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Robert Carr Doctrine

Robert Carr Doctrine

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Published by: Sergio Nahuel Candido on Jul 25, 2012
Copyright:Attribution Non-commercial


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Robert Carr
Principles for a Meaningful Response to HIV Among the World’s Key Affected Populations  
RE-THINK the problem
HIV and AIDS are byproducts of social inequity.
The HIV epidemic has taken its heaviest toll on socially,fnancially, politically, and legally marginalizedcommunities:Gay men and other men who have sex with men(MSM)Sex workersPeople who use drugsTransgender peopleThis epidemiologic act is the biological maniestationo social ault lines. Gay men and other MSM, peoplewho inject drugs, sex workers, and transgender peopleare legally marginalized and socially stigmatized, andare commonly the targets o discrimination and brutalviolence worldwide. Experiences o marginalization,stigma, discrimination, and violence are compoundedor people living with HIV. Criminalization o HIV trans-mission, HIV exposure, and non-disclosure is oten aproxy or broader human rights abuses aimed at MSM,people who use drugs, sex workers, and transgender people. Stigma, discrimination, criminalization, andviolence hinder access to vital inormation, services,and support or the populations that need them most,undermining the overall HIV response.
RE-STRUCTURE the response
HIV is not just a public health issue.
The current response to the epidemic is underpinned bythe aulty assumption that HIV is solely a public healthissue. Eorts to address the epidemic are thereore cen-tered on a narrow range o actors and strategies. In reality,the epidemic is a symptom o underlying societal inequi-ties and injustices. A National AIDS Council that prioritizeskey aected populations is severely compromised whenthe rest o that country’s government continues to arrest,harass, and violate the rights o MSM, people whouse drugs, sex workers, and transgender peo-ple, including those living with HIV. Similarly, sci-entifc advances in HIV prevention and treat-ment, while welcomed and strongly encouraged,are wasted when communities shouldering a dis-proportionate HIV disease burden are blatantlydenied access to services or cannot access themsaely. Bilateral and multilateral unding strat-egies that ail to prioritize investment towardhardest-hit populations, civil society advocacy, and com-munity development will inevitably all short o achiev-ing an “AIDS-Free Generation.” Structural actors drivethe HIV epidemic, so our solutions must address thoseactors as well. Small-scale interventions targeted at theindividual level are important, but they are not enough.
RECLAIM the movement
HIV is a human rights issue—we all have a “right to be.” 
All human beings, by virtue o their humanity, are bornequal in dignity and rights. Yet afrmation o the humanrights o MSM, people who use drugs, sex workers, andtransgender people has provoked denials, excuses, vit-riolic statements, and draconian legislation by govern-ments around the world. We hear about “values” and“religion” and “morality” and “tradition” and “goodsociety” and “sovereignty” as reasons to perpetuateindierence and oppression. Denial o human rights,police brutality, and discriminatory laws become ac-ceptable i they apply to MSM, people who use drugs,sex workers, and transgender people. We emphaticallyreject these alse notions.The end o the HIV epidemic lies with our capacity to develop targeted, tactical, and multi-tiered approaches. Interventionsand services are needed at the biological, behavioral, interpersonal, amilial, community, social, cultural, and legal levels. Allstakeholders, at multiple levels, must act comprehensively, concurrently, over a sustained period o time, and with respect tothe HUMAN RIGHTS and DIGNITY o MSM, people who use drugs, sex workers, and transgender people, including thoseliving with HIV. Although difcult, COALITION work is transormative, and holds the key to unlocking our collective potentialto end the epidemic. Ultimately, our success depends on how well we can work together to respond to those most in need.

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