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 workers• People who use drugs• Transgender peopleThis epidemiologic act is the biological maniestationo 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 compoundedor people living with HIV. Criminalization o HIV trans-mission, HIV exposure, and non-disclosure is oten 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 inormation, 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. Eorts to address the epidemic are thereore 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 aected 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 themsaely. 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 thoseactors 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 afrmation 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 perpetuateindierence 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 difcult, COALITION work is transormative, 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.