Panelists talk about AIDS prevention

Wednesday, December 10, 2008

Behavioral change, partner reduction and circumcision were the AIDS prevention options discussed yesterday during a symposium hosted by the Global Alliance to Immunize Against AIDS.

Commemorating World AIDS Day, the Brown University AIDS Program, among other campus and community groups, joined GAIA in welcoming three speakers – Daniel Halperin, a professor in the department of Global Health and Population at Harvard University; Rick Altice, director of the Yale University School of Medicine’s HIV in Prisons program; and David Thomas, from Nova Southeastern University.

Anne DeGroot, adjunct associate professor of pediatrics and cofounder and scientific director of GAIA, said she chose the three speakers for their innovative approaches to impeding the spread of the disease and for their outstanding contributions to the field of HIV prevention.

“We really want to shed a light on the need to stop the number-one killer in the world,” she said. “That is why are we are here today.”

Focusing mostly on AIDS in African countries, Halperin began the symposium with an hour-long presentation, in which he explained the epidemiology of the disease and possible preventive measures.

“Factors of spreading can be radically different from country to country,” he said. “Southern Africa is the wealthiest, most educated part and it has a 30 percent of HIV prevalence.”

Halperin also discussed the use of condoms in Africa, stating that people were much more inclined to use one when having sexual intercourse with a sex worker than with their stable partner.

“It is a human phenomenon,” he said. “It’s quite feasible to get people to use condoms when using prostitutes, but people go home to their regular partner – and most of them of them will not use one.”

The underlying problem is that people who are in concurrent relationships with more than one partner – a married spouse and a lover – spread the disease.

“In Lesothos, 55 percent of the male and 40 percent of the female population have more than one partner,” he said. “Over the last three years, more than two-thirds of the population was linked to the single chain of infection.”

Halperin introduced ecological evidence to demonstrate the connection between a lack of circumcision and the transmission of AIDS. There is biological proof, he said, that the foreskin of the penis is much more “permeable” than the skin in the rest of the body.

Since “the foreskin is nine times more vulnerable to AIDS transmission than the cervical tissue,” Halperin said, there is a higher transmission of AIDS in sexual acts with an uncircumcised penis. Thus, male circumcision reduces transmission rates by 70 to 80 percent.

In a statement released in 2007, World Health Organization/UNAIDS confirmed that “the efficacy of male circumcision in reducing female to male transmission of HIV has been proven beyond reasonable doubt.”

Halperin finished his presentation by expressing the necessity, in light of this finding, of increasing the availability of “safe, voluntary, affordable male circumcision.”

“It is unethical that poor men in these countries cannot afford the procedure,” he said, adding that some men are put on a six-month wait-list.

After Halperin’s presentation, Thomas and Altice spoke to a more national concern. Their short presentation addressed their efforts to quell the spread of AIDS in American prisons, where some inmates who often don’t have condoms readily available have intercourse with one another. HIV is also spread when some prisoners share needles, they said, and they presented statistics showing that incarcerated individuals make up one of the groups with highest rates of HIV infection in America.

While recognizing the global need for AIDS groups, Julie Caplow ’09, co-president of GAIA at Brown, said the disease is also a cause of concern in the U.S.

“It is easy to think (of) HIV/AIDS as a problem for the rest of the world,” she said. The goal of this week of events, she said, is that “students will realize that it is a problem that can affect them.”

DeGroot agreed, adding, “We need every single one of you in the fight against AIDS.”

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