“Know Your Epidemic: From Data to Action,” was the title of a CROI symposium last week. The session, with presentations on population surveys, as well as on data gathered in England and Swaziland, showed how existing information, including from Demographic and Health Surveys, combined with sentinel surveillance from more limited populations, can gather critical information on the path of epidemics and be used to inform the policies and practice of HIV responses. The more information available for analysis, the better the odds that researchers and policy makers can even ask the right questions, let alone answer them.
For example: “Social networks play a crucial role in in HIV epidemiology because they determine the extent and pace to which HIV can spread in a population,” Stephane Helleringer of Columbia University pointed out during the session. Analyzing those networks can inform action, as well as the cost of inaction, or as Helleringer put it, “If we do nothing, who will become infected next?”
But as the presentations made clear, gathering pertinent and accurate information can be challenged, by biases stemming from non participation, as well as obstacles to even seeking information on populations that are targeted by laws, silenced by abuse and violence and marginalized by institutional neglect. Which makes the reading we caught up with on returning from CROI particularly worrisome.
Reaching out to men who have sex with men in Myanmar – The leftover colonial law penalizing same sex relationships with prison terms in Myanmar is rarely enforced, this IRIN article notes, but its impact is deadly all the same. The article quotes local HIV responders telling the obstacle the law presents to providing services and information. But it is a combination of data from the country’s National AIDS Programme that gives a picture of some of the harm done: the program estimates men who have sex with men make up less than one half of one percent of the population, and reports that fewer than 30 percent of them have received HIV prevention services. The program’s first surveillance of HIV prevalence among men who have sex with men found a 29 percent infection rate.
After Uganda, Kenya Gears Up for Gay Rights Debate and Kenya: Anti-Gay Groups in Campaign to ‘Prevent Sodom’ – Current leftover colonial laws in Kenya criminalize sex between members of the same gender and threaten up to 14 years in prison, according to the first article. While the law has seldom been enforced in the past, as many as eight cases are pending now, it says. But a lawmaker who concedes he is prompted in part by a bad experience with “an unfaithful bisexual girlfriend” wants more enforcement, and consideration of harsher punishments, the article says. A human rights attorney in the first article also is quoted, noting the country has other problems to worry about, and that existing laws already compromise rights and privacy. The second article quotes members of a group called “Save our Men” who plan to submit a petition “against homosexuality in Kenya” on April 15, one of whom calls homosexuality “a serious threat” to life.
Kenya: Gays flee Mombassa Over Public Attacks – In the meantime, the Mtwapa Initiative for Positive Empowerment, a group supporting men who have sex with men, reports that gay men in the country are “defaulting from HIV treatment for fear of victimisation following the heightened debate about homosexuality in the country.”
United States Urges Dropping Appeal Against Paul Kasonkomona – Finally, after reporting the good news recently of HIV treatment activist Paul Kasonkomona’s acquittal, here comes the news that the Zambian government is planning to continue the case against Kasonkomona with an appeal. Kasonkomona was arrested for speaking on Zambian television of the obstacles the country’s colonial era criminalization of homosexual sex poses to its planning of relevant HIV responses.