Safety and Tolerability of Tenofovir for Preexposure Prophylaxis Among Men Who Have Sex With Men; Lessons for all population demographics

Guidance from Earthjustice

Earthjustice Supporter Survey

Earthjustice could not do our work without YOU—and that is why we want your feedback. Please take a minute to complete this quick survey and let us know why our work is important to you.

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1. Which statement best explains why you support Earthjustice's work?

(Please make up to 1 selection)

 I believe in using the law to even the odds against powerful special interests and hold big polluters accountable.

 I support building strong partnerships with community-based organizations, public health groups, and other environmental nonprofits.

 I recognize that Earthjustice is effective and wins—averaging more than 40 major victories a year.

 I am passionate about the same issues as Earthjustice.

2. Which of the following Earthjustice priorities is most important to you?

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 Preserving magnificent places and wildlife: Ensure that our public lands and waters, and the species that depend on them, are preserved for generations to come.

 Protecting our health: Provide a toxic-free environment for our communities and safeguard the air we breathe, the food we eat, and the water we drink.

 Advancing clean energy: Champion smarter energy policies and advocate for renewable sources.

 Combating climate change: Stop our reliance on coal, oil, and gas and build resilience for ecosystems in the face of climate change.

3. Please tell us the specific issues that you think are most important for Earthjustice to continue focusing on.

(Please make up to 3 selections)

 Preserving iconic wildlands

 Cleaning up harmful pollution from coal

 Protecting communities from fracking

 Defending citizen power to obtain justice

 Advancing clean energy and efficiency

 Reducing climate pollution

Bottom of Form

Social-networks are e-peer networks

They have become a recruitment point and through them beneficiaries get to know each other and their status. Read about a Los-Angles study into influence of social networks on adherence to prevention practices and the significant association of social network characteristics with UAI point to network-level factors as important loci for both ongoing research and HIV prevention interventions among U.S. MSM of color. For more information:http://journals.lww.com/jaids/Abstract/publishahead/Social_Network_Characteristics_and_HIV_Risk_among.98120.aspx 

Strictly wait about 6-7 weeks to heal before unprotected sexual intercourse

Circumcision with condom use is a preventive best practice; penile viral shedding before complete wound healing still occurs but should pose no additional risk of HIV transmission if men adhere to six weeks post-circumcision sexual abstinence and use condoms consistently. For more read: http://journals.lww.com/jaids/Abstract/publishahead/Changes_in_plasma_viral_load_and_penile_viral.98121.aspx

Long Term Relationship sustainability among MSM

Long Term relations are an environment within which partners develop mutually monogamous, partner reduction and reduce on risks of exposure to sexually transmitted infections. For more information read about the advantages of encouraging MSM to negotiate clear sexual agreements with their primary partner:http://journals.lww.com/jaids/Abstract/publishahead/Factors_Associated_with_Regular_HIV_Testing_among.98119.aspx 

Standard of care issues among Injecting Drug Users; lessons from India

As you care for IDU's note their state of mind and their vulnerability issues. Read on: http://journals.lww.com/jaids/Abstract/publishahead/Association_of_depression,_anxiety_and_suicidal.98122.aspx

Let us join hands in the effort to eradicate HIV

Join me as I develop a unique tool. A tool with short action statements not exceeding 105 words. In fact am using the technology of an existing platform to cut, edit and publish these words. I am grateful to the services of Twitter. I am able to develop those tweets and hopefully they are helpful to all of you as you look for what and how you can contribute to end HIV, Poverty and make Earth a better place to live in. Join me please: https://twitter.com/hivmdgprogress

Harmonization, Indigenization, Documentation and Empowerment through policy and programming for effective HIV Response; looking at 2015 and beyond

                                                                 CONCEPT[1]

                                                          HIV MDG Progress[2]

INTRODUCTION:

Countries agreed to achieve 8 bench-marks by the year 2015. These were the MDGs developed out of the eight chapters of the Millennium Declaration, signed in September 2000. There are eight goals with 21 targets and a series of measurable health indicators and economic indicators for each target.

This tool will take one through four steps: Harmonization; Indigenization; Documentation and; Empower (HIDE) as you read it and become familiar with the 8 MDG’s. In essence you are bringing all your knowledge and experience with the MDG’s to focus and bear on the 8 pillars. You will need to use them to plan or monitor your activities. This is the whole idea of HIDE.

At all times, we need to work at linking, integrating all the action and interventions that will culminate into any of the 8 MDG’s. We must also ask what the Prevailing policy is. What is the Readiness of the existing beneficiaries? What is the level of Empowerment for all beneficiaries, stakeholders and marginalized population groups? What are the Sustainability plans? What Effort is there to expand? What Negative forces are there at play? What will break our Consistence even when we have pulled out? How is the Environment affected by our activities? The acronym at this level is: PRESENCE.

There are two assumptions made: this tool is for those already working with groups, organized entities or intending to form viable groups; it is for those who are into progressive social justice that is biased towards eradicating social ills.

Goal 1: Eradicate extreme poverty and hunger

Target 1A: Halve, between 1990 and 2015, the proportion of people living on less than $1.25 a day

·         Proportion of population below $1.25 per day (PPP values)

·         Poverty gap ratio [incidence x depth of poverty]

·         Share of poorest quintile in national consumption

Target 1B: Achieve Decent Employment for Women, Men, and Young People

·         GDP Growth per Employed Person

·         Employment Rate

·         Proportion of employed population below $1.25 per day (PPP values)

·         Proportion of family-based workers in employed population

Target 1C: Halve, between 1990 and 2015, the proportion of people who suffer from hunger

·         Prevalence of underweight children under five years of age

·         Proportion of population below minimum level of dietary energy consumption

Goal 2: Achieve universal primary education

Target 2A: By 2015, all children can complete a full course of primary schooling, girls and boys

·         Enrollment in primary education

·         Completion of primary education

Goal 3: Promote gender equality and empower women

Target 3A: Eliminate gender disparity in primary and secondary education preferably by 2005, and at all levels by 2015

·         Ratios of girls to boys in primary, secondary and tertiary education

·         Share of women in wage employment in the non-agricultural sector

·         Proportion of seats held by women in national parliament^.

Goal 4: Reduce child mortality rates

Target 4A: Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate

·         Under-five mortality rate

·         Infant (under 1) mortality rate

·         Proportion of 1-year-old children immunized against measles

Goal 5: Improve maternal health

Target 5A: Reduce by three quarters, between 1990 and 2015, the maternal mortality ratio

·         Maternal mortality ratio

·         Proportion of births attended by skilled health personnel

Target 5B: Achieve, by 2015, universal access to reproductive health

·         Contraceptive prevalence rate

·         Adolescent birth rate

·         Antenatal care coverage

·         Unmet need for family planning

Goal 6: Combat HIV/AIDS, malaria, and other diseases

Target 6A: Have halted by 2015 and begun to reverse the spread of HIV/AIDS

·         HIV prevalence among population aged 15–24 years

·         Condom use at last high-risk sex

·         Proportion of population aged 15–24 years with comprehensive correct knowledge of HIV/AIDS

Target 6B: Achieve, by 2010, universal access to treatment for HIV/AIDS for all those who need it

·         Proportion of population with advanced HIV infection with access to antiretroviral drugs

Target 6C: Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases

·         Prevalence and death rates associated with malaria

·         Proportion of children under 5 sleeping under insecticide-treated bed-nets

·         Proportion of children under 5 with fever who are treated with appropriate anti-malarial drugs

·         Incidence, prevalence and death rates associated with tuberculosis

·         Proportion of tuberculosis cases detected and cured under DOTS (Directly Observed Treatment Short Course)

Goal 7: Ensure environmental sustainability

Target 7A: Integrate the principles of sustainable development into country policies and programs; reverse loss of environmental resources

Target 7B: Reduce biodiversity loss, achieving, by 2010, a significant reduction in the rate of loss

·         Proportion of land area covered by forest

·         CO₂ emissions, total, per capita and per $1 GDP (PPP)

·         Consumption of ozone-depleting substances

·         Proportion of fish stocks within safe biological limits

·         Proportion of total water resources used

·         Proportion of terrestrial and marine areas protected

·         Proportion of species threatened with extinction

Target 7C: Halve, by 2015, the proportion of the population without sustainable access to safe drinking water and basic sanitation (for more information see the entry on water supply)

·         Proportion of population with sustainable access to an improved water source, urban and rural

·         Proportion of urban population with access to improved sanitation

Target 7D: By 2020, to have achieved a significant improvement in the lives of at least 100 million slum-dwellers

·         Proportion of urban population living in slums

Goal 8: Develop a global partnership for development

Target 8A: Develop further an open, rule-based, predictable, non-discriminatory trading and financial system

·         Includes a commitment to good governance, development, and poverty reduction – both nationally and internationally

Target 8B: Address the Special Needs of the Least Developed Countries (LDCs)

·         Includes: tariff and quota free access for LDC exports; enhanced programme of debt relief for HIPC and cancellation of official bilateral debt; and more generous ODA (Official Development Assistance) for countries committed to poverty reduction

Target 8C: Address the special needs of landlocked developing countries and small Island developing States

·         Through the Programme of Action for the Sustainable Development of Small Island Developing States and the outcome of the twenty-second special session of the General Assembly

Target 8D: Deal comprehensively with the debt problems of developing countries through national and international measures in order to make debt sustainable in the long term

Some of the indicators listed below are monitored separately for the least developed countries (LDCs), Africa, landlocked developing countries and small island developing States.

Ø  Official development assistance (ODA):

·         Net ODA, total and to LDCs, as percentage of OECD/DAC donors’ GNI

·         Proportion of total sector-allocable ODA of OECD/DAC donors to basic social services (basic education, primary health care, nutrition, safe water and sanitation)

·         Proportion of bilateral ODA of OECD/DAC donors that is untied

·         ODA received in landlocked countries as proportion of their GNIs

·         ODA received in small island developing States as proportion of their GNIs

Ø  Market access:

·         Proportion of total developed country imports (by value and excluding arms) from developing countries and from LDCs, admitted free of duty

·         Average tariffs imposed by developed countries on agricultural products and textiles and clothing from developing countries

·         Agricultural support estimate for OECD countries as percentage of their GDP

·         Proportion of ODA provided to help build trade capacity

Ø  Debt sustainability:

·         Total number of countries that have reached their HIPC decision points and number that have reached their HIPC completion points (cumulative)

·         Debt relief committed under HIPC initiative, US$

·         Debt service as a percentage of exports of goods and services

Target 8E: In co-operation with pharmaceutical companies, provide access to affordable, essential drugs in developing countries

·         Proportion of population with access to affordable essential drugs on a sustainable basis

Target 8F: In co-operation with the private sector, make available the benefits of new technologies, especially information and communications

·         Telephone lines and cellular subscribers per 100 population

·         Personal computers in use per 100 population

·         Internet users per 100 Population

SOURCE: http://www.un.org/millenniumgoals/.

As part of the indigenization, Sexual Reproductive, Health Rights issues among LGBTI, Sex-workers and Drug-users and other marginalized population groups need to be addressed at country-specific levels. This will help tap into the various networks developed over time. There is need to continue raising awareness of the relationships between sexuality, orientation, gender, identity reproductive health and rights and development. In answer to this there is need to merge aspirations of frameworks or action plans. In this case ICPD Programme of Action has supported policy frameworks and programmes that focus on the reproductive rights and sexual health needs of marginalized population groups for instance. This does not stop one from recognizing or addressing the whole spectrum of men, women and young people. Ensure that significant disparities, inequalities and new emerging challenges are addressed. Therefore, YOUR ORGANIZATION will seek to generate dialogue and action around:  Cultural competency of health workers, social workers and the legal regime towards issues and needs as alliances are built; ensure raised issues should inform basis for interventions; training in dignity affirming skills and perceptiveness for providers; empowering beneficiaries to form support groups or to form registrable organizations; supporting the organizations with resources to promote leadership, accountability and recurrent execution of duty; avail sexual reproductive prevention prophylactics; documentation and record keeping through a Friendly management information system (FMIS); provide safe and regular check-ups for STIs; link drug-use, contamination of blood products and sex-work; provide sexuality and orientation-friendly/affirming counselling services; improve Maternal and Child health for those in child-bearing relations; provide family support counselling for those with child dependants; foster community, religious and parental dialogues on tolerance for children born with non- heterosexual conforming gender/identity/sexuality and orientation and; ensure formed organizations are able to tap into the existing national civil society networks.

OBJECTIVE:

To make the MDGs understable and a tool for everyone be they at Civil Society, Parliament, and Ministry of Health and Community levels.

VISION:

To cascade into the core tasks for the next development framework of MDGs.

PROBLEM STATEMENT:

Lack of support to organize/self determination focusing on poverty, environment, HIV morbidity, mortality and hate-related crimes continue to be a health and social challenges. Unmet need for resources, skills and consistency of promise to eradicate poverty, promote democratization, access to protective prophylactics, family planning remain as key challenges.

SOLUTION:

Design a tool that brings into focus the MDGs through provision of short actionable statements that point one towards participation as opposed to being a deterrent or discouragement.

METHODOLOGY:

Short Term Objective: Come up with two tools: the concept note and a twitter platform with short MDG-related aspirations not exceeding 100 words. It is hoped the issues below will be addressed:

·         Cultural competency of health workers, social workers and the legal regime towards MDG requirements.

·         Integrating interventions targeting marginalized population groups.

·         Training in dignity affirming skills and perceptiveness for providers.

·         Empowering to form registrable organizations.

·         Supporting the organizations with resources to promote leadership, accountability and recurrent execution of duty.

·         Avail sexual reproductive prevention prophylactics.

·         Documentation and record keeping through Friendly management information system (FMIS). This can cascade into: UN, Global Fund data-base.

·         Provide scheduled safe and regular check-ups for STIs under trained cultural competent provider.

·         Establish systems that break STI transmission Linked to drug-use, contamination of blood products and sex-work.

·         Provide Transgender and gender non-conforming cultural competency trainings for providers, allies and Gay, Bisexual, Lesbian and Intersex (GBLI) persons.

·         Provide bisexual-friendly/affirming counselling services to improve Maternal and Child health for those in child-bearing relations.

·         Provide family support counselling for those with child dependants.

·         Foster community, religious and parental dialogues on tolerance for children born with non- heterosexual conforming gender/identity/sexuality and orientation.

·         Ensure formed organizations are able to tap into the existing national civil society networks through attending harmonization and internationally-recognized day activities.

TWITTER AND BLOG ACTIVITIES 2013-2015:

1.      Formation and establishment of platforms to twit short MDG-related aspirations.

2.      Increase conscietisation a) by twitting on MDGs b) by blogging on MDGs

3.      Report-making

4.      Report dissemination; a) listserve b) public dialogue platform c) social networks d) civil society meetings

WORK PLAN: 2013- 2015

Objective	Activity	Time	Outcome
To gain visibility and continued conscietisation around MDGs	Concept note development	By August 2nd2013.	Make intentions known
To develop and manage a twitter platform		By August 6th 2013.	Twitter Account:  https://twitter.com/hivmdgprogress
To develop and manage a blog platform		By August 6th 2013.	Blog Account: http://hivmdgprogressactivism.blogspot.com/

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[1] Concept developer blog: (hivmdgprogressactivism.blogspot.com)

[2]  Specific UNAIDS-led HIV Response.