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.

Talking and Telling about HIV

posted: 28/02/2011

There’s a lot of fuss made about how important it is for gay and bi men diagnosed with HIV to tell their sexual partners about HIV, before any sex takes place – which is known as ‘disclosure’.

Telling people whether or not you have an STI / HIV is your choice.

We think it is smarter if every  person in the UK were to talk about HIV and discuss their and partners’ HIV and STI status and risks before sex. But telling others about having HIV is always a choice.

One-sided talking

One major problem is that undiagnosed people, including gay and bi men, rarely ever talk about their own HIV status, but instead expect diagnosed people to always reveal their HIV status.

Some undiagnosed men then decide not to have sex, or decide on less risky sex after the partner says they have HIV.

Conference debates

George House Trust has critically examined the evidence for and against relying on being told HIV status as a way of avoiding getting HIV. Chris Morley, George House Trust's HIV policy expert, issued a challenge to gay men's HIV prevention workers when he gave a detailed presentation at the CHAPS conference last week for England's sexual health and HIV prevention organisations.

The challenge is to tell undiagnosed men that relying on being told by people with HIV is a seriously flawed way to try to avoid HIV. The HIV risk run by men expecting disclosure is simply too high. The challenge was also to help undiagnosed men be more respectful to anyone who does disclose having HIV. Some disclosing men with HIV are then shamed, abused, rejected, or worse.

Talking about HIV happens very unevenly and the expectations of disclosure put an unbalanced burden on people with HIV.

Dysfunctional Disclosure

The far bigger problem however, is that relying on being told, and being told accurately, is a highly risky way to manage anyone's HIV risks.

Only men diagnosed with HIV have HIV status information that is at all reliable.

Depending on men to tell you they have HIV puts you at a big HIV risk. Disclosure doesn't work at all well as a way of staying HIV negative. 

• 1 in 3 gay and bi men have never had a HIV tested - so untested, can't tell anyone anything useful about their own HIV status
• Men who have been tested usually only have information that is past its sell-by date
• Many men have had condomless anal sex since they had their last negative HIV test. An MOT certificate saying your car was roadworthy is no guarantee of future safety after you have had a crash. In the same way, a negative HIV test result becomes worthless once you have had unprotected sex.
• The only dependable information is from men who have been diagnosed with HIV to tell you this; but not all diagnosed men disclose in all situations; for example disclosure by diagnosed HIV+ men is less common in gay saunas and clubs.

George House Trust is also making a second presentation, about cuts in legal advice and representation for people with HIV. 

HIV Legal Advice Services
Among the hundreds of cuts, one cut would remove most legal aid for advice and representation at courts and tribunals. £450 million is to be slashed from budgets for advice, such as provided by Citizens Advice, Manchester Advice, Law Centres and other organisations, for immigration and asylum, welfare benefits, housing, employment and most discrimination cases.
 

This will affect millions of people a year, and you can tell things will become really bad, because even the Judges’ Council has gone public with its objections.

HIV Talking and Telling - George House Trust discussion for CHAPS-14 conference, Manchester  

HIV Advice Services - George House Trust discussion for CHAPS-14 Conference, Manchester

CHAPS-14 Conference, Manchester, March 9-11th

Image - Let's Talk HIV - Swedish language HIV site
 

Fresh Conference News

posted: 25/02/2011

HIV Conferences come in different sizes and the biggest this year is CROI, in Boston, USA, which begins this Sunday. This conference is about understanding, preventing and treating HIV.
 

Among this year’s main attractions will be the latest about using antiretroviral drugs to prevent HIV infection, new drugs, and treatment when people also have hepatitis C.
 

Keeping Informed

NAM has writers who will report the news on their website. The CROI conference website has its own webcasts and summaries.

You can read NAM’s conference bulletins on their own web site.

You can also sign up for NAM’s email conference news bulletins here – at the bottom right of the page: a daily email news bulletin over the four days.

Free HIV Conference Places

posted: 12/01/2011

There are some free places reserved for people living with HIV, at 'Positively Together' a conference in Sheffield in late February. If you want to attend please ask for a free place as soon as possible, because they will give the free places to whoever asks first.

Positively Together is a conference 'Promoting the Health and Well-being of People Living With HIV' on Wednesday 23rd February 2011, in Sheffield (about an hour from Manchester by train or coach).

The aim of this one day conference is to bring together people living with and affected by HIV, as well as services responsible for planning and delivering HIV treatment, care and support in order to raise awareness about how to promote the health and well-being of people
living with HIV.

Apply for a free place

Free places will be allocated on a first come, first served basis.

To apply, please email Liz Wilson, Training Manager by January 26th 2011.

Please feel free to pass this information onto anyone you feel may benefit from attending.
 

More about the conference

It will be chaired by Baroness Joyce Gould, and keynote speakers include Sir Nick Partridge (Terrence Higgins Trust), Dame Denise Platts (Chair of National AIDS Trust), and Silvia Petretti (Positively UK).

There will be a range of workshops to choose from including

• HIV stigma and discrimination,
• the role of the voluntary sector,
• clinical care pathways, 
• service user involvement.

People from George House Trust will be among those presenting at a workshop.

The conference is aimed at a wide audience, including:
 

• People living with and affected by HIV
• GPs and primary care staff
• GP Consortia
• HIV Support Organisations
• Sexual Health Clinics
• GUM staff
• Health Promotion Teams
• Commissioners
• Other relevant clinicians

Positively Together conference

HIV Stigma Conference

posted: 20/12/2010

'It's time to have an honest conversation about the bad attitudes that spread HIV, stigma'. This was the reason for the first international HIV stigma conference, held on World AIDS Day, 1 December, in Washington, DC, USA.

The conference was organised by the Coalition for Elimination of AIDS-related Stigma (CEAS) who believe we need to include HIV stigma in every conversation, prevention method and piece of research about HIV.
 

The conference was held to

• Explain what stigma is
• Describe how stigma spreads HIV
• Understand the interaction of religion, race, and nationality on stigma
• Advocate for those affected with HIV to eliminate stigma
• Develop policies and social marketing to eliminate stigma

Conference sessions 

• What is HIV- related stigma?
• How does stigma impact people living with HIV?
• How stigma and lack of disclosure fuel HIV
• HIV-related stigma in health care and its impact on families
• Double stigma: being both gay and at risk for HIV
• Lessons learned in the global effort to reduce HIV stigma
• Faith, spirituality, and HIV: barriers and facilitators to HIV prevention
• HIV Stigma: effect on youth and families
• Criminalisation of HIV
• Reducing the stigma of HIV and STD testing in healthcare
• Moving Forward: Center for Stigma and Cultural Competency

Conference website