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Frerichs, R.R. Theme for Fourth International Conference on AIDS in Asia and the Pacific

SEA-AIDS Network, March 25, 1996.

Posted in response to:

SEA-AIDS, March 22, 1996

The Philippines has accepted the invitation to host the 4th International Conference on AIDS in Asia and the Pacific is 1997. We have to start the preparations this early to start disseminating the information and invitation during the AIDS conference in Vancouver this July. I would like to ask the users of SEA-AIDS to send us some suggested theme for the 1997 Manila conference. The theme in New Delhi, India in 1993 was "The Reality, The Challenges, The Opportunities". In the 1995 conference in Chiang Mai, Thailand, the theme was "Responding to HIV/AIDS through Understanding, Commitment and Care." Thank you.

Dr. Evelyn Grace Gacad

AIDS Program Manager, Philippines

Vice-President, AIDS Society of the Philippines

R.R. Frerichs Posting

I have a suggestion for the theme, partially suggested by my work with colleagues here in Los Angeles and by a conversation I had last September in Bangkok with Dean Chitr Sitthi-amorn of Chulalongkorn University. My suggestion for the theme is:


By EARLY DETECTION, I mean discovering early in the natural history of HIV that a person is infected. As you know, many years go by before most people learn that they harbor the virus. Even in the United States, about half of all AIDS patients did not learn they were infected until 8 to 9 years after becoming infected. Among heterosexuals who developed AIDS patients, the percentage was about 60-65%. This problem of avoiding knowledge is most graphically described by a poster brought back by Professor Detels from one of his recent trips to Asia. It shows three persons bent over with their heads firmly submerged in the ground. The caption read, "another [country to remain blank] family considering AIDS."

By GIVING YEARS TO LIFE, I mean preventing infection of spouse, lover or child and preventing early death from a compromised immune system.

Finally by LIFE TO YEARS, I mean encouraging the acceptance and support of family and friends, reducing discrimination and promoting other measures to help normalize HIV infection in the society so that it is viewed as just another chronic disease.

If this theme (or a similar one) is adopted, then possibly the conference will focus more extensively on ways to promote early detection. One approach applicable to all countries is to encourage the use of HIV indicators - simple devices that use saliva or fingerstick blood to determine likely infection. People should be free to buy these self-help devices in their pharmacies or grocery stores, giving them some control over their own lives. If found to be positive, the test "indicates" that the person needs to see a medical care provider for counseling and confirmatory testing. Such prior screening would keep the "worried well" at home and allow hard-pressed HIV/AIDS clinic staff to spend more time with those who are truly infected.

If this theme is selected, it would also encourage countries experiencing higher levels of HIV infection to support universal premarital screening and pregnancy screening, much as they now do for blood screening.

In addition, such societies would need to develop longer-term care programs, so that HIV infected persons are not left alone to slowly be overcome by the virus. Counseling would be couple-based, with continued contact over time to help discordant couples understand how to avoid transmitting the virus from infected to susceptible. Such support and care groups are now in place in several Asian countries, but without testing these care givers cannot reach those with silent infection. The early detection theme offers new opportunities, but also new responsibilities. Presenting and discussing these issues would give your conference an exciting edge and take us in directions that have not previously been explored.

Please feel free to share my ideas with others and give this matter your full consideration. I look forward to visiting with you at the coming Vancouver meeting and hearing more about friends in the Philippines and the challenges of your position these past few years.