Elizabeth Pisani (an epidemiologist--and a DIFFERENT elizabeth) has a new video out on TEDtalks titled "Sex drugs and HIV: let's get real": http://www.ted.com/talks/elizabeth_pisani_sex_drugs_and_hiv_let_s_get_rational_1.html

This video talks about how law enforcement makes people make stupid decisions, i.e. using unclean needles because people fear arrest in Indonesia.

"What's rational for public health is rational for individuals"

This week in honor of International Women’s Day, I was invited as a youth representative to the Vital Voices Global Leadership Awards Ceremony at the Kennedy Center in Washington, DC. It was an honor to be among the many women (and few men) in Washington who make sure that women’s voices around the world are heard.

The award ceremony honored six women: Melinda Gates (United States), Afnan Al Zayani (Bahrain), Panmela Castro (Brazil), Andeisha Farid (Afghanistan), Rebecca Lolosoli (Kenya), and Roshaneh Zafar (Pakistan). With the exception of Melinda Gates, chances are, you have not heard of any of the other women. However, they really do serve as “vital voices,” taking a stand for women and children in order to make their countries better.

Afnan Al Zayani works to educate Bahraini businesswomen, lobbying for support of small and medium businesses. She has also helped to protect women within the judicial system, helping to pass a law that protects the rights of Sunni Muslim women in cases of divorce and child custody.

Panmela Castro is a young artist who uses her creativity to spark social change and awareness. She links graffiti to a project that works to combat violence against women, and educated disadvantaged women on the Domestic and Family Violence against Women Act.

More...

For those of you who may not know, today is International Women’s Day. As a woman, a Nicholas Kristof fan, and an advocate for women’s sexual and reproductive rights, I traveled across DC last Thursday to sit in a crowded auditorium (filled with a 95% women audience) to see the Half the Sky Live one-day event. This event was filmed at New York University, featuring celebrities who sang and spoke about their experiences in the developing world. Although some parts of it were gimmicky -- at least 3 times the celebrities repeated the same message about texting a number to join CARE, the sponsoring organization -- the one message which resonated with me was the story of Woineshet, an Ethiopian girl. Marisa Tomei, a famous actress, found Woineshet through Nicholas Kristof, and decided to make a documentary based on her story. I saw a short section of the documentary as a part of this viewing, but the presentation of this young girl’s story reminded me of why I became involved with these issues in the first place.

Woinoshet was kidnapped and raped at the age of 13. Her attacker was arrested, and released on bail. After he raped her again, she  continued refusing to marry him. She tried to go to a clinic far away from her village to get a medical examination to prove she was raped, but the doctor said she did not look like a “fresh virgin,” since her wounds were “old” and therefore, was unable to provide the medical evidence needed for her case.  In Ethiopia at that time, there was a law that stated there was no prosecution for men who raped women and later married them. She was forced to sign a paper marrying him, essentially freeing him from his jail sentence. Woineshet left the village and moved to Addis Ababa, and with strong support of her father and brother, has worked toward prosecution of her rapist, and solving the problem of rape all over Ethiopia. Her story and work has inspired women and men alike to think about the rights of women, and that women CAN stand up for their rights. Woineshet is still trying to resolve the case, as it has reached the Ethiopian high court, and is studying law, in hopes to defend women all over Ethiopia.

Woinoshet’s bravery sends a message to every woman who has ever felt as though she does not have equal power to a man. It reminds us of the global dynamic that women are still not seen as equals. However, the actions Woinoshet has taken remind us of the power we could have if we do indeed speak out against injustices.

Woinoshet’s story has been featured in The Washington Post (http://www.washingtonpost.com/wp-dyn/articles/A20835-2004Jun6.html), and several other prominent news sources. I recommend that this International Women’s Day, we pay tribute to women like Woinoshet, who devote their lives to women’s rights.

 I recently attended an event at the World Bank entitled “AIDS in Southern Africa: a socio-cultural interpretation from USAID’s first AIDS anthropologist.” Suzanne Leclerc-Madlala was the speaker, and she primarily discussed the problem of multiple and concurrent partnerships (MCP) of men and women with low consistent condom use.

Her presentation discussed many aspects of sexual relationships that I had not heard about before in the context of HIV in sub-Saharan Africa, including different types of concurrent partnerships (ongoing, occasional or one-off) and exchange of money for sex as a “normative cultural expectation in relationships.”

Now, I am not a doctor or an expert, but in these circumstances, I would think that pushing condom use by education, motivation or non-profit organizations (i.e. giving condoms to sex workers and educating them) would be policy suggestions put forth by the presentation. However, when an audience member asked about condom use, and the idea of giving out condoms, the speaker rejected the idea saying that only 18 percent of people wear condoms, and it is less of a priority than ending this pattern of multiple concurrent partnerships.

With all of the drivers in the presentation explaining the reasons for multiple concurrent partnerships, it seems as though it will take decades for these multiple concurrent partner behaviors to stop. The younger generations seem to be getting the idea that MCP is acceptable, and they are not thinking about the dangers that can come from this type of behavior. The speaker further mentioned that most people are aware of the epidemic, but they practice “active avoidance.” Additionally, Leclerc-Madlala discussed the high rates of hopelessness among young people, characterized by this practice of high risk sex and excessive drinking.  How is the epidemic of HIV ever going to stop if that is the case?

I think that a good short-term solution to this problem is promotion of condom use. If these people used condoms in their MCP relationships, the risk of passing HIV would diminish. I think that in these types of situations, condom use should not be pushed aside as it has proven to be the only way to protect yourself from HIV besides abstaining. Since we know that everyone does not abstain, condom use should be an inevitable suggestion to stopping this problem of the spread of HIV through multiple concurrent partnerships.

Furthermore, the “hopelessness” of youth populations should be addressed by further mental health care through aid organizations in the U.S. since these types of care are generally stigmatized, it would need to be implemented slowly and in a way that does not ostracize those who seek care.

The presentation was otherwise informative and had a lot of interesting information on the problem of MCP and how it affects youth. You can see the PowerPoint slides here: http://siteresources.worldbank.org/INTHIVAIDS/Resources/375798-1118234887771/LeclercMadlalaCultureAIDS2010.pdf. 

Recently, I have been a little distraught by the apathy on my campus when it comes to sexual and reproductive rights and HIV/AIDS.

Our Student Global AIDS Campaign chapter, has about 7-8 people who come to meetings regularly, on a campus of about 10,000 students which is rated the most politically active by the Princeton Review.  Two years ago, there were about 20 students who attended meetings, being enthusiastic activists for the HIV/AIDS cause. So, you might be asking what happened? What went wrong?

We know that the rates of HIV have been the same, if not worse, especially in the District of Columbia.

Because World AIDS Day is approaching, I wrote an op-ed in my school's newspaper featured here: http://media.www.gwhatchet.com/media/storage/paper332/news/2009/11/23/Opinions/Elizabeth.Orlan.Join.The.Fight.Against.Hivaids-3839446.shtml

I'm hoping that students will be receptive to my message, and not pass it by because of looming papers and other concerns. 

My question to you, fellow activists and advocates for youth, is this: what is your response to the issues you care about on YOUR campuses? How do you battle the apathy?In order to stay motivated, I think of Margaret Mead's famous quote:

"Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has."

 Last month, at Advocates for Youth’s 2009 Urban Retreat, I had the privilege of hearing from the new Executive Director of UNAIDS, Mr. Michel Sidibé. Mr. Sidibé talked to a group of 120 youth activists from around the United States and from Jamaica, Ethiopia, and Nigeria, about the inequities that persist all over the world when it comes to access to HIV treatment and prevention information. He specifically shared the startling fact that of those 2 million people who died of AIDS in 2007, 1.5 million were in sub-Saharan Africa.

We as Americans cannot imagine the plight of communities devastated by AIDS in parts of sub-Saharan Africa. We, as HIV/AIDS activists and advocates, youth, doctors, healthcare professionals and citizens of the developed world, need to address the inherent inequalities in treatment access. This opens up a whole new door of how we might start to attack this major inequality problem.  However, the fact that Mr. Sidibé is addressing this issue from the very start shows his dedication and knowledge about what he has to do during his tenure at UNAIDS.

He told us that he supported us, as young people, and that we should not be neglected. He openly discussed how sex and drugs in music and movies are difficult to discuss in an intergenerational dialogue.  Furthermore, Mr. Sidibé took a clear stance in pointing out that drug users are NOT criminals and that everyone has a basic human right to HIV prevention, treatment and care. This stance is controversial in American politics, and today, the only government funded needle exchange programs are in Washington, DC. Mr. Sidibé, unlike many of our American politicians, knows that this evidence-based approach of providing clean needles and harm reduction efforts for injection drug users helps to keep these populations safe from not only HIV but Hepatitis B.

More...

Yesterday I came across an op-ed in the New York Times entitled “Have Faith in an AIDS Vaccine.”   A lot of people were thrilled a few weeks ago when the news came out that the Thailand AIDS Vaccine trial was a success. However, for some who read into the materials, it looked like the success rates of the vaccine were very low.

This op-ed in today’s Times written by Seth Berkley, the Director if IAVI (International AIDS Vaccine Initiative) pointed out the controversy involved with this newly released data, and admitted that the success rate of the vaccine trial was “overblown” by the news media.

Apparently, the 31.2% reduced risk of infection was not COMPLETELY accurate. The vaccine itself may not have produced the reduced risk of infection, but those who were vaccinated may have not come in contact with the disease even though these individuals may have participated in at-risk behavior.

The complexity of HIV/AIDS in addition to the attempt to find a vaccine is a truly difficult process. I applaud those who participate in the vaccine trials all over the world, as well as Mr. Berkley for pointing out to the public about some inaccuracies that may have been left out of news media coverage.

As a student interested in public health and an HIV/AIDS activist, I’m glad that Mr. Berkley took the step to point out this error to the public. His article reasserts the importance of having vaccine trials, and hopefully these trials will continue to be funded, even though there has not been great success shown thus far.  The mere publicity of the Thai vaccine trial showed the public that this is something the public health community is working on, but the controversy over its success could deter people from having faith in the cause.