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TheBody.com Covers The XVII International AIDS Conference (AIDS 2008) in Mexico City, August 3-8 2008
  
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Key Messages

Positive Leadership Summit -- Reclaiming the Advocacy Agenda

August 1, 2008


About the Summit

The Living 2008 Partnership believes it is vital that LIVING 2008 is an effective event that will further strengthen the PLHIV movement through promoting the involvement and leadership of PLHIV in the global HIV response, as well as benefiting participants and programming at both the Positive Leadership Summit and at AIDS 2008.

  1. Living 2008 is the most important gathering of PLHIV for social advances in the response to HIV/AIDS and the release and discussion of key issues for the PLHIV movement, including:

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    • Universal access to HIV treatment, care and prevention programmes;
    • Positive Prevention;
    • Sexual and reproductive rights;
    • Criminalization;
    • Women and most at-risk groups as a major cross-cutting issue.
    Overarching issues include addressing gender inequality, increasing PLHIV youth involvement; stigma and discrimination; the greater involvement of people living with HIV (GIPA); and creating effective partnerships.
  2. Living 2008 identifies and develops common positions and strategies on key priorities to take forward into AIDS 2008 and also assist PLHIV to prepare for AIDS 2008.
  3. Living 2008 develops technical and leadership skills in PLHIV as part of the ongoing effort to strengthen the PLHIV movement's ability to contribute to the AIDS response in countries.
  4. Living 2008 will ensure the issues, outputs and decisions identified during the conference that require attention and action are recorded, widely shared (disseminated) and followed-up in a timely manner by the Living with HIV Partnership, especially the PLHIV networks.
  5. The impact of Living 2008 goes well beyond the two-days meeting; the Summit will be a catalyst for action throughout the world.
  6. Living 2008 will review and innovate community based research methods that maximize the PLHIV leadership and community engagement in order to generate useful evidence for effective advocacy.
  7. Living 2008 is an opportunity for social exchange.
  8. Living 2008 will ensure creative ideas and commitment for new and sustainable Positive Leadership.
  9. Living 2008 strengthens the PLHIV movement by effective implementation of Advocacy Campaigns and linkages between national, regional and global levels.


Key Messages by Thematic Area

Universal Access to treatment prevention care and support

There is a critical mass of reliable evidence that access to care treatment and support (ACTS) works in saving lives of those infected with HIV, and helps in preventing new HIV infection. Care, treatment and support are all intertwined in a synergistic way that supports this purpose. People living with HIV in many countries can, and do, provide many of these services ourselves. We are critical leaders to scaling up access to these services.

Providing access to HIV care, treatment and support in a holistic manner helps to strengthen national health care systems, including: development of a Procurement Supply Management Chain for products and services; making available new HIV diagnostics processes and equipment; making new treatment modalities available; puts in place programmes to prevent and treat opportunistic infections (such as tuberculosis and hepatitis C); and helps put in place social services for people living with HIV/AIDS and their families.

Key Messages

  1. People living with HIV see access to care treatment and support (ACTS) as a fundamental human right and essential to survival.
  2. People living with HIV, with proper ACTS, including monitoring and support services required to manage HIV treatment, can lead long, healthy and socially and economically productive lives.
  3. ACTS is effective prevention, in many countries such as Uganda, treatment has shown a reduction on new infections. A Swiss national commission on HIV states that with effective ACTS there may be little or no risk of sexual transmission of HIV.
  4. ACTS saves lives and saves money. The World Bank in 2007, issued a report stating the treatment is cost effective, as it allows people living with HIV to lead economically productive lives.
  5. ACTS keeps parents alive maintaining the family unit and effective programmes focused on preventing Mother to Child Transmission of HIV (PMTCT) can lead to no more children being born with HIV.

Criminalization and Human Rights

People Living with HIV sees criminalization as a violation of fundamental human, sexual and reproductive rights. The vast majority of people living with HIV-Aids do not want to transmit HIV and are concerned about transmission.

To penalize the HIV+ person where transmission occurs discriminates against the person that is positive, in favour of the person that is negative when in fact both parties share responsibility. We strongly believe that a combination of evidence and experience compels the conclusion that criminalization of HIV transmission is counterproductive to good public health practice.

  1. Criminalization is counter-productive;
  2. Criminalization is not a solution;
  3. Criminalization promotes discrimination which drives transmission;
  4. Criminalization will increase stigma;
  5. People living with HIV-Aids do not want to transmit HIV.

Decriminalizing drug use, homosexuality, sex work, and migration will be more effective than criminalizing HIV transmission.

Positive Prevention

Positive prevention means acting to improve our lives, the lives of people living with HIV, so we can take care of ourselves and others. People living with HIV from around the world are working to define what positive prevention is for us -- what we need to keep ourselves strong and contribute to everyone's health. Positive prevention is what we people living with HIV have been doing all along -- taking responsibility for our own health.

  • Positive prevention belongs to people who know they are positive.
  • Positive prevention means empowering positive people.
  • Positive prevention is about our quality of life.
  • Positive prevention is about taking care of myself to be able to care for others.
  • Positive prevention means helping us to live our lives positively.
  • Positive people are the key to success in positive prevention.

Sexual and Reproductive Health and Rights (SRHR)

It is a need for the best program outcomes, that People Living With HIV, networks and their partners be involved in:

  • The choice, design, implementation, monitoring and evaluation of SRH-related policy, programs and resource allocation.
  • Developing ethical and adequate research and guidelines to provide the evidence base that will result in the identification of the specific SRHR needs of PLHIV and the services to address these needs.
  • Guide the design and program implementation of the particular SRHR needs of HIV-positive young people, women and girls, prisoners, transgender people, men who have sex with men, injecting drug users, and other key populations.

People living with HIV have:

  • the freedom of choice regarding consensual and pleasurable sexual expression;
  • the freedom of choice regarding reproduction, marriage and family planning;
  • the fundamental right to access sexual health information and comprehensive sexual health services.

Most At-Risk Groups

Women and most at-risk groups

Risk factors for vulnerable groups ...
Including women, prisoners, drug users, sex workers and MSM to HIV are also risk factors for poverty, stigma, discrimination, criminalization and political disempowerment making it more difficult to access prevention, care treatment and support.

Access to care, treatment and support for HIV positive women
For HIV positive women access to care, treatment and support is about quality support, advice, and options obtainable for all. Understand the obstacles they face. It is not only about getting medications. It's about changing the conditions of women's lives so they can use those essential treatments successfully.

Sexual and reproductive health and rights of HIV positive women
Sexual and reproductive health and rights for HIV positive women is about having the freedom to choose whether or not to conceive and having the freedom to engage in sexual relationships if they want to, without fear or criticism from others. It is also about access to comprehensive, non-coercive, appropriate and confidential sexual and reproductive health services.

Addressing violence against HIV positive women
Violence against HIV positive women is rooted in unequal gender relations and HIV-related stigma and discrimination. The link between violence, gender and HIV is not just about increasing women's vulnerability to HIV transmission but violence can also be directed at us because of our HIV status. The fear of violence against us, loss of homes and livelihoods, can lead us not to disclose our status to our partners and family members. It can also prevent us access and using vital health services and treatments. Therefore we must consider the impact of HIV (and related) policies and programmes, including HIV testing, treatment, partner notification and criminalization on violence against HIV positive women.

Meaningful involvement of HIV positive women
Meaningful implementation of the GIPA principle is not simply about seating HIV positive women at decision-making tables where a mandatory space has been created, or because it is the 'fashionable' thing to do. It is also about us setting the agenda. Therefore, it is not only vital that HIV positive women with the skills and capacity to make decisions are involved as equal partners but that those who are in positions of power learn to engage with women living with HIV in ways that are inclusive and respectful, or else our involvement becomes tokenistic.

  • Women are made into criminals for having HIV positive children in resource poor settings where there is no access to PMTCT.
  • Routine testing of women leads to the assumption that women know their status. If a woman cannot disclose her status to her partner due to violence and she continues her sexual relationship with her partner (whether consensually or not) she could be prosecuted for transmitting HIV to her partner.
  • Women's realities, including a strong economic dependence on men, do not dictate that they can negotiate condom use which is a potential mitigating factor in the criminal offense of transmission.
  • Women who are already marginalized, i.e. sex workers and drug users, could be further targeted by the government through gaps in the law which would allow for the prosecution of positive people who "should reasonably know" that they have HIV.

Vulnerable Groups

  • Many people living with HIV are also men who have sex with men, transgenders, drug users, sex workers, prisoners, refugees, migrants and/or indigenous people and have specific needs and based on their additional identities. They often face increased stigma and discrimination, including increased likelihood of being criminalized, and frequently experience lack of access to quality prevention, sexual reproductive health and treatment and care services that adequately address their needs.
  • Opioid substitution therapy and other harm reduction services must be provided in conjunction with prevention, sexual reproductive health and treatment and care services to positive women and men who use drugs, including those in prisons.
  • In order to improve the effectiveness of HIV response, it is critical to promote the human rights and build the capacity of diverse groups of people living with HIV including women, men who have sex with men, injecting and other drug users, sex workers, indigenous peoples and others. They must be meaningfully involved in prevention, sexual reproductive health, treatment and support program and policy and research design, implementation, monitoring and evaluation.
  • Groups vulnerable to HIV infection are subject to oppression imposed by the government, in addition to suffering discrimination and stigma.

Governments should intensify effort to eliminate, through legislation, policies, education and national and international public awareness campaigns, and other measures, HIV/AIDS associated stigma and discrimination, and to protect and promote all human rights and fundamental freedoms of people living with HIV/AIDS, women, children, youth, and vulnerable groups including men who have sex with men, sex workers.


  
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This article was provided by Living 2008: The Positive Leadership Summit.
 
See Also
AIDS 2008 Newsroom



Please note: Knowledge about HIV changes rapidly. Note the date of this summary's publication, and before treating patients or employing any therapies described in these materials, verify all information independently. If you are a patient, please consult a doctor or other medical professional before acting on any of the information presented in this summary. For a complete listing of our most recent conference coverage, click here.

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