The 19th International AIDS Conference (IAC) is being held this week in Washington, bringing together the world’s HIV and AIDS stakeholders in order to try to shape the global response to the epidemic. The world needs effective action and leadership to ‘Turn the Tide Together’ against HIV and AIDS, according to AVERT (AVERTing HIV and AIDS).

The Conference aims to present new scientific knowledge and advances, and offer the opportunity to discuss the major issues facing the global responses to HIV and AIDS.

Executive Director of UNAids, Michel Sidibé, in his opening speech claimed that ‘the end of the AIDS epidemic is in sight’, due to scientific advances in treatment and prevention with more people being treated now, than actually need treatment (8 out of 15 million people).  However, Sidibé also emphasised the stark reality that millions more are at risk of infection due to the social aspects of the disease such as poverty, gender inequality, homophobia, prejudice and funding shortages. Adding that

‘It is outrageous that in 2012, when we have all the tools to beat the epidemic, we still have to fight the prejudice, stigma, discrimination, exclusion and criminalisation, not only in homes, but in streets, police stations and courtrooms. This is impossible for me to understand’.

The International AIDS Conference is the world’s largest forum for the discussion of HIV and AIDS-related policy and practice. It is being held in the US this year in order to recognise President Obama’s decision in 2009 to lift the travel ban on people living with HIV from entering the US.

However, there is still US legislation that bans sex workers from entering the country and therefore excluding these communities from the debates that directly concern their lives – despite the emphasis made on the social stigma and discrimination that the virus brings.

In response to this, sex workers from more than 40 countries are meeting in Kolkata in India this week to attend an alternative AIDS Summit – the Sex Workers Freedom Festival, with the official slogan ‘Save us from our Saviours’. According to Prasada Rao, UN Special Envoy for HIV and AIDS in Asia-Pacific,

‘these two groups [sex workers and drug users] have to be central to the global response to HIV, and their absence make any discourse on HIV and AIDS insufficient and not meaningful. While the IAC in Washington will have a large gathering of AIDS activists, the exclusion of two important communities robs it of the universality of its message. They have literally been forced into organising a separate conference instead of participating in the main event in Washington…IT shows that the battle for recognition of their rights is still a long and arduous one, and stigma and discrimination are still overriding issues for vulnerable communities’.

Whether or not sex work is legal or illegal this group of people exists and they are still one of the most vulnerable groups to the HIV and AIDS. Where regional data is difficult to reliably capture, an example of the magnitude of sex work in can be found from the Commission on AIDS in Asia which reported that there are an estimated 10 million sex workers in Asia, and 75 million male clients. For a marginalised and often criminalised population, debates about the spread of HIV and drivers of the epidemic are levelled at sex workers, stigmatising them further as the core transmitters of the virus. Sex workers should be acknowledged in coordination processes like the IAC that seek to remove barriers to HIV prevention campaigns. Avert acknowledges the obvious gains that are to be made:

Prevention campaigns aimed at sex workers not only reduce the number of HIV infections that result from paid sex; they can also play a vital role in restricting the overall spread of HIV in a country. Proof of this can be seen in countries such as Bangladesh, Benin, Cambodia, the Dominican Republic, India and Thailand, where general reductions in the national HIV prevalence have been largely attributed to HIV prevention initiatives aimed at sex workers and their clients.

The Sex Workers Freedom Festival, which has been organised by the Durbar Mahila Samanwaya Committee, (represents 65,000 male, female and transgender sex workers in West Bengal, India) has been made an official IAC ‘hub’ and will be connected to Washington by videolink, however, it has its own agenda with a focus on key freedoms such as the freedom to move and migrate, access to quality health care, and freedom from stigma and discrimination.

What will be the outcome? What decisions will be made? Watch this space…

Is the end in sight?

So, is Sidibé right? Is the end of the AIDS epidemic in sight? According to Scientists from International AIDS Society, the end is in sight, that it is time to go for a cure – that this is the best hope. Most scientists and drug companies have been focusing on treatment to keep the virus under control, due to the fact that the virus itself is so elusive and smart.  Read more from Sarah Boseley’s Global Health blog on the Guardian newspaper about the potential for a ‘cure’, including the opinion of Francoise Barré-Sinoussi, the Nobel prize laureate and co-discoverer of the virus, who is one of the key players in the campaign for a cure.

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