This presentation was prepared for an IRMA global teleconference on December 4, 2009.

For further information check the PrEPWatch Website.

Addressing poor condom use therefore is not a question of simply promoting them but a question of knowing and understanding these numerous factors, their interactions and additive effects and ultimately understanding what leads people to do what they do or can do in their individual situation with their own perspectives, understanding, resources and options.

This conceptual framework summarises only the biological factors that influence HIV transmission. When assessing the risk of infection, each should be considered in turn and as a whole.

Exposure alone is not enough to predict the risk of infection, viral load maters and though there is no direct correlation between viral load and infectiousness, a high viral load has been associated with higher infectiousness. However, a low viral load may not be underrated if exposure is direct through blood, like with IDUs.

When it comes to sex with an HIV-infected person or a person of unknown status, different levels of risk have been attributed to different sexual practices. But this does not mean that the risk is always the same for the same practice. Oral sex may be overall much safer than unprotected anal sex, but oral sex with bleeding teeth and rotten gum isn’t certainly safe!

By and large, there is no clear cut or definitive risk factor and often risk is what we estimate it to be and how we relativise it. The risk of HIV infection is dynamic and depends on many factors who weight differently. Though there is an agreement that some factors weight more than other this cartoon does not give a weight to each factor identified as this is open to debate and only add to the existing confusion around risk.

Knowing and understanding what these factors are and how they interact one with another to determine the overall level of risk of HIV infection when exposed to the virus, particularly during sexual intercourse, will help individual to assess the risk of being infected.

]]> http://www.rogertatoud.com/2009/05/24/hiv-prevention-an-overview/feed/ 0 http://www.rogertatoud.com/2007/09/30/volunteer-fundraiser-for-the-food-chain/ http://www.rogertatoud.com/2007/09/30/volunteer-fundraiser-for-the-food-chain/#comments Sun, 30 Sep 2007 11:00:33 +0000 Roger http://www.rogertatoud.com/?p=19 Since 2003 volunteer and chair (2003-2006) of the Community Fundraising Committee of The Food Chain whose mission is to improve the health and well being of London’s population living with HIV by alleviating hunger and malnutrition.

The Food Chain is a UK registered charity delivering meals every week to more than 500 users across London, free of charge, since 1988. Every Sunday, Food Chain volunteers prepare and deliver delicious, nutritionally balanced, individually tailored meals and groceries to people who, because of their illness, are housebound and unable to provide or prepare meals for themselves.

The Food Chain has long understood that good nutrition can help prevent, stop or reverse weight loss, manage symptoms, and reduce the side effects of medications. Many HIV medicines are only effective if taken with food. Each meal is prepared according to specific guidelines established by professionals and is specially suited to everyone taste.

The Food Chain is a unique organisation with more volunteers than users and was awarded the Queens Award for Voluntary Service in 2004 and a Guardian Award in 2005.

I started volunteering for the Food Chain as a Navigator at the Kentish Town Kitchen. I was helping a driver to find his way through London and was delivering meals to service users. It was a challenging task since I never drove through London. I was paired with experienced drivers but also with drivers who knew little of the area we were visiting. We got lost a few times but we always delivered all our meals and we had a lot of fun in the traffic jams or trying to find a road that was not on the map!

Meeting the services users was also a challenge. Sometimes the Food Chain Navigator is the only person a service user will see or talk to during the week. Sometimes he or she is not in very good health and it could be emotionally demanding for the Navigator. We always tried to say a few comforting words and our service users always have good things to say about the meal or the service.

After a few months, I was elected chair of the Community Fundraising Committee to which I was also contributing at the same time as I was navigating. The Community Fundraising Committee, which I chaired for 2 years (2004-5), was committed to raise £60,000 per year i.e. 20% of the budget of the organisation. We reached our target both year and did even better than we expected.

With the help of dedicated volunteers, we organised collections in tube stations, pubs and clubs. We organised special events in the summer in conjunction with St Paul Church (the Actors’ church) in Covent Garden which has always been one of our supporter. We managed a network of more than 60 collecting tins placed in public places and shops. We ran raffles, sang Christmas Carols, and participated to Walk for Life, and several marathons and pride events.

We organised events, big and small, to bring money in and also to promote the work of the Food Chain within the community and attract potential supporters and volunteers. An important part of the work of the Committee was to build and maintain relationships with the donors. We identified sponsors and encouraged and supported individual initiative.

I have met some great and dedicated people while volunteering. I really enjoyed community events. They bring people together to have fun while at the same time raising valuable funds to help the organisation.

Both messages were embodied in Bill Gates’s keynote speech:

“We need to put the power to prevent HIV in the hands of women. This is true whether the woman is a faithful married mother of small children or a sex worker trying to scrape out a living in a slum. No matter where she lives or what she does, a woman should never need her partner’s permission to save her own life.”

An Eldis report notes that “a decade ago women seemed to be on the periphery of the epidemic, today they are at the epicentre”. Of the 38.6 million people living with HIV at the end of 2005, nearly half of them, 17.3 million, were women (Unaids, 2006 Report on the Global Aids Epidemic). And of the 16,000 new infections that occur every day, up to sixty percent are now amongst women (ILO).

Empowering women was a central policy goal of both the International Conference on Population and Development (ICPD) in Cairo in 1994 and the Fourth World Conference on Women (FWCW) in Beijing in 1995. Women’s empowerment was emphasised in agreements at the World Summit for Children in 1990, the World Conference on Human Rights in 1993, the World Summit for Social Development in 1995, the World Food Summit in 1996, Habitat II in 1996, and the fifth-year review of ICPD implementation (ICPD+5) in 1999.

That, ten years later, women’s empowerment is back on the agenda in the fight against HIV/Aids suggests that it has somehow failed to fulfil its objectives. One explanation for the relative achievements of empowerment strategies might be the failure to recognise that empowering women without disempowering men is like giving a moneybox to the poor in the hope that they will get rich.