Aids 2010: The state we're in

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Today the world acknowledges the impact of a disease that has killed millions. Yet the news from around the world is not all bad

USA: Needle exchange helps drug users take the first step

Dame Elizabeth Taylor – founding international chairman of amfAR, The Foundation for Aids Research:

"Volunteering at a syringe exchange centre in New York City was an eye-opening and moving experience. For so many of these clients, being approached by staff from the syringe exchange programme was the first time in a very long time that anyone had expressed concern about their health and well-being. In my personal interactions with syringe exchange clients, I was privileged to witness first hand the true connection between syringe exchange as a method for preventing HIV infection among drug users and as an important first step in helping these vulnerable people to learn to love themselves again and begin that important journey to rehabilitation."

Chris Collins, director of public policy at amfAR:

"For over 20 years, the US government banned the use of federal assistance for syringe exchange programmes that reduce the spread of HIV. The historic December 2009 legislation lifting this ban ends decades of ideology trumping scientific evidence while people die of a preventable disease."

Uganda: Fighting rape to treat the cause of the problem

Rwechungura Gerevas, medical clinical officer for Kawala Health Centre in Kampala, Uganda:

"This year, my clinic has been collaborating with the Centre for Domestic Violence Prevention so that women who have been raped can get access to post-exposure prophylaxis – or PEP – medication that can prevent them getting HIV.

"Before our collaboration, the staff at the clinic, including me, did not really understand the issues around sexual violence or how critical it is to provide treatment and forensic examination as quickly as possible.

"Now we treat injuries, provide medication and refer cases to the police. The number of women coming into the clinic for this support is increasing every day. It has made me understand the extent of the problem, and taught me to prioritise treating women who have been through this ordeal.

At least, as a clinical officer, I can offer them the opportunity to avoid living with HIV."

Tamara Mellon, chief creative officer and co-founder, Jimmy Choo:

"Uganda has one of the highest incidences of rape in sub-Saharan Africa – up to 15 per cent of girls and women aged five to 49 are raped each year, and thousands become infected with HIV. I am proud that Jimmy Choo has worked with the Elton John Aids Foundation to support programmes helping victims of sexual violence in South Africa and Uganda and preventing them from contracting HIV."

South Africa: Free clinics change lives in gay community

Renaldo, an HIV-positive man who uses the Health4Men clinic in Cape Town:

"Hearing my HIV status was really traumatic. At that time I didn't really take HIV too seriously. My CD4 count [crucial cells that form part of the immune system] turned out to be 61, and I needed treatment urgently but I was shocked that even professional people were more interested in my sexuality than with how I was feeling.

"Then I heard about Health4Men, which offers free services to gay and bisexual men, including free antiretroviral treatment. This is one of the few clinics in Africa offering such services, particularly within national health provision. Going to them changed my life: for the first time I felt heard and not judged.

"They even did couple counselling with my partner and I, and I commenced ARV treatment. What they did inspired me to help other gay men who experience discrimination, and I disclosed my HIV status and my being gay in Drum, a national magazine, in January."

Justice Edwin Cameron, member of South Africa's Constitutional Court, and South Africa's first openly gay, HIV-positive public figure:

"Even in South Africa, and in spite of our Bill of Rights, gay men are subjected to discrimination and often receive inadequate healthcare."

Lesotho: Motorbikes bring villages into reach

Litlama Makhakhe, community counsellor at Khabo Health Centre in Leribe, Lesotho:

"I work with communities in 22 villages. A lot of my time is spent counselling and testing people for HIV, and helping people get on to treatment and stay on treatment. I used to spend half of every day walking. Some villages were too far for me to ever reach on foot. This year, a programme called Riders for Health set me up with a motorbike. I am seeing six times as many patients, many of whom were dying because I was not able to reach them. Now instead of walking to my job, I can spend more time doing it."

Christiane Amanpour, former chief international correspondent, CNN:

"A motorcycle is the best way to get around rural Africa. I should know, I've seen it and reported on it. Yet Africa is littered with vehicles that are broken and abandoned. The fantastic thing about Riders for Health is that their support lets the nurses and community health workers get on and do their job."

Cambodia: Women find they can protect their unborn children

Huy Mary, HIV-positive mother in Prey Veng Province, Cambodia:

"I had heard of women who were HIV-positive being advised by doctors that if they became pregnant, they should have an abortion or know that their baby was unlikely to survive. But when I went to the antenatal clinic, they told me not to worry.

"They gave me advice on what medication to take so that my baby would be healthy. After he was born, my son was tested and given medication. My beautiful baby boy does not have HIV and I am on treatment so I can be well to take care of him."

Dr Mean Chhi Vun, director of Cambodia's National Centre for HIV/Aids:

"Three years ago we only tested 11 per cent of pregnant women for HIV. With support from the Clinton Health Access Initiative and funding from the Elton John Aids Foundation, we started a programme that better linked antenatal care to HIV care.

"Now more than 80 per cent of pregnant women access testing during antenatal care in participating districts."

Ukraine: 'For years I lied about the pills we needed to take'

Anna, HIV-positive mother from Odessa, Ukraine:

"In 1996, when I was pregnant with my daughter, Alice, I found out I was HIV-positive. I was so scared and desperate, I tried to kill myself.

"Back then Aids was everywhere in the news as a deadly disease. It was a source of shame to be infected. Since my daughter was born, I have always dreaded revealing to her that her mum has a deadly illness, and that she has passed this disease on to her. For years, I lied about the pills we both needed to take.

"Now my daughter is a teenager and prone to mood swings. She gets very depressed. I was worried she might harm herself. I went to the psychologist in the Children Plus programme run in my city by the All-Ukrainian Network of People Living with HIV/Aids. He discussed with Alice her HIV-positive status: I couldn't do it. To my surprise, Alice had known something was wrong for a long time and wanted to talk about it but didn't know how. Since then we have talked a lot. My daughter is much more open and optimistic.

"Without the advice and support of a psychologist, I don't think I would ever have got the courage to be open with my daughter, so she would probably have found out in the worst way – from a rumour or an insult. Now she can be responsible as she starts sexual relationships. We can share our worries. It has changed our lives."

Olivia Harrison, widow of George, and co-founder of the Romanian Angel Appeal:

"When we started the RAA to care for children infected with HIV, I never dreamed that what we learnt in Romania would be needed 18 years later by young people who were never meant to survive infancy. The RAA has provided specialist support in disclosing HIV diagnosis to thousands of parents and children, including the Children Plus project in Ukraine. This is changing their futures, preventing them repeating the problems with their own children."

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