International HIV Sidelines Gay Men

posted: 07/03/2011

Every two years the world’s biggest HIV conference faces criticism for sidelining the needs of gay men, sex workers, transgender people, and injecting drug users. The International AIDS Society conference visited Vienna in 2010, around 25,000 people attended, but it still grossly under-represented four groups most at risk for HIV infection.

A detailed study by the Global Forum on MSM & HIV (MSMGF), confirms the long-held suspicions and criticism of this neglect, and calls for change.

The International AIDS Society may be part of the problem, but it can solve it.

Shame of stigma and discrimination
Stigma and discrimination against marginalised and unpopular groups affected by HIV is unprofessional and brings shame on the International AIDS Society.

The 2010 conference programme seriously neglected key needs. There is little exclusive time and exposure given to the four groups, and the four groups are often ignored even in general studies.  

• Only 6.6% of the abstracts of studies were only concerned with gay and bi men / MSM, 5.7% targeted only people who use drugs, 3.5% looked only at sex workers, and 0.6% solely considered transgender people.
• Only 3.8% of ordinary conference sessions exclusively focused on gay and bi men / MSM, 5.1% on IDU people, 2.5% on sex workers and 0% on transgender people.
• Just 3.7% of all workshops exclusively focused on gay and bi men / MSM, 6.4% on people who use drugs, and 0% on sex workers and 0% on transgender people.
• Out of over 4,500 abstracts sent in for selection and publicity, only 558 even mentioned MSM, only 442 mentioned IDU, just 338 mentioned sex workers, and a bare 134 mentioned transgender people.
• Only 2.6% of all sessions in the entire conference programme exclusively focused on MSM, 4.5% exclusively focused on IDU, 3.0% on sex workers and 1.1% on transgender people.

The percentage of all sessions at the conference exclusively focused on the four marginalised groups was 2.6% for MSM, 1.1% for transgender people, 3% for sex workers and 4.5% for people who use drugs.

Research shows these four populations are at higher risk for HIV than the general population in nearly every country where reliable data exist.

Compare tiny conference gestures with actual needs

• MSM represent more than a quarter of HIV infections in Latin America and the Caribbean
• People who inject drugs are more than half of HIV infections in Eastern Europe
• Up to half of all sex workers across Sub-Saharan Africa have HIV
• Transgender people in El Salvador, Indonesia and India have HIV rates as high as 25%, 35%, and 42% respectively.

"Abysmal representation reinforces discrimination and invisibility"

“While the International AIDS Society turns a blind eye, HIV rates among these populations continue to climb around the world,” said Dr. George Ayala, Executive Officer of the MSMGF.

“The IAC is the world’s most important opportunity for international exchange and collaboration on HIV and AIDS. Such abysmal representation of most-at-risk groups only serves to reinforce the invisibility, discrimination and disregard that drive the epidemic among these communities.”

“Ostensibly, the IAC offers chances for local healthcare providers to learn ways to improve their services, provides channels for advocates to engage in dialogue with powerful decision-makers, and creates opportunities for community members to shape global funding and research agendas,” said Dr. Mohan Sundararaj, Policy Associate at the MSMGF. “This really is a phenomenal platform, but how useful can it be when those who need it most are locked out?”

Calls for change
The report recommends steps to make the Conference programme fairer, based on the numbers of people affected . These include involving the communities affected in the conference planning.

“The International AIDS Conference has unparalleled potential to impact the global AIDS epidemic,” said Dr. Ayala. “It is incumbent upon the organizers to ensure that the IAC becomes a vehicle for change, shifting the global landscape so that funding, research and programs are directed to those who need them most. Right now it’s part of the problem.”

Source The Global Forum on MSM & HIV

Read the full report Coverage of Four Key Populations at the 2010 International AIDS Conference: Implications for Leadership and Accountability in the Global AIDS Response February 2011

The Global Forum on MSM & HIV (MSMGF) is an expanding network of AIDS organizations, MSM networks, and advocates committed to ensuring robust coverage of and equitable access to effective HIV prevention, care, treatment, and support services tailored to the needs of gay men and other MSM. Guided by a Steering Committee of 20 members from 18 countries situated mainly in the Global South, and with administrative and fiscal support from AIDS Project Los Angeles (APLA), the MSMGF works to promote MSM health and human rights worldwide through advocacy, information exchange, knowledge production, networking, and capacity building.

End to HIV Health Staff Ban?

posted: 10/02/2011

The much criticised ban on surgeons and dentists with HIV from working could be lifted this year. At long last, the government is acting on HIV campaigners’ calls to end the employment ban.

Department of Health rules stop HIV-positive health workers from carrying out what are called ‘exposure prone procedures’ which are thought to risk HIV and hepatitis transmission. Basically 'exposure-prone procedures' are treatments where the healthcare hand goes inside the patient body, especially when there are sharp things like bones and surgical tools around - like when a dentist is extracting teeth.

But the rules are old and there is very little solid evidence of actual HIV transmissions from health care workers to patients. Despite this, the UK rules mean no dentist with HIV can carry on working as a dentist, and many midwives, surgeons, some nurses and ambulance workers have also had to end or change their careers.

Rules review

The Department of Health has now said there will be a review of the rules. HIV charities have been invited to join the working group that will draw up new guidelines.
 

The British bans on healthcare workers with HIV and hepatitis are stricter than in many European countries and the USA and Australia, where dentists with HIV can work, so there are alternative rules ready to be adapted for Britain.

Evidence gap

With effective HIV treatments there is usually almost no virus in healthcare workers’ blood, so whatever risk there was, is even smaller now, say campaigners. It is extremely unusual for blood-borne viruses to be passed between doctors and patients. Only four patients worldwide are thought to have contracted HIV from health workers. There have been no transmissions from healthcare workers in the UK. And there are significant doubts about the evidence even for these few transmissions. 

Deborah Jack, chief executive of the National Aids Trust, said ‘advances in testing technologies and treatment’ and ‘high levels of infection control’ supported calls for change.

Catherine Murphy, of the Terrence Higgins Trust, added: ‘We’re not saying entirely lift restrictions but it is time for another look – especially for dentists.’ The British Dental Association has backed calls for change.

UK healthcare workers and exposure prone procedures policy

Source

Catholic HIV Guide

posted: 07/02/2011

The Vatican will hold an international conference in May on HIV prevention and care, after all the confusion the Pope caused last year about using condoms for HIV prevention.

The conference findings will help create a guide that the Vatican is preparing on the prevention and care of AIDS patients.

The Vatican's Pontifical Council for Health Care Workers also announced that they are working on a set of guidelines for Catholic doctors, nurses and others who care for people with HIV.

More information 

Catholic bio-ethics guide for healthcare workers
Rome HIV conference
 

No Fear in HIV Prevention

posted: 09/11/2010

Using fear as a tool for HIV prevention, like in the 1980s British AIDS tombstone and icebergs campaigns, causes more harm than good, according to a recent review of the evidence.

The idea behind the AIDS tombstones and icebergs was that making people fear death would encourage self preservation by using condoms. Similar fear approaches to HIV prevention were used in the United States, and in Australia (with images of the Grim Reaper).

Following the success of HIV treatments, fear arousing campaigns have picked out some unwanted treatment side effects (for example, facial wasting and diarrhoea).

Attention Grabbing, but does fear work?
Campaigns arousing fear are good at grabbing public attention by using graphic imagery, simplistic language and shocking statements. Fear campaigns are often very memorable.

Recently the use of fear has increased in other health promotion campaigns highlighting the harm from smoking, excess alcohol use, and drug use. The public has great faith in the use of fear to change behaviour.

Frustration
The media, including the gay press, have been calling for more emphasis on harm from sexual risks. The public and campaigners are frustrated at high rates of HIV and STI infection in the UK and the lack of progress in reducing these. That is often behind the calls for what seems to be an ‘obvious solution’.

Does using fear of HIV work?
Would using more fear in HIV prevention work? The role of fear in HIV prevention is written as a guide for gay men’s HIV prevention workers, but many other people, including people with HIV, are very interested in this and have strong views about it. It is an interesting and informative read in four illustrated pages.

It looks at the scientific evidence for whether fear works or not, considers the ideas behind it, and looks into the unforeseen consequences and risks of using fear in HIV campaigns.

Fear is for the Fearless
Fear only works with people who are not frightened by HIV. But 98% of gay men say (in Gay Men’s Sex Survey, 2008) they agree or agree strongly that “HIV is still a very serious medical condition.” So almost every single gay and bi man is already fearful of HIV. Perversely, adding to that fear can make things worse for the men at more risk of HIV.

As Adam Bourne says: “It will remain a constant challenge for those promoting sexual health and well-being to attract the attention of their target audience among the many other advertisements that compete for their attention.

“The temptation is to produce shocking or explicit imagery, which may stand a better chance of being noticed or being remembered.

“However, it is doubtful whether it will actually be successful at influencing behavioural choices.

“Most gay men and other men who have sex with men are already motivated to avoid HIV, but some still lack the knowledge or the power to do so.”

“Inducing fear is not an effective way to promote previous HIV relevant learning or condom use either immediately following the intervention, or later on.

However, HIV counselling and testing can provide an outlet for previous HIV-related anxiety and, subsequently, gains in both knowledge and behaviour change immediately and longitudinally.”

Earl & Albarracin, 2007

Read The role of fear in HIV prevention, Adam Bourne, 2010, Sigma Research Briefing no.1 for the CHAPS gay and bi men’s HIV prevention partnership 
 

Laws Should Not Worsen HIV

posted: 02/07/2010

The ‘Vienna Declaration’  sounds like a half-forgotten piece of school history, but it is brand new and all about ending laws and policy across the world that cause HIV harm. The UN has at the same time set up a brand new Global Commission on HIV and the Law  to deal with some of the toughest issues in HIV. Laws and policies across the world are making the HIV epidemic worse and causing harm to many people. Anti-gay, anti-sex-worker, anti-drug, anti-HIV sex and transmission laws and policies are all the UN Commission’s new battle-ground.
 

If you agree that the law should not criminalise drug users because this makes the HIV epidemic far worse and causes more harm than good, you are invited to sign the Vienna Declaration. The Vienna Declaration is a call from the international scientific community to countries across the world (including the UK) to face the facts and recognise that the so-called 'War on Drugs' isn't working, and causes far more harm than good, particularly in the fight against HIV.

It asks the UN and countries to update drug policy and laws to end this HIV harm, discrimination against people's human rights, and to remove the legal and other barriers to effective HIV prevention, treatment and care.
You can read and sign the Vienna Declaration here  and facebook and twitter it from there
 

Why is the Declaration from Vienna? Well, the International AIDS Conference opens in Vienna in Austria later this month.

This conference is the largest HIV conference, and is held every two years, and is the one where big HIV news on treatments and almost everything else is revealed. 

New - Global Commission on HIV and the Law
The Global Commission on HIV and the Law was set up last month – the secretary general of the UN said “I urge all countries to remove punitive laws, policies and practices that hamper the AIDS response … . Successful AIDS responses do not punish people; they protect them … . We must ensure that AIDS responses are based on evidence, not ideology, and reach those most in need and most affected.”

The Commission has a challenging job – its job is to produce practical steps, based on evidence and that support human rights, that will reduce HIV transmission caused by laws and policies. So it will focus its efforts on ending laws that criminalise HIV transmission and exposure, illicit drug use, sex work, and same sex relationships. Global Commission on HIV and the Law
 

HIV and the Law is part of the Law on Trial  season at Birkbeck College this weekend, and Matthew Weait, a long-time ally of George House Trust and who works at Birkbeck as a senior law lecturer, writes about how the law should not worsen HIV discrimination and stigma, and if laws do this they do not deserve our support.