Spotlight Center on HIV Prevention Today


From Pragmatic to Profound, It's All Powerful: Snapshots as AIDS 2014 Begins to Close

July 24, 2014

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Indonesian Health Minister, on drug criminalization: "Do we want to kill them? Or do we want to save them?"

Meanwhile, at the Melbourne town hall, the popular Q&A panel discussion featured a panel of notables, including Indonesian Health Minister Nafsiah Mboi, currently also chair of The Global Fund to Fight AIDS, Tuberculosis and Malaria.

As reported by Australia's The New Daily, Mboi arguably stole the show, as she answered a question about facing religious and political opposition to the distribution of condoms and sterile syringes:

"When the President appointed me Secretary of the National AIDS Commission, the first thing I did was indeed invite all of them who were against [fighting AIDS], as well as the ones who were for it.

"But we knew this was a very difficult question, because the law criminalized drug use, so there was a big resistance. So I said okay, let's stop for a moment. We have 330,000 young people who are injecting drugs. Previously in some districts it's already 67 per cent HIV positive, Hep C, as well as syphilis, etc. What do we want to do? Do we want to kill them? Or do we want to save them? The easiest way is to kill them.

"Because if you don't do anything, we keep on fighting among us, they will die. They will die of overdose, they will die of AIDS, they will die of Hep C. And if they get imprisoned they will die even faster. Because they get beaten up.

"But we are the government. Where were we when our kids became victims of the drug pushers? And there was total silence. Then a policeman came and said, 'You're right. We have to save them if we can. Because my son is a drug user. And I don't know what to do.'

"And that, my friends, changed the whole atmosphere."

View her testimony on YouTube.

Risk Compensation Continues to Be Non-Revealed

The big news from the iPrEx Open-Label Extension (OLE) was that even those who took as few as four doses of tenofovir/emtricitabine (Truvada) a week had complete protection from HIV. But as reported by's Warren Tong, the study also revealed no evidence of risk compensation, with participants reporting safer sexual practices and a similar syphilis incidence (a marker of sexual risk behavior) between both groups in the study.

The ever intrepid Gus Cairns of was hot on the trail of compensatory risk analyses at AIDS 2014.

He notes that three different methods of statistical analysis detected no rise in risk among men who underwent circumcision in Zambia, a nation on the path to circumcising 80% of eligible men by next year. And in a presentation titled "Is use of antiretroviral treatment (ART) associated with decreased condom use?" the answer was also a very clear "nope!"

Cairns explains that the latter presentation's meta-analysis of every study of new ART users that tracked sexual behavior found "not a single instance" of risk compensation. Actually, he notes, "in 15 studies that met inclusion criteria for the analysis, starting HIV treatment was consistently associated with a fall in sexual risk behavior, as measured by increased condom use. This association held true for both genders; for committed relationships and casual sex; and for partners both known, and not known, to be HIV negative." The studies evaluated condom use in heterosexual people in sub-Saharan Africa.

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This article was provided by TheBodyPRO. It is a part of the publication The 20th International AIDS Conference.


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