Sunday, August 30, 2009

India's Moon Mission is Dead: Chandrayaan-I Spacecraft Loses Radio Contact



Radio contact with Chandrayaan-I spacecraft was abruptly lost at 0130 Hrs (IST) on August 29, 2009. Deep Space Network at Byalalu near Bangalore received the data from Chandrayaan-I during the previous orbit upto 0025 Hrs (IST).

Detailed review of the Telemetry data received from the spacecraft is in progress and health of the spacecraft subsystems is being analysed, according to ISRO scientists.

It may be recalled that Chandrayaan-I spacecraft was launched from Satish Dhawan Space Centre Sriharikota on October 22, 2008 .The Spacecraft has completed 312 days in orbit making more than 3400 orbits around the Moon and providing large volume of data from sophisticated sensors like Terrain Mapping Camera, Hyper-spectral Imager, Moon Mineralogy Mapper etc., meeting most of the scientific objectives of the mission.

Radio contact with Chandrayaan-I spacecraft was abruptly lost at 0130 Hrs (IST) on August 29, 2009. Deep Space Network at Byalalu near Bangalore received the data from Chandrayaan-I during the previous orbit upto 0025 Hrs (IST).

Detailed review of the Telemetry data received from the spacecraft is in progress and health of the spacecraft subsystems is being analysed.

It may be recalled that Chandrayaan-I spacecraft was launched from Satish Dhawan Space Centre Sriharikota on October 22, 2008 .The Spacecraft has completed 312 days in orbit making more than 3400 orbits around the Moon and providing large volume of data from sophisticated sensors like Terrain Mapping Camera, Hyper-spectral Imager, Moon Mineralogy Mapper etc., meeting most of the scientific objectives of the mission.

Friday, August 28, 2009

Charak Samhita: Did swine flu find mention in Ancient Ayurvedic texts


By Syed Akbar
Hyderabad, Aug 27: Did swine flu, which has killed hundreds of
people world-wide, find a mention in Charak Samhita, the ancient
Ayurvedic text dating back to the third century BC?

The Department of Ayush suggests that Charak Samhita and other
ancient Ayurvedic medical books had made references to symptoms
that are similar to swine flu. The Ayurvedic texts had classified viral
ailments and epidemics including those with symptoms of swine flu
under "Vaata Kaphaja Jwara" category.

According to Charak Samhita, which deals with internal medicine, the
outbreaks of Vaata Kaphaja Jwara are noticed during autumn/spring, in
seasonal change and in moderate climatic conditions.

Soon after swine flu claimed its first victim in the country, the
department of Ayush constituted a group of experts to study the health
problem. Several Ayurveda experts and research councils were
involved in the task of finding remedial measures to curb the spread of
the novel human influenza virus. The experts in their report traced
swine flu to Vaata Kaphaja Jwara category and came out with a number
measures to prevent the spread of the disease.

"The new swine flu virus is just a mutant of the already existing virus.
Ayurvedic texts deal extensively with viral ailments. The symptoms of
swine flu appear in these texts, particularly in Charak Samhita. It has
given a list of do's and don'ts to prevent such ailments. It has also
advised certain preventive measures to build body immunity against
attack of seasonal diseases," senior Ayurvedic physician Dr M Chandra
Sekhar of Institute of Panchakarma and Research, Hyderabad.

According to Charak Samhita, one should avoid kapha provocating diet
like curd, cold food, fruit juices specially citrus, fermented food and
take hot water instead of cold water. One should use decoction made up
of any one or combination of tulsi, ginger, black pepper, long pepper
and guduchi (Tinospora) every morning.

"Ayurvedic medicines like sudershanghana vati, sudershana churna and
samshamani vati improve the host defence mechanism. The medicines
can be taken by normal healthy persons as well as those who have mild
cold, cough, body pain etc. However, in serious cases, people should
go to the nearest screening centre," the Ayush document on swine flu
points out.

Monday, August 24, 2009

High lead levels in enamel paints: Be choosy about the colour when you paint your house


By Syed Akbar
Hyderabad, Aug 23: Enamel paints available in India contain high levels of lead which damage the central nervous system, particularly in children and pregnant women.

According to a joint study by 10 international research organisations, including the Bengaluru-based National Referral Centre for Lead Poisoning, Indian paints on average contain 33,000 ppm (parts per million) of lead as against the permissible levels of 600 ppm.

Interestingly, the percentage of lead differs in different colours with white enamel paints having 1,330 ppm, making it the safer bet though it is more than twice the permissible levels.

According to the study, yellow paint has the highest lead at 85,000 ppm (dry weight), followed by orange 79,700 ppm, red 30,600 ppm, green with 28,200 ppm, black 8,050, blue 4,610.

"Though lead poisoning of children is widely recognised as a major public health problem in many parts of the world, very little attention has been given in many countries to the role of leaded paints," Dr Venkatesh Thuppil, one of the members of the research team, said.

"The colour with the lowest lead concentration was white and the colours with the highest concentrations are yellow and orange, followed closely by green and red," said Dr Thuppil, popularly known as the "Lead Man of India" for his pioneering efforts in the introduction of lead-free petrol in the country.

He said the concentration of lead in most of the samples was greater than or equal to 600 ppm. Dr Thuppil along with Dr C.S.
Clark, who led the research, said the lead levels should not cross 90 ppm if people are to be protected from heavy metal poisoning.

The study noted that 73 per cent of paint brands tested from 12 countries fail to comply with the standard limits. Almost half of the world's population lives in these countries which include India and China. About 70 per cent of the brands had at least one sample exceeding 10,000 ppm.

Saturday, August 22, 2009

Death of a river? Will Polavaram project kill the river Sabari?


By Syed Akbar
Hyderabad: The picturesque Sabari river that originates in the hilly jungles of the tribal Bastar in Chastisgarh will lose its basic character if the State government goes ahead with the controversial Polavaram project across the river Godavari.
Sabari flows for about 30 km in Andhra Pradesh after entering the State from Chattisgarh and joins the river Godavari at Kunavaram in Khammam district. Once the Polavaram project is constructed, the backwards will extend up to the Chattisgarh border wiping out the Sabari from the face of Andhra Pradesh.
"Polavaram will not only affect the lovely Papi Hills, part of Eastern Ghats, with their unique flora and fauna, but also damage the Sabari river system. The river system of other tributaries will also be hit badly affecting the overall Godavari hydrological cycle," argues irrigation expert Nitin Desai.
The backwaters of Polavaram will not allow the Sabari to drain into the Godavari when the dam is full. The overall length of the Sabari will be reduced by about 30 kilometres which will severely upset the ecology of this tribal river.
According to environmental activist Bhiksham Gujja, even the river system of Sileru that flows through the Eastern Ghats and joins the Sabari on Andhra Pradesh-Chattisgarh-Orissa borders will suffer heavily. "The river rises as the Machkund in the Eastern Ghats in northeastern Andhra Pradesh. Leaving the Machkund reservoir, it flows as the Sileru parallel to the mountain ranges at an elevation of 2,000-3,000 feet in a northeast-to-southwest direction to empty into the Sabari," he says.
Since the Sileru joins the Sabari at the AP border, the backwaters of Polavaram will also prevent Sileru from emptying fully into Sabari.
The Sabari river is not only important from environment point of view but also from the historical perspective. The river was mentioned in several of the ancient texts of India.
A team of irrigation experts and environmentalists on Wednesday visited the Polavaram dam site and studied the impact of the dam on the environment, wildlife as well as the tributaries of the Godavari. Former CWC member Vidyasagar is of the view that there would be larger environmental havoc if the natural river system was disturbed. In the case of Polavaram, not only the Godavari river is exploited, but also its tributaries.
"Generally, only one river is affected by dam. But in the case of Polavaram several tributaries along with the main river Godavari are affected. This is something unpardonable," Vidyasagar observes.

Retinoblastoma: Early detection of eye cancers will save the sight


By Syed Akbar
Hyderabad: Early detection of eye cancers particularly retinoblastoma will save the sight.
According to specialist doctors at LV Prasad Eye Institute, retinoblastoma in children is curable if timely treatment is provided to the patient. The hospital has released a set of do's and don'ts for parents as part of the world retinoblastoma awareness week which will conclude on May 19.
Retinoblastoma is a cancer in a child’s eyes and accounts for about 11 per cent of all cancers in children below one year of age and five per cent of childhood blindness.
"More than 1000 children are diagnosed every year in India with the problem. About 75 per cent of children have a tumour in one eye and
25 per cent have a tumour in both eyes. The early symptoms include a white reflex of eye, squinting eyes and vision loss," says Dr Santosh Honavar, chief ocular oncologist.
He regretted at poor and low levels of awareness among people. "The white reflex in the child’s eye is retinoblastoma. Such a child needs immediate medical attention. By taking the child to an eye specialist, you can help save the child’s life and eyesight," he points out.
Retinoblastoma is a genetic disorder and may be caused by abnormal genes inherited from one or both parents or a mutation of a particular gene after the child is born. This cancer is curable if detected early.
"There are doctors and facilities available in India to provide appropriate treatment that will cure the child of this eye disease. However, it is often the case that parents are not aware of the warning symptoms of retinoblastoma or they may choose to ignore the early symptoms of a white glint in the eye or squinting eyes. Instead, the parents may take the child to the doctor at a later stage when the cancer has advanced, the tumour weighing down the child's face to one side," he said.

Tuesday, August 18, 2009

Docodont: A new mammal species discovered

By Syed Akbar
Hyderabad: A new mammal belonging to the docodont group has been discovered from the Kota Formation at Paikasigudem village in Adilabad district.

The fossilised mammal is at least 150 million years old and this is the first time that a docodont mammal has been found from the Southern Hemisphere. Docodont mammals are primitive animals found during the Jurassic period along with dinosaurs and they are considered to be the final line of mammalian old-timers.

Scientists the world over thought that docodonts were present only in North America and England as the remains of several species of docodont mammals were excavated only from these parts in the Northern Hemisphere. The latest discovery showed the presence of such animals in Southern Hemisphere too. "It is now quite clear that docodonts were widely spread across the earth," says GVR Prasad, who discovered the animal remains.

The new animal has been named Gondtherium dattai in honour of the local Gond tribal population. The find from Adilabad is of paramount importance as it testifies to the presence of typical docodont mammals in Gondwanan continents.
The Kota Formation, which dates back to late middle Jurassic period (150 million years ago) and lower Cretaceous period (65 million years), had earlier yielded mammal groups like symmetrodontan and eutriconodontan.

Bulk screen-washing of the clays and mud stones found in Kota Formation produced an isolated mammalian upper premolar. A detailed study of the tooth led to the discovery of the new mammal genius Gondtherium.

The premolar tooth has asymmetrical chewing/biting outline, two labial cusps and other features very similar to the upper premolars of docodont mammals. Detailed comparisons with the upper dentition of various known docodont animals showed that the premolar pattern of the new specimen from Adilabad was similar to Haldanodon, an animal found during the Mesozoic period.

The tooth of Gondtherium dattai differed from the upper molars of all known docodont animals in having labial cusps with diverging tips that are separated by a broad notch. The enamel of the tooth was not preserved as also the roots, but from the broken dorsal surface it appeared that there were probably three roots. The pulp chamber was widely open and had a smooth surface and rounded edges as in permanent teeth.

Docodont mammals were earlier known only from the Upper Triassic, Middle and Upper Jurassic, and Lower Cretaceous deposits of North America and Europe, pointing to a typical Euramerican distribution for this group.

"The associated mammalian study helps us in reconstructing a generalised paleobiogeographic scenario. The more recent discovery of Dyskritodon from the Kota Formation first recorded from the Early Cretaceous of Morocco, represents an example of faunal continuity across India and Africa. The occurrence of closely related mammals in the Jurassic of India and Late Triassic and Early Cretaceous of Africa, as well as Middle and Late Jurassic of Europe points to biogeographic connections between these regions," he points out in his study.

This is not surprising because paleogeographic maps show Europe in close proximity of NW Africa and India adjacent to Africa in the Early/Middle Jurassic. The cosmopolitan distribution of the Kota fauna has also been corroborated by the non-mammalian vertebrate groups like ostracods and charophytes.
Barapasaurus and Kotasaurus, sauropod dinosaurs from the Kota Formation, and the Early Jurassic sauropod Vulcanodon of Zimbabwe appear to be closely related to the Late Triassic sauropod Isanosaurus of Thailand.

"In view of this continuity of mammalian as well as non-mammalian animal remains during the Jurassic and Early Cretaceous across Gondwanan continents, it is predicted that early docodonts might have existed on other southern continents as well," says Prasad.

The possible reasons for not finding Docodonts on the southern continents until now are restricted occurrence of Jurassic continental sequences in this part of the globe; low intensity sampling of the known deposits; and taphonomic (decaying) factors.

NGRI sets up geothermal climate change observatory: Gives insight on temperatures 300 years ago

By Syed Akbar
Hyderabad, Aug 17: The city-based National Geophysical Research Institute has set up a geothermal climate change observatory at Choutuppal near here. The observatory is capable of recording and finding out warming or cooling of the earth in the last 300 years, besides giving data on the present scenario. It will also give clues on the meteorological conditions.

The observatory, which comprises an automatic weather station located next to a set of boreholes going down to 210 metres, will allow earth scientists to study how meteorologic variables affect ground temperature and eventually the deep rock temperature, according Dr VP Dimri, NGRI director.

"The datasets being acquired at the observatory will be invaluable for studies on global climate change and its signature in the solid Earth. This is the first geothermal climate change observatory of its kind in the low latitude belt (0-30 degrees N), and will allow comparisions with a similar observatory set up in Utah, USA in the higher lattitudes," he said.

The weather station samples the surface air temperature, humidity, precipitation, solar radiation, wind speed and direction at two second intervals and stores the information once every 15 minutes. The diurnal and annual variations of surface air temperature decay by about 50 cm and 15 mts of depth respectively.

The long term (10 to 100 years) changes insurface air temperature due to climate change diffuse down in the earth and perturb the natural temperature distribution up to depths of 100 to 200 metres. "By measuring the temperatures in a borehold today, scientists are able to infer both the magniturde and the onset time of warming (or cooling) that took place during the last 300 years, much before the start of the extensive meteorological records in India.

Friday, August 14, 2009

NASA Satellites Unlock Secret to Northern India's Vanishing Water

By Syed Akbar
Beneath northern India’s irrigated fields of wheat, rice, and barley ... beneath its densely populated cities of Jaiphur and New Delhi, the groundwater has been disappearing. Halfway around the world, hydrologists, including Matt Rodell of NASA, have been hunting for it.

Where is northern India’s underground water supply going? According to Rodell and colleagues, it is being pumped and consumed by human activities -- principally to irrigate cropland -- faster than the aquifers can be replenished by natural processes. They based their conclusions -- published in the August 20 issue of Nature -- on observations from NASA’s Gravity Recovery and Climate Experiment (GRACE).

"If measures are not taken to ensure sustainable groundwater usage, consequences for the 114 million residents of the region may include a collapse of agricultural output and severe shortages of potable water," said Rodell, who is based at NASA’s Goddard Space Flight Center in Greenbelt, Md.

Groundwater comes from the natural percolation of precipitation and other surface waters down through Earth’s soil and rock, accumulating in aquifers -- cavities and layers of porous rock, gravel, sand, or clay. In some of these subterranean reservoirs, the water may be thousands to millions of years old; in others, water levels decline and rise again naturally each year.


Groundwater levels do not respond to changes in weather as rapidly as lakes, streams, and rivers do. So when groundwater is pumped for irrigation or other uses, recharge to the original levels can take months or years.

Changes in underground water masses affect gravity enough to provide a signal, such that changes in gravity can be translated into a measurement of an equivalent change in water.

"Water below the surface can hide from the naked eye, but not from GRACE," said Rodell. The twin satellites of GRACE can sense tiny changes in Earth’s gravity field and associated mass distribution, including water masses stored above or below Earth’s surface. As the satellites orbit 300 miles above Earth's surface, their positions change -- relative to each other -- in response to variations in the pull of gravity. The satellites fly roughly 137 miles apart, and microwave ranging systems measure every microscopic change in the distance between the two.

With previous research in the United States having proven the accuracy of GRACE in detecting groundwater, Rodell and colleagues Isabella Velicogna, of NASA’s Jet Propulsion Laboratory and the University of California-Irvine, and James Famiglietti, of UC-Irvine, were looking for a region where they could apply the new technique.

"Using GRACE satellite observations, we can observe and monitor water changes in critical areas of the world, from one month to the next, without leaving our desks," said Velicogna. "These satellites provide a window to underground water storage changes."

The northern Indian states of Rajasthan, Punjab and Haryana have all of the ingredients for groundwater depletion: staggering population growth, rapid economic development and water-hungry farms, which account for about 95 percent of groundwater use in the region.

Data provided by India's Ministry of Water Resources suggested groundwater use was exceeding natural replenishment, but the regional rate of depletion was unknown. Rodell and colleagues had their case study. The team analyzed six years of monthly GRACE gravity data for northern India to produce a time series of water storage changes beneath the region’s land surface.

They found that groundwater levels have been declining by an average of one meter every three years (one foot per year). More than 109 cubic km (26 cubic miles) of groundwater disappeared between 2002 and 2008 -- double the capacity of India's largest surface water reservoir, the Upper Wainganga, and triple that of Lake Mead, the largest man-made reservoir in the United States.

"We don’t know the absolute volume of water in the Northern Indian aquifers, but GRACE provides strong evidence that current rates of water extraction are not sustainable," said Rodell. "The region has become dependent on irrigation to maximize agricultural productivity, so we could be looking at more than a water crisis."

The loss is particularly alarming because it occurred when there were no unusual trends in rainfall. In fact, rainfall was slightly above normal for the period
The researchers examined data and models of soil moisture, lake and reservoir storage, vegetation and glaciers in the nearby Himalayas, in order to confirm that the apparent groundwater trend was real. Nothing unusual showed up in the natural environment.

The only influence they couldn’t rule out was human.

"At its core, this dilemma is an age-old cycle of human need and activity -- particularly the need for irrigation to produce food," said Bridget Scanlon, a hydrologist at the Jackson School of Geosciences at the University of Texas in Austin. "That cycle is now overwhelming fresh water reserves all over the world. Even one region’s water problem has implications beyond its borders."

"For the first time, we can observe water use on land with no additional ground-based data collection," Famiglietti said. "This is critical because in many developing countries, where hydrological data are both sparse and hard to access, space-based methods provide perhaps the only opportunity to assess changes in fresh water availability across large regions."

Promises stem cell therapy holds for in future

By Syed Akbar
Hyderabad: Just think of a world where there's cure for every disease and no one need to donate his or her body parts to save someone else's life. What if kidneys, cornea, heart, liver, mammary glands, lungs and limbs grow in test tubes or petri dish, ready for harvest in a person suffering from some severe organ failure! This will soon become a reality, thanks to the marvellous technological development in stem cell research.

Stem cells provide raw material for virtually every kind of human tissue. It's just a matter of time, before stem cell research can be applied for therapeutic uses.

Here is a small list of benefits stem cells research offer in near future:


Cancer:

One of the promising benefits of stem cell research is treatment for cancer. Research on dogs has shown that adult stem cells are helpful in fighting cancerous tumours. In lab studies stem cells when injected had migrated into the cancerous area and produced cytosine deaminase, an enzyme that converts a non-toxic pro-drug into a chemotheraputic agent. Tumour was reduced by about 80 per cent.

Spinal cord injury:

Spinal cord injuries, which cripple patients, can also be cured through stem cell technology. Korean scientists have demonstrated that multipotent adult stem cells when injected will help patients with spinal cord injuries to walk on their own, without any external support.

Cure for deafness:

British scientists have demonstrated that stem cells will help in curing deafness. They have developed cilia (hair) in internal ear, which will help in curing deafness. Patients will be able to hear once the transplant is done.


Breast implants:

If scientists involved in stem cell research have their way, artificial breast implants will soon be a thing of the past. Those suffering from cancer of breast as also those who want to enlarge their mammary glands for better looks can now pin their hopes on stem cell research. Unlike artificial implants, stem cells will give breasts a natural look.

British scientists have developed a technique in which they extracted stem cells from the spare fat on stomach or the thigh region. Later, they are grown in a woman's breasts. But the process is quite slow and takes months for the breasts to grow "naturally" in size.

Stem cells: Scientists see cure for health problems including AIDS

By Syed Akbar
Hyderabad: US President Barack Obama is now the new icon of change for scientists around the world. His decision to lift ban on federal funding for research involving embryonic stem cells has opened up new frontiers for biologists to explore. Though Obama's decision will not bring in immediate medical benefits to patients suffering from genetic and non-genetic diseases, scientists see in it a new hope for cure, in near future, for a plethora of health problems including AIDS.

And back home in India, biologists and researchers feel that the US administration's move will stir up the policy-makers here to hasten with the much-awaited legislation on stem cell research. Two years have passed since the Indian Council of Medical Research announced the new draft guidelines on stem cell research. The Central government has been sitting on the guidelines without transforming them into a formal legislation to boost stem cell research in the country.

"It's a welcome decision," says Dr Jyotsna Dhawan of the Hyderabad-based Centre for Cellular and Molecular Biology. "In India clinical trials on stem cells are already approved. But we have not reached the stage where we can use the research for therapeutic purposes," she adds. Dr Jyotsna is one of the three members from Hyderabad on the ICMR expert panel that drafted the stem cell research guidelines.

Once India gets its own legislation on stem cells research, hospitals can use both embryonic stem cells and adult stem cells for medical treatment. However, human cloning will not be permitted in the country. Stem cells are considered to have the ability to divide without limits and to give rise to daughter cells that can form specialised cells. The cells categorised as totipotent have the unlimited ability to differentiate into any tissue including extra-embryonic membranes and all embryonic tissues and organs.

"Lakhs of patients suffering from kidney, liver, heart, blood, pancreas, brain and blood problems will stand to benefit once Parliament passes the proposed Bill on stem cell therapy. Only clinical trials are allowed in the country and it's high time the Indian government followed the Barack Obama administration," argues Dr MN Khaja, who is involved in liver stem cell research.

In the absence of legislation, only a few research centres, who have secured special permission from ICMR, Department of Science and Technology and Department of Biotechnology, are allowed to conduct research on stem cells in laboratories. When it comes to application of the technology to human subjects for treatment purposes, it has been a strict "no" thus far. The only exception is the bone marrow transplantation.

Research on stem cells involves two types of stem cells: embryonic stem cells and adult stem cells. As far as research on adult stem cells are concerned, there's no restriction and researchers have already developed artificial cornea in petri dish. The trouble is with the embryonic stem cell research.

As eminent liver scientist-physician Dr CM Habibullah, who is also a member of the ICMR committee, points out the proposed legislation would permit research on embryonic stem cells. "But to do this, the consent of the donor should be obtained. We have also made a provision that cord blood banks should be registered with the Drug Controller-General of India".

Scientists and doctors are elated over the developments. But many fear that the nascent research will be misused by unscrupulous elements, particularly when it comes to human embryos, as was done in the case of genetically modified crops. Embryonic stem cell research and therapy is a promising medical industry in the country which will boost medical tourism in the next few years. This opens the doors for commercialisation.

Dr RVG Menon, veteran scientist, expresses concern over the possible commercialisation of stem cell research. "There are fears that immature technologies may be marketed for the sake of profit. This means that we would have no idea of the possible after-effects. They would not have been studied properly. We are seeing such unexpected after-effects in GM crops now".

Agrees infertility expert Dr Roya Rozati, stem cell research raises several ethical and social issues such as destruction of human embryos to create human embryonic stem cell lines.

"Ethical and social concerns should be given prime importance in this area of research. There should be controls, but they should come from within the scientific community itself. This will make stem cell research beneficial to humanity."

Geological Survey of India finds thorium reserves in Nalgonda district

By Syed Akbar
Hyderabad: The Geological Survey of India has found Thorium reserves in the backward district of Nalgonda. The values of this radioactive element ranged between 104 and 165 parts per million.

This is the first time that Thorium reserves have been observed in Nalgonda. The district is already famous for its Uranium mines and with the detection of Thorium, Nalgonda is going to play a major role in meeting the future power needs of the country.

Andhra Pradesh is one of the few States in the country with vast resources of Thorium and Uranium, the two important radioactive elements required for generation of nuclear energy.

The GSI carried out low altitude magnetic and radiometric aerogeophysical surveys spread over 5000 sq km area in and around Nalgonda district. During the surveys, the GSI found significant radioactive anomaly. The area where the Thorium resources was found forms part of Eastern Dharwar Craton.

Granite rich in biotite (black mica) near Jangammaiahguda showed Thorium values of the order of 165 ppm. In the same area, the GSI also found Uranium ranging between 66 and 138 ppm.

The biotite granite in Mathmurigudem also showed Thorium. But the values varied from 35 ppm to 55 ppm. The Uranium values in the village ranged from 38 to 53 ppm. The GSI found a mineralised zone of Scheelite (tungsten ore) near Guddipalli village.

According to GSI officials, the State has the largest resources of Monazite, a mineral of Thorium, in the country. The city-based Atomic Minerals Directorate for Exploration and Research has identified 3.73 million tonnes of Monazite at 21 places spread over Srikakulam, Vizianagaram, Vishakapatnam, East and West Godavari, Krishna, Guntur, Prakasam and Nellore districts. In addition to these places, the GSI has found Thorium resources in Nalgonda, which is a land-locked district, unlike the coastal belt.

Thursday, August 13, 2009

Swine flu: Dry spell saves Hyderabad from novel pandemic influenza H1N1

By Syed Akbar
Hyderabad, Aug 11: The continued dry spell and above normal temperatures so far this rainy season have saved Hyderabad from the wrath of swine flu, while low temperatures played havoc in Pune.

Hyderabad initially led the swine flu cases in the country but the prolonged dry spell helped in the containment of the novel H1N1 virus that causes human influenza. Above normal temperatures coupled with proper planning by health authorities arrested the spread of the virus in the community. Unlike in Pune, the human influenza virus has not penetrated into the local community. Hyderabad has thus far recorded 74 positive cases and only a couple of them are locally contacted cases.

While day temperatures hovered between 33 and 37 degrees C in Hyderabad, the mercury did not cross 28 degrees C in the last 10 days in Pune. Added to the low temperature was the cloudy sky. In Pune the virus has penetrated into the community as all the fresh cases reported from there have been local residents.

"The climate has been cold in Pune and for several days we have not seen the sun in full brightness. The day temperature was also below normal," said G Dayanidhi, who frequents between Pune and Hyderabad on business.

Pune now leads the swine flu cases with about 270 positive cases and five of the 10 deaths reported in the country. In cold climate, the aerosols stay longer carrying the virus and thus the chances of infection are high during winter and rainy seasons.

"While environmental factors like low temperatures help in the fast spread of influenza virus, the host and viral factors determine the survival or otherwise of the patient. In case of Hyderabad, above normal temperatures helped in the containment of the virus. Since Pune has the maximum number of cases, it also
leads in terms of fatalities. The immunity of a patient (host) and the potent of the virus decide the fate," said senior physician Dr Aftab Ahmed of Apollo Hospitals.

Location of international airport in Hyderabad has also helped in the arrest of the virus from spreading to the locals. Those with swine flu symptoms were quarantined at the airport level itself and those who came into close contact with them had been kept under medical surveillance. But in the case of Pune, the international passengers, with the virus, landed in Mumbai airport and later spread the disease in the community.

Hyderabad district medical and health officer Dr Ch Jayakumari said they had prevented the virus from going to the secondary level in Hyderabad. "Had it gone into the community, it would have been catastrophic. Moreover, those in Hyderabad are nutritionally in an advantageous stage as compared to those living in western India," she said.

Wednesday, August 12, 2009

ICAAP9: Removal of punitive laws essential for effective AIDS responses in Asia-Pacific

By Syed Akbar
Bali, Aug 12: UN agencies, legal experts and human rights defenders at the 9th International Congress on AIDS in Asia and the Pacific (ICAAP) concur that crafting an effective AIDS response in the region will require addressing legal
barriers that are impeding progress.

Throughout the week, scientists, legal experts, activists, people living with HIV and
community representatives will discuss challenges and progress in addressing legal barriers to achieving universal access to HIV prevention, treatment, care and support by 2010.

Experts from the Commission on AIDS in Asia concluded that in order to prevent and control HIV in the region, there must be a significant focus on improving human rights protections for people living with HIV and typically marginalized populations such as men who have sex with men, transgender people, sex workers, people who use drugs, prisoners and detainees.

According to Kyung wha-Kang, Deputy High Commissioner for Human Rights (Office of the High Commissioner for Human Rights), “we have known for years that human rights are the bedrock upon which effective AIDS responses are built. In spite
of this, human rights violations continue to proliferate. Human rights frameworks and principles must be translated into real protections for people living with HIV, men who have sex with men, transgender people, sex workers, people who
use drugs, prisoners and detainees. We must also pay specific attention to ensuring protections for women and children.”

According to JVR Prasada Rao, Director of the Joint UN Programme on AIDS (UNAIDS) Asia-Pacific Regional Support Team, “in spite of recent progress, insufficient coverage of services for people living with HIV, men who have sex with men, transgender people, sex workers and people who use drugs is still a reality and the lack of legal protections just drive these populations underground – far out of the reach of the meager services that do exist. If we don’t invest in strengthening legal protections for people living with HIV, women, men who have sex with men, transgender people, sex workers and people who use drugs, we will jeopardize the gains we have made in the region. This is why the UNAIDS family has recently reinvigorated its collective efforts to advocate for the removal of punitive laws, policies and practices which are thwarting effective HIV responses. This also
means stepping up action to tackle inappropriate criminalization.”

According to Jeffrey O’Malley, Director of the United Nations Development Programme’s (UNDP) HIV Group, “the law can and should be instrumental in scaling up a rights based AIDS response. Instead, we often have situations where laws and their
arbitrary, inappropriate enforcement are increasing risk and vulnerability – thereby posing formidable barriers to effective HIV responses for those most vulnerable and the general population.”

According to O’Malley, “laws which criminalize sex work are used to blackmail, exploit and harass sex workers and sex workers often experience violence at the hands of police and service providers. Violence and harassment often extends to outreach workers, service providers and human rights defenders. Laws which criminalize drug use hamper the implementation of evidence based harm reduction services.

Laws which do not uphold women’s property and inheritance rights can set off a
downward spiral of lost economic opportunities, reduced security and increased risk and vulnerability for women and girls.

Many countries in the Asia Pacific region criminalize male to male sex and these laws often lead to violations of the rights of men who have sex with men and transgender people. ”

According to Anand Grover, Director of the Lawyers Collective HIV/AIDS Unit and UN Special Rapporteur on the Right to Health, “there have been a number of success stories in the region which give us hope. Courts in Nepal, India and Pakistan have been instrumental in recognizing and upholding the rights of sexual minorities. This means that they will no longer be considered criminals in accessing life-saving prevention, care and treatment services. We hope that other countries in the Asia-Pacific region and across the globe will follow suit.”

Community representatives and activists note in order to effectively overcome legal barriers and remove punitive laws, it is critical to build robust strategic alliances across traditional and non-traditional constituencies and between groups of people living with HIV and other key populations, women’s groups, affected communities, service providers, the legal profession, law enforcement agencies, human rights bodies, parliamentarians and policy makers.

The momentum for reversing the tide of punitive laws, policies and practices must be sustained for HIV prevention, treatment, care and support to be effective. And in the context of a global financial and economic crisis, it is both cost-effective and a moral imperative to implement legal and social programmes which counter discrimination and stigmatization.

ICAAP9: 90 per cent of men having sex with men in Asia Pacific have no access to HIV prevention and care

By Syed Akbar
Bali, Aug 12: More than 90 per cent of men having sex with men (MSM) in Asia Pacific do not have access to HIV prevention and care services, and if interventions are not urgently intensified the spread of HIV in this vulnerable population will escalate sharply in the very near future.

Moreover, legal frameworks across the region need a dramatic and urgent overhaul to allow public health and community sectors to reach out to MSM, or the consequences could be dire and stretch well beyond MSM to affect the general population.

This warning came at a high level and ground breaking symposium – “Overcoming Legal Barriers to Comprehensive Prevention Among Men who have Sex with Men and Transgender People in Asia and the Pacific” -- held at the 9th International Congress on AIDS in Asia and the Pacific (ICAAP) today, and hosted by the United Nation Development Programme (UNDP) and the Asia Pacific Coalition on Male Sexual Health (APCOM).

Speakers discussed how effective and comprehensive HIV prevention among MSM and transgender (TG) people can occur only when a conducive and enabling legal environment is created that allows unimpeded dissemination of prevention messages and services; appropriate provision of treatment, care and support services; and confidence-building measures among the most marginalized and vulnerable to seek essential information and access services.

“In order to achieve universal access to HIV prevention, treatment, care and support and realize the Millennium Development Goals, we must facilitate an enabling legal environment and human rights based HIV policies and programmes for MSM and TG,” said Jeffrey O’Malley, Global Director of UNDP’s HIV Group, among the speakers at the symposium. “This will mean stepping up our investment in legal and social programmes which effectively address stigma and discrimination directed at MSM and TG.”

Due to the increased availability in recent years of epidemiological data on HIV among MSM, there is a better understanding of the magnitude and nature of the HIV epidemic amongst MSM and TG within the Asia Pacific region. However, there remains a dangerous lack of interventions which comprehensively address HIV prevention, treatment, care and support needs for MSM and TG.

A 2006 survey of the coverage of HIV interventions in 15 Asia Pacific countries estimated that targeted prevention programmes reached less than 8% of MSM and TG, far short of the 80% coverage that epidemiological models indicate is needed to turn the HIV epidemic around.

“A strategy of prevention requires bold and effective legal and policy measures to reach out to vulnerable communities and individuals at risk,” stated the Honourable Michael Kirby of Australia. “It is here that reform of laws concerning MSM must be seen as an imperative step in the path of reducing the isolation, stigma and
vulnerability felt by MSM communities and individuals. This will help enhance their self-respect and dignity as citizens and protect their legal rights, including receiving information on safer sex practices.”

Currently 22 countries in the Asia Pacific region criminalize male to male sex, and these laws often taken on the force of vigilantism, leading to abuse and human rights violations. Even in the absence of criminalization, other provisions of law violate the rights of MSM and TG along with arbitrary and inappropriate enforcement, thereby obstructing HIV interventions, advocacy and outreach, and service delivery.

These structural barriers significantly increase the vulnerability of MSM and TG to HIV infection and have an immense adverse effect on their health and human rights.
Developing strategic partnerships and alliances between affected communities, the legal profession, human rights bodies, parliamentarians and policy makers is critical.

This very debate was at the heart of the recent landmark ruling by the Delhi High Court that Section 377 of the Indian Penal Code unfairly discriminates against MSM and consenting adults in general.

“The Delhi ruling is a shining example of such an approach, where education and sensitization of these different sectors was central to the success of the case,” said Shivananda Khan, Interim Chair of APCOM.

“Other key rulings in the region include the 2007 Nepal Supreme Court ruling recognizing the rights of sexual minorities, and the June 2009 Pakistan Supreme Court ruling that hijras or transgendered individuals, are a minority community in the legal sense of the term.”

Given the current global economic crisis and the ever-mounting bill for life-saving anti-retroviral treatment, the impetus for effective comprehensive HIV prevention becomes even stronger. Only a strategy of comprehensive, rights-based prevention, supported by an enabling legal environment, offers a possibility of reducing the numbers of persons infected with HIV each year.

In this context, it is both cost-effective and imperative that governments and other key players introduce and implement legal and social frameworks and programmes which counter discrimination and stigmatization that have long targeted MSM and TG.

ICAAP9: UN Report Draws Parallels with ’97 Financial Crisis and its impact on Migrants and AIDS

By Syed Akbar
Bali, Aug 12: Migrants are left out of current stimulus packages and HIV/AIDS programmes are under threat, warns a UN paper released today at the 9th International Congress on AIDS in Asia and Pacific (ICAAP).

The adverse impact of the financial crisis on health and migration is likely to expand, just as it did in the ’97 Asian crisis, as currency devaluations lead to higher drug prices, donor funding declines, and government programs are cut, says the report.

Issued jointly by the UN Development Programme (UNDP), the International Labor Organization (ILO) and the Joint Programme on HIV/AIDS (UNAIDS), the paper (“The threat posed by the economic crisis to Universal Access to HIV services for migrants”), makes predictions on migration policies and HIV/AIDS programmes which mirror trends from the ’97 financial crisis.

“It is critical that policy makers don’t make the same decisions that were made in ’97 vis-√†-vis cuts to essential HIV/AIDS programmes, and adverse policies that worked against migrant workers. In contrast to the massive stimulus packages that countries are launching to boost their economies, AIDS spending for a comprehensive response represents a mere 0.01% of such programmes”, said Caitlin Wiesen, UNDP Regional HIV Practice Team Leader for Asia and the Pacific.

According to JVR Prasada Rao, Director of UNAIDS Regional Support Team, Asia and the Pacific, “Even before the financial crisis, HIV programmes and services for migrants and mobile populations often fell through the cracks in national programmes. Besides, we had seen from the past financial crisis that HIV prevention programmes were first to face budget cutbacks. Issues related to migrants are critical in a region with fast economic growth like Asia. We must strongly advocate with governments and donors not to cut resources on migrant HIV programmes as this will cause serious setbacks to universal access targets and MDG6”.

The ’97 Asian financial crisis showed that policies to reduce migration, such as limiting migrant work permits or cutting jobs and deporting workers, are not successful in reducing irregular migration. Without access to formal channels of migration, many people on the move seek informal, unsafe channels of movement that puts them in conditions with greater risk and vulnerability to HIV. Also, cuts in HIV government funding risks losing all the achievements made in reducing the spread of the AIDS epidemic on a national scale.

The paper illustrates that governments have stopped issuing work permits, are cracking down on undocumented migrants (Malaysia, Taiwan) and many foreign workers in manufacturing and construction are being laid off (Indonesia, China). Also, in several countries there are increasing reports of worsening working conditions (in Hong Kong, Taiwan, Malaysia and Singapore).

There are increasing concerns that female migrants who lose their jobs may move into sex work to survive. In Cambodia, for example, 70,000 garment workers, mostly female, have lost their jobs since the crisis began. A recent study by the UN Inter-Agency Project on Human Trafficking has found that among a sample of sex workers, 58% of them entered into sex work in the wake of the financial crisis, and that 19% of these women were former garment sector workers.

“In times of economic downturn, we cannot forget the needs and rights of migrant workers who are such an integral part of so many economies, especially in our region” says Dhannan Sunoto, of the ASEAN Secretariat. “It is critical to ensure that potential migrants are not barred from working abroad based on their HIV positive status, and that migrants working abroad are not deported because of their positive status.”

“In the context of the current economic crisis we have reports of increased human rights violations, and pressure on migrant workers to move from formal to informal employment or to return to their countries of origin. These trends are likely to exacerbate vulnerability to HIV” says Dr Sophia Kisting, Director of the ILO Programme on HIV/AIDS and the world of work.

“The ILO is in the process of formulating an international human rights instrument on HIV/AIDS and the world of work. If adopted in 2010, this standard focusing solely on HIV and the world of work will give new impetus to anti-discrimination policies at national and workplace levels”, she adds.

According to Rina, from the Philippines, a positive migrant worker, “Undocumented migrant workers are more vulnerable to a lot of problems and challenges including getting infected with HIV because their rights are not protected.”

She continues,“The global recession will affect more and more migrants, and several will become undocumented, moreover, health services for non nationals will be a major challenge. I urge policy makers and practitioners to look into this and ensure that migrants are not further discriminated or marginalized.”

The paper outlines key recommendations for host countries and countries of origin, as they both have an equal responsibility to provide protective policies and programmes. These include:

* Establish protective mechanisms like welfare funds, social insurance schemes and training programmes to help migrants returning home or to relocate on site. Investment to support one migrant or mobile person impacts estimated 3-5 family members in their home countries.

* Translate regional and national strategies for HIV that include migrants and mobile populations into budgets and services that are designed to reach people on the move.

* Maintain prevention programmes and budgets: every $1 invested in prevention can save up to $8 in averted treatment costs1.

* Engage with and support civil society organizations to monitor the health seeking behaviour of migrants so that they do not have to sacrifice treatment for other basic necessities for themselves and their families.

Human influenza: What can I do?

By Syed Akbar

The main route of transmission of the new influenza A(H1N1) virus seems to be similar to seasonal influenza, via droplets that are expelled by speaking, sneezing or coughing.

You can prevent getting infected by avoiding close contact with people who show influenza-like symptoms (trying to maintain a distance of about 1 metre if possible) and taking the following measures:

• avoid touching your mouth and nose;

• clean hands thoroughly with soap and water, or cleanse them with an alcohol-based hand rub on a regular basis (especially if touching the mouth and nose, or surfaces that are potentially contaminated);

• avoid close contact with people who might be ill;

• reduce the time spent in crowded settings if possible;

• improve airflow in your living space by opening windows;

• practise good health habits including adequate sleep, eating nutritious food, and keeping physically active.

What about using a mask? What does WHO recommend?

If you are not sick you do not have to wear a mask.
If you are caring for a sick person, you can wear a mask when you are in close contact with the ill person and dispose of it immediately after contact, and cleanse your hands thoroughly afterwards.

If you are sick and must travel or be around others, cover your mouth and nose.
Using a mask correctly in all situations is essential. Incorrect use actually increases the chance of spreading infection.

How do I know if I have influenza A(H1N1)?

You will not be able to tell the difference between seasonal flu and influenza A(H1N1) without medical help. Typical symptoms to watch for are similar to seasonal viruses and include fever, cough, headache, body aches, sore throat and runny nose. Only your medical practitioner and local health authority can confirm a case of influenza A(H1N1).

What should I do if I think I have the illness?

If you feel unwell, have high fever, cough or sore throat:
• stay at home and keep away from work, school or crowds;

• rest and take plenty of fluids;

• cover your nose and mouth when coughing and sneezing and, if using tissues, make sure you dispose of them carefully. Clean your hands immediately after with soap and water or cleanse them with an alcohol-based hand rub;

• if you do not have a tissue close by when you cough or sneeze, cover your mouth as much as possible with the crook of your elbow;

• use a mask to help you contain the spread of droplets when you are around others, but be sure to do so correctly;

• inform family and friends about your illness and try to avoid contact with other people;

• If possible, contact a health professional before traveling to a health facility to discuss whether a medical examination is necessary.

Should I take an antiviral now just in case I catch the new virus?

No. You should only take an antiviral, such as oseltamivir or zanamivir, if your health care provider advises you to do so. Individuals should not buy medicines to prevent or fight this new influenza without a prescription, and they should exercise caution in buying antivirals over the Internet.

What about breastfeeding? Should I stop if I am ill?

No, not unless your health care provider advises it. Studies on other influenza infections show that breastfeeding is most likely protective for babies - it passes on helpful maternal immunities and lowers the risk of respiratory disease. Breastfeeding provides the best overall nutrition for babies and increases their defense factors to fight illness.

When should someone seek medical care?

A person should seek medical care if they experience shortness of breath or difficulty breathing, or if a fever continues more than three days. For parents with a young child who is ill, seek medical care if a child has fast or labored breathing, continuing fever or convulsions (seizures).

Supportive care at home - resting, drinking plenty of fluids and using a pain reliever for aches - is adequate for recovery in most cases. (A non-aspirin pain reliever should be used by children and young adults because of the risk of Reye's syndrome.)

Should I go to work if I have the flu but am feeling OK?

No. Whether you have influenza A(H1N1) or a seasonal influenza, you should stay home and away from work through the duration of your symptoms. This is a precaution that can protect your work colleagues and others.

Can I travel?

If you are feeling unwell or have symptoms of influenza, you should not travel. If you have any doubts about your health, you should check with your health care provider.

Swine flu: Clean hands protect against human influenza H1N1 infection

By Syed Akbar
Here are some of the suggestions by the World Health Organisation on prevention of the pandemic flu virus.

To protect yourself:

* Clean your hands regularly.
* Wash your hands with soap and water, and dry them thoroughly.
* Use alcohol-based handrub if you don’t have immediate access to soap and water.

You may ask, "how do I wash my hands properly?"

Washing your hands properly takes about as long as singing "Happy Birthday" twice,
using the images below.

Swine flu: Some guidelines on novel H1N1 human influenza

By Syed Akbar
The world health organisation has come out with a set of guidelines on prevention of the pandemic flu virus currently creating havoc in parts of the world, including India.

At present, evidence suggests that the main route of human-to-human transmission of the new Influenza A (H1N1) virus is via respiratory droplets, which are expelled by speaking, sneezing or coughing.

Any person who is in close contact (approximately 1 metre) with someone who has influenza-like symptoms (fever, sneezing, coughing, running nose, chills, muscle ache etc) is at risk of being exposed to potentially infective respiratory droplets.
In health-care settings, studies evaluating measures to reduce the spread of respiratory viruses suggest that the use of masks could reduce the transmission of influenza.

Advice on the use of masks in health-care settings is accompanied by information on additional measures that may have impact on its effectiveness, such as training on correct use, regular supplies and proper disposal facilities. In the community, however, the benefits of wearing masks has not been established, especially in open areas, as opposed to enclosed spaces while in close contact with a person with influenza-like symptoms.

Nonetheless, many individuals may wish to wear masks in the home or community setting, particularly if they are in close contact with a person with influenza-like symptoms, for example while providing care to family members. Furthermore, using a mask can enable an individual with influenza-like symptoms to cover their mouth and nose to help contain respiratory droplets, a measure that is part of cough etiquette.

Using a mask incorrectly however, may actually increase the risk of transmission, rather than reduce it. If masks are to be used, this measure should be combined with other general measures to help prevent the human-to-human transmission of influenza, training on the correct use of masks and consideration of cultural and personal values.

It is important to remember that in the community setting the following general measures may be more important than wearing a mask in preventing the spread of influenza.

For individuals who are well:

Maintain distance of at least 1 metre from any individual with influenza-like symptoms, and:
• refrain from touching mouth and nose;
• perform hand hygiene frequently, by washing with soap and water or using an alcoholbased handrub, especially if touching the mouth and nose and surfaces that are
potentially contaminated;
• reduce as much as possible the time spent in close contact with people who might be ill;
• reduce as much as possible the time spent in crowded settings;
• improve airflow in your living space by opening windows as much as possible.
For individuals with influenza-like symptoms:
• stay at home if you feel unwell and follow the local public health recommendations;
• keep distance from well individuals as much as possible (at least 1 metre);
• cover your mouth and nose when coughing or sneezing, with tissues or other suitable
materials, to contain respiratory secretions. Dispose of the material immediately after use or wash it. Clean hands immediately after contact with respiratory secretions!
• improve airflow in your living space by opening windows as much as possible.
If masks are worn, proper use and disposal is essential to ensure they are potentially effective and to avoid any increase in risk of transmission associated with the incorrect use of masks. The following information on correct use of masks derives from the practices in health-care settings:
• place mask carefully to cover mouth and nose and tie securely to minimise any gaps
between the face and the mask
• while in use, avoid touching the mask
− whenever you touch a used mask, for example when removing or washing, clean
hands by washing with soap and water or using an alcohol-based handrub
• replace masks with a new clean, dry mask as soon as they become damp/humid
• do not re-use single-use masks
− discard single-use masks after each use and dispose of them immediately upon
removing.

H1N1 novel strain: Pandemic influenza in pregnant women

By Syed Akbar
Hyderabad, Aug 12: Researchers and health experts have warned of an increased risk of severe or fatal illness in pregnant women when infected with the novel strain of H1N1 human influenza virus.

According to a report by the World Health Organisation, several countries including the USA that have been experiencing widespread transmission of the pandemic virus have reported an increased risk in pregnant women, particularly during the second and third trimesters of pregnancy.

An increased risk of fetal death or spontaneous abortions in infected women has also been reported.


Evidence from previous pandemics further supports the conclusion that pregnant women are at heightened risk.

While pregnant women are also at increased risk during epidemics of seasonal influenza, the risk takes on added importance in the current pandemic, which continues to affect a younger age group than that seen during seasonal epidemics.

WHO strongly recommends that, in areas where infection with the H1N1 virus is widespread, pregnant women, and the clinicians treating them, be alert to symptoms of influenza-like illness.

The following are the recommendations of the WHO for treatment:

Treatment with the antiviral drug oseltamivir should be administered as soon as possible after symptom onset. As the benefits of oseltamivir are greatest when administered within 48 hours after symptom onset, clinicians should initiate treatment immediately and not wait for the results of laboratory tests.

While treatment within 48 hours of symptom onset brings the greatest benefits, later initiation of treatment may also be beneficial. Clinical benefits associated with oseltamivir treatment include a reduced risk of pneumonia (one of the most frequently reported causes of death in infected people) and a reduced need for hospitalization.

WHO has further recommended that, when pandemic vaccines become available, health authorities should consider making pregnant women a priority group for immunization.
Danger signs in all patients

Worldwide, the majority of patients infected with the pandemic virus continue to experience mild symptoms and recover fully within a week, even in the absence of any medical treatment. Monitoring of viruses from multiple outbreaks has detected no evidence of change in the ability of the virus to spread or to cause severe illness.

In addition to the enhanced risk documented in pregnant women, groups at increased risk of severe or fatal illness include people with underlying medical conditions, most notably chronic lung disease (including asthma), cardiovascular disease, diabetes, and immunosuppression. Some preliminary studies suggest that obesity, and especially extreme obesity, may be a risk factor for more severe disease.

Within this largely reassuring picture, a small number of otherwise healthy people, usually under the age of 50 years, experience very rapid progression to severe and often fatal illness, characterized by severe pneumonia that destroys the lung tissue, and the failure of multiple organs. No factors that can predict this pattern of severe disease have yet been identified, though studies are under way.

Clinicians, patients, and those providing home-based care need to be alert to danger signs that can signal progression to more severe disease. As progression can be very rapid, medical attention should be sought when any of the following danger signs appear in a person with confirmed or suspected H1N1 infection:

* shortness of breath, either during physical activity or while resting
* difficulty in breathing
* turning blue
* bloody or coloured sputum
* chest pain
* altered mental status
* high fever that persists beyond 3 days
* low blood pressure.

In children, danger signs include fast or difficult breathing, lack of alertness, difficulty in waking up, and little or no desire to play.

ICAAP9: Lack of awareness and unified strategy fuels HIV epidemic among men who have sex with men in Asia Pacific

By Syed Akbar
BALI, Aug 13: The Asia Pacific Coalition on Male Sexual Health (APCOM) will
conduct a full-day forum on August 8 on the unique challenges posed by
HIV infection among men who have sex with men (MSM) and transgenders
(TG) in the region.

The interactive consultation is an official pre-conference activity of the 9th International Congress on AIDS in Asia and the Pacific (ICAAP 9) being held in Bali. Authorities from around the world armed with the latest epidemiological data will provide important new insights into the directions the epidemic is taking in the region.

Every 7.5 minutes in Asia Pacific, a man who has sex with men, irrespective of their being homosexual or heterosexual, gets infected with HIV. APCOM, a regional coalition focusing on HIV and MSM of community-based organisations that includes the government sector and the United Nations system, will target its day-long forum squarely on this key affected population.

It will bring together a diverse mix of experts, from developers of national HIV response programmes to scientific researchers to those involved in the UN’s global and regional response to HIV among MSM and TG. They are joined by community leaders from the Asia Pacific region involved in local, national and sub-regional service delivery and community mobilization.

Asia Pacific faces a number of hurdles that make HIV prevention among MSM particularly difficult, including religious and cultural attitudes, legal,
economic and social discrimination, linguistic challenges and varying levels
of awareness. Highly concentrated and severe HIV epidemics among MSM in urban areas across the region are well documented, yet investment in HIV programming for MSM and TG remains limited, ranging from 0% to 4% of the total spending for HIV programming in countries region-wide.

Several major cities across the region are now experiencing HIV epidemics
among men who have sex with men. Recently released data from Myanmar, for example, shows the estimated HIV prevalence rate among MSM in Yangon to be hovering near 30%. In Bangkok, it is 30.7%, Phnom Penh 8.7%, Mumbai 9.6%, and Beijing 5.8%.

ICAAP9: Call for stronger commitment to universal access

By Syed Akbar
Bali, Aug 9: The 9th International Congress on AIDS in Asia and the Pacific (ICAAP) opened Sunday with calls for a strengthened commitment to achieving Universal Access and providing prevention, care, support and treatment for those who need it most.

Indonesian First Lady and AIDS Ambassador, Her Excellency Hj. Ani Bambang Yudhoyono, and other AIDS Ambassadors also urged nations to work towards implementing the Declaration of Commitment adopted at the UN General Assembly Special Session on AIDS in 2001 and the Political Declaration of 2006, despite the pressures of the global economic crisis.

More than 3,000 delegates are taking part in ICAAP at the Bali Convention Centre in Indonesia. This year's theme is "Empowering People, Strengthening Networks."

In a message to the Congress, UNAIDS Executive Director Michel Sidibé said some countries in the Asia Pacific were beginning to see success in their efforts to reverse the spread of HIV, but not enough to break the trajectory of the epidemic.

“We must transform the AIDS response in Asia so that it works for people — especially for people who have been marginalized and without a voice," he said.

"This means protecting sex workers, men who have sex with men, transgender, injecting drug users and their intimate partners.”

A meeting of AIDS Ambassadors discussed ways of mobilizing greater action and putting in place stronger accountability measures in responses to the continuing epidemic.

ICAAP is a biennial gathering for the release and discussion of scientific, programmatic and policy developments in the global response to HIV/AIDS and is convened by AIDS Society of Asia and the Pacific (ASAP).

Local Organizing Committee Chair Prof. Dr. Zubairi Djoerban said,
“The 9th ICAAP takes place when this region, like much of the world, is challenged by stability threats and of a new variant of influenza which have claimed lives while leaving many others severely ill the world over.

“For this very reason, let me express my gratitude to all of you who have unaffectedly shown your greatest courage to be here and enhance our commitment to reverse the course of the AIDS epidemic in the region,”

UNAIDS guidelines on terms to be used for HIV/AIDS patients

Summary of preferred terminology for use in HIV/AIDS reporting


HIV/AIDS;
HIV and AIDS
Use the term that is most specific and appropriate in the context. Examples include people living with HIV, HIV prevalence, HIV prevention, HIV testing, HIV-related disease; AIDS diagnosis, children made vulnerable by AIDS, children orphaned by AIDS, the AIDS response, national AIDS programme, AIDS service
organization. Both HIV epidemic and AIDS epidemic are acceptable.

There is no “AIDS virus”. The virus associated with AIDS is called the Human Immunodeficiency Virus, or HIV. Please note: “virus” in the phrase “HIV virus” is redundant. Use HIV.

Avoid the term infected. No one can be infected with AIDS, because it is not an infectious agent. AIDS is a surveillance definition meaning a syndrome of opportunistic infections and diseases that can develop as immunosuppression deepens
along the continuum of HIV infection from primary infection to death. Use person living with HIV or HIV-positive person.

There is no test for AIDS. Use HIV or HIV antibody test.

The word “victim” is disempowering. Use person living with HIV. Use the term AIDS only when referring to a person with a clinical AIDS diagnosis.

Use the term patient only when referring to a clinical setting. Use: patient with advanced HIV-related illness (or disease) or AIDS-related illness (or disease).

Use risk of HIV infection; risk of exposure to HIV.
Use key populations at higher risk (both key to the epidemic’s dynamics and key to the response). Key populations are distinct from vulnerable populations, which may be subject to societal pressures or social circumstances which may make them more vulnerable to exposure to infections, including HIV.
Use sex work or commercial sex or the sale of sexual services.
Use only in respect to juvenile prostitution; otherwise use sex worker.
Use injecting drug user. Drugs may be injected subcutaneously, intramuscularly or intravenously.
)
Use using non-sterile injecting equipment if referring to risk of HIV exposure; use using contaminated injecting equipment if the equipment is known to contain HIV or if HIV transmission has occurred.

Use response to AIDS. Use evidence-informed.
Use HIV prevalence. The word “rates” connotes the passage of time and should not be used in most instances.
ions
Please spell out all abbreviations in full.

----------
Background for commonly used terms and abbreviations

ABC
Prevention strategies: abstain from penetrative sexual intercourse (also used to indicate delay of sexual debut); be faithful (reduce the number of partners or have sexual relations with only one
partner); condomize (use male or female condoms consistently and correctly). ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS) Not…immune deficiency. . .

ADVOCATE
As a verb: write ‘advocate change’ (rather than advocate for change).

AIDS CARRIER
This term is often used to mean any person living with HIV. However, it is stigmatizing and offensive
to many people living with the virus. It is also incorrect, since the agent being carried is HIV not AIDS.

AIDS- or HIV-RELATED ILLNESS OR DISEASE
Although ‘the person died of AIDS’ is commonly said or written, actually people do not die of AIDS, they die of HIV-related or AIDS-related disease. The expression AIDS-related illness can be
used if a person has an AIDS diagnosis.

AIDS RESPONSE
The terms AIDS response, HIV response, response to AIDS and response to HIV are often used interchangeably to mean the response to the epidemic.

AIDS VIRUS
Since AIDS is a syndrome, it is incorrect to refer to the virus as the “AIDS virus”. HIV (the human immunodeficiency virus) is what ultimately causes AIDS (acquired immunodeficiency syndrome).
In referring to the virus, write the full expression at first usage and then use HIV; avoid the term HIV virus (which is a tautology, i.e. it is saying the same thing twice).

ART
Spell out in full, i.e. antiretroviral therapy or antiretroviral treatment. The term ART can be used if it clearly refers to a triple antiretroviral drug combination.

BEHAVIOUR CHANGE (NOT ‘Behavioural Change’)
There are a number of theories and models of human behaviour that guide health promotion and education efforts to encourage behaviour change, i.e. the adoption and maintenance of healthy
behaviours.

CLIENT-INITIATED TESTING
Alternative term for voluntary counselling and testing (VCT). All HIV testing must be carried out under conditions of the “three Cs”: i.e. that it be confidential, accompanied by counselling and
conducted only with informed consent.

CONTAMINATED and NON-STERILE
Drug injecting equipment was “contaminated” if it caused infection, that is, the equipment contained HIV; “unclean”, “dirty” or “non-sterile” if it carried the risk of HIV exposure: that is, it may or may not have carried the virus.

COSPONSORS
The Joint United Nations Programme on HIV/AIDS (UNAIDS) has the following ten cosponsors, listed in the following order (according to UN rules): United Nations High Commissioner for Refugees (UNHCR) http://www.unhcr.org/ United Nations Children’s Fund (UNICEF) http://www.unicef.org/ World Food Programme (WFP) http://www.wfp.org/ United Nations Development Programme (UNDP) http://www.undp.org/ United Nations Population Fund (UNFPA) http://www.unfpa.org/ United Nations Office on Drugs and Crime (UNODC) http://www.unodc.org/odccp/index.html International Labour Organization (ILO) http://www.ilo.org/ United Nations Educational, Scientific and Cultural Organization (UNESCO)
http://www.unesco.org/ World Health Organization (WHO) http://www.who.int/en/ World Bank http://www.worldbank.org/

CRIS
Country Response Information System. Developed by UNAIDS, CRIS provides partners in the global response to HIV with a user-friendly system consisting of an indicator database, a programmatic database, a research inventory database and other important information. The indicator database provides countries with a tool for reporting on national follow-up to the United
Nations General Assembly Special Session on HIV/AIDS (June 2001) Declaration of Commitment on HIV/AIDS. The country-level CRIS will be complemented by a Global Response Information Database (GRID), which will support strategic analysis, knowledge-based policy formulation and subsequent programming. At country and global levels a Research Inventory Database (RID) is also being developed.

CULTURAL DOMINANCE
Familiar terms used in some cultures may not be appropriate in other cultural contexts e.g. seasons of the year—avoid “fall” or “autumn” and prefer instead last quarter of the year or instead of summer prefer mid-year. Similarly remember that different cultures celebrate the New Year at different times and that seasons in the northern and southern hemispheres are opposite to each other.

DESCRIBING AIDS
AIDS is often referred to as a “deadly, incurable disease”, but this creates a lot of fear and only serves to increase stigma and discrimination. It has also been referred to as a “manageable, chronic illness, much like hypertension or diabetes”, but this may lead people to believe that it is not as serious as they thought. It is preferable to use the following description: AIDS, the acquired immunodeficiency syndrome, is a fatal disease caused by HIV, the human immunodeficiency virus. HIV destroys the body’s ability to fight off infection and disease, which can ultimately lead to death.
Currently, antiretroviral drugs slow down replication of the virus and can greatly enhance quality of life, but they do not eliminate HIV infection.

DRIVER
The term relates to the structural and social factors, such as poverty, gender, and human rights abuses that can increase people’s vulnerability to exposure to HIV. It is often reserved to describe underlying determinants.

EPIDEMIC
In epidemiology, an epidemic is a disease that appears as new cases in a given human population (e.g. everyone in a given geographic area; a university, or similar population unit; or everyone of a certain age or sex, such as the children or women of a region) during a given period, at a rate that greatly exceeds what is “expected” based on recent experience. Defining an epidemic is subjective, depending in part on what is “expected”. An epidemic may be restricted to one locale (an outbreak), more general (an epidemic) or global (a pandemic). Common diseases that occur at a constant but relatively high rate in the population are said to be “endemic”. Widely known examples of epidemics include the plague of mediaeval Europe known as the Black Death, the influenza pandemic of 1918–1919, and the current HIV epidemic which is increasingly described as a pandemic (made up of distinct types of epidemics in areas across the globe).

EPIDEMIOLOGY
Epidemiology is the branch of medical science that deals with the study of the incidence, distribution and determinants of patterns of a disease as well as its prevention in a population.

EVIDENCE-INFORMED
This term is preferred to evidence based in recognition of the fact that several elements may play a role in decision making, only one of which may be evidence; others may include cultural appropriateness, cost, feasibility and concerns about equity and so on.

FAITH-BASED ORGANIZATIONS
Faith-based organization is the term preferred instead of e.g. church, synagogue, mosque or religious organization, as it is inclusive (non-judgmental about the validity of any expression of faith) and moves away from historical (and typically European) patterns of thought.

FEMINIZATION
Referring to the pandemic, feminization is now often used by UNAIDS and others to indicate the increasing impact that it has on women. It is often linked to the idea that the number of women
infected has equalled, or surpassed, the figure for men or that women and girls are bearing the brunt of the epidemic in many settings.

FIGHT
Avoid using words such as “fight” and other combatant language e.g. struggle, battle, campaign or war, unless in a direct quotation. Alternatives include: response to; management of; measures against; initiative; action; efforts; and programme. One rationale for this is to avoid a transference being made from the fight against HIV to a fight against people living with HIV.

GAY MEN
Write “men who have sex with men” unless individuals or groups specifically self-identify as
gay. The broader community of men and women and transsexuals should be described as lesbian, gay, bisexual and transgendered—the abbreviation LGBT is often used for such communities, but
UNAIDS’ general preference is to spell out all terms in full.

GENDER and SEX
The term “sex” refers to biologically determined differences, whereas the term “gender” refers to differences in social roles and relations between men and women. Gender roles are learned through socialization and vary widely within and between cultures. Gender roles are also affected by age, class, race, ethnicity and religion, as well as by geographical, economic and political environments. Since many languages do not have the word gender, translators may have to consider other alternatives to distinguish between these concepts.

GLOBAL FUND TO FIGHT AIDS, TUBERCULOSIS AND MALARIA
The Global Fund to Fight AIDS, Tuberculosis and Malaria, established in 2001, is an independent public-private partnership. Its purpose is to attract, manage and disburse additional resources to make a sustainable and significant contribution to mitigate the impact caused by HIV, tuberculosis and malaria in countries in need, while contributing to poverty reduction as part of the Millennium Development Goals. Since 2001, the Global Fund has attracted US$ 4.7 billion in financing through 2008. In September 2007, donors provided initial pledges to the Global Fund worth US$ 9.7 billion over three years. These pledges constitute the largest single financing exercise for health ever and they will allow the Global Fund to move towards annual commitments of US$ 6–8 billion by 2010. http://www.theglobalfund.org/en/

GIPA
An acronym for the “greater involvement of people living with HIV/AIDS”. In 1994, 42 countries prevailed upon the Paris AIDS Summit to include the Greater Involvement of People Living with
HIV/AIDS Principle (GIPA) in its final declaration. http://www.unaids.org/en/Issues/Affected_communities/gipa.asp

UNAIDS does not use the term “high-risk group” because it implies that the risk is contained within the group whereas, in fact, all social groups are interrelated. It may also lull people who don’t identify with such groups into a false sense of security. As well it can increase stigma and discrimination. It is often more accurate to refer directly to “higher risk of HIV exposure”, “sex without a condom”, “unprotected sex”, or “using non-sterile injection equipment” rather than to generalize by saying “highrisk
group”.

Membership of groups does not place individuals at risk, behaviours may. In the case of married and cohabiting people, particularly women, it may be the risk behaviour of the sexual partner that places them in a “situation of risk”. There is a strong link between various kinds of mobility and heightened risk of HIV exposure, depending on the reason for mobility and the extent to which people are removed from their social context and norms. UNAIDS prefers the term “key populations” because it emphasizes that these populations, while being important to the dynamics of HIV transmission in a setting, are equally essential partners for an effective response to the epidemic.

HIGHLY ACTIVE ANTIRETROVIRAL THERAPY (HAART)
This term is now infrequently used in favour of antiretroviral treatment or therapy (ART). It referred to treatment regimens recommended by leading HIV experts to aggressively suppress viral replication and slow the progress of HIV disease. The usual HAART regimen combines three or more different drugs such as two nucleoside reverse transcriptase inhibitors and a protease inhibitor, two nucleoside analogue reverse transcriptase inhibitors and a non-nucleoside reverse transcriptase inhibitor or other combinations. More recently, new drugs have been developed to prevent the virus from entering the cell. These treatment regimens have been shown to reduce the amount of virus so that it becomes undetectable in a patient’s blood.

HIPC INITIATIVE
The Heavily Indebted Poor Countries Initiative is a debt relief tool for increasing the funds that countries have available and for ensuring that they are channelled to core human development
priorities, such as basic health care. The HIPC initiative, created in 1996 by the World Bank and further enhanced in 1999, has already helped some of the poorest nations in the world to free up precious resources for human development that would otherwise have been spent on servicing debt.

Fully funded and implemented, the enhanced HIPC initiative has the potential to be an even more powerful tool to allow countries to devote more resources to combating infectious diseases.

HIV-RELATED DISEASE
Symptoms of HIV infection may occur both at the beginning of HIV infection and after immune compromise sets in, leading to AIDS. During the initial infection with HIV, when the virus comes
into contact with the mucosal surface, it finds susceptible target cells and moves to lymphoid tissue where massive production of the virus ensues. This leads to a burst of high-level viraemia (virus in the bloodstream) with wide dissemination of the virus. Some people may have flu-like symptoms at this stage but these are generally referred to as symptoms of primary infection rather than HIV-related disease. The resulting immune response to suppress the virus is only partially successful and some virus escapes and may remain undetectable, sequestered in reservoirs for months to years.

As crucial immune cells, called CD4+ T cells, are disabled and killed, their numbers progressively
decline. In this manner, HIV-related disease is characterized by a gradual deterioration of immune function. Eventually high viral turnover leads to destruction of the immune system, sometimes
referred to as advanced HIV infection, which leads to the manifestation of AIDS.

HIV-INFECTED
As distinct from HIV-positive (which can sometimes be a false positive test result, especially in infants up to 18 months of age), the term HIV-infected is usually used to indicate that evidence of
HIV has been found via a blood test.

HIV-NEGATIVE
Showing no evidence of infection with HIV (e.g. absence of antibodies against HIV) in a blood or oral fluid test. Synonymous with seronegative. An HIV-negative person can be infected if he or she is in the window period between HIV exposure and detection of antibodies.

HIV-POSITIVE
Showing indications of infection with HIV (e.g. presence of antibodies against HIV) in a blood or oral fluid test. Synonymous with seropositive. Results may occasionally be false positive.

HUMAN IMMUNODEFICIENCY VIRUS (HIV)
The virus that weakens the immune system, ultimately leading to AIDS. Since HIV means “human immunodeficiency virus”, it is redundant to refer to the HIV virus.

HUMAN IMMUNODEFICIENCY VIRUS TYPE 1 (HIV-1)
The retrovirus isolated and recognized as the etiologic (i.e. causing or contributing to the cause of a disease) agent of AIDS. HIV-1 is classified as a lentivirus in a subgroup of retroviruses. Most viruses
and all bacteria, plants and animals have genetic codes made up of DNA, which is transcribed into RNA to build specific proteins. The genetic material of a retrovirus such as HIV is the RNA itself. The viral RNA is reverse transcribed into DNA, which is then inserted into the host cell’s DNA preventing the host cell from carrying out its natural functions and turning it into an HIV factory.

HUMAN IMMUNODEFICIENCY VIRUS TYPE 2 (HIV-2)
A virus closely related to HIV-1 that has also been found to cause AIDS. It was first isolated in West Africa. Although HIV-1 and HIV-2 are similar in their viral structure, modes of transmission
and resulting opportunistic infections, they have differed in their geographical patterns of infection and in their propensity to progress to illness and death. Compared to HIV-1, HIV-2 is found primarily in West Africa and has a slower, less severe clinical course.

INCIDENCE
HIV incidence (sometimes referred to as cumulative incidence) is the number of new cases arising in a given period in a specified population. UNAIDS normally refers to the number of people (of
all ages) or children (0–14 years) who have become infected during the past year. In contrast HIV prevalence refers to the number of infections at a particular point in time (like a camera snapshot). In specific observational studies and prevention trials, the term incidence rate is used to describe incidence per hundred person years of observation.

INJECTING DRUG USERS (IDUs)
This term is preferable to drug addicts or drug abusers, which are seen as derogatory terms and which often result in alienation rather than creating the trust and respect required when dealing with
those who inject drugs. UNAIDS does not use the term “intravenous drug users” because subcutaneous and intramuscular routes may be involved. It is preferable to spell out in full and not use the abbreviation. An acceptable alternate phrasing is people who inject drugs.

INTERVENTION
This term conveys “doing something to someone or something” and as such undermines the concept of participatory responses. Preferred terms include programming, programme, activities, initiatives, etc.

MILLENNIUM DEVELOPMENT GOALS (MDGs)
Eight goals developed at the Millennium Summit in September 2000. Goal 6 refers specifically to AIDS but attainment of several goals is being hampered by the HIV epidemic. http://www.un.org/millenniumgoals/

MONITORING AND EVALUATION REFERENCE GROUP
Established by UNAIDS, the Monitoring and Evaluation (M&E) Reference Group (MERG) has a broad membership of national, bilateral agency and independent evaluation expertise, enabling it to assist in the harmonization of monitoring and evaluation approaches among collaborating organizations
and in the development of effective monitoring and evaluation of the response to the epidemic.

MSM
Abbreviation for “men who have sex with men” or “males who have sex with males”. This term is useful as it includes not only men who self identify as gay or homosexual and have sex only with other men but also bisexual men, and heterosexual men who may, nonetheless at times have sex with other men.

MTCT

Abbreviation for “mother-to-child transmission” (PMTCT is the abbreviation for “prevention of mother-to-child transmission”). Some countries prefer the term “parent-to-child transmission” to
avoid stigmatizing pregnant women and to encourage male involvement in HIV prevention.

OPPORTUNISTIC INFECTIONS
Illnesses caused by various organisms, some of which usually do not cause disease in persons with healthy immune systems. Persons living with advanced HIV infection may have opportunistic
infections of the lungs, brain, eyes and other organs. Opportunistic illnesses common in persons diagnosed with AIDS include Pneumocystis carinii pneumonia, cryptosporidiosis, histoplasmosis, bacterial infections, other parasitic, viral and fungal infections; and some types of cancers. Tuberculosis
is the leading HIV-associated opportunistic infection in developing countries.

ORPHANS
In the context of AIDS, it is preferable to say “children orphaned by AIDS” or “orphans and other children made vulnerable by AIDS”. Referring to these children as “AIDS orphans” not only stigmatizes them, but also labels them as HIV-positive, which they may not necessarily be. Identifying a human being by his/her medical condition alone also shows a lack of respect for the individual.

Contrary to traditional usage UNAIDS uses “orphan” to describe a child who has lost either one or
both parents.

PANDEMIC
A disease that spreads across an entire region, continent or the whole world. Preferred usage is to write “pandemic” when referring to global disease and to use “epidemic” when referring to country or regional level. For simplicity, UNAIDS often uses “epidemic”,

PATHOGEN
An agent causing disease.

PEOPLE LIVING WITH HIV
Avoid the expression “people living with HIV and AIDS” and the abbreviation PLWHA. With reference to those living with HIV, it is preferable to avoid certain terms: AIDS patient should only
be used in a medical context (most of the time, a person with AIDS is not in the role of patient); the term AIDS victim or AIDS sufferer implies that the individual in question is powerless, with
no control over his or her life. It is preferable to use “people living with HIV” (PLHIV), since this reflects the fact that an infected person may continue to live well and productively for many years.
Referring to people living with HIV as innocent victims (which is often used to describe HIV-positive children or people who have acquired HIV medically) wrongly implies that people infected in
other ways are somehow deserving of punishment. It is preferable to use “people living with HIV”, or “children with HIV”.

PREVALENCE
Usually given as a percentage, HIV prevalence quantifies the proportion of individuals in a population who have HIV at a specific point in time. UNAIDS normally reports HIV prevalence among adults, aged 15–49 years. We do not write prevalence rates because a time period of observation is not involved. “Prevalence” is sufficient, e.g. the Caribbean region, with estimated adult HIV prevalence of 2.3% in 2003, is an area to focus on in the future”. HIV prevalence can also refer to the number of people living with HIV as in “by December 2007 an estimated 33.2 million people were living with HIV worldwide.


PROSTITUTION
Use this term in respect to juvenile prostitution only. Otherwise for people of older ages use “commercial sex” “sex work” or “the sale of sexual services”.

PROVIDER-INITIATED TESTING
Under certain circumstances, when an individual is seeking medical care, HIV testing may be offered. It may be diagnostic—as when a patient presents with symptoms that may be attributable to HIV or has an illness associated with HIV such as tuberculosis—or it may be a routine offer to an asymptomatic person. For example, HIV testing may be offered as part of the clinical evaluation of patients with sexually transmitted infections and pregnant women. HIV testing may be offered to all patients where HIV is prevalent. Regardless of the type of testing and the location of the offer,
All HIV testing should always be carried out under conditions respecting the three Cs—confidentiality, informed consent and counselling. Testing without counselling has little impact on behaviour and is a significant lost opportunity for assisting people to avoid acquiring or transmitting infection.





RISK
Avoid using the expressions “groups at risk” or “risk groups”. People with behaviours which may place them at higher risk of exposure to HIV do not necessarily identify themselves with any
particular group. Risk refers to risk of exposure to HIV which may be high as a result of specific behaviours or situations. Examples of the latter include risk in discordant couples unaware of their
serostatus and recipients of unscreened blood or blood products. Behaviours, not memberships, place individuals in situations in which they may be exposed to HIV. Some populations may be at
increased risk of exposure to HIV.

RISK COMPENSATION or RISK ENHANCEMENT
A compensatory increase in behaviours which can result in exposure to HIV brought on by reduced perception of personal risk e.g. uptake of a 50% effective preventive HIV vaccine might tend to encourage abandoning condom use.


SAFER SEX
Use by preference the term safer sex because the term safe sex may imply complete safety. Sex is 100% safe from HIV transmission when both partners know their HIV-negative serostatus and
neither partner is in the window period between HIV exposure and appearance of HIV antibodies detectable by the HIV test. In other circumstances, reduction in the numbers of sexual partners and
correct and consistent use of male or female condoms can reduce the risk of HIV transmission. The term safer sex more accurately reflects the idea that choices can be made and behaviours adopted to reduce or minimize risk.

SEROPREVALENCE
As related to HIV infection, the proportion of persons who have serologic evidence of HIV infection, i.e. antibodies to HIV at any given time.

SEROSTATUS
A generic term that refers to the presence/absence of antibodies in the blood. Often, the term refers to HIV antibody status.


SEXUALLY TRANSMITTED INFECTION (STI)
Also called venereal disease (VD), an older public health term, or sexually transmitted disease (STD), terms that do not convey the concept of being asymptomatic in the same way that the term sexually transmitted infection does. Sexually transmitted infections are spread by the transfer of organisms from person to person during sexual contact. In addition to the “traditional” STIs (syphilis and gonorrhoea), the spectrum of STIs now includes HIV, which causes AIDS; Chlamydia trachomatis; human papilloma virus (HPV) which can cause cervical, penile or anal cancer; genital herpes; chancroid; genital mycoplasmas; hepatitis B; trichomoniasis; enteric infections; and ectoparasitic diseases (i.e.
diseases caused by organisms that live on the outside of the host’s body). The complexity and scope of sexually transmitted infections have increased dramatically since the 1980s; more than 20 diseasecausing organisms and syndromes are now recognized as belonging in this category.

SEX WORK
“Commercial sex work” is considered a tautology, which is saying the same thing twice over in different words. Preferred terms are “sex work”, “commercial sex”, and “the sale of sexual services”.

SEX WORKER
The term “sex worker” is intended to be non-judgmental, focusing on the conditions under which sexual services are sold. Alternate formulations are: “women/men/people who sell sex”. Clients of
sex workers may then also be called “men/women/people who buy sex”. The term “commercial sex worker” is no longer used, primarily because it is considered to be saying something twice over in different words (i.e. a tautology).

SHARING
When referring to injecting equipment UNAIDS does not use the word “sharing” in its publications. Instead, “use of contaminated injecting equipment” is preferred if referring to actual
HIV transmission and “use of non-sterile injecting equipment” if referring to risk of HIV exposure. This is because injecting drug users uncommonly “share” their needles in the usually understood
sense of the word—with the exception of sexual partners who inject together. In the absence of needle exchanges, people may use discarded needles (which are anonymous) or bargain away
drugs for a needle or are injected by professional injectors. They do not regard this as sharing.

Neither does “sharing” distinguish between needle borrowing and needle lending; this is important because (usually) different dynamics are at work. A person aware of his or her HIV-positive status may try to avoid lending, but may continue to borrow or vice versa. Also “sharing” has positive connotations in injecting drug use communities (and wider communities also), e.g. sharing a meal, which are not appropriate in writing about HIV risk.

STIGMA and DISCRIMINATION
As the traditional meaning of stigma is a mark or sign of disgrace or discredit, the correct term would be stigmatization and discrimination; however, “stigma and discrimination” has been accepted in everyday speech and writing, and may be treated as plural.

SURVEILLANCE
Continual analysis, interpretation and feedback of systematically collected data, generally using methods distinguished by their practicality, uniformity, and rapidity rather than by accuracy or
completeness.


VERTICAL TRANSMISSION
Sometimes used to indicate transmission of a pathogen such as HIV from mother to fetus or baby during pregnancy or birth but may be used to refer to the genetic transmission of traits. UNAIDS
primarily uses the term mother-to-child transmission.