Greater involvement of people living with HIV in health care

via Journal of the International AIDS Society, by Odetoyinbo Morolake1, David Stephens2 and Alice Welbourn3

1Positive Action for Treatment Access, Lagos, Nigeria
2Nossal Institute for Global Health, University of Melbourne, Victoria, Australia
3International Community of Women Living with HIV/AIDS, London, UK

Journal of the International AIDS Society 2009, 12:4doi:10.1186/1758-2652-12-4

Greater Involvement of People Living with HIV/AIDS represents a mobilising and an organising principle for the involvement of people living with HIV in program and policy responses. People with HIV have been at the forefront of designing and implementing effective HIV treatment, care and prevention activities. However, governments and health systems have yet to act to fully harness the potential and resources of people living with HIV in addressing the epidemic.

The lives and experiences of people living with HIV highlight the need for a shift in the existing paradigm of disease management. The high prevalence of HIV amongst health care providers in many countries, exacerbated by stigma towards those with HIV in the health care professions, is seriously undermining the capacity of health systems and signals the need to change the current nature of health care delivery. Moreover, the negative experiences of many people with HIV in relation to their health care as well as in their daily social interactions, coupled with the ever-limited current investment in treatment, care and support, demonstrate that the current system is drastically failing the majority of people with HIV. Current health management systems urgently need to be more effectively maximised, to increase the quality of standards of health care systems and services in resource poor countries. An integrated approach to health care based on a human rights framework, grounded in community realities and delivered in partnership and solidarity with people living with HIV, offers the most viable approach to overcoming the crisis of HIV in the health care system.

Read the rest.

AIDS 2008 Impact Report Available

The AIDS 2008 Impact Report, a report of the key learning from the XVII International AIDS Conference, held in Mexico City in August 2008, is now available here.

The report is also available on the AIDS 2008 homepage, as well as the IAS homepage.

According to the IAS, the report is not meant to capture all of the hundreds of sessions, events and activities at AIDS 2008 (as no one report could reasonably do this), rather it is an analysis/reflection on the key learning in the following areas:

- Epidemiology

- Basic and Clinical Research

- Biomedical Prevention Research

- Regional Focus

- and a section on how AIDS 2008 and previous international AIDS conferences have contributed to the overall response to HIV/AIDS

All analyses are referenced to sessions/abstracts.

Please note that several organizations are producing their own reports associated with conference activities, or key issues/areas of focus during AIDS 2008, and we will make them available on the AIDS 2008 website as well.

Oh, the Humanity

We must envision a day
when we are reflexively
empathetic to gay men.

Homophobia—multiplied nineteen times

by Jim Pickett
in the November/December 2008 issue of Positively Aware

So, as it turns out, efforts (and the lack thereof) to eradicate HIV across the globe are systematically ignoring, denying, under-serving, and failing gay men and other men who have sex with men (MSM).

While this was not exactly a surprise on a planet where 86 countries continue to criminalize LGBTs in any number of human rights-crushing ways, to fully comprehend the broad, wide-reaching neglect of gay/MSM in the global AIDS pandemic is nevertheless a shock and awe to the soul. I was delighted that this issue emerged as a key, defining theme of the XVII International AIDS Conference (AIDS 2008), held in Mexico City August 3–8.

The AIDS 2006 conference in Toronto had frustrated me with the paucity of discussion and energy around gay/MSM topics. While AIDS 2008 featured gay/MSM issues prominently, my emotions were yet again set to frustration, and rage, as the extent of the neglect was revealed in countless plenaries, sessions, symposia, and press conferences.

Read the rest of the article.

Homophobia continues to hamper HIV efforts globally

Craig McClure, Executive Director of the International AIDS Society, recently released the important statement below. Many thanks to the Global Forum on MSM and HIV for sending this out on their list.

As a chief goal of IRMA is to advance the research and development of safe, effective and acceptable rectal microbicides, we are very concerned about the pervasive, and lethal, stigma and homophobia that so many gay men and MSM face around the world. And we remain committed in the fight for the human rights of all vulnerable and disenfranchised people. To be sure, when we do have safe and effective rectal microbicides, it will not matter to millions of people who need them if gay men and MSM are denied access due to such flagrant human rights abuses as we continue to see in 85 countries.

It is an outrage that something like one in twenty gay/MSM in the world have access to prevention. This cannot stand!

Jim Pickett
-IRMA Chair

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Homophobia continues to hamper HIV efforts globally
-Craig McClure, International AIDS Society

Mexico City/Geneva – (29 May 2008)


The International AIDS Society (IAS) today expressed its deep concern about continuing inflammatory and homophobic statements by political leaders in Uganda, Poland, and most recently by the President of The Gambia, and urged national and international leaders to reject homophobia and to take affirmative steps to reduce its impact on HIV.

One of the many lessons learned in the IAS' more than 20 years of leadership in HIV/AIDS, is that well-designed and appropriately targeted programs, implemented with the support of public health and political leadership, can effectively reduce HIV transmission in communities most at risk for HIV, including gay men and other men who have sex with men (MSM).

A report issued at the end of 2007, led by researchers at the Johns Hopkins Bloomberg School of Public Health in the US, provides solid evidence that HIV among MSM continues to be widespread, and in many cases, is exacerbated by stigma, criminalization and the lack of appropriate services. The study indicates that, even in countries with low HIV prevalence in the general population, the epidemic among MSM is raging.

According to UNAIDS, fewer than one in 20 MSM around the world has access to HIV prevention, treatment, and care – and even fewer in low-income settings. Compared to the HIV testing rates of 63-85 percent seen among MSM in Australia, Europe, and North America, rates among MSM in much of Africa, Asia, and Eastern Europe are often under 20 percent.

As it has been demonstrated in many different countries, reducing the social exclusion of gay and MSM communities through the promotion and protection of their human rights (including sexual rights and the right to health) is not only consistent with, but a prerequisite to, good public health. Once discriminatory policies are abolished and stigma and discrimination are confronted, country-based programs can be put in place to encourage gay men and MSM to stay free of HIV-infection, thus supporting national goals of reducing HIV burden.

However, efforts to replicate these successful strategies in more countries are hampered by recent homophobic statements made by political leaders from Uganda, Poland and The Gambia. Comments from these leaders, and other politicians who call for the arrest, detention, and even killing of homosexuals, are reprehensible.

In 2008, despite the accumulation of more than a quarter of a century of knowledge of successful HIV interventions, homophobia and the criminalization of homosexuality continue to be significant obstacles to the scale up HIV prevention, treatment, care and support. Though countries such as Cape Verde and South Africa have repealed their sodomy laws, and government officials in Kenya, Malawi, and Mauritius have begun discussions about the harmfulness of such laws, a resurgence of intolerance and homophobia, coupled with lack of action to repeal laws that violate the human rights of same sex practicing men and women, is posing a grave threat to the AIDS response in many countries.

Despite its much heralded success in promoting a public health response to HIV, Uganda continues to cling to a colonial-era sodomy law that punishes homosexual conduct with life imprisonment. And, Uganda is by no means the exception. Worldwide, more than 85 countries criminalize consensual homosexual conduct. Such laws give governments a pretext to invade people's private lives and deny them essential human rights: to live in peace and in health.

The XVII International AIDS Conference, to be held in Mexico City from 3-8 August 2008, will highlight successful work with MSM in several Latin American countries. The experience from Latin America, as well as from other parts of the world, can provide invaluable guidance to leaders from other middle- and low-income countries in Africa, Asia and Eastern Europe. [IRMA is presenting "Making Anal Sex Safer for MSM in the Developing World" at the conference.]

The very high proportion of MSM in Latin America who, over the past 25 years, became infected with HIV, developed AIDS and later died can only be described as catastrophic. But, in the past decade, in a growing number of countries throughout the region, there have been positive responses that continue to serve as shining examples to the rest of the world. If national and world leaders are serious about curbing the epidemic, programmes that bridge across sexual orientation, that protect public health, and transform stereotypes and prejudices must be a first line priority.

"Homophobia – whether propagated by government leaders, enforced by outdated laws, or perpetuated through stigma and discrimination – continues to fuel this epidemic, and should therefore be the number one enemy of those who are serious about ending this global tragedy," said Dr. Pedro Cahn, IAS President, AIDS 2008 Co-Chair and President of Fundación Huésped in Buenos Aires, Argentina.


With an international membership of more than 10,000, the International AIDS Society is the world's leading independent association of HIV professionals.