August - September 2016
Positively UK

AIDS 2016

For this month’s newsletter, we are going to focus on the 21st International AIDS Conference held in Durban last month, known as AIDS 2016.

The International AIDS Conference is the largest conference on any global health issue in the world, and is the leading gathering of people living with and working in the field of HIV.  It provides a unique forum for the intersection of science, advocacy, and human rights.

The theme for AIDS 2016 was Access Equity Rights Now, and aimed to establish a clear path towards guaranteeing that no one is left behind in the global response to HIV.  It was attended by more than 15,000 participants from 153 countries, including UN Secretary-General Ban Ki-moon, actor and activist Charlize Theron, singer and philanthropist Sir Elton John, and Bill & Melinda Gates Foundation Chair Bill Gates; and most importantly Positively UK staff.
Positively UK staff weren’t just attending the conference as delegates, but were also speaking there.  Sophie Strachan took part in a panel focussing on an extremely neglected, yet critical, issue for true empowerment of communities and for successful HIV programmes – self-stigma.

The Stigma Survey UK 2015 found that around half of people living with HIV in this country reported feeling shame, guilt or self-blame in relation to their HIV status.  Although inherently connected to social stigma and discrimination, self-stigma needs to be understood and addressed in its own right.

This issue is under-recognised, under-researched and imperfectly understood and yet, at the same time, plays an immensely powerful role in silencing us and keeping us fearful, ashamed and blocks us from testing, treatment, self-acceptance and support.

You can watch a video of the session below:

5 take-home messages from AIDS 2016

There has already been a lot of excellent coverage of what went on and what was discussed at AIDS 2016, and we don’t want to just repeat that here.  Rather we decided to pick out what were the top 5 take-home messages which are relevant to the ongoing work Positively UK does.  Peer support is a crucial element within all of these, and addressing self-stigma a recurrent theme in what we need to do, as a community, to break down one of the largest blockages in our way.  Our 5 take-home messages are:

Achieving 90/90/90 requires the whole community

The UNAIDS 90/90/90 target calls on countries to achieve 90% of people living with HIV diagnosed; 90% of diagnosed people on antiretroviral treatment; and 90% of those on treatment having undetectable viral load.

The take away from AIDS 2016 was that these ambitious targets cannot be reached by simply throwing more money or medication at HIV, but rather that the community of people living with HIV are a crucial partner in ensuring that people are supported in living well with HIV.  When it comes to HIV, one size treatment does not fit all, and for interventions to be effective the community has to be integrated into testing, starting medication and supporting adherence.

Health programmes will fail until there are better human rights for all

A key take away from the conference’s theme of Access Equity Rights Now was that better human rights for marginalised groups are essential for health programmes to be successfully implemented.  This is especially true for people from some of the key populations in accessing and taking HIV treatment, including women, young people, LGBT+ people, people who use drugs, sex workers and prisoners.

Both in the UK and overseas, people from these groups face life where they have to cope with higher levels of criminalisation than the rest of the population.  These extra laws are not only an attack on their basic human rights, but also limit the potential effectiveness of any health and wellbeing support programmes or initiatives.  The criminalization of sex workers, same sex acts, trans bodies, and drug use, have a major negative impact on public health.  This is shown in how inequality between those with access to HIV services and those marginalized seems to be widening.

This also applies to specific HIV criminalisation laws, which are ineffective and hold the whole community back.

Working in silos diminishes the community

While it is important to always remember that different groups have specific issues and difficulties, the community has to work and campaign together as people living with HIV if meaningful change is going to happen.  Working in silos separates and diminishes the whole community’s effectiveness, and leads to people being left behind, often the most vulnerable among us.

For HIV interventions to be successful they must have integrated approaches, involving the whole community of people living with HIV.  A key aspect of achieving this comes from recognising the commonalities amongst the experiences and difficulties which the community faces and producing a united response to these challenges.

Care needs to consider wider health and wellbeing needs

This joined up thinking needs to extend beyond our advocacy for HIV care, we need to advocate more effectively for the community’s wider health and wellbeing needs.  This is even more important in the face of reduced funding for health care and support, and the constant demands placed upon healthcare to do more with less.  This advocacy needs to include both improvements in people’s wider health, including support for issues such as diabetes and cardiovascular disease among the community, but also wider wellbeing issues such as poverty and nutrition.

As was emphasised beautifully by Dr Coutinho in Tuesday morning's Plenary session, funding health systems is not the way forward, rather we need to create holistic systems for health.  These systems must include health and social care workers, community health workers, peer supporters, activist/advocates and family involvement.  The community of people living with HIV must be an integral part of the system in supporting good health.

Young people are the future campaigners and activists

Young people are already showing themselves to be the next generation of campaigners and activists, and the rest of the community needs to support and engage with them to make sure that all the changes we achieve will be meaningful and impactful for them and the generations to come.

It is vital for the future that young people are fully integrated into the community at every level of decision making.  With proper training, support and mentoring from the rest of the community, young people have an enormous amount of potential to improve the lives of everyone living with HIV.  One young panellist Loyce Maturu of Zimbabwe summed this up by saying “stop thinking of young people as beneficiaries, and start seeing us as partners in the effort to end AIDS by 2030.
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