PrEP for sex workers in Kenya, HIV and contraception research, Uganda a gay-friendly tourist destination? . . . We’re reading about approaches with promise

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NewWWRState to buy sex workers HIV prevention drugs – This article, topped by a photo that tells its own story, backs into the description of a promising plan unpromisingly (“Kenyan taxpayers will have to part with approximately Sh4 billion [4 billion Kenyan shillings] annually to provide sex workers with a daily HIV and AIDS prevention pill . . .”). It goes on, however to tell of a partnership among the U.S.-funded Health Policy Project, the Kenyan National AIDS and STI Control Programme, and the Sex Worker Outreach Programme (SWOP)to provide male and female sex workers with daily doses of Truvada as pre-exposure protection from HIV infection. In the process the article refers to the Health Policy Project Study on the Cost of Providing Oral Pre-Exposure Prophylaxis to Prevent HIV Infection Among Sex Workers in Kenya. The study found that the cost of providing the pills to one sex worker would be 48,667 Kenyan shillings a year — about $602. The study did not assess the potential cost effectiveness of the move, and did assume “that services would be provided without fear of arrest by authorities or stigma and discrimination by healthcare workers.” It comes with a series of recommendations that indicate realizing the promise of oral pre-exposure prophylactic use of antiretroviral medicine will require ongoing commitment from researchers, governments and funders.

Advocates Call for Full Funding of Research on HIV and Contraception – With more than half the people in the world with HIV women, and fewer than 20 percent of women in sub-Saharan Africa accessing modern contraceptive methods, questions about whether the long-acting injected Depo — one of the most common contraceptive methods there —  increases risks of HIV acquisition are pressing and have long gone unanswered. Current World Health Organization guidance, this editorial points out, for example, includes the not very elucidating recommendation that “women at high risk of HIV infection should be informed that progestogen-only contraceptives may or may not increase their risk of HIV infection.” But a clinical trial called ECHO — Evidence for Contraceptive Options and HIV Outcomes — to answer the question definitively is at risk because of questions of protocol compounded by funding issues. Background on the issue is available at the AVAC website.

Analysis: Rethinking global drug policy – While we’ve written about the Global Commission on Drug Policy’s new report urging a health-focused approach to drug use, and about a discussion at the Center for Strategic and International Studies about the prospects of that happening, this IRIN article offers a concise summary of more of its main points, and challenges.

Uganda tourism board: Gays are welcome – Tourism contributed about $1.88 billion to Uganda’s economy last year, this article notes, which apparently is why Ugandan tourism officials recently met with the International Gay & Lesbian Travel Association to issue assurances that, not only will “no gay person be killed in Uganda,” but that the officials themselves have gay family members and that “gay people are welcome.” This suggests an innovative approach to health policy in Uganda — what if government officials figure out what the people who already live in Uganda contribute to the economy, especially when they access health services, and issue assurances that gay people — many of whom are family members —  are safe and welcome to do so.

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