NGOs attempting to grapple with the thankless task of helping the Rwandan refugee camps have come in for some rough treatment from two directions over their HIV/AIDS efforts. At the policy level, an AMREF paper presented to the Vancouver conference charges bluntly that "There is no policy regarding HIV/STDs in refugee camps among international organizations specializing in refugee crises; thus there is absence of STD drugs and protocols, no privacy in open (tent) clinics, no means of protection (no condoms), and no information regarding STDs/HIV." AMREF bases its comments upon its experience among 700,000 Rwandan refugees in camps in West and North-West Tanzania, an area where (AMREF remarks pointedly) there was previously a low prevalence of HIV by Tanzanian standards, at 2-5%. At the operational level, CARE International, in a conference paper, reported rough treatment at the hands of the Rwandans themselves. It has been working under contract from AIDSCAP among the 400,000 Rwandans who fled to the Ngara district of Tanzania. Not surprisingly, it found that women and girls in the camps faced a higher risk than men. But more surprisingly at first sight, it found that after its HIV educational efforts "negative attitudes about condom use increased from 22% to 78%," which was possibly explained by "political ideology." "Young Hutu men in the camps boasted of their efforts to impregnate as many women and girls as possible to help replenish the population."

Africa↗

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Vancouver AIDS conference: special report. Zambia criticised for "missed opportunities".

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AIDS Serodiagnosis↗

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Vancouver AIDS conference: special report. The role of the military: to protect society -- and themselves.

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Acquired Immunodeficiency Syndrome↗

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Vancouver AIDS conference: special report. Three African countries to take part in trials to reduce mother-to-child transmission.

UNAIDS has announced that 1900 HIV-positive women in five sites in South Africa, Tanzania, and Uganda are to take part in a clinical trial to evaluate the efficacy and tolerance of three regimens for the prevention of mother-to-child (MTC) transmission of HIV in a population where breast-feeding is the norm. The regimens will use zidovudine in combination with 3TC, compared to a placebo. Some 3 million children are estimated to have been infected via MTC since the HIV epidemic started, and of these, 85% are in sub-Saharan Africa. HIV/AIDS prevalence among children in developing countries is about 35 times higher than in the industrialized world. A trial conducted in the US and France using zidovudine showed a 67% reduction in the risk of MTC transmission. But UNAIDS warns that the cost of this treatment, at about $1500 per mother-child pair, makes it impractical for widespread use in developing countries, where mothers tend to wait more than 30 weeks after birth for their first visit to a clinic, too late for the treatment to start. Breast feeding is another issue. For many mothers, the risk of their infant dying if not breast fed is greater than the risk of transmitting HIV by breast feeding. So the trial will try to ensure that any gains from early drug treatment are not simply lost again through losses due to breast feeding.

Adolescent↗