HIV/AIDS experts fret over budget cuts for tackling infections

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HIV/AIDS experts fret over budget cuts for tackling infections

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HIV virus (red) attacks a normal cell. [JoongAng Ilbo]

The news went almost unnoticed.
Last month, after years of lobbying and protests, an amendment to the AIDS Prevention Act took place: It is now illegal for doctors to notify anyone other than the person in question of the results of an HIV test.
Nam Jeong-gu, an official at the Korea Center for Disease Control and Prevention, says there have been cases in which companies discovered the HIV status of employees after they took a company health examination. “The new law makes it very clear that such information is now strictly confidential,” says Nam. “Before, the law was a little bit vague.”
The first person to be diagnosed HIV-positive in South Korea, was a man who according to Nam is still alive, in 1985, yet Korea has been slow to adapt to the reality of HIV and AIDS. Despite the amendment to the law last month, the aim of which is to protect people’s rights, the budget to combat HIV infections has been trimmed even though the number of HIV infections has increased rapidly.
According to a report in January by the KCDC, 744 Korean nationals and 88 expatriates were diagnosed with HIV last year, bring the total of people currently living with the virus in South Korea to 4,343. Nine hundred and eight people are thought to have died of HIV-related complications and in cases where the route of transmission is known, 98.8 percent of infections were through sexual contact.
In its report, the KCDC says the number of HIV infections declined 0.8 percent on figures from 2006, the first time the number of infections had fallen. Officials at the center hailed the figures as a policy victory, but Kim Hun-suk, the director of the Korea Federation for HIV/AIDS Prevention, warns that the statistics are deceiving.
“This is not a time to be complacent. Not at all,” he points out that the low number of voluntary tests is concealing the real number of infections here. “It’s not about alerting people about AIDS. Everybody knows about AIDS. You have to make people take a voluntary blood test. Only then will you know the true scope of AIDS here.”
To back this up, research from the Joint United Nations Programme on HIV/AIDS suggests the number of HIV-infected people here stands at 13,000, more than double the government numbers.
Last November, Unaids said the number of people living with HIV doubled from 420,000 to 800,000 in East Asia between 2001and 2007.
Once the number of HIV infections reaches the 10,000 mark, the rate of infection picks up exponentially, experts say. Nam estimated that South Korea would reach that level in 2012.
Nevertheless, South Korea’s budget to address the issue is not expanding as one might expect. The center’s total budget for this year amounts to 202 billion won. In 2005, the budget for HIV/AIDS stood at 8.3 billion won ($8.32 million) but has been in decline since.
This year the center has to operate within the limits of a 7 billion won budget, even though the number of HIV patients has increased tenfold since 1995. Thirteen years ago, 517 people were thought to be infected.
Since 2003, more than 500 people each year have been infected, more than 90 percent of whom are males while 38.8 percent of sexual contact came from homosexual activities and the rest from heterosexual ones.
“There are other important projects that can’t be ignored,” says Nam Kwang-su, another official with the KCDC. The center is able to run an AIDS awareness TV campaign just once a year, usually in November before the annual World AIDS Day on December 1.
Such budget constraints have cut into the center’s operations such as projects for HIV awareness, and promoting voluntary AIDS testing has decreased in recent years.
The budget for regular examination of venereal diseases has also taken a hit. In 2005, 240 million won (separate from the HIV/AIDS budget) was spent for such purposes, but last year, it fell to 196 million won.
“We think that people slated for regular checkups may have a higher chance of being infected with sexually transmitted diseases including AIDS because they have more sex partners,” says Nam Jeong-gu.
In Hae-gyeong, another official at the center, says that ssince the introduction of the Anti Prostitution Act in September 2004, the center has seen budget cuts taking place in funds for testing for STDs.
For a country where prostitution has been a lingering issue, the Anti Prostitution Act was supposed to signal change. The authorities initiated a number of high-profile crackdowns in red-light areas around the nation three and a half years ago, but they only lasted for a limited period. Experts say prostitution diversified rather than lost its foothold.
Yet even with the act in place, the KCDC identifies close to 100,000 people in the most at-risk population segment — people working at massage parlors, hostesses at room salons and similar places — who are required to take mandatory tests for venereal diseases under the Epidemic Prevention Act every six months.
Civic groups are concerned that people living with HIV will experience greater discrimination if the government continues to cut budgets and awareness and education projects continue to get cut.
“Socially [being HIV positive] is a death sentence here. The biggest problem is discrimination,” says Cho Byeong-hee, a professor at Seoul Health College. “The moment word about your HIV status gets out, a person’s relationship with friends, your company, your church, everything crumbles.”
Cho says that ignorance is a major problem. “There is certainly an unnecessary amount of fear on both sides. The infected fear social discrimination and others are afraid they’ll get infected.”
More public education is needed to change risk perception in order to establish a society that treats people with HIV without prejudice, he adds.
The results of a KCDC survey last year underline such need. Out of 1,087 people surveyed, 26.7 percent said that those infected with the HIV virus should resign from their jobs, compared to 15.5 percent in 2005.
In a survey conducted by the National AIDS Trust in the United Kingdom in January this year, only 8 percent of those surveyed said they would feel uncomfortable working with someone who was HIV positive.
In its latest report on HIV/AIDS, the World Health Organization estimates that over 6,800 get infected with HIV every day, while an estimated 5,700 people die of AIDS-related medical conditions.
Last year, 33.2 million people were believed to be living with HIV. including 4.8 million in Asia alone. Globally, a total of 2.1 million people died last year.
But in South Korea, unless the number of infections jumps significantly, the government seems reluctant to commit more resources.
“We expect our budget to decline,” says Nam Kwang-su.


By Brian Lee Staff Reporter [africanu@joongang.co.kr]

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Korea takes a tough stance on expats with ‘epidemic diseases’


South Korea employs a strict deportation policy for expatriates infected by HIV. According to Chung Gye-seong, an immigration official, a total of 46 were deported last year, and 570 in total since 1988.
Lim Jin-taek of the Justice Ministry says that once the Korea Centers for Disease Control and Prevention has identified a foreigner as having HIV, the ministry initiates deportation procedures. But, Lim says, the process is not foolproof.
“Sometimes we get inaccurate information from the center making it hard to find a person,” says the official. “Then the person might just stay in the country. It happens from time to time.” Expatriates married to South Korean citizens are usually allowed to stay, Lim says.
Under the Immigration Act, the ministry can bar individuals and deport them if they have “epidemic diseases.”
Expatriates on E-6 visas — for people working in the entertainment industry and doing public performances — an HIV test is mandatory. According to data collected by Germany’s Deutsche AIDS Hilfe, 106 out of 170 countries have some form of HIV-specific travel restrictions. South Korea is one of 13 countries that ban HIV-positive people from entering for any reason or length of time.
“The global tendencies are worrying. There are a number of countries that have increased their restrictions within the last few years,” says Peter Wiessner, an official at the German organization. “The existence of these regulations is based on assumptions that are wrong and discriminatory. Another reason for the existence of these regulations is simply to avoid costs for expected treatment and care.”
The South Korean government does not enforce travel restrictions on South Korean citizens carrying the virus.
Pai Hyunjoo, a doctor at Hanyang University’s College of Medicine who treats HIV patients, says one of her patients, who holds American citizenship and is married, was told recently to quit his job and leave the country. “There are a lot of problems there,” says the doctor.
Chung Jeong-hoon, a lawyer who took part in the recent amendment process of the AIDS Prevention Act, argues that the law is flawed when it comes to deporting expatriates.
“It’s like a summary deportation without due process of law. The law states that the authorities have to decide case by case whether to deport, but in reality the authorities opt to deport in every case,” Chung says.
Seoul officials argue that South Korea is not the only country that enforces strict rules. “Our main concern is protecting the public and national interest,” says Nam Jeong-gu of the Korea Centers for Disease Control and Prevention.
Nevertheless, last week the Seoul Administrative Court overruled a decision by the Justice Ministry to deport a 32-year-old Korean-Chinese man who tested positive for HIV. The court argued that the man was not a threat to others living around him.

[africanu@joongang.co.kr]

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