Fri, December 02, 2011
AMSTERDAM, Dec. 1 (Xinhua) -- Despite the promising figures from the latest report by the Joint United Nations Program on HIV/AIDS (UNAIDS), there is still a long way to go, said Dutch experts.
The number of AIDS-caused death fell from a peak of 2.2 million in the mid-2000 to 1.8 million in 2010, according to the report, but in vulnerable groups such as refugees, immigrants, sex workers and men who have sex with men (MSM) , there is still a high risk to get HIV infected.
Anna, who declined to give her full name, is a counselor for male and female sex workers for the communal health care (GGD) in a southern province of the Netherlands.
She and her colleagues visit legal and illegal escort houses on a weekly basis in order to build up trust with the workers and to talk to them about the dangers of their sexual behavior. The job is an extremely difficult one with many constraints.
First of all, there is language barrier. Most male sex workers are from Eastern Europe and Brazil and speak poor English.
"When I communicate with them I try to use Google Translate on my smartphone, through a translator or I use nonverbal communication," Anna said.
Once the first contact is made, Anna would begin to teach them the dangers of STD and HIV as well as other daily problems for these sex workers, many of whom are illegal.
"As soon as they understand the risks of their sex behavior I will propose them to get tested on HIV/STD. But as soon as I know the results, most boys are already transferred to other houses in the region or abroad," Anna said.
It is extremely difficult to keep in touch with these workers, to follow them up closely and to provide them with the treatment they need.
Moreover, it is almost impossible to say how many of these sex workers operate in the Netherlands, said Marieke Ridder, program leader of the Prostitution Program Soa/Aids in the Netherlands.
"There are rough estimates of 25,000 sex workers nationwide, but because this group is constantly relocated, no accurate figures are available. This makes it extremely hard to develop custom-made campaigns," she added.
Another difficulty is that in the Netherlands between 25 to 40 percent of the population doesn't know that they are HIV-infected. The government decision to stop offering HIV tests in asylum centers in 2010 made things even worse, according to several specialists.
"This was not wise, to put it nicely. Refugees often come from areas in the world with a high HIV percentage. If an HIV test is taken in an early stage of infection, a more effective treatment and longer life expectancy could be the result," Robert Witlox, director of the HIV organisation in the Netherlands.
It was widely agreed that people should optimize resources and explore more ways to fight against HIV/AIDS.
Tom Coenen, director of Soa/Aids in the Netherlands, argued that a proactive attitude of generalists could help to reduce the number of HIV-infected patients.
Given that 70 percent of the STD patients are determined in the treatment chamber of a GP, "it means that a dialogue about sexual risk behavior should start here," Coenen said.
"In the Netherlands we have special HIV treatment centers. They do an excellent job. I truly hope that they can continue their specialized programs for HIV-patients. But the first step should be taken by holding an open dialogue about sexual health, starting in the treatment chamber of a GP," Coenen added.
