Cambodian sex workers describe barriers to HIV prevention, rights advocates track a widening treatment divide, and researchers look at syringe sharing . . . We’re reading about access to health services as a human right

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The hidden world of Cambodian sex workers

Last week we were reading a study highlighting how an anti-sex trafficking law enacted in Cambodia to protect women was having the unintended and opposite effect of standing between women and vital health services. In this video, reported and produced by Steve Sapienza, you can hear about the law’s unhealthy side-effects from the women themselves. They tell how, where previously condoms had been widely available, the 2008 law closed brothels and drove them underground into entertainment venues where condom use became more challenging, and health services harder to find. Sapienza notes that “reaching the unreached population is critical, because the HIV rate for Cambodian sex workers is among the highest in Southeast Asia.”

Evolving Human Rights and the Science of Antiretroviral Medicine – Less than two weeks after the announcement of START trial results, which showed that early antiretroviral treatment more than halves risks of serious illnesses among people living with HIV, the authors of this article in Health and Human Rights Journal, who include Matthew Kavanagh of Health GAP and Jennifer Cohn of Médecins Sans Frontières, review the body of evidence that adds up to “rights-based obligations” to provide early access to that treatment. That includes findings from the Strategic Timing of AntiRetroviral Treatment trial that show that “denying access to early [antiretroviral treatment] violates the rights of people living with HIV, as does telling [people living with HIV] that there is a CD4-test-based ‘right’ time to start ARVs.” It includes the findings from the HPTN 052 study that proved treating HIV also prevents transmission, and showed that “delaying individual access to early treatment in turn also violates the collective right of disease prevention.” And it includes preliminary findings from the TEMPRANO study, which show immediate antiretroviral treatment initiation  — including above current World Health Organization guidelines — reduces severe HIV related illnesses and deaths from all causes.

High prevalence of syringe lending among HIV-positive people who inject drugs in Bangkok, Thailand – Among the findings from this study is that people with HIV who use injecting drugs and lend their syringes to others are more likely to have gone without antiretroviral treatment. This is concerning, note authors led by Pauline Voon of the Urban Health Research Initiative, British Columbia Centre for Excellence in HIV/AIDS, because treatment reduces transmission risks. The finding, they note, suggests that those receiving antiretroviral treatment may have more access both to sterile needle and syringe providers, and information that helps them reduce their risks.

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