Today we mark World AIDS Day with our allies around the globe. It has been an incredible year for HIV prevention research. But with this year’s theme – Universal Access and Human Rights – as a reminder of global priorities, we wanted to share three of AVAC’s top issues that will shape our work in 2011.
First, the most clinically effective intervention, regardless of the approach, will fail to prevent a single infection in the absence of an environment of respect, legal protection and human rights for all. The rights of gay and transgender men who have sex with men are fundamental to any HIV prevention effort. Colleagues at the Global Forum for MSM & HIV reported earlier this week initial findings from a global survey of men who have sex with men, which showed that a majority of MSM find it difficult or impossible to access basic HIV prevention tools including HIV testing, HIV counseling, free condoms and free lubricant.
Stigma, discrimination and criminalization are major structural obstacles to providing these services to the people who need them most. Gay men and other men who have sex with men, transgender people and lesbians are leaders in the fight to end AIDS all over the world. Overturning and dismantling policies, laws and cultural norms that discriminate, criminalize and stigmatize these and other groups is a prevention strategy—perhaps the most important one of all.
Second, the effort to expand and improve HIV prevention programs is inextricably linked to robust HIV treatment efforts. Treatment access for HIV-positive people is essential. Sustaining and expanding programs to meet the needs of all people living with HIV, including providing prevention strategies for their HIV-negative partners, is a global imperative.
Third, success depends on solidarity. We do not always have to agree, and a vigorous discussion sometimes points the way forward. The current debates about the next steps for PrEP based on the iPrEx data are evidence of how many different conclusions can be drawn from a single trial result. (For more commentary on iPrEx and the possible ways forward, download No Turning Back: Pursuing the promise of HIV prevention, a recent opinion piece by AVAC’s Mitchell Warren.) There are also issues that can and should be readily resolved: it is not treatment v. prevention but universal access to treatment and prevention; rights of gay men are not only a challenge and priority in certain countries but everywhere; and while no new prevention strategy will be a silver bullet, new partially effective tools have promise that cannot be ignored.
We work with many advocates in this network every day to address these and many other concerns. As we reiterate our commitment this World AIDS Day, we also say thank you for all the work we’ve done together—and all the work that is still to come.