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第10回アジア太平洋地域エイズ国際会議参加報告書
 

千葉工業大学 工学部 生命環境科学科
ハイテクリサーチセンター
Chang Myint Oo

    The 10th.International Congress on AIDS in Asia and the Pacific (ICAAP10) was held from 26-30th.August, 2011 in Busan, Republic of Korea. ICAAP10 brought the many perspectives in understanding and joint action against AIDS. We got a chance there to know the present efforts and achievements to control HIV transmission and treatment of AIDS, in countries of ASIA and pacific countries. We also had a chance to discuss matters on how to overcome social and financial difficulties which we are facing in the process of prevention and treatment of AIDS.
    ICAAP10 concentrated on “diverse voices and united action” to achieve equal care for the AIDS patients and HIV-positive persons from all societies. Its principal aim was getting Zero-AIDS in Asia and Pacific region. To achieve this aim, national AIDS control efforts need to be focused on the populations, like sex workers, injecting drug users, men who are in same sex relations with other men and most importantly people living with HIV. Although there is progress in such focused programs on reducing the infection rates among the vulnerable populations, criminalization and discrimination of these vulnerable populations create unsafe environments, facilitating uncontrolled spread of the HIV epidemic among them. The absence of law and legal protection is the problem and without rights, we cannot change the stigma and discrimination. Even with the provision of legal aid services in most countries, we find that people who use drugs and sex workers are not accessing this legal aid. Drug users and sex workers should be involved in program planning to provide legal aid and education materials.
    To deliver HIV/AIDS programming, community based organizations are required to manage grants and establish appropriate financial systems. Challenges include finding and retaining staff with appropriate capacity, recording, analyzing and maintaining accurate financial transaction records, meeting donor requirements, and donor reporting. New medias like social networks, text messaging, blogs, micro-blogs, video messaging, wikis, etc. are an important tools to help reduce new HIV infections and increase advocacy efforts among young people. E-radios, Facebook, Twitter, blogs and other internet based media initiatives around the world are the important pillars of prevention revolution.
    In the other hand, HIV vaccine and antiretoviral (ARV) drugs in preventing HIV infection was echoed by the successful trials in 2010-2011, in Thailand. This involved the use of ARV as pre-exposure prevention of HIV infection in people with risk behaviors such as men having sex with men, heterosexual men and women as well as discordant couples. In addition, results of HPTN-052 were announced in July 2011, emphasizing the benefit of early initiation of antiretroviral therapy as a mean to prevent viral transmission. However, long term use of ARV drugs for preventive measure may lead to the occurrence of unwanted side effects and drug tolerance as well as to the insufficient financial support with shortage of ARV drugs. Therefore, the development of a safe and efficient AIDS vaccine remains as a major concern and also, the need to find a cure for HIV is even more urgent now than ever before.
    In conclusion, 30 years after the discovery and isolation of the human immunodeficiency virus, there are the impressive advances in basic research and clinical treatment. Public health prevention measures for AIDS have succeeded in controlling viral transmission and extending human life-spans to near normal expectancies. However, HIV still remains insurmountable and viral transmission also continues. To achieve complete eradication of HIV, we must speed up and sustain access to antiretroviral treatment as well as development of an effective preventive AIDS vaccine.

Summary
ICAAP10は全ての社会におけるAIDSの患者とHIV陽性の人のケアを成し遂げるために‘多様な声と統一行動’に狙いを定める。主な目的はアジアと太平洋地域におけるZero-AIDSの達成である。この目的を達成するためには売春婦のような人、注射針を使用する薬物常習者と同姓愛者などの集団、そして何よりも、HIVと共に生きている人々に焦点をあてて、国がAIDSをコントロールする努力が必要である。
HIVの感染を防ぐワクチンとして、薬剤 (ART) は2010~2011年に試みが成功したと示された。これはリスク行為を伴った人において、HIV感染による暴露前の予防としてARTの使用を含んでいた。しかしながら、長い間予防のためARTの薬を使用しているチームを測定した結果、望まない側の効果の出現と薬剤耐性の出現、不十分な財政的支援によるARTの薬の不足を導いた。さらに、安全かつ効率的なAIDSワクチンの開発は懸念されたままであるため、早急に求められており、HIVのケアに必要な発見である。
結論として、人免疫不全ウイルスが発見、及び単離されてから30年、基本的な研究と臨床の処置においては印象的な進歩が伺える。人が普通に生きていく上でのウイルスの伝染と拡散のコントロールAIDSの公衆衛生予防処置は成功したといえる。
しかしながら、HIVにはいまだ打ち勝てずウイルスの伝染は存続したままである。HIVの根絶を成し遂げるために、私たちはスピードを上げて、抗ウイルス処置を持続したときと同じくらい効果のあるAIDS予防ワクチンの開発をしなければならない。

References
1. SaPS1-01
Getting to Zero in Asia and the Pacific. (Steve Kraus, UNAIDS Regional Support Team, Asia Pacific, USA)
2. SaPS2-03
At the Front Line - Sex Workers Rights and Communities Role in Transforming Negative Legal Environments. (Kay Thi Win, Population Services International, Myanmar)
3. SuPS3-01
Recent Progress in Basic Science. (Sang-Kyung Lee, Hanyang University, Republic of Korea)
4. SuPS3-02
The Journey: HIV/AIDS Treatment and Prevention. (Praphan PHANUPHAK, Director, the Thai Red Cross AIDS Research Centre, Thailand)
5. SaOB02-03
Drug Resistance Patterns of HIV-1 Infected Patients Experiencing Virological Failure on LPV/r-based 2nd Line Antiretroviral Regimen in Cambodia. (Janin Nouhin1*, Sopheak Ngin1, Sreymom Ken1, Kerya Phon1, Vara Ouk2, Olivier Segeral3, Vonthanak Saphonn4, Laurent Ferradini5, Jean-Francois Delfraissy6, Eric Nerrienet1, 1HIV/Hepatitis Laboratory, Institut Pasteur du Cambodge, Cambodia, 2ESTHER, Calmette Hospital, Cambodia, 3Clinical Immunology Department, Bicetre Hospital, France, 4National Center for HIV/AIDS and STD, (NCHADS), Cambodia, 5FHI, Phnom Penh, Cambodia, 6ANRS, Paris, France)
6. MoOD02-01
Social Media as a Platform for Diverse Voices and United Action: Experience of Hong Kong AIDS Foundation. (Man Ting Krystal Yiu*, Publicity Section, Hong Kong AIDS Foundation, Hong Kong)
7. SuOE12-03
Impact from HIV Prevention and Harm Reduction Program: Improve IDU's Quality of Life. (Duangta Pawa1*, Yaowalak Jittakoat1, Gary Mundy2; 1 Research and M&E, PSI Thailand, Thailand, 2 Research, PSI, Vietnam)
8. SuOF02-02
Fighting Stigma & Discrimination through Enhancing Legal Response and Human Rights Advocacy Capacity. (Minh Huynh, Community Health, CARE International in Vietnam, Vietnam)
9. SuOF02-06
Community Legal Empowerment in Indonesia: A Means of Improving Access to Justice for PLHIV and Key Populations and Addressing Human Rights Violations, Stigma and Discrimination. (Ajeng Larasati1*, Ricky Gunawan1, Naomi Burke-Shyne2; 1 Community Legal Aid Institute (LBH Masyarakat), Community Legal Aid Institute (LBH, Masyarakat), Indonesia, 2 International Development Law Organisation, International Development Law Organisation, Australia)
10. MoOD02-02
Media Role on Addressing LGBTI. (Binaya Pokharel; Media, Blue Diamond Society, Nepal)
11. MoOD02-05
AIDS Aware - How to Use Social Media to Engage Youth in HIV Awareness. (Kevin Baker; Communications, PT Foundation, Ireland)