Spet 2002 News

You might find the following items of interest from the Terrace Higgins Trust (THT):
Launch of the THT Direct Help-line : 0845 1221 200

THT Direct help-line is a gateway to HIV services, support and information for everyone living in England and Wales. This new service has been formed by merging the THT national help-line with THT Direct, a pilot telephone advice and information service which ran successfully in London last year. Merging the help-line with THT Direct, allows the Terrace Higgins Trust to provide a comprehensive range of services to callers, ad enables everyone phoning THT to access a local rate number. The service is staffed by paid and volunteer staff who are trained in providing advice, information and emotional support.

THT Direct help-line welcomes calls from people living with, concerned about or affected by HIV. If you would like further information on the service, please email info@tht.org.uk

What is the THT Direct Help-line?

THT Direct Help-line is a gateway to HIV services, support and information. This new national telephone service has been created by the merger of the THT Direct pilot London service with THT’s national Help-line and it opened on the 16th September 2002.

What does it offer?

THT Direct Help-line aims to improve access to HIV services, information and support by providing a main point of contact into the organisation, staffed by a team who can respond to all enquiries and provide clear and accurate, current and comprehensive signposting, referral, information, support and advice.

The main foci of THT Direct Help-line are: providing service information, giving generalists advice, answering frequently asked questions about HIV and offering emotional support to people who want to talk through any issues or questions they might have about HIV: whether they are infected, affected or concerned.

THT Direct Help-line can offer:

• HIV related information
• Details of and/or referral to HIV services (THT, Lighthouse and others)
• Briefing sheets on frequently asked questions and on the different services that THT and Lighthouse provides
• Assistance with completion of forms
• Appointment booking
• Generalist advice, for example about eligibility for welfare benefits
• Emotional support

How it works

THT Direct Help-line is staffed by a mixture of skilled volunteers, generalist advisers and assisted information officers, who have between them a wide range of skills and experience in emotional support, advice giving, information provision and are also able to speak a variety of languages. Clients will also be able to conduct calls in languages other than English using Language Line, who can provide THT Direct Help-line with interpreters in most languages. The team respond to telephone enquiries, emails and written requests for advice and information.

Phone lines are staffed from 10am to 10pm, Monday to Friday, and 12pm to 6pm on Saturday and Sunday. Outside of these hours and when the team are busy, a menu is available to callers which provides:

• Information on THT services and how to access them.
• A message leaving service for students with an information request, people who want to volunteer, callers seeking Living Wills and clients would like to be called back in a language other than English.
• Clients can email THT Direct Help-line at info@tht.org.uk or write to THT at their Grays Inn Road address.

Why did the services merge?

Our Help-line has provided emotional support to people who want to talk through any issues or questions they might have about HIV, whether living with HIV, affected or concerned, for nearly 20 years. Merging the Help-line with THT Direct, which provides practical information and advice, allows us to provide a more holistic and comprehensive service to callers, and enables everyone phoning THT to access a local rate number.

What does generalist advice & assisted information mean?

These terms are from a government organisation called the Community Legal Service and we use these terms to help differentiate between the different levels of service provided to clients.

Assisted Information Service

‘There should be staff that are able to help clients access information, to identify where a client needs further information or advice and help clients select an appropriate service where they will be able to receive this.’

General Help

‘The Community Legal Service defines giving general Help as providing a service that includes diagnosing client’s problems, giving information and explaining options, identifying further action the client can take; and giving basic assistance, e.g. filling in forms, contracting third parties to seek information.’

The Generalist Advisers will be working up to the level of general help and the Assisted Information Officers will be working to the definition from the Assisted Information Service.

Who can use THT Direct Help-line?

Anyone can use the THT Direct Help-line. Many of the callers are:
• People living with HIV, or affected by HIV – partners, families, friends or carers
• Advisers, medical or social care professionals who provide services to people with HIV
• People with questions or concerns about HIV

When is THT Direct Help-line open?

Monday to Friday 10am to 10pm; 12pm to 6pm Saturday and Sunday. Outside of these hours and when all of the THT Direct Help-line team are busy a menu is available to callers which provides information on their services and how to access them and a message leaving service. Clients can also emails them or write in.

What’s the number?

Call: 0845 1221 200
Email: info@tht.org.uk
Write: THT Direct Help-line, 52-54 Grays Inn Road, London, WC1X 8JU

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Case of HIV 'Superinfection' Reported
September 04, 2002 02:54:53 PM PST, Reuters

Doctors in Europe are reporting what they say is the first proven case of HIV in which an already HIV-positive person becomes infected again with a different strain of the virus.

Researchers say the case highlights the importance of consistent safe sex, even between two HIV-positive people. In addition, the fact that HIV superinfection can occur could be another obstacle to developing an effective AIDS vaccine.

The patient, a 38-year-old man whose blood levels of HIV had fallen sharply while on drug therapy, was found to have resurgent viral levels after stopping his medication as part of an AIDS vaccine trial. Tests revealed, however, that the rebound was due to a new strain of HIV that had rapidly "replaced" the strain the patient had contracted 2 years earlier.

Just weeks before this viral rebound, the man had had unprotected sex several times while in Brazil. The new HIV strain in his blood, known as subtype B, is endemic in Brazil, whereas the patient's initial strain - called AE - is prevalent in Southeast Asia.
"This is the first proven case of HIV superinfection," said Dr. Bernard Hirschel, one of the authors of the case report appearing in the September 5th issue of The New England Journal of Medicine.

Hirschel, of the University of Geneva in Switzerland, told Reuters Health that this patient's superinfection underscores the importance of being vigilant against HIV transmission, regardless of one's own HIV status. "If you aren't careful you (might) catch it twice," he said.

With many viruses, one-time exposure creates lifelong immunity against a new infection, and superinfection with HIV is thought to be rare - with only a few possible cases reported previously.

According to Hirschel, superinfection still appears to be rare, but part of the importance of this case are the possible implications for AIDS vaccine research.
For one, he noted, the p atient was in a trial of a vaccine designed to treat HIV and stop its progression to AIDS. "Not only did this experimental vaccination not protect against rebound of the original strain," Hirschel said, "it didn't protect against superinfection."

In addition, the fact that natural infection does not necessarily protect against a range of HIV strains challenges the hope that one vaccine might do so, according to an editorial published with the report.

On the other hand, "there are aspects of this case that need not leave us in despair," write Drs. Philip J. R. Goulder and Bruce D. Walker of Massachusetts General Hospital in Boston.

For example, they explain, it is probably far more common for people to be exposed to the same subtype of HIV over time, whereas this man was exposed to a new strain by traveling. In addition, they point out, vaccine researchers are already working on the assumption that it will tough to develop a single vaccine that fights multiple strains of HIV.

But whatever the implications of this case for vaccine development, Goulder and Walker write, "the public health implications...are clear."

Infected or not, people should use "the same degree of vigilance" against HIV infection, they urge. "This is a public health message that needs to be broadcast loud and clear."

SOURCE: The New England Journal of Medicine 2002;347:731-736, 756-758.

Shock posters break taboo to fight child prostitution

By Tracy McVeigh and Ben Cooper
Sunday September 15, 2002
The Observer

A controversial new campaign by Barnardo's highlights the plight of the growing number of young victims lured into sex rings in the UK. Its aim is tough new laws to curb their tormentors.

The poster shows a little girl sitting on a sofa. Her face is grotesquely old and worn. Behind her a man runs his fingers through her hair. In another scene, a young boy, his face aged and lined, is shown standing in a public toilet in front of an undressing man.

The controversial images are part of a new campaign by the children's charity Barnardo's to highlight the alarming rise in the number of children being lured into prostitution. Amid claims that the Government is doing little to tackle the problem, the charity hopes that the shocking new images will force Ministers to act. Backed by the Metropolitan Police, the 'Stolen Childhood' series comes two years after Barnardo's caused outrage with a homelessness campaign which showed a photograph of a baby injecting heroin.

The poster caused a furore and narrowly escaped a ban by the Advertising Standards Authority. This time the subject is even more taboo and the charity is bracing itself for criticism, but it is unrepentant about the need to shock to get the message home.

'The increase in child prostitution is a worrying new trend,' said Barnardo's policy officer, Tink Palmer. 'Children as young as nine are known to have been abused through prostitution. Over the past three years we have worked with 2,215 children who have been abused. 'These children have been entrapped, coerced, and beaten. Their childhoods have been stolen, yet the law does little or nothing to protect them. It's time this changed.'

Barnardo's wants legislation to create five new offences: to groom a child for the purpose of sexual exploitation, to buy the sexual services of a child, to recruit or force a child into prostitution, and to receive money for or to participate in the sexual exploitation of a child. At present few men are charged if they are found with a child prostitute and pimps face only the minor offence of living off immoral earnings.'There is a serious lack of political will. We have the proof that we need new legislation to protect children simply in the growth of the number of children using our services,' said Palmer.

Barnardo's has found an increasing demand on its services for child victims of controlling adults, and by March this year had 12 projects dedicated to the issue across the country. They are expanding as quickly as resources can be allocated.

'Where do these children come from? Most of them will have traumatic backgrounds, but they are from middle-class families as well as socially deprived. Just as the people who abuse these chil dren have diverse backgrounds,' said Palmer. Child prostitution and trafficking has expanded rapidly in the UK with the internet's advent. Children are filmed being sexually abused and the images put out on internet-pornography channels or the internet is used to sell children. The internet and the use of mobile phones have also helped take abuse, particularly of young boys, off the streets and into bedsits and grotty flats.

Libby Fry runs one Barnardo's project in Islington, north London. Demand is so high that they have had to limit their work to just 13- and 14-year-old girls. At the moment the project is trying to help 65 children. 'We decided to focus this project on sexual exploitation because in our work with the homeless and other vulnerable children the issue was coming up more and more,' she said. 'Social services and the police were telling us it wasn't happening; we could clearly see it was. We are now deluged with referrals. 'The stories of these children are diverse. Trafficking is an issue and asylum seekers' children can be very vulnerable. We have one 12-year-old who would seem to have been brought into the country by people who are not her parents.'

'It can be kids in care homes who are recruited by other children. It can be runaways or children groomed over the internet, or girls whose mothers or aunties are involved on the fringes of prostitution and they are then targeted. We know places in London where pimps are actively out looking for children. There is also the drug issue. The crack houses and clubs where drugs are widely available also seem to be places where child abusers gravitate to.'

It has only been in the past two years that the Home Office has advised police that they should no longer treat child prostitutes as criminals but as victims. But still many children are sent not to agencies that might help them but to courts, or are cautioned and allowed to return to adults who control them. 'Not every police force has adopted this practice yet, and certainly while there is only an offence of "living off immoral earnings" for pimps and customers, going after the men behind this abuse is never a priority,' said Fry.

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Top Tory backs blast at gays and lesbians

Kamal Ahmed, political editor
Sunday September 15, 2002
The Observer

A senior Tory baroness has given her personal backing to a book which claims that multi-culturalism is ruining Britain by importing 'foreign practices', homosexuality is 'destructive' and that abortion can be directly equated with the Holocaust.

Caroline Cox, a Deputy Speaker in the House of Lords, writes a series of endorsements in the book, Great Britain has Fallen, saying its arguments 'showed the way forward' in reversing what she called Britain's moral decline.

Her words will embarrass Iain Duncan Smith, the Conservative leader, only 48 hours after he said the party must reach out to vulnerable people and others who had not traditionally seen the Tories as their natural home. Labour MPs immediately called for Cox to apologise unreservedly and said her support for the book revealed there was still an extremist wing of the party that needed to be dealt with.

'Iain Duncan Smith must show whether he really means what he says,' said Tom Watson, a Labour MP who is on the Commons Home Affairs Select Committee. 'He should demand that she apologises and if she doesn't she should be expelled from the party.'Cox's position as Deputy Speaker means she has the tacit support of Duncan Smith's front bench team.

The book is by Wale Babatunde, a minister at the World Harvest Christian Centre in London, who has been described as a missionary to Britain from his home country, Nigeria. It was launched at an event at the Lords last June, supported by Cox.

Babatunde writes:'Modern Britain is a multi-cultural society, which has allowed a whole variety of foreign religions and practices to flourish.' He describes lesbianism as 'against nature' and claims gay lifestyles are undermining the family, while lowering the age of consent shows how 'unrighteous, how unprincipled, how depraved the Government can be'. Babatunde says of abortion: 'By 2005 Britain will have killed as many as 6 million children - the same number of Jews that Hitler killed. Evil should be called evil, and not freedom to make a choice whether to kill your child or not.'

In her endorsements of the book, Cox regrets a lower commitment to Britain's 'rich spiritual and cultural heritage based on the Judaeo-Christian tradition', and adds: 'We have sown to the wind and are reaping the whirlwind of declining morality and increasing cynicism. 'There is an urgent need to recreate a vision, which will preserve all that is best in our spiritual heritage. This book will help highlight the need and show the way forward.'

Mean streets

Guardian, 16th September 2002

In the past 10 years, at least 60 prostitutes have been murdered in the UK. Many more are missing. Yet the violence against these mainly young, drug-addicted women is often unreported. Worse still, says Maggie O'Kane, who has spent four months working on a TV documentary about street sex in the UK, new laws against kerb-crawling are forcing prostitutes to work in more and more dangerous areas.

We usually met in her squat and went to McDonald's on Spital Fields. She always ordered a Big Mac, chips, Coke or Fanta, a strawberry milkshake, and a chocolate fudge sundae. It was the only time I ever saw her eat. The last time I saw Lynne Carroll, she was pulling her coarse navy woollen gloves over her translucent, veined hands and getting ready for work. A shredded white plastic bag was flapping in the broken glass of her bedroom window.

Carroll was 21, a victim of Dublin's 80s heroin rush. When she went on the run for shoplifting, she ran from Dublin to Sheffield; her boyfriend's mother had emigrated there before her. In the squat, the kitchen sink had a necklace of dust in the plughole. She only used the flat to sleep in and to tighten that black leather belt around her arm, inject and let her brain flop into heroin. It had been that way since she was 17. If she had any plans to leave Sheffield suddenly, she never mentioned them.

Carroll was fussy about her hair, her long, tired hair with long split ends and the faint hint of red. She always had a faint whiff of sex about her. At night she fed her hungry heroin and cocaine master with £150 worth of prostitution: hand job, £15; blow job, £20; and full sex, £25. The clients buying sex were mostly ordinary men: lonely men, bored men, and weekly men. Angry men occasionally killed. The risks were huge.

Just before we met, Carroll had spent the night working the same streets as another prostitute, Michaela Hague. It was November 5 last year. By the end of the night, Hague was bleeding to death on the gravel of a deserted car park near Corporation Street, choking as she tried to give the details of her killer to a young PC named Richard Twigg. Below, in the distance, shone the lights of Sheffield. Around them were the used condoms of previous transactions. Hague had 19 stab wounds. The ambulance arrived to take her to die in hospital, word of her murder got around the street - and Carroll went back to work.

Heroin is not a patient master. For four months, a television documentary team and I filmed Carroll and dozens of other prostitutes as part of a survey that uncovered the phenomenal rate of violent attacks on, and murders of, British prostitutes. Through talking to more than 100 women and the police, and going back through newspaper cuttings and home office data, we uncovered violence against these women that has so far gone unnoticed. Even their deaths often pass unmarked, and they make up the largest single group of unsolved murders in Britain. At least 60 prostitutes have been murdered in the past 10 years - probably more. An unknown number of women are missing. The vast majority of murder cases are solved, yet in a third of all prostitute murders, the killer is never found. Their deaths make small paragraphs in the national newspapers: when they go missing, as Carroll did, often nobody bothers to report their loss - mostly their families lost them to heroin years earlier. They become a body found in a ditch, or a prostitute last seen at a motorway service station.

In Europe's prostitution capital, Amsterdam, only two prostitutes have been murdered while working in the last five years. In Britain, the most recent case was just three months ago. The victim was 21 years old, a heroin addict and pregnant. Her name, Danielle Moorcroft, like those of other murdered prostitutes, was quickly forgotten. Most of these women you will never have heard about. Their deaths rarely make the national press.

Is there another serial killer on the loose? The police say not. Operation Enigma was set up six years ago to investigate possible links between the murders. Now defunct, it concluded that there was no evidence of a mass killer, but that some men may have killed more than one woman.

Alun Kyte was such a man, convicted of two prostitute murders. Kyte had sex then strangled his victims and dumped their bodies in ditches. In prison he reportedly told a cellmate: "You don't pay for those kind of women." In Kyte's case, it was days before the women were even reported missing. Forensic psychologist Paul Britton helped the police investigate the Kyte murders: "He is not a highly complex, careful-planning, puzzle-making serial killer. He killed because they are easy to kill."

In our investigation, prostitutes all over the country, usually reluctant to go on camera or talk to journalists, were eager to talk about attacks on them. Mostly they are frightened. Of the women we spoke to, 73% said that they had been attacked in the past 12 months - most more than once. Almost half the women said that the men got violent when they asked for payment for their services, a quarter said that they had been threatened or stabbed with knives, and 8% said that they had been threatened with guns.

Like Carroll, who weighed five stone when I last saw her in April, many of the women are emaciated by heroin, strung out on the drug and incapable of putting up a fight. "It's Tuesday night now - I won't go to sleep until about Thursday, Thursday or Friday," she told us once. "Could be later than that again but depends when I can keep my eyes open until. 'Cos I don't like being tired on the street 'cos that's a danger in itself. There've been occasions when I've fallen asleep in punters' cars and they've woken me and told me, 'Are you ready for business?' and I'm like, 'Silly girl, silly girl'."

For years, Sheffield's prostitutes worked the brightly lit, non-residential streets near the city centre where CCTV cameras covering offices and businesses also provided them with some protection. Murderers don't like cameras. There were quiet places for cars to park nearby where Carroll could "do business" without being seen. But, following complaints from local businesses, the police threatened to prosecute the women who stayed. The crackdown intensified in October last year when new laws gave the police the right to arrest kerb-crawlers. In Sheffield, the prostitutes were moved from the city centre to an old industrial estate near Corporation Street where there are few lights and no cameras. It was from here, the same streets that Carroll was working on, that Hague was driven to her death last November.

"There are no bright lights or high-quality CCTV cameras," says Sharon, a former hairdresser turned addict and prostitute who also works Carroll's beat. "There's no lighting, no security, nothing well lit. The only people round here are weirdos and punters. It's just basically scary and horrible. "They should put us in an area where we'll all be safe, which is well lit and with cameras, things like that. The police go round arresting us, making it hard for us to work. We've had to go so underground, it's unbelievable."

The theory: scare off the punters and the prostitutes will go out of business and off the streets. The main flaw to the theory: men still want to buy sex and these women are heroin addicts. Supply and demand. Even if some men are scared off by police clampdowns, the women we surveyed said that that meant they had to hang around longer and go to more isolated locations to earn the same money from fewer men.

As far as she can, Sharon tries to control the level of risk. "When the car pulls up, go to the window, bend yourself down. Look at the guy. Basically, I make sure the person's by himself, have a good look at the guy himself and try to judge him as best you can." But when the new law was introduced, Sharon says all that changed as a result of punters becoming more frightened that the police would catch them. "Car pulls up, you haven't got time to check it out as well as you like, it's just in and off."

Just six weeks after the new law was introduced, a man in a smart car approached Sharon. He was nervy, impatient - the police might arrive at any minute. Sharon got in the car. The man drove her out of town, along a country road, where no one could hear her scream. Her ordeal lasted two-and-a-half hours. She was tied up, gagged, beaten, raped and strangled. While hitting her, the man shouted: "You fucking slag, you love it really." She lost consciousness several times. Then the man in the smart car gave her £40 and drove her back to town. Like most street prostitutes, Sharon did not report this attack. She says that the police in Sheffield are not sympathetic. "They are shite, killed by shite; who gives a shite?" one police officer reportedly told the Sunday Times after a prostitute murder in 1995.

Other officers, such as Detective Chief Superintendent Max McLean, do care. He has spent more than a year investigating the murder of a 19-year-old prostitute, Becky Hall, in Bradford. He appealed for help on Crimewatch and is dismayed by public indifference. "Your general man in the street, I think, genuinely doesn't care if a prostitute gets murdered. And if you speak to any senior detectives throughout this country, the first decision they make when they find a naked prostitute who's been murdered is whether to tell the press she's a prostitute. Because you think, right, if I go to the press and say that a 19-year-old single mother has been brutally murdered in the street, then I'm going to get the shock, horror, I'm going to get people interested." Many of the prostitutes are young women who have been abused as children. Now their deaths bore the public. "If I say that a 19-year-old prostitute's been found stripped naked and murdered in a red-light area, the public think it's one of those things, isn't it, hazard of the job," says McLean.

In Liverpool, Anne-Marie survived a sinister attack by a man, who picked her up in a van, already kitted out with black plastic bin liners and a noose. He forced her into the back of the van at knifepoint, stabbed her, made her strip, and then tied her up. "He put a rope from me neck down to me hands to a slip-knot, so that if I moved or struggled the rope would tighten on me neck. Then he put me into a big industrial plastic bag, got into the front of the car and started driving. And I thought then, I've got to try and get out. I wriggled like a snake on to my sides. I got my toes out of my shoes and into the handle of the van door and I pushed with every ounce of strength I had and I just booted it then and I started rocking in the back of the van and I swung myself right out." Her attacker was caught and sentenced to 21 months in prison. The sentence was light because Anne-Marie was a prostitute and hadn't been forced into the van.

Forensic psychologist Professor David Canter, who specialises in male violence, says Anne-Marie's attack is not untypical: "From the reports we're getting from these women, the people who are violent are not an unusual sample of the population of customers... these people are in their 30s, and seem to be local individuals, often reasonably well dressed. In therapy sessions in clinics the violence comes from people that can include senior army officers, businessmen, doctors, pillars of the community. Frequently, our studies report a huge range of abuses in the family - beating their wives and assaults against their children. If these men find the opportunity to indulge in that violence and get away with it against strangers, where they feel less guilt, then these opportunities will be acted on."

Britton, a psychologist who has provided psychological profiles for the police in many unsolved prostitute murder cases, is equally certain that the majority of men who murder prostitutes are ordinary and mundane - not serial killers such as Peter Sutcliffe on a mission from God to clean up society. "They kill not to fulfil any particular sexual fantasy," he says. "They kill because prostitutes are easy to kill."

Back in Sheffield, Carroll told us that the new laws meant that the women had to take their clients to a swamp, half an hour's drive out of town along the Riverlin Valley road, the road along which another prostitute, Dawn Shields, was picked up and then driven to her death in 1994. It's quiet, dark, remote, and there's no one around. "What would happen if you were attacked here?" Carroll looked around. "God only knows what would happen. I'd be fucked."

Superintendent John Brennan - the man in charge of policing in Sheffield's red-light district - wants the city cleaned up. He believes that prostitution can be wiped out in Sheffield. Dealing with heroin addiction (and every street prostitute we met was an addict) is not his top priority. His job is to enforce the law and he believes that by cracking down hard on the women and the kerb-crawlers, he can eradicate prostitution in the city. No prostitutes on the streets means no dead prostitutes. Canter says that that is naive. We found only two women who had stopped working as prostitutes because of police crackdowns.

Glasgow is one city in Britain where keeping prostitutes alive seems to be a priority. It took seven murdered prostitutes to change policy there and an extraordinary police chief - Nanette Pollock (now retired). "Because of the murders we'd had, we realised it would be so much more dangerous to push women out to isolated spots," she says. "I'd love to eradicate prostitution, but we've got to be realistic and realise that prostitution does happen. We don't condone the work they do, we don't condemn it, we're not here to be judgmental, but they're part of the community, and we've got to keep them safe like everyone else."

The Glasgow women are allowed to work in a zone of eight streets - provided they obey the rules. They can only work between 8pm and 4am, after the office workers have gone home, and must be discreet. It's a compromise most people find acceptable. The streets in Glasgow's red-light area are well lit and surrounded by high-quality CCTV cameras. They are a strong deterrent - any man who is violent to a prostitute he picks up here is likely to get caught. The cameras can pick up car registration numbers and even drivers' faces. The same cameras also protect the businesses in the area.

The Scottish Executive has also invested £1m in Glasgow to help women leave prostitution. Last year, 15 women got off heroin and another 100 asked for help to leave the trade.

Before leaving Sheffield, we went back to see Carroll. The door to her squat was boarded up. We drove round the red-light area looking for her. None of her friends had seen her for weeks. It's now been five months since she disappeared. We went to find her long-time boyfriend Alan, serving time at HMP Young Offenders Institute Deerbolt. He played with his teacup on the Formica table. He was serving six months for shoplifting. He tried to help Carroll feed her heroin habit by robbing in Debenhams and Marks & Spencer in Sheffield's Meadowhall Centre. But Alan was a bad shoplifter and Lynne was a bad addict. He kept getting caught.

In the prison visitors' room, he told us that he hadn't heard from Carroll since March. He spoke in the dismissive tones expected of young men serving time in their regulation trousers and crew cuts. But they have been together since they were 16 and she told us she had miscarried his child earlier this year. In their world of prison, heroin addiction, violence and pimps, Lynne and Alan offered each other a gentle, strung-out shoulder. Since his release, Alan has been back to the squat several times to look for Lynne. No one has seen her since March. Someone else lives there now.

UK: HIV infection rate pinpointed

One in 50 gay men attending a sexual health clinic has contracted HIV in the previous year, according to researchers. Last year saw a record number of new HIV diagnoses.

Experts from the Public Health Laboratory Service used a new test to identify the rate of new infections. However, experts did not know how many were new infections and how many patients had been infected years before, but only recently been diagnosed.

Special tests were carried out on the blood of 33,000 gay men attending 15 clinics across England and Wales between 1995 and 2000. By checking how mature antibodies were, scientists could see how recent the HIV infection was. They found one in 50 - 2% - per year become infected with HIV. The 2% risk is amongst gay men attending sexual health clinics, not gay men in general.

Experts had believed new infections would be concentrated amongst younger men in the 20 to 35-year-old group studied because they took more risks in their sexual behaviour. Researchers found there was no difference in HIV incidence across the age range.

Dr John Parry of the PHLS Central Public Health Laboratory, who was one of the researchers in this study, said: "This is a worrying finding because it confirms what we have feared, that 20 years into the HIV epidemic, transmission of this incurable but preventable infection is continuing at a steady rate in gay men."

Dr Noel Gill of the PHLS Communicable Disease Surveillance Centre told BBC News Online: "There's a constant rate of transmission. The safe sex message is not being adhered to. Behaviour is not changing."

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UK Doctors Warn of Drug-Resistant HIV Spread

September 10, 2002 02:33:02 PM PST,
Reuters

A worrying proportion of people in Britain are becoming infected with HIV that is already resistant to some drugs, leaving them with limited treatment options, researchers warned on Tuesday.

HIV has the ability to mutate and overcome the antiretroviral drugs used to fight it, forcing doctors to change the combination of medicines they prescribe to AIDS patients in a kind of medical arms-race.

At the Public Health Laboratory Service (PHLS) annual scientific conference on Tuesday, a leading drug-resistance specialist said that up to 25% of new infections are with strains that already have these resistance mutations.

"We now know that resistant strains can be transmitted from one person to another, meaning that patients can be carrying drug-resistant strains from the moment they are infected," said Dr. Deenan Pillay of the PHLS Antiviral Susceptibility Reference Unit in Birmingham.

"This does not mean that they cannot be treated, but it does mean that the range of drugs available to treat them is reduced."

At the meeting, scientists showed that these resistant viruses stay resistant in people that are newly infected, contradicting a theory among doctors that the virus might become vulnerable to the drugs again.

"It was thought that these viruses would continue to mutate and lose the ir resistance patterns, so that when treatment was started those patients would respond as well to treatment as those infected with other HIV," Pillay told Reuters Health.

"What we found was that when we monitor those patients around the time they've been infected, and for up to 5 years, those resistant viruses in the absence of therapy continue to be present."

"There's a better argument now than ever before that whenever people are diagnosed with HIV, their viruses should be tested for resistance just to see whether they were infected with a resistant strain originally," he said.

The study also reinforces the importance of prevention, according to Pillay.
"We still have no cure for HIV, and with the advent of resistance we do not know how long those drugs which we currently use to keep the disease in check will remain effective," he said. "Safer sex is the key to preventing HIV."

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Giving AIDS the Red Light

The Sonagachi AIDS Project in Kolkata, India, has gone from being a quasi-governmental program to one of the largest community-run intervention projects in the world.

Sex workers now run the show, and inSonagachi (meaning "golden tree"), famous as the oldest, largest, and most storied red-light district in the city, only 9 percent of about 6,000 sex workers are HIV-positive. In comparison, as many as 70 percent of prostitutes in Mumbai (formerly Bombay) were HIV-positive in 1997.

The women organized the Durbar Mahila Samawaya Committee -- Asia's first union of sex workers -- in 1997 and took control of the local government AIDS project. With 60,000 male and female members in West Bengal, the union worked for the decriminalization of prostitution, for equal worker's rights, and entitlement to negotiate working conditions.

Dr. Smaraajit Jana, a government epidemiologist who spearheaded the Sonagachi project, explored enhancing self-esteem as part of changing deeply entrenched sexual practices by the sex workers. He trained 12 sex workers to come forward as "peer educators." These educators informed about STDs and urged the workers to get clinic-approved blood tests.

Soon hundreds of women were refusing unprotected sex, even if their clients offered to pay more. "When a customer comes, I take the money first and then let him in my room," said Priya Begum, 23, a Sonagachi sex worker. "Then I ask whether he'll use a condom. If he says no, I keep the money and show him out," she said.

Today, 430 peer educators spread awareness throughout Bengal, and 36 brothel-based medical clinics regularly test sex workers. DMSC has also established a school for sex workers' children, a loan co-op, and a cultural group that spreads AIDS awareness through music, dance and street theater.

Recently, Sonagachi AIDS Project has inspired broader projects. Responding to the increasing epidemic in India -- the total number of people living with AIDS in India in 2001 was 3.97 million, according to UNAIDS -- a group of professionals and citizens opened the City Counseling Center in downtown Kolkata, and with it an affiliate support network -- the Kolkata Network of HIV Positive People. "Intervention
programs running in high-risk areas are only the tip of the iceberg. Awareness has to spread to the rest of society," said Dr. Debjani Banerjee, one of CCC's coordinators.

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Watchdog May Force Cut In AIDS Drug Prices

Aids activists have accused GlaxoSmithKline and Boehringer of pricing South Africans out of the market and yesterday began a campaign to bring the cost of HIV/Aids drugs down. The companies have denied the allegation and insist that the treatments are cheaper in poorer countries.

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Police in Amsterdam Detained Two Hundred Bulgarians and Romanians

Police in Amsterdam detained some two hundred Bulgarians and Romanians who stayed illegally in the Netherlands. Moments of the police raid, in which over five hundred policemen participated, were aired on the Dutch TV channels.

Half of the detained reportedly were prostitutes. The rest allegedly were stealing and cheating. Some of the detained reportedly cheated on tourists, presenting themselves as policemen. All who have been arrested currently are in a former refugee camp near Amsterdam and most probably will be taken back to their countries by charter flights on Wednesday.

Only three weeks ago eighty-two Bulgarians were arrested in Hague and sent back to Sofia.

High speed condom to fight AIDS

It just takes three seconds to put on.

A new method of using condoms has been developed in South Africa to help the fight against HIV/Aids. An applicator has been developed to make the process of putting on the condom much faster and simpler.

Tyrel Murray, Metropolitan Using it, a condom can be put on in just three seconds, compared to the standard 30-40 seconds, the developers say.

Research shows that many people do not use condoms because they are fiddly and can be "passion killers". This prompted South African life insurer Metropolitan to fund the search for an easier way to use condoms and so help reduce the spread of HIV, Tyrel Murray from Metropolitan told the BBC's Focus on Africa programme.

"People couldn't put it on the dark," he said of a traditional condom - a problem he says the new applicator solves.

About 25% of sexually active South Africans are HIV positive, according to the government.

The applicator was developed by Cape Town-based entrepreneur Willem van Rensburg but is not yet being marketed. However it costs just one US cent more to produce than a traditional condom.

It is made of polyethylene and comes inside the same package as a condom.
To use it, you bend the packet, which splits open. The condom then slides directly onto the penis and the applicator "pops" off the condom.

"The intention is to make more people use condoms more readily," Mr Murray said.

As a life insurer, Metropolitan has an interest in helping people live longer he said, explaining why he had agreed to fund the project.

And Mr Murray also gave it his personal seal of approval. "It was fun," he said.
"I'm an old married man. I need the novelty."

New Report on AIDS

London -- A new report on AIDS funded by the British government says that a record number of gay men examined at British clinics have contracted HIV over the last year.
Between 1995 and 2000, the Public Health Laboratory Service tested the blood of 33,000 men from England and Wales, of which one out of every 52 were found to have contracted the HIV virus over the previous 12 months.

The report also found that AIDS is not only increasing among younger men, who it was generally believed were ignoring safe-sex messages, but also among mature men.

The researchers said that they had believed the majority of patients would be aged between 20 and 35 but there was in fact no difference between the age groups.
"This is a worrying finding because it confirms what we have feared, that 20 years into the HIV epidemic, transmission of this incurable but preventable infection is continuing at a steady rate in gay men," said researcher Dr John Parry.

But Will Nutland of the Terrance Higgins Trust, a London AIDS clinic, stressed that the figures related to gay men attending clinics, rather than the gay population in total.
Nevertheless, he warned, that many men who are HIV-positive are not telling their sexual partners about their status. "If they don't tell you they are positive, men shouldn't assume they have the same status as themselves," Nutland said.

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Transgender issues

In a landmark session on Thursday, public health workers learned that they can -- and should -- ask transgender patients what pronoun they wish to be called. Otherwise, doctors and nurses may bungle their only opportunities to detect or treat HIV in a vulnerable and neglected risk group, transgender activists said.

"If you use the wrong pronoun, you can offend them and they'll clam up," warned Jessica Xavier, a transsexual and volunteer director at the Whitman-Walker Clinic, a Washington, D.C., gay health center.

Xavier and other activists spoke about the unique health needs of transgender people in a panel at the annual U.S. Conference on AIDS in Anaheim, Calif. More than 100 public health workers attended the daylong workshop, the most extensive ever held on transgender health issues at an AIDS conference.

No one knows how many transgender people there are or how many are infected with the AIDS virus. But a 2000 study found that 15 percent of those tested in San Francisco were HIV-positive, and some experts think the numbers may be much higher, as much as 7 in 10.

"We could really have a lot higher prevalence of HIV in our community than even anyone's aware of it. Many don't want to get tested because of the stigma," said Brenda Thomas, a senior sexual health educator for the city of Houston who is in transition from male to female.

According to health officials, transgender people are at high risk for HIV infection for several reasons: they sometimes work as prostitutes, they suffer from high rates of drug and alcohol addiction and they sometimes share dirty needles for hormone injections.

Also, transgender people can make themselves more susceptible to HIV transmission through chafing and bleeding caused by body shaving and the practice of tucking their penises out of sight in order to appear more feminine.

"The penis can get rubbed raw, it can get nicks, scratches and cuts, and become another entry point for HIV," Thomas said.

On Thursday, Xavier and others called on public health workers to recognize the special needs of transgender people and not consider them to just be gay men.
Transgender activists have been working to convince federal officials to create a separate category other than "MSM" (men who have sex with men) to track transgender people with AIDS.

"They bundle us with men who have sex with men, and it's not what we want, it's not what we are," Thomas said. "It doesn't send the proper message to us in terms of prevention and what we do. Most transgender people don't identify as gay. The bulk consider themselves to be heterosexual."

But the government has not changed its tracking system. "They see two people with penises and they say 'MSM'," Xavier said, even though the transgender population "works from a different script."

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HIV positive muppet on SABC TV

Her name is Kami and she has HIV, she is also a Takalani Sesame character and she is unique to South Africa.

Sapa, September 23, 2002 0

CAPE TOWN - Moshe, Zikwe, Zuzu and Neno will be back on SABC TV screens and radio with a new friend, Kami, a muppet living with HIV, when the second season of Takalani Sesame debuts on September 30.

The programme is specifically targeted at the seven out of eight young children who have little or no exposure to formal early childhood development programmes and was made possible through a partnership of private, government and non-government organisations.

Speaking at the launch of the HIV-positive muppet as part of the new children's series, at Groote Schuur Hospital in Cape Town on Tuesday, Education Minister Kader Asmal said South Africa was the first country in the Sesame Street family to introduce a radio component.

"As many of our children live in rural areas, often with no access to television or electricity, we needed to make it possible for children to have access to the programme through radio," Asmal said.

He said another first for South Africa concerned the muppet living with HIV.
"For us it is our responsibility as a nation, as a government, and more specifically as partners with the education sector, to respond to the needs of many of our children who are infected and affected by HIV and Aids," Asmal said.

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'Drug Holidays' Not Beneficial for Fighting HIV

September 23, 2002 05:32 PM ET

NEW YORK (Reuters Health) - Despite hopes that taking regularly scheduled breaks from combination drug therapy would train the immune system to keep HIV, the virus that causes AIDS, under control, a new study fails to detect any benefit of such "drug holidays."

Once a person becomes infected with HIV, levels of the virus in the blood rise, but eventually this level, known as viral load, stabilizes at a certain point, which varies from person to person. This so-called set-point viral load is a good indicator of how quickly a person will progress to AIDS without treatment.

Since the mid-1990s, many people with HIV have had their viral load suppressed to undetectable levels thanks to powerful combination drug therapy. Although combination therapy has been life-extending for many people, the drugs are expensive and can have serious side effects. In addition, some people have a hard time sticking to the complicated regimen of daily pills.

A few reports have suggested that structured, physician-supervised breaks from combination therapy may improve the ability of the immune system to fend off HIV. The hope was that repeatedly exposing the immune system to HIV during short drug vacations might lower the set-point viral load.

In a study of 97 patients with chronic HIV infection, however, that did not turn out to be the case, according to an online report in the Proceedings of the National Academy of Sciences Early Edition. Dr. Annette Oxenius, of the Eidgenossische Technische Hochschule in Zurich, Switzerland, found that viral load was slightly lower after drug vacations, but the difference was very small. But taking a break from combination therapy did not affect immune cells called CD8 T-cells that specifically target HIV. Only those patients who had a vigorous CD8 response to HIV before taking a break continued to do so afterwards.

The researchers conclude that structured treatment interruption is "generally unable" to alter how a person's immune system responds to HIV. The authors point out, however, that the study included patients who were chronically infected with HIV. Research has shown that structured treatment breaks for newly infected patients can alter the immune response to HIV.

SOURCE: Proceedings of the National Academy of Sciences
Early Edition 2002;10.1073/pnas.202372199.

XXL Condoms fail to sell in UK

The condom maker Condomi reported that its launch of a new extra-big version was a flop in the United Kingdom because British men were too shy to buy them.

''Research shows that most men rate their penis as smaller than average, which of course is not true, and may be an illusion based on the distorted view of the genitals from above,'' said Glenn Wilson, a psychologist employed by Condomi to examine the issue. ''Knowledge of this effect may be reassuring to many men and help raise their self-esteem.''

The Condomi XXL is 200mm long, 20mm longer than its standard size, and 54mm across, 2mm wider than its other products. ''We launched the XXL condom in the U.K. on the basis that there is a demand for a larger condom. In all Condomi's other markets it is selling well,'' Condomi's Victoria Wells said. ``Unfortunately, U.K. retailers aren't as convinced as we are that British men are well-endowed, but we hope that our research, coupled with Dr. Wilson's research, will help convince them to now start selling the XXL product.''

HIV Vaccine Trials May Be Opposed by AIDS Victims

September 20, 2002 04:06:59 PM PST, HealthScout News

By Randy Dotinga
HealthScout News Reporter

FRIDAY, Sept. 20 (HealthScoutNews) -- The very groups who may most benefit from an AIDS vaccine may also be the ones who offer the most resistance to its final testing phase. Researchers said this week they expect opposition to widespread HIV vaccine tests from groups comprising gay men, blacks and IV drug users.

"There are social and political challenges," said Joy Workman, a senior program manager with the National Institutes of Allergy and Infectious Diseases, at the annual U.S. Conference on AIDS in Anaheim, Calif.

In a series of video interviews presented at the conference, people in the major risk groups said they feared taking part in health research because they don't trust their government. Many summed up their concerns by mentioning the words "guinea pig" and "Tuskegee" -- a reference to the disastrous study of syphilis among Alabama black men.

The willingness of people to participate in vaccine testing is no minor matter, experts s aid. As many as 15,000 people must take part in the final testing phase of any HIV vaccine, said Steve Wakefield, associate director for community relations with the HIV Vaccine Trials Network. And it makes the most sense to launch the studies in developed countries that have strong health systems in case someone gets infected with HIV, he said.

Researchers have been testing HIV vaccines on people since 1987. Their goal is to develop a vaccine that will prevent infection by HIV, the virus that causes AIDS. While researchers have studied 50 vaccines worldwide, only one has reached so-called "Phase III" testing, in which thousands of people at high risk are given the vaccine and then followed for several years to see if they become infected. The other phases, which last as long as two years each, test the vaccines on small numbers of people, usually at low risk, to determine if they are safe and if they work better than placebos.

Results from testing of the one vaccine in Phase III -- known as AIDSVAX -- are expected next year. It is being developed by the VaxGen company, which has been examining its effectiveness among subjects in North America, Puerto Rico, the Netherlands and Thailand.

There's reason to believe a vaccine is possible, because some people at extremely high risk -- prostitutes, for example -- don't get infected despite repeated exposure, said Dr. Gaston Djomand, a clinical trials physician with the HIV Vaccine Trials Network. Also, a small number of HIV-positive people have never developed AIDS despite being infected for many years.

"There is probably a natural mechanism of protection," Djomand said. "We strongly believe that a vaccine is possible."

However, researchers have had to abandon several vaccine strategies because they didn't work, he said. Researchers are no longer looking at using a live weakened strain of the virus (as is used in measles and chicken pox vaccines) or a dead in activated virus (as in flu vaccines).

The most promising vaccines in development may be able to prime the immune system to protect against transmission of HIV through both sex and blood.

Vaccine experts said education is key to convincing people at high risk to take part in the final phases of HIV vaccine studies, which may become more common. "Just handing out a brochure will not bring out all the information you need," Wakefield said.
The challenges appear to be major, according to a video that studied opinions about vaccine studies among gay men in San Francisco, IV drug users in Philadephia and blacks in Durham, N.C.

"We're in a minority, and in the bigger picture, we're not treated that well by the government," said a gay man. "Are they really going to be honest with us?" asked a woman from Philadelphia.

And a male IV drug user asked, "What good is it going to do for you to cure me?"
Renee Turner, a television produ cer and member of a federal HIV vaccine communications task force, said researchers must find ways to get people at risk to stop worrying about "boogiemen" and think about the health of their community.
"There is a cost for being left out," she said.

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Most Testing HIV+ Willing to Tell Partners: Survey

September 18, 2002 10:28:15 AM PST, Reuters

Most people who test positive for HIV ( news - web sites) are willing and able to contact their sex partners to inform them, a survey of New York City individuals seeking HIV testing has found.

In 1998, New York State legislators passed an amendment to the public health law mandating partner notification for people newly diagnosed with HIV, note Dr. Alex Carballo-Dieguez of the New York State Psychiatric Institute and colleagues.

To investigate how willing people would be to either give the counselors contact information for their partners, or contact them themselves, the researchers surveyed nearly 1,400 people who underwent pre-HIV-test counseli ng at one of 14 NYC Depa rtment of Health STD (sexually transmitted diseases) Control Program sites.

Between January and May 2000, just before the notification law went into effect, 1,372 individuals (11% of clients seeking testing) completed the survey. Of those who reported having unprotected sex during the previous 2 months and who supplied information on their ability to contact partners, only 4% of women who had sex with men reported that they would be unable to do so. The corresponding proportions were 8% of men who had sex with women and 18% of men who had sex with men.
More than 94% of respondents also said they would contact at least one partner on her or his own.

Ethnicity did not affect willingness to contact partners or to give information to the Department of Health (DOH). However, heterosexual men were significantly more likely than men who have sex with men to give information to the DOH, according to the report in the August issue of Sexually Transmitted Diseases.

Of respondents who acknowledged any drug abuse, 85% were willing to give contact information to the DOH on partners with whom they had had unprotected sex. Women who reported drug abuse were less likely to do so than were women with no such history of abuse during the previous 2 months.

According to published reports, not all HIV-infected individuals do notify current or past sex partners, Carballo-Dieguez and his colleagues write. Therefore, the form of partner notification that they would recommend is "contract referral." In this scenario, the person is encouraged to notify his or her partner within a certain amount of time, but if he or she does not, the healthcare provider will do so.

Drew De Los Reyes is director of the David Geffen Center for HIV Prevention and Health Education at Gay Men's Health Crisis in New York. Noting that the center had already been working with clients regarding partner notification before the law took effect, De Los Reyes told Reuters Health that the law's implementation had little effect on client counseling.

"Part of our standard of care all along has been to talk about and motivate clients to pass along information about their HIV serostatus to their partners," he said. "Of those who test positive, only a very small percent choose not to notify their partner themselves.

"Before the partner notification law passed, there were a lot of questions. Will people continue to be tested confidentially, or will they avoid testing?" De Los Reyes continued. "We saw no drop in numbers at all. As a matter of fact, we've seen a slight increase in the numbers being tested, with a return rate over 99%."

He believes this is one of the best return rates in the country for HIV testing sites. He attributes the success rate to the amount of counseling that clients receive even before blood samples are collected. "We allow time for the client to look at his or her individual needs" and don't just lecture them on risk avoidance, he added.

"Perhaps no area of STD research has been more neglected than partner notification," Dr. Matthew R. Golden, from the University of Washington in Seattle, writes in an editorial accompanying the article by Carballo-Dieguez and colleagues. "Fortunately, some momentum appears to be developing in support of a renewed emphasis on this longstanding disease control activity."

De Los Reyes noted that he and his associates are planning to publish details of their methodology within the next year.

SOURCE: Sexually Transmitted Diseases 2002;29:465-471, 472-475.

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