George Ayala (Credit: MPact)
In September, we reported that networks worldwide of people living with HIV/AIDS, sex workers, and drug users were calling for an "alternative" 2020 international AIDS conference outside the U.S. to protest that the traditional biennial one is being held in the Bay Area despite the fact that people from Muslim-majority countries may have a hard time getting into the U.S. for the conference. In addition, sex workers and people who use drugs -- populations that intersect with HIV work -- are not allowed into the U.S. unless they (essentially) lie on their admission paperwork.
Well, on December 10, a coalition of those networks announced HIV 2020: Community Reclaiming the Global Response, to be held in Mexico City July 6 to 8, 2020, concurrent with the first two days of the traditional conference in the Bay Area. In other words, the alternative, people-living-with-HIV/AIDS-focused conference is definitely happening. We hopped on Skype with one of the key organizers, George Ayala, Psy.D., executive director of MPact Global Action for Gay Men's Health and Rights, to get more details.
Tim Murphy: Thanks for hopping on Skype from Amsterdam, George. So, tell us everything you know so far about the alternative conference.
George Ayala: We deliberately set the dates for the front end of the international conference, partly because there's going to be a handful of people who want to attend both. We're still researching possible venues in Mexico City. I have some steering committee members who are connected with the new president [of Mexico, Andrés Manuel López Obrador] and his administration, and they've given us every indication that they're open to hosting. We think that Mexico is a little easier to get into if you're a sex worker or a person who uses drugs. Their immigration website says they'll deny entry for anyone who has a criminal record, but I don't think they ask at the border like the U.S. does. It's not ideal, but it's easier than the U.S., plus it's in a time zone that would permit an easy connection to the Bay Area if we want to open up lines of communication. There may be an opportunity for us to co-program or telecast our keynote speaker to the main conference and vice versa.
TM: What is the programming for the alternative conference?
GA: In January, we'll set up three big working groups: communications, fundraising, and programming. There is plenty of opportunity for anyone who's interested to get involved. [Scroll down to "Join the Team."] We're going to shine a spotlight on communities and their role in the global HIV response, and we're going to emphasize peer exchange, which is not typically seen at these international AIDS conferences. But in terms of specific content, we're not there yet.
TM: What will be the key issues central to the programming?
GA: Structural barriers to HIV services and the need for us to reframe the global HIV response within a broader discussion about sexual and reproductive health, particularly for key populations including gay men, sex workers, trans women, and people who use drugs. We'll talk about strategies that bring movements together, like how is HIV a racial justice issue, or how can we think about it from an economic justice perspective? Should the HIV movement be working toward universal health coverage? The debate about the traditional conference being in the U.S. reveals some of this. Why is it okay to have a conference in a country that would openly discriminate against people who use drugs and sex workers?
TM: How have the organizers of the traditional conference answered that question?
GA: I think they get embarrassed by it. They said that if the U.S. decided to reinstate the ban on entry into the country among HIV-positive people, they would move the conference, but when we asked, "Why are legal barriers for sex workers and drug users okay?", they basically said, "That's different." There's a double standard. The main conference's main constituents are public health officials and researchers whose main purpose is to feature their own work. Through the years, there's been this trend to sideline community in favor of science-based discussions, but without community assent, the best interventions in the world won't get anywhere.
TM: Do you have an estimate on the number of participants and also the cost?
GA: As for participants, as low as 800, with a goal of 2,500 -- but your guess right now is as good as mine. It's all going to be about how much money we raise. We want to make this as accessible as possible and bring folks who otherwise would not participate. We want to raise enough money to support the travel and accommodations of half of the attendees.
TM: Will you take money from Big Pharma if they offer?
GA: Absolutely, as long as the money is given without strings attached, which in my experience Big Pharma is willing to do. We've been in early conversations with ViiV, so we have reason to believe they'll give us some funding. We have some early inroads with Gilead, and the Open Society Foundations have asked us to come back to them in February or March. We're also talking to the Dutch foreign ministry. Starting in January, you'll see more of a drumbeat about the alternative event, and that'll help keep visibility up.
TM: Will the event be fun?
GA: Yes! I think so. What excites me most is the opportunity to be in community. It's so rare for such a diverse coalition to come together to talk about cross-cutting issues that are impacting everyone. Some of the most exciting work the past few years is with sex workers and people who inject drugs around the world. But when we show up to these big international conferences, we're siloed into the Global Village [community-focused section of the traditional conference]. There's very little opportunity to have true peer-to-peer exchange.
TM: Can you give some examples of the exciting work going on among drug users and sex workers?
GA: In countries like Kenya, Kyrgyzstan, Indonesia, and South Africa, key-population technical working groups are popping up and influencing their countries' national AIDS plans, with funding going to community groups led by sex workers. We're seeing more harm-reduction programs sensitive to gay men, more gender-based programming sensitive to trans women rather than just for cisgender women and girls. Pre-exposure prophylaxis (PrEP) programs are springing up for both gay men and trans women.
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