Incidence, prevalence, laws and policies show: “We in fact are being left behind”
DURBAN, South Africa – What if, as global HIV program leaders pursue unprecedented goals to close testing and treatment gaps, international donors cut their contributions to efforts in the hardest hit countries, leaving governments of those countries to pick up the slack? And what if many of those governments already were harming their most vulnerable citizens with laws that criminalize their identities?
Since that is a real, rather than hypothetical, situation in countries around the world with laws, policies, and institutionalized discriminatory neglect of gay and bisexual men, the resulting needs and demands were the subject of a pre-conference event here over the weekend leading up to AIDS 2016. Put together by MSMGF — the Global Forum on MSM and HIV — the daylong program highlighted how missing information and input continue to enable human rights abuses, and stall success in “ending AIDS.”
At a time when ambitions to double current access to HIV testing and effective treatment have seen drops in new infections and deaths in countries around the world, those numbers are on the rise among gay and bisexual men, speakers noted. “We in fact are being left behind,” International AIDS Society President Chris Beyrer said.
Some of the reasons are well known — bias and discrimination that make health settings hostile, antigay laws that make accessing HIV prevention, testing and treatment daunting, difficult or impossible, and a paucity of funding for peer-led programs — although they are known to be effective. But at the same time, few are well documented.
When, for instance, Meg Davis of NYU Center for Global Justice and Human Rights set out to discover the impacts of punitive laws on global HIV indicators, she learned surprising news. And that was that no one had bothered to find out. “No UN agency,” she said, “had done this basic mapping.”
She discovered that the impacts of laws against same-sex relationships were not only damaging but convolutedly misleading. Who would expect, for one thing, that countries with the harshest antigay laws had the highest testing and treatment coverage rates for men who have sex with men? The answer to how that could be may be obvious, but all the same had been hidden: those countries had, for, again obvious reasons, gravely undercounted the total of the population in question.
That’s one of the missing links that will have to be connected for awareness, funding, and finally services to match need, speakers reiterated.
How much more effective are chances to take an HIV test, counseling, clinic visits, access to lifelong treatment when offered by peers, rather than by ignorant, as well as intolerant of your needs? Again, obvious, but undocumented.
And how much are donors missing, when they plan programs without the active and informed participation of people who will need the services they’re funding? That was the driving topic Saturday, as activists discussed efforts, nominal and in progress on the part of in-country offices of the President’s Emergency Plan for AIDS Relief, meeting requirements put in place two years ago mandating local input to local responses.
Stay tuned: AIDS 2016 this week has scheduled an unprecedented three plenary speakers representing sexual minorities dealing addressing gaps in global HIV responses.