AIDS can be eliminated in a decade

If All At High Risk Are Tested, Model Suggests Disease Could Be History.

The virus that causes AIDS could theoretically be eliminated in a decade if all people living in countries with high infection rates are regularly tested and treated, according to a new mathematical model.

It is an intriguing solution to end the AIDS epidemic. But it is based on assumptions rather than data, and is riddled with logistical problems. The research was published online on Tuesday in the medical journal, the Lancet.

“It’s quite a startling result,” said Charlie Gilks, an AIDS treatment expert at the World Health Organization and one of the paper’s authors. “In a relatively short amount of time, we could potentially knock the epidemic on its head.”

Gilks and colleagues used data from South Africa and Malawi. In their model, people were voluntarily tested each year and immediately given drugs if they tested positive for HIV, regardless of whether they were sick.

Within 10 years, HIV infections dropped by 95%. Other initiatives like safe sex education and male circumcision were also used.

The strategy would cut the estimated number of AIDS deaths between 2008 and 2050 by about half, from about 8.7 million to 3.9 million, leaving only sporadic HIV cases.

Experts think the strategy’s cost would peak at about $3.4 billion a year, though expenses would fall after an initial investment. “This is certainly beyond the bounds of the current infrastructure for many countries, but that is not a reason not to think big,” said Myron Cohen, of the University of North Carolina, who has done similar research.

Only 3 million people are currently on AIDS drugs. Nearly 7 million people are still awaiting treatment, and about 3 million more people were infected last year. Worldwide, WHO guesses that about 33 million people have HIV. Increasing access to testing and drugs would stretch already weak health systems in Africa, which has most of the world’s HIV cases.

World Health Organization emphasized that the study findings do not signal a policy change. “This is only a theoretical exercise,” said Kevin De Cock, director of WHO’s HIV/AIDS department. He said WHO would hold a meeting next year to study the idea more closely.

Gold need not always glitter

“Borrowers will default. Markets will collapse. Gold will skyrocket.” - Michael Belkin

During apocalyptic times, every investor wants to move his investments to safer options. The emergence of gold in this regard has been remarkable.

Gold - value investing
Gold is considered a preserver of value, making it a good hedge during inflation. Gold is a unique commodity - while it is part of the basket of commodities and broadly moves in line with commodity prices, in periods of uncertainty, it can move in the opposite direction or have a lower impact. Gold is also a depleting commodity, which will continue to thrust the prices higher in the long term. While it is well known that gold is a coveted commodity across the globe, East-Asia, the Indian sub-continent and the Middle-East accounted for 72% of world demand in 2007.

A significant part of the gold demand comes from sales and disposals. With volatility in currencies/financial markets, central banks could end up increasing the composition of gold in their reserves. This is likely to create additional demand for the commodity, thereby pushing the prices further up.

Gold vs other commodities
Like most other markets, commodities also underperformed as an asset class in the third quarter of the calendar year, as investors became increasingly concerned about the strength of spillover effects to the real economy. Gold also saw a dip in prices from record highs. However, the fall has been much lower than in other commodities probably due to the flight to safety.

Interestingly, except lead, all commodities took a battering during the global financial meltdown. Tin, palladium, aluminum, platinum, copper, silver and nickel each fell by over 20% during the quarter. Gold was the second best performing commodity, behind lead, falling by just 5%.

Energy (brent crude), another key indicator of the strength of the economy, also took a strong dip. However, there is limited correlation seen between gold prices and crude prices in the long term. Over the past twenty years, gold and oil have moved in the same direction twelve times; but in opposite directions, eight times.

Bullion and capital markets correlation
It is interesting to see that gold is negatively correlated to equities; this has been the trend over many years. The trend can be related back to September 2005, when the markets slipped below 8,200, intra-day, closed with a loss of 265.50 points at 8,221.64 on September 22, 2005. At the same time, gold was seen to be trading at an all time high of Rs 6,780 per 10 gram. It is no different today, Sensex has dropped from a close of 20,301 on January 1 to 13,802 on June 27 - a whooping 32% drop; in the same period gold prices went up a whopping 18.01% in absolute terms.

A contrarian can take the cue from capital markets and move out of equities into gold, at peaks. One can do it in phases at key resistance and support levels. Gold is likely to rally when the equity market sees a down-trend. Further, gold is a more stable asset class in the long term; therefore, a good stability provider and a unique diversification tool as well.

Investing in Gold
India has an affinity towards jewelry, given their importance on all festive occasions. In ancient India, gold jewelry came into being, because people did not have access to banking and other financial instruments to preserve wealth. Jewelry, at that time, was the most convenient and most efficient medium of storing and preserving family wealth.

Today, however, if one intends to hold gold in physical form, it is best to consider holding it in the form of coins, biscuits, etc. and not in the form of jewels. A more popular form of holding of this asset globally, which has caught the fancy of the Indian investor, is the ETF (exchange traded funds). Gold ETFs are open-ended mutual fund schemes that invest in standard gold bullion (0.995 purity). The investment will be denoted in units, which will be listed on a stock exchange. They can be bought and sold on a real time basis, based on price movement of gold.

Gold Mining Funds launched recently in India are mainly feeder funds - they are funds which conduct investment through another fund which is the master fund, normally which has run successfully around the globe. The master fund invests in precious metal mining companies. Currently, there are only two such Gold Mining Funds AIG World Gold and DSPBR World Gold. Do keep in mind that this is a higher risk/return product since it invests in the stocks of the mining companies. Returns have been significantly better. For instance, the GDM index, an index of gold miners, has moved up 6.5 times since 2000 as compared to gold price which has increased by 3 times during this period. However, the recent fall has been very short on these two funds.

One should keep in mind that gold has also become pretty volatile of late, in line with most other asset classes. While gold and equities are negatively correlated, there are points of time when both move in the same direction. This requires a contrarian investor to make a more careful study before deciding on investing/exiting from gold. One can allocate about 5%- 15% of ones funds into gold - this can be through a mix of physical holding and virtual holding, although one has to keep in mind the costs involved and the risks thereof.

TIPS FOR THE WEEK
Gold is a good diversification tool for an equity investor, due to their inverse correlation.
It is also a good hedge against Inflation - since it is a store of value.
If you prefer holding physical gold - buy coins, biscuits or bars. Jewelry is not considered as an investment due to high transaction costs.
Hold a part in the form of ETFs /Mining funds, which will offer easier liquidity and lower risk of theft.
On an overall basis, have about 5%-15% of your portfolio in gold; do not overdo!
Manage the volatility of gold through phased investments.

It’s labour minus pain as hypnobirthing comes to India

Saloni Zutshi was terrified of labour just like any mother-to-be. But on November 4, she surprised herself when she gave birth to her first baby in a pain-free delivery. She is so thrilled that she wants to “do it all over again”. While this Delhi mother is extraordinary in wanting to repeat labour, she is also the first in the country to use hypnobirthing, a new technique that makes childbirth easier.

‘Hypnobirthing’ may conjure up an image of a hypnotist standing in front of a hapless woman with a swinging pendulum. But it is actually a combination of relaxation, breathing and visualisation methods.

Already popular in the West — celebrities such as Hollywood actress Jessica Alba have opted for it — the technique has just come to India. It is fast gaining ground. “Two of my patients are taking hypnobirthing classes,’’ says Dr Ameet Dhurandhar, a Mumbai-based gynaecologist. Both are expected to deliver at this month’s end at Bandra’s Chrysalis Hospital.

“Hypnobirthing is the use of selfhypnosis to achieve maximum relaxation, comfort and relief during childbirth,” explains Divya Deswal, gynaecologist and hypno-therapist who handled Saloni’s delivery.

But didn’t Saloni and her husband have any reservations about using a method untried in India? Yes, at first, but their desire for a natural birth made them choose hypnobirthing. “Caesareans have become very common now but we wanted Saloni to have a natural birth. So, we attended a hypnobirthing workshop in Mumbai, and learnt about this new technique. But it was only after we were confident that we said yes,” says Vasant Goel, Saloni’s husband and birthing partner.
Deswal, who’s been certified by the Hypnobirthing Institute in New Hampshire, USA, admits that it took some time to convince the couple. “I assured them that there would be a gynaecologist on standby, in case of any emergency.”

When the time came, Saloni stayed calm. “We had dimmed the lights and played soothing music as Vasant whispered the hypno prompts to her. After three hours of labour, she gave birth,” says Deswal.

Success hinges on preparation so that when the time comes, a woman is actually looking forward to giving birth rather than dreading the pain. This is what happened with 28-year-old Saloni, who works as a researcher with the UNDP on HIV/AIDS. “The technique is based on the power of suggestion,” Marie Mongan, founder-director of the Hypno-Birthing Institute, told TOI by e-mail. It is based on English obstetrician Grantly Dick-Read’s 1944 manual ‘Childbirth Without Fear’. Dick-Read said that hypnosis during labour helps women break what he described as the “fear-tensionpain syndrome”. Once contractions start, fear kicks in as a reflex, causing blood to flow away from the uterus to muscles in the legs. The reduced blood flow causes the uterus to cramp, resulting in pain. So, if women could only relax, they would have less pain, more effective contractions and shorter labour. That’s where hypnosis helps. “It allows a woman to enter a state of deep relaxation. The feeling is similar to daydreaming or when one is lost in a book or movie,” explains Mongan. A review of patients who had used hypnobirthing was published in the British Journal of Anaesthesia in 2004. The review suggested that there was evidence of a reduced need for pharmacological analgesia. A controlled trial is currently under way in Australia, which is seeking conclusively to prove that hypnosis can a make a significant difference to women in pregnancy and labour.

“The method has been gaining acceptance in the US, where there is a growing trend of moving towards natural birthing. Of the 1,059 cases that came to us between October 2005 and January 2008, as many as 80% were from the US,” says Kathie Dolce, who works at the Hypnobirthing Institute.

Dr Urvashi Sehgal, whose hospital was used for the hypnobirth, says she had no reservations at all about the procedure. “Doctors should understand that hypnobirthing is not a parallel medical procedure, it simply eases the labour. It also eliminates the use of drugs to hasten labour. If used in combination with water birthing, it gives wonderful results.”

Gynaecologists who use conventional delivery methods don’t disagree. Dr Asha Sharma, senior gynaecological consultant at Delhi’s Rockland Hospital, says, “Such positive techniques can help check the rise in C-sections which more women are choosing over natural births as they get stressed about labour and obstetricians don’t have the time to address those fears.” Hypnobirthing helped Vasant and Saloni tackle those fears and bring baby Anaadyanta into the world without pain. Could it herald the birth of a whole new order for Indian women?

OTHER OPTIONS

Lamaze method:
Lamaze is the oldest and most popular method of childbirth preparation in the US. It originated in the 1960s but gained popularity only in the 1970s. Lamaze involves rhythmic breathing techniques which help women take their mind away from the pain of contractions.

Bradley Method:
Also known as “husband-coached childbirth”, it is the brainchild of Dr Robert A Bradley. Teachers of the Bradley Method believe that — with adequate preparation, education and help from a supportive coach — most women can give birth naturally, without drugs or surgery.

Ensure EMI is below 40% of monthly income

More than half of my salary goes towards paying my monthly EMIs. This is something we hear quite often. Young professionals are finding it tough to handle the pressure of EMIs and credit card payments with high interest rates.

Raghavendra V (28) pays Rs 22,250 towards his housing loan and Rs 8,000 towards his personal loan every month. He works with a cruise liner and earns about Rs 65,000-Rs 70,000 a month.

“My dream was to own a house at an early age. In 2007, I had sufficient funds from my investments in the share market to buy a house. The house was for Rs 32 lakh and I was fortunate to get a home loan of Rs 20 lakh and separately opted for Rs 4 lakh as personal loan. The remaining was from my investment and savings,” he says.

But now, with the economic meltdown, Raghavendra is finding it difficult to manage the loan amount. “I plan to clear the personal loan first and then completely concentrate on the housing loan, since the interest rate on the personal loan is too high,” he says.

When it comes to monthly expenses, the basic rule should be to live within one’s means. “The total of all expenses and loan repayments must not exceed the income,” says Mahadevan, CEO of Wealth Advisors India.

“The amount of loans should be such that the total repayment amount (EMI) is no more than 35%- 40% of the monthly income after tax,” he says.

Anything in excess of this could mean that one may need to borrow funds for normal, everyday expenses, which must be avoided. “Create a reserve fund of liquid investments amounting to about 6 EMIs. This could provide the necessary protection in cases of loss of job or sudden mishaps,” Mahadevan says. Shreyas (26), a PR professional, has taken a car loan of Rs 4.48 lakh for 5 years from HDFC Bank. In the current scenario it has become difficult for her to handle her EMI and other monthly expenses. “I pay a monthly EMI of Rs 10,000 for the car loan. My husband uses his credit card more often than me. On an average, the credit card bill comes to Rs 5,000 a month. At the moment it is tough, as we had to use all our savings for the down payment of the car but is not an extreme situation yet as both of us are working,” says Shreyas, whose yearly package is Rs 4.6 lakh.

Each month the couple keeps a chunk of their salaries aside for clearing loans and other payments. “We are aware of the monthly petrol bills and other expenses like groceries and ensure that we only buy what is required. It helps in cutting down on unnecessary expenditure,” Shreyas says.

Maintain a budget sheet every month and break up your expenses into different categories like committed expenses, personal expenses, luxury spending and savings. “You will know exactly where your money is going and how much money you need if you have a budget. Accordingly, calculate the EMI you can afford. When it comes to credit card spending, it should not go beyond your one-month salary,” says a wealth manager.

If you have already gone overboard and are in a debt trap, it would be most important to find ways and means of getting out of it. Spending will have to be brought down to bare essentials, with a strong focus of repaying as much of the loans as possible. You could search for alternative cheaper sources of finance to pay off more expensive loans. “Sale of some assets may also need to be considered if the situation warrants it. It would be the attitude, the mindset and the willpower that will be severely tested at such times,” says Mahadevan acharya.

A sip of ‘liquid smoking’ to shut out cigarettes

For smokers saying ‘a puff of cigarette’ may not be in vogue anymore. Rather a sip of ‘cigarette drink’ may be the new lingo as a drink promises the same smoking experience, sans nicotine.
Called ‘liquid smoking’ the drink has South African herbal extracts, say its Dutch manufacturers United Drinks and Beauty Corporation.

The drink has already been on sale for one year now in Netherlands and United Drinks hopes the product would be available in the UK before Christmas, The Telegraph reported recently.

“The manufacturers say it does not contain the drug nicotine but rather a mix of roots from South African plants which is said to give ‘a slight energising effect, followed by a euphoric sense of calming and relaxation,” the newspaper said.

‘Liquid smoking’ would cost about £1.50 in the shops and would have less than 21 calories in every 275 ml can.

Meanwhile, the Guardian in a recent report about the drink said, “coming in a can reminiscent of a cigarette packet, it has a box proclaiming ‘no warning needed’ where a health warning would be on a packet of cigarettes”.

Quoting United Drinks chief executive Martin Hartman, The Telegraph said, “the product we (United Drinks) have developed has got similar properties to nicotine, so we are trying to help

people out who are affected by the ban on nicotine.

People might use this instead of a cigarette or tobacco to help the cravings.”

Martin Hartman was further quoted as saying “it will take the edge off of a need for nicotine for

between one to four hours... I think it will help people who feel the need for nicotine in bars, restaurants, long-haul flights and on the train.

Low sex drive? No big deal, say most women

The majority of women who experience low libido, poor arousal or face difficulties in orgasming, don’t seem upset by these problems.

These findings are based on one of the largest ever studies of its kind, which probed 32,000 women aged between 18 and 100 plus years across the US, regarding distress bearing on sex life, including anger, guilt, frustration and worry.

“Sexual problems are common in women, but problems associated with personal distress, those which are truly bothersome and affect a woman’s quality of life, are much less frequent.” said Jan Shifren of Massachusetts General Hospital (MGH), who led the study. Though women over 65 years faced most of sexual problems, they reported the lowest levels of distress. The most distressed were women aged 45 to 64, according to an MGH press release.

The youngest group, aged between 18 and 44 years, had lower levels of both problems and distress. Depressed women were more than twice as likely to report distress over any kind of sexual problem rather than non depressed women.

About 43% of respondents experienced some degree of sexual problem, with 39%reporting low
desire, 26% problems with arousal and 21% difficulties with orgasm. But distress bearing on any of these problems was restricted only to 12% of the volunteers.

“Although sexual problems were very common in women over age 65, these problems often weren’t associated with distress,” Shifren, associate professor of obstetrics and gynaecology at Harvard Medical School, added. “Several factors could be behind the lower levels of distress in the oldest group. If their partners also have low desire, it may not be looked on as a problem, or additional health issues could be of greater concern.”

INTIMACY WOES
Four in ten women experience sexual dysfunction 43% of the women reported having some sort of sexual dysfunction, although only 12% said that these problems affected their day-to-day lives