HIV and the Law

via the Global Commission on HIV and the Law

The end of the global AIDS epidemic is within our reach. This will only be possible if science and action are accompanied by a tangible commitment to respecting human dignity and ending injustice.

Law prohibits or permits specific behaviours, and in so doing, it shapes politics, economics and society. The law can be a human good that makes a material diff erence in people’s lives. It is therefore not surprising that law has the power to bridge the gap between vulnerability and resilience to HIV.

We came together as a group of individuals from diverse backgrounds, experiences and continents to examine the role of the law in eff ective HIV responses. What we share is our abiding commitment to public health and social justice. We have listened with humility to hundreds of accounts describing the eff ects of law on HIV. In many instances, we have been overwhelmed by how archaic, insensitive laws are violating human rights, challenging rational public health responses and eroding social fabric. At other times, we have been moved by those who demonstrate courage and conviction to protect those most vulnerable in
our societies.

Many would say that the law can be complex and challenging and is best left alone. Our experience during this Commission has shown us a very different perspective. We have been encouraged by how frank and constructive dialogue on controversial issues can sometimes quickly lead to progressive law reform, the eff ective defence of legislation or better enforcement of existing laws. Even in environments where formal legal change is a slow and arduous process, we have witnessed countries taking action to strengthen access to justice and challenge stigma and discrimination.

Click here for the full report.


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Don't Delay HIV Prevention for Gay and Bi Men

via The Huffington Post, by David Ernesto Munar

Lives will be saved when the Food and Drug Administration puts its stamp of approval on a groundbreaking preventative approach called pre-exposure prophylaxis, or PrEP, recently found to reduce HIV infections.

With PrEP, people who are not infected with HIV take a daily pill, usually used to treat the disease, to help prevent infection -- as part of a broad HIV prevention approach that includes condoms and safer-sex counseling.

But the longer the FDA waits before beginning its review of the HIV medication Truvada for prevention, the more lives will be unnecessarily lost. This is particularly true for those at greatest risk: gay and bisexual men.
We urge the FDA to immediately begin its review for approval of Truvada for PrEP for gay and bisexual men.

Last year the iPrEX trial, touted as the scientific breakthrough of the year by TIME magazine, found that gay, bi and other men who have sex with men who took Truvada, along with counseling and condoms, had 42 percent fewer HIV infections than with counseling and condoms alone. Among those who used the prevention pill most consistently, the drop in infections was far greater.

And remember the sobering context: between 2006 and 2009, the number of young gay African-American men infected with HIV in the United States increased by 48 percent, according to the U.S. Centers for Disease Control.

Read the rest.


[Content that is linked from other sources is for informational purposes and should not construe a Mapping Pathways position.]

HIV Prevention and LGBT Communities: Syndemics, Resilience, and Real Change

How can justice be better served for the lesbian, gay, bisexual and/or transgender (LGBT) community? This remains one of the biggest questions in the US – the last few months have seen a country-wide discussion on this issue, sparked off by what is being called an “epidemic” of suicides by gay teenagers.[1] “People are talking about the important ways through which the US, in the coming generation, can begin to honor the rights of LGBT communities – I believe, in time, that would reduce the incidence of HIV infection,” says Julie Davids, Director of National Advocacy and Mobilization at the AIDS Foundation of Chicago and Coordinator at the HIV Prevention Justice Alliance.

There is strong data on the “syndemics” phenomenon[2] (synchronous epidemics) in the lives of gay men. Gay men often face violence, abuse, marginalization and rejection by parents, friends and peers – there is compelling data that these conditions make them far more vulnerable later in life to substance use and abuse, intimate partner violence, and contracting HIV. The syndemics discussion has also led to an increasing focus on the idea of resilience. Says Julie, “Although HIV is very widespread among gay men, the majority of gay men are not HIV positive – what helps them remain HIV negative? As someone who believes very strongly in the idea of gay and queer liberation, I believe that members of LGBT communities create resilience, have innovative ways of living and of structuring families and lives that can be extended to broader society for better health outcomes and happier lives.”

There is a concerted effort to steer prevention efforts away from an earlier reliance on fear tactics and a vocabulary based on vulnerability. The gay men’s health movement and their allies in the HIV/AIDS community are increasingly emphasizing resilience and trying to create a scale of measuring this quality in the lives of gay men – and hopefully extend this to other communities as well. “There are a number of programs – like Project CRYSP, Lifelube, the Gay Men’s Health Crisis, and the Gay Men's Health Summit – that confront the conditions that drive the syndemic among gay men and build resilience and resourcefulness in gay communities[3]. Other projects doing fantastic work in this field include the Gay City Health Project in Seattle, Magnet in San Francisco, and William Way in Philadelphia,” says Jim Pickett, Director of Prevention Advocacy and Gay Men's Health at the AIDS Foundation of Chicago, chair of IRMA, and a member of the Mapping Pathways team. In fact, Jim recently checked in with Dr. Ron Stall, an expert in gay men’s health, to get his views on syndemics and the HIV/AIDS epidemic among gay youth and adults, as well as the idea of resilience. You can read the eye-opening interview here.

The approach to HIV prevention could also benefit from elements of asset-based community development: focusing on the assets of a community, the skills and experiences that are available, can help illuminate the path forward and create sustainable solutions.

“We can’t do it all on our own though,” says Julie, “so it’s important to continue to push for government policies that honor the human rights of all people – specially now that there is a focus on the impact of bullying of LGBT people. We need to made sure doesn’t just end up contributing to mass imprisonment – another social driver of HIV in our country. Creating merely a punitive system doesn’t really solve the problem – it just results in more imprisonment, thus exacerbating health issues like HIV. Many people who are bullies have been bullied themselves. We need policies and mechanisms to increase parental acceptance of gay and gender variant children, strengthen communities to support all their LGBT members rather than rejecting them, and help people proactively stand up to bullying. Addressing the root causes will bring about real, long-term change.”

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[1] To know more, take a look at The New York Times’ “Coming Out” project, which captures compelling first-person accounts by gay teenagers.

[2] Syndemics: A set of linked health problems involving two or more health conditions, interacting synergistically, and contributing to excess burden of disease in a population. Learn more about the syndemic among gay men that drive the HIV/AIDS epidemic by accessing Ron Stall’s presentation here.

[3] Take a look at Jim Pickett’s presentation on this here.

[Content that is linked from other sources is for informational purposes and should not construe a Mapping Pathways position.]