reparative therapy’ proponents to spread their misinformation.”

But Western influence can also be a positive factor for lesbian and gay Chinese. As the country emerges from decades of cultural isolation, websites like Aibai bring news of gay rights struggles around the world to Chinese citizens every day.

“Although in different continents and social, cultural and political environments, we find many things in common between LGBT people in the U.S. and in China: the oppression from the mainstream society towards sexual minorities, and the struggles LGBT people go through,” Bin said.

“We are inspired by many stories in the history of the LGBT movement in the States, the courage and the dedication of LGBT individuals to make social change. We hope to do the same.”

Victims of Britain's tainted blood scandal speak

By GREGORY KATZ, Associated Press WriterSat Aug 23, 1:20 PM ET

Robert Mackie trembles with rage when he describes how he and his wife were kept in the dark about his HIV infection — and how doctors published his medical data in journals years before they gave him the devastating news.

Mackie is one of some 5,700 British hemophiliacs who received tainted blood and were infected with HIV, hepatitis or both, in what has been viewed as one of the worst treatment disasters in the history of Britain's heath care system. Nearly a third of those infected have since died.

Tainted blood scandals have been investigated throughout the world — in France, Canada, Japan and elsewhere — leading to some convictions of health officials and many compensation packages for infected hemophiliacs, but there has been no detailed probe in Britain until now. One inquiry under way will likely end in a nonbinding report, while the other is an official investigation by the Scottish government that could lead to charges filed against individuals.

"They used me as a guinea pig," said Mackie, 58, in his house in Scotland. "It's just a miracle my wife wasn't infected."

Hemophiliacs suffer from an inherited disorder that prevents blood from clotting. Mackie — an active sportsman who had hoped to become a salmon fishing guide — had controlled his hemophilia with a treatment called cryoprecipitate when he switched in 1980 to a new product. Called Factor VIII, it was supposed to be more effective in helping his blood clot.

In 1983, he heard hemophiliacs were developing AIDS, then a mysterious disease that usually claimed its victims in two or three years.

He said he asked his doctors if he could be exposed to the killer virus through his use of Factor VIII, a relatively new blood plasma product made from blood collected from thousands of donors.

They told him not to worry. A year later, he was infected by a contaminated batch.

"We could have had more of a family," says Alice Mackie, who had a son with Robert before he became infected. "The two of us had plans for what we were going to do. But you could say our whole lives stopped."

The tainted blood led to the deaths of Mackie's cousin, two uncles and friends, who were part of a close-knit community of hemophiliacs in Scotland.

"From '87, all we saw was people dying," said Alice, her hair white at 51. "And believe me, when you see someone dying of AIDS, it's really bad. It's different each time. No one dies the same way."

Mackie said he was told of his infection in 1987. But he told an independent inquiry commission that when he finally obtained his medical records, he learned he had been used for an AIDS study that began several years before then.

"This AIDS study was, it seems, the beginning of many years of research being carried out on me without my knowledge or consent," he told the inquiry committee headed by Lord Archer, a former solicitor general.

Factor VIII was meant to thicken blood so that it would clot properly, and Mackie was told it was a breakthrough when he got his first treatment in 1980.

But the risks were high. With each dose, blood plasma from thousands of donors was introduced into his system. Between 2,500 to 22,000 donors contributed to each batch of Factor VIII, which could then treat about 100 patients.

The contamination risk increased as the number of donors grew, but it was only once AIDS emerged as a global public health threat that doctors learned how great that risk was.

By 1983, U.S. medical experts had established that AIDS — previously concentrated among gay men — was striking hemophiliacs.

In April 1983, an American doctor wrote in The Lancet medical journal asking for data on hemophiliacs in areas where there was no reported HIV in the blood donor community.

The journal published a response one month later — from Mackie's physician, Dr. Christopher Ludlam.

In the letter, published on May 28, 1983, Ludlam described his own patients as a valuable resource for further study because Scotland produced its own Factor VIII and seemed to have an AIDS-free donor community.

Mackie said that in 1985 — when he was already infected but didn't know it — Ludlam wrote to government authorities seeking ethics approval to study the immune system of infected patients and claimed that his patients knew about the research and had agreed to participate.

"If, as the ethics application form states, consent was obtained from all subjects ... how is it that I did not know about my AIDS status until 1987?" he said at the hearing. "I did not know anything about his studies or research."

Mackie obtained copies of the form submitted by Ludlam in which the doctor says his patients were well informed about his studies.

Ludlam, who practices at the Royal Infirmary of Edinburgh, declined to talk with The Associated Press about the case.

Brian Montgomery, a National Health Service executive who oversees the hospital, said it would be "inappropriate" to comment while the inquiries are ongoing.

Two of Mackie's uncles and a cousin were also hemophiliacs under Ludlam's care. They learned they had been infected around the same time. All three succumbed fairly quickly. The family held three funerals in two years.

Mackie was convinced he would be next.

Surprisingly, he stayed relatively healthy for a decade. He thought he had escaped a death sentence, but in 1997 his appetite began to wane. By 2000, he had advanced symptoms of AIDS.

He became too weak to climb stairs. The smell of food sickened him. Doctors said he had a few weeks left, but he was too stubborn, and too suspicious about doctors, to take the new anti-retroviral drugs that were by then extending the lives of many AIDS patients.

For days he sat, feverish, in his kitchen, believing death was imminent.

Then, drawing on reserves he did not know he possessed, his fighting spirit returned. He gave in to Alice's pleas and started to take the new drugs after she convinced him they were not poison.

The drugs worked. Mackie said they at first caused a dangerous reaction that left him "out of his head" but eventually gave him more energy and confidence.

Despite being weak from AIDS and Hepatitis C, which he found out he had in 2000, Mackie insisted on giving evidence to the Archer committee last year. The hearings were closed to the public but a report is expected next month.

Alice read most of his statement, and he spoke quietly when he spoke at all, but he did raise his voice at one point to tell the committee that doctors had endangered the safety of his wife and son by holding back his HIV status.

"I believe nonconsensual research was conducted by doctors of hemophilia in this country," he said, voice booming again. "We were all used as lab rats."

The Mackies say they are not expecting much from the new investigations.

But Andrew March, a hemophiliac in London who became HIV positive when he was nine after exposure to tainted blood plasma products, said the surviving victims want the truth to finally be told.

"I feel anger a lot of the time," said March, who is now 34 and generally free of AIDS symptoms. "Frustration. A sense of being repeatedly betrayed. There are lessons to be learned that haven't been learned yet."

He said the slightest cold makes him wonder how long his immune system will be able to fight off illnesses.

Christopher James, chief executive of the Haemophilia Society, said a generation of hemophiliacs was exposed to HIV and Hepatitis C.

He said doctors had an obligation to tell Mackie, and other victims, that they were HIV positive so they could take steps to protect their partners.

"There was a very high death rate," said James, who hopes the inquiries will lead to a financial settlement for the victims as well as a public apology. "These people have faced enormous financial and emotional hardships from this catastrophe and they deserve to know what happened and why and to be sure it will never happen again."

Safe sex ring tone sings "Condom, condom!"

It's always wise to condomise

NAIROBI , 21 August 2008 - During a recent trip to report on a pilot male circumcision programme in Kisumu, a part of Kenya where male circumcision is not traditionally practiced, I was allowed to sit in on a pre-op counselling session.

The counsellor gave information on hygiene and the signs of infection, and practical advice like placing a cold metal padlock against the genitals as a sort of cold shower equivalent to avert the temptation of masturbating during the six-week healing period.

Most said they'd heard about the protection circumcision offered against HIV, while others hadn't actually come to get it done, they were just curious.

One of them questioned the wisdom of an invasive procedure like circumcision when South Africa's former deputy president and possible future president, Jacob Zuma, said he took a shower after having sex with an HIV-positive woman because it would minimise the risk of contracting HIV.

Another said he was doing it to escape the fate of some ethnic Luos in central Kenya who were forcibly circumcised, sometimes with tools as unkind as a broken bottle, by rival ethnic groups during the country's post-election violence.

How certain was the counsellor that circumcision actually cut down the chances of contracting HIV? This question kept coming up. He explained patiently and clearly that the men should keep on using condoms, as circumcision was not a guarantee against HIV.

But isn't it possible that many circumcised men, lulled into a false sense of security by their missing foreskins and unaware of the continued risks, will be less inclined to use condoms?

Various ethnic communities in Africa traditionally only remove part of the foreskin, still leaving men at high risk of contracting sexually transmitted infections.

AIDS programmes need carefully tailored messages to ensure that condoms stay at the forefront of HIV prevention.

As more African countries embark on ambitious national male circumcision programmes, one can't help wondering whether the advice that it is safer to always use condoms will still be heard above the circumcision din.

KENYA

: High levels of stigma persist in the north

IJARA, 21 August 2008 - For the past ten months, health workers at Ijara District Hospital in Kenya 's North Eastern Province have been caring for two children, aged six and seven, who were abandoned by their father after he discovered he was HIV-positive. Nurses say the children were weak, malnourished and suffering from tuberculosis when they arrived.

"We have been forced to keep these children; all their relatives have declined to take them, although they are now in good health condition and can enjoy life like other kids," Dr Mohamed Abdikadir Sheikh, Ijara district's medical officer, told IRIN/PlusNews. "Stigma associated with HIV/AIDS is very, very strong here; it is without any doubt responsible for the plight facing these children."

Ijara has 130 registered HIV-positive people, giving it the lowest prevalence in the province, but many residents still associate HIV with evil spirits, curses and witchcraft; most people diagnosed with HIV, he added, sought ritual rather than medical treatment.

"The VCT [voluntary HIV counselling and testing] centre in the district remains idle because the local community believe they cannot contract the disease," Sheikh said. "We need an aggressive awareness campaign in these remote areas."

In Isiolo, a district in the north of Eastern Province , the Isiolo Youths against AIDS and Poverty (IYAP) said spreading awareness in the community was difficult because of the remoteness of the area, the transient nature of its pastoralist population, and cultural taboos.

"This region is vast ... to reach a majority of the youths who are in the remote parts of our region, we need support," said Amina Abdullahi, an IYAP official. The group was limited to conducting their education and information sessions in town, because they lack the resources to travel beyond it.

Group members said they regularly faced personal physical risk while visiting parts of the region prone to conflicts over scarce water and pasture, and had to be careful who they sent to certain areas, or to a specific clan or ethnic community, for fear of reprisals if they sent someone perceived to be from a rival group.

Openly talking about HIV was also problematic because the largely Muslim population frowned on open discussions of sex and sexuality. "As you can see, we have no picture or poster of a condom here - we cannot take the risk ... the landlord cannot allow us to do that," said Ali Boru, another IYAP official.

Cultural norms also hamper awareness-raising efforts, because most of the HIV educators are young people. "It is impossible for me to talk to an elderly woman about HIV/AIDS, my culture does not allow me to advise or discuss any sexual matter with a woman who is older than me," Abdullahi said.

North Eastern Province has the country's lowest HIV prevalence - one percent - but also the lowest literacy rate, another obstacle in the path of HIV education in this remote province.

ETHIOPIA

: Cappuccino with condom

Reuters and AlertNet are not responsible for the content of this article or for any external internet sites. The views expressed are the author's alone.

ADDIS ABABA, 20 August 2008 - Bellissima, on bustling Gabon Street in the Ethiopian capital, Addis Ababa, could be just another upmarket café, except that each order comes with a packet of 'Sensation' condoms, and is served in 'Sensation' cups by staff wearing 'Sensation' T-shirts.

"I wanted to link business with a message for sexually active people," Bellissima's owner, Hayat Ahmed, 26, told IRIN/PlusNews. "I am the brand ambassador for 'Sensation' condoms in Ethiopia , and I want to spread the message that condoms can protect you from HIV/AIDS."

Hayat, a former beauty queen, has been involved in HIV/AIDS campaigns since she was crowned Miss Ethiopia in 2003 and subsequently named an HIV/AIDS ambassador.

Her face adorns billboards and she regularly appears on Ethiopia 's only television station promoting condom use. "When I walk down the road even children recognise me," she said. "But they do not call me Hayat; they call me 'Sensation'."

Modelled on 'condom bars' in Asia, Bellissima handed out six boxes of condoms, each containing 48 packets of three-in-a-pack, within two days of opening its doors.

The free 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.

"We have had young people come in and ask 'Is it true that you actually give free condoms?' and when we say, 'yes', their faces brighten up and they quickly order," said one waiter. "But we have also had people who get shocked when we bring the bill with a condom, some saying we are promoting immorality."

Guests do not have to take the packs home when they leave the restaurant. "It is your choice to take it or leave it," Hayat said. "We also plan to set up condom vending machines in the toilets."

Her campaign is supported by social marketing groups such as the non-profit organisation, DKT-Ethiopia, which sold almost 60 million condoms in 2007 and also launched a coffee-flavoured version of Sensation condoms. Ethiopia is widely thought to be the birthplace of coffee and is drunk nationally.

Hayat intends to open more cafés in the capital and other towns, and continue promoting various anti-HIV strategies, including abstinence and faithfulness. She might even expand the 'condom bars' concept to other African countries.

"A lot of people in Ethiopia are ashamed of talking about or using condoms," said. "Yet some companies put condoms in their toilets and when you go to look, each day, the boxes are empty. I don't care if the condoms are used behind closed doors or in public – as long as many people use them."

Ethiopia

's HIV prevalence is estimated at over two percent among sexually active people aged 15 to 49. A report by the Federal HIV/AIDS Prevention and Control Office in March noted that between 2000 and 2005, condom use among males increased from 30.3 percent to 51.9 percent, and among females from 13.4 percent to 23.6 percent.

According to Ethiopian government data, half the public sector institutions and 20 percent of private businesses have mainstreamed HIV/AIDS prevention in their operational policies.

However, Philopos Petros, head of the Ethiopian Civil Service College 's HIV/AIDS management unit, noted that "There are still educated people exposed to HIV and dying of AIDS," and said greater awareness was necessary.

"One person cannot change the world, but I want to make a contribution," Hayat said. "I have a name and the will, and I will use that."

KENYA

: The lure of dodgy herbal "cures" for HIV

MOMBASA, 21 August 2008 - People in Kenya's Coast Province, believed not to be genuine herbalists, are selling concoctions purported to treat HIV and persuading many patients on life-prolonging antiretroviral (ARV) drugs to abandon their medication.

Omari Mwanjama, of the National AIDS Control Council in Coast Province , said people were told the concoctions contained unique ingredients that would boost their immune system and could even cure the disease.

"It is ironic to see people living with HIV/AIDS are being swindled of their money in broad daylight, yet the government was providing them with antiretroviral drugs free of charge."

He added that patients were sometimes offered free samples as a way of getting them to buy the concoctions, which would later prove to be very expensive. The quacks often claimed their 'drugs' were moringa olifera, a herb known for its nutritional and medicinal properties.

"The fact that most of the con-herbalists say they were also once infected by HIV/AIDS but have since recovered after using the concoctions is making them even more popular," said Raphael Mwachofi, a Mombasa resident whose brother abandoned his ARVs in favour of one such potion.

Mwanjama said the government would need to redouble its efforts to convince people to adhere to their ARV regimen. Coast Province , where many people still lack information about HIV/AIDS, has an HIV prevalence of 7.9 percent, similar to the national average of 7.8 percent.

Stigma made it difficult for the provincial administration to crack down on the culprits, said Benjamin Nzuki, a senior district officer in the area. "You see, nobody infected or affected would want to come out openly, and those using the concoction seem to have made up their minds about [its ability to cure]," he said.

Elizabeth Mwakolo, 32, a mother of four, commented: "Having suffered from the disease for four years now, it feels good to find a drug that is sweet and easy to swallow. Moringa has even made me fatter, and I do believe I'll soon become negative again." She paid the equivalent of US$75 for the drug, money she can ill afford.

The government is developing an action plan to regulate the use of traditional medicine and incorporate it in the treatment of major illnesses such as malaria and HIV, but the vast majority of traditional practitioners are unregulated.

Although there are few avenues to test the efficacy of these remedies, an estimated 80 percent of Kenyans use traditional healers either exclusively or in conjunction with Western medicine.

AFRICA : Many children still miss out on treatment

MEXICO CITY , 19 August 2008 - Experience has shown that it is possible to run successful paediatric HIV programmes in rural African settings, yet less than 10 percent of patients on life-prolonging antiretroviral (ARV) drugs are children, field officers of the international medical NGO, Médecins Sans Frontieres (MSF), have said.

"Studies show that without treatment, 50 percent of children with HIV will die within the first two years of their lives," Fernando Parreno, who has worked for MSF's ARV programme in Bulawayo , Zimbabwe 's second city, said at the recent International AIDS Conference in Mexico City . "It is imperative that all children are diagnosed and started on treatment as early as possible after diagnosis, or too many children will continue to die."

Children in rural Africa are rarely taken to hospital for HIV testing and accurate testing facilities for children are few and far between, so they are often diagnosed too late to benefit from treatment programmes.

MSF has more than 10,000 paediatric patients in more than 50 projects in poor countries around the world. An analysis of all child patients under five who started taking ARVs in 2002 found that by January 2008, 79 percent were still on treatment.

"In Rwanda , where MSF has over 300 children on ARVs, we decided to increase testing by proposing to all patients that they bring their children in for testing," said Johan Van Griensven, of MSF's programme in Rwanda . "We faced reluctance from the nurses, who were uncomfortable disclosing the HIV status of children, and from parents, who feared a positive result and its implications."

Van Griensven said after training the nurses were better able to disclose a child's status to them in a sensitive and informative way. Parents whose children test positive are actively encouraged to disclose their children's status to them.

"We have developed child-adapted tools to talk to children about HIV in ways they can understand," he added. "But as kids get older their perceptions change, so it is important to keep supporting them as they grow into adolescence; support groups have been very helpful in enabling children to talk openly about their experiences."

Helen Huerga, who is with MSF Kenya, said it was crucial for the family to be involved in the child's treatment, so programmes encouraged parents to attend children's clinic days; she also noted that community support was crucial to follow-up.

However, support at the community and health centre level was not being matched with the same commitment by large drug manufactures, according to Karen Day, a pharmacist from MSF's Campaign for Access to Essential Medicines.

"Although there are 13 ARV formulations specifically developed for children, they are not adapted for use in resource-poor settings. Most of them are liquid, and come as three, often unpalatable, separate drugs that are difficult for children to take; others are in powder form and need to be reconstituted. In many cases there may not be an adequate supply of clean water to do this," she said.

"What we need from the drug companies are small, scored – and therefore easy to halve – tablets that are chewable and stable at high temperature and high humidity," Day suggested. "They must also develop fixed-dose ARVs for children; so far, only one fixed-dose exists, and none for second-line treatment."

She said there was a need to reach children earlier with treatment in order to improve their chances of survival. New guidelines by the UN World Health Organisation recommend that children under 12 months be diagnosed as early as six weeks and be started on treatment immediately, regardless of CD-4 count (which measures the strength of the immune system) or clinical signs.