Abstract Book Vol. 1 [International Conference on AIDS (16th: 2006: Toronto, Canada)]

Description: We have set up a front-line network of health professionals and
influential community members (Reseau Sante et Droits de I' Homme, DR
Congo) to promote non-discriminatory access to health care and understand to
which extent the paradigm Health and Human Rights was considered in the fight
against HIV. We organize conferences, workshops, and conduct field surveys
using questionnaires, focus group discussions, participatory observational
methodology, and in-depth interviews with key-informants.
Lessons learned: People living with HIV are still victims of stigmata and
exclusion, especially in emergency situations and/or late-stage disease.
In certain circumstances, this situation has resembled a pure, passive and
systematic euthanasia hidden inside clinics, homes, or hospitals. Most people
including subjects living with HIV acknowledge the importance of implementing
structures to ensure respect and protection of fundamental human rights.
However, a most troubling and consistent finding was that very few did believe
in the success of such endeavor. The main reasons were, but not limited.to: (1)
lack of operational and culturally-competent approach, (2) frustration among
health care professionals and other community leaders who often make a link
between imperialism and the paradigm Health and Human Rights, therefore
rejecting the validity of the latter, (3) most professionals had no trust in
government-led initiatives. Poverty seems to be a key-issue underlying the
HIV pandemic.
Recommendations: The classic Health and Human Right approach should be
enhanced by a proactive political involvement of the world community to reduce
poverty, stop corruption, and promote democracy in the developing world; this
remains a major step that should be taken unequivocally and integrated in the
global fight against HIV.
MOPE0890
Health and human rights dimensions of HIV/AIDS
and policy implications in Swaziland
K.S. Leiter', S. Weiser2, M. Heisler3, F. Percy-de Korte', S. DeMonnerl,
Z. Hlanze4, D. Tuller', S. Masekos, W. Wolfe6, V. Iacopino'. 'Physicians
for Human Rights, Cambridge, Massachusetts, United States, 2University
of California, San Francisco, Epidemiology and Prevention Interventions
Center, San Francisco, California, United States, 3University of Michigan,
Division of General Medicine, Department of Internal Medicine, Ann Arbor,
Michigan, United States, 4Women and Law in Southern Africa Research Trust
- Swaziland, Mbabane, Swaziland, 'United Nations Development Programme,
Mbabane, Swaziland, 'University of California, San Francisco, Department of
Psychiatry, San Francisco, California, United States
Background: Throughout southern Africa, inequitable and discriminatory
economic, political and social structures drive the HIV/AIDS epidemic and
disproportionately affect already vulnerable and marginalized populations. This
study sought to assess the prevalence and correlates of human rights concerns
associated with HIV/AIDS and to quantify associations between indicators of
inequality and discrimination and HIV risk.
Methods: We conducted a cross-sectional, population-based study of 812
women and men in all four regions of Swaziland, using a two-stage probability
design. Descriptive statistics characterized the study population and distribution
of responses and multivariate logistic regression analyses examined factors
associated with sexual practices that increase risk of HIV transmission.
Results: A wide range of health and human rights concerns were identified.
The majority of individuals held HIV-related stigmatizing beliefs (61%) and
gender discriminatory attitudes (96%). Eighty-four percent of participants held
two or more gender discriminatory attitudes. Sexual practices with potentially
life-threatening consequences were common. For example, a large proportion
of men reported multiple sexual partnerships (40% versus 8% for women).
At the same time, many women reported lacking control over decisions to
have sex (29%) or use condoms (19%). Food insecurity affected one-third
of participants and for women was correlated with lack of control in sexual
relationships and risky sexual practices. Though correct knowledge of HIV was
high (81%), perceived access to HIV testing was low (57%) and only 18% of
male participants and 25% of females had tested. The chief barrier to testing
was fear of knowing one's status (42%). Community survey participants were
highly critical of the response of local and national leaders to the HIV/AIDS
crisis.
Conclusions: For HIV/AIDS policy to be effective in Swaziland, interrelated
health and human rights concerns must be holistically addressed through
legal reform, popular education, the strengthening of civil society and other
comprehensive remedies.
MOPE0891
Refugee women in Canada: reflections on health,
human rights and HIV/AIDS
L. Elford. Calgary Immigrant Women's Association, Settlement and
Integration Department, Calgary, Canada
Issues: Of the 19.2 million people who make up the UNHCR's populations of
concern at the end of 2004, 9.2 million were refugees and some of the most

vulnerable people known the world over. Due to poverty and displacement,
they are threatened by innumerable health problems and are forced into
activities that inevitably place them at a greater risk for contracting HIV/
AIDS. Simultaneously fulfilling the role of economic centre of the family
and marginalized member of the family, women typically bare the greatest
burdens. The experience of living with large refugee populations under harsh
conditions rarely leaves the memory of refugee women as do the violations
they experienced of their human rights.

Description: As part of a larger project entitled "Immigrant Community
AIDS Resources and Education (I CARE)" we asked women about the risks
associated with living in refugee camps and how that potentially impacted their
health, with particular attention to HIV/AIDS. This feedback, while informing
the prevention materials we developed, also provided a wealth of contextual
information that we felt compelled to investigate further.
This workshop will present the findings from our one on one interviews with
refugee women in Calgary where we asked them to reflect on their experiences
living in refugee settlements. Using a rights-based and anti-oppressive
approach, this presentation will discuss the findings of this research project.
By incorporating the voices of refugee women, the argument in favour of
respecting women's rights and human rights as an effective means to reduce
the harm associated with HIV/AIDS for those living as refugees throughout the
world will be debated.
Lessons learned: The results of this project will be a report reflecting the
experiences of the women we are interviewing.
Recommendations: The project will share recommendations for policy change
and feedback on possible changes in practice.
MOPE0892
The role of legal practioners in HIV/AIDS
V. Nwangumal, S. Iwuagwu2. 'Center for the Right to Health, Human Rights/
Legal, Lagos, Nigeria, 2Center for the Right to Health, Programs, Lagos,
Nigeria
Issues: One of the problems that HIV/AIDS pandemic has raised is the issue of
human rights violations experienced by People Living With HIV/AIDS (PLWHA).
They are subjected to several forms of violation. These ranges from testing
patients for HIV without their knowledge or consent, non respect of privacy
and confidentiality, denial of treatment and care, inhuman and degrading
treatments among others.
Description: Most of these violations are neither investigated nor redressed.
Experience has shown that the cause of this problem is fear fueled by lack of
knowledge. Worse still, the court of law, which should serve as a refuge of
justice for these violations have shown little knowledge of the issues involved.
Hence, PLWHA are left with doubt as to obtaining justice for violation of their
rights. This fact is corroborated by a Person Living Positively who is a plaintiff
in a case before a judge in a high court in Lagos, Nigeria. The judge allegedly
ruled that the entry of the plaintiff to the courtroom would be dependent on
expert evidence to show that people in the courtroom will not be contaminated
with the virus.
To reverse this ugly trend Center for the Right to Health (CRH) embarked on
sensitization seminars on educating and sensitizing the judiciary in Nigeria on
HIV/AIDS.
Lessons learned: Equipping the judicial system with adequate knowledge of
HIV/AIDS did increase their awareness level on legal and human rights, ethical
and socio-economic issues as they are better informed as PLWHA can look up
to the judiciary as their last hope for succor.
Recommendations: PLWHA should ensure they seek redress for the various
violations they experience. Judicial authorities should create an enabling
environment for civil society organization to reach out to the judiciary with
more seminars. Human Rights education and HIV/AIDS should be incorporated
into curriculum of law schools in Nigeria.
MOPE0893
Legal, regulatory and institutional barriers to the
approval of an effective microbicide: an examination
of investigational new drug approval processes in
three African countries
C. Brabazon', N. Novogrodsky2, A. Bains', G. Caplan'. 'Faculty of Law,
University of Toronto, Toronto, Canada, 2University of Toronto, International
Human Rights Program, Faculty of Law, Toronto, Canada
Issues: With HIV incidence and prevalence continuing to rise, an effective
affordable microbicide could be a powerful prevention tool for heterosexual
women. Rapid regulatory approval and appropriate pricing and distribution
mechanisms will be key once an effective product is found.
Description: As part of a law school course aimed at providing research
assistance to the U.N. Special Envoy for AIDS in Africa, a research project was
undertaken to determine the processes necessary to approve a microbicide for
use in three African nations: South Africa, Nigeria, and Ghana.
Lessons learned: Microbicides in Phase III trials offer tremendous hope
and promise for prevention of heterosexual HIV transmission. Countries vary
significantly in the complexity of the drug approval process, and associated
costs. Nations also lack efficient distribution schemes for pharmaceuticals,
including microbicides as well as purchasing power to supply them to women
at risk.
Recommendations: A single system of regulatory approval and drug
distribution is needed for all African nations. The existing WHO system could
serve this purpose, but requirements of FDA approval by some supplying

nations and funders is a significant barrier. Strategies to overcome disparities
in infrastructure between nations are required.

Monday
14 August
PosterEyhibition

XVI INTERNATIONAL AIDS CONFERENCE * 13-18 AUGUST 2006 * TORONTO CANADA * ABSTRACT BOOK VOLUME 1