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Navi Pillay

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Time to Change Our Response to HIV

Posted: 07/19/2012 12:10 pm

The world's collective response to HIV three decades ago can be summed up in one word: shameful. At worst, people living with HIV were, inexplicably, chained to their beds, detained, turned away from medical facilities, criminalised and deported. At best, they lost their jobs, were kicked out of schools and denied access to basic services. We responded to a virus by humiliating, stigmatizing and punishing those infected. Our response to the virus was as painful, and sometimes as deadly as the virus itself.

Fortunately, impressive strides have since been made in the fight against HIV. In the last few years, major scientific advances have occurred and the number of new HIV infections, particularly among children, has been slowly declining, fewer people are dying from AIDS-related causes, nearly half of those people eligible for antiretroviral treatment, including in low- and middle-income countries, are now receiving it, and treatment has become the new engine for prevention. HIV is no longer the certain death sentence it once was.

And yet, the stigma and discrimination faced by HIV-positive people remains high, in every region of the world. Even today, we continue to focus on punitive approaches to HIV such as the criminalization of HIV transmission, non-disclosure and exposure. Entry restrictions against and deportation of HIV-positive non-nationals at borders are still far too common, particularly in the more affluent countries. The most vulnerable communities, the ones that least enjoy their fundamental human rights, also remain disproportionately more vulnerable to HIV infection -- and this is no coincidence.

The face of HIV has always been the face of our failure to protect human rights. One of the key drivers of AIDS has always been, and remains, this failure to ensure human rights protection for marginalised communities, including prisoners, sex workers, drug users, people with disabilities and migrants, refugees and asylum seekers. Homophobia, gender discrimination, racial profiling and violence against women have further impeded efforts to effectively manage and contain the spread of HIV.

The theme of this year's International AIDS Conference, which is being held in Washington D.C. later this month (July) is Turning the Tide Together. It is indeed now time to turn the tide. The human rights violations that have characterised the spread of HIV -- and in many cases also the fight against HIV -- must be curbed.

It is time to build on the gains of the past few years to create a sustainable global response to an epidemic that still challenges us. Taking a human rights perspective on the issue is essential.

The starting point is the recognition of all people as equal in the enjoyment of their human rights. Vulnerable populations that are most at risk must not only be included in national responses to HIV, they must also be given the opportunity to participate in making the policies that will affect them.

Human rights norms must accompany public health considerations to ensure that our laws, policies and programmes do not increase vulnerability to HIV or result in further human rights violations. Broad laws and policies in many countries that criminalize non-intentional HIV transmission, exposure and non-disclosure, target specific groups for mandatory HIV testing, and restrict travel of individuals based on HIV status alone are examples of such alarmist and misguided policies.

Advances in the right direction have been made, one of which -- the lifting of travel restrictions -- has enabled the United States to host this important AIDS conference this year, after 22 years. But much remains to be done. Even in States where laws are on the books to protect and promote the human rights of HIV-positive people, the extent to which they are respected and enforced is not clear.

More resources certainly need to be channelled into ensuring access to good quality lifesaving antiretroviral treatment, but also to human rights programmes, including awareness raising, training of healthcare providers and law enforcement officials, access to justice for HIV-positive individuals, fighting stigma and educating young people about safe sex.

Funding the fight against AIDS in this holistic fashion is not only necessary; it is also a human rights legal obligation. The current economic crisis cannot be an excuse for diminishing our investment in the response to AIDS. This would result in a reversal in the gains made so far.

This is not a time for complacency. UNAIDS has as its goal: zero new infections, zero AIDS-related deaths and zero discrimination. At this AIDS conference, a gathering of high-level government officials, civil society, the international community and, importantly, people living with HIV, it is essential to drive home the point that in order to succeed, human rights must inform and motivate our response.

 
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HUFFPOST SUPER USER
Zilo
Indie--The GOP opposes critical thinking
06:35 PM on 07/22/2012
I personally think de-stigmatizing homosexuality would be a huge step towards lower AIDS rates. Any behavior when treated as if it's dirty and unnatural when it's not is going to make the people engaging in it do more risky things while engaging in it. I blame that on the Reagan area conservatives for stigmatizing AIDS more than it had to be, thanks to their so-called religious "values."
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Amber Berglund
Just say "no" to shiny pants.
03:18 PM on 07/22/2012
HIV never caused AIDS. Period. People don't die from HIV, they die from AZT. They can't even find the HIV virus, they can only find HIV antibodies...and if your body is producing antibodies, that means your body is developing an immunity. If HIV is present, and someone dies from some other disease, they say they died from AIDS, if HIV is not present, and they died from the same some other disease, they say they died from that disease. There is no global standardized test for HIV...you can test positive in one clinic, and negative in another, depending on where you test and which lab they use. HIV/AIDS is an industry that generates a ton of money for a lot of people. It is a myth that HIV causes AIDS. AIDS in New York is a completely different thing than AIDS in Africa...and they don't even usually test for HIV in a lot of African countries! AIDS is a real syndrome, but there are a lot of factors that can cause AIDS...and HIV is not one of them. Poverty, lack of clean water, clean living spaces, mosquitos, living a fast-track lifestyle with a lot of drugs, lack of sleep contribute to the breakdown of the immune system. Want to remove the stigma from HIV? Stop blaming it for AIDS.
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jmounday
Don't believe anything you read below
01:47 PM on 07/22/2012
Stigma is not a bad thing.But removed it does expand ones capacity to injure others without responsibility.Doing my thing the 1960' battle cry.Well we have a society that requires stuff and things and more free stuff.

Bankers have removed the stigma of dishonesty from the board room.
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Zilo
Indie--The GOP opposes critical thinking
06:31 PM on 07/22/2012
Usually social stigmas are a bad thing. And they're usually driven by conservative "values" that are actually hate-based.
12:19 PM on 07/22/2012
yada yada yada... although i have much compassion for people suffering, i have none for the endless blaming of society for everything.
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RedBirdy
A right delayed is a right denied
06:36 AM on 07/22/2012
Some of these comments are insane. Yes, HIV is preventable. But in order to prevent HIV infection you need education and resources. Some people don't have the luxury of having health educators or condoms available. And I'm not just referring to those in African Countries. I'm also talking about many people right here in America. We throw money at abstinence only programs knowing how irresponsible and unrealistic it is.

Also, testing is important, but prevention is key. I did HIV testing and giving someone a positive result didn't mean they weren't going to infect someone. I've tested the range of folks, married, single, gay, straight, black, white, asian... and this disease certainly does not discriminate. I find most people could use an HIV 101 course.
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09:30 AM on 07/22/2012
i have been doing HIV/AIDS/STD Health Education for 17 years now. As part of our prevention program we have speakers living with HIV tell their personal stories to middle/high school kids to put a face and name with the disease. Make it personal.

Letting the kids hear a personal story of the life history of someone living with HIV, including peer pressure, fitting in, substance abuse (even experimentation), possible family issues ie abuse, divorce, all the bad choices and mistakes made, the diagnosis and then life with HIV including every aspect of living with it, is the MOST EFFECTIVE part of our program. Speakers have moved many a teen to change their current path and behavior to love themselves, respect themselves and protect themselves.
12:21 PM on 07/22/2012
again with education and resources...... i think people know the dangers by now...if they dont want to listen to them, its on them....
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sj-99999
"Nobody who works hard should be poor in America."
09:25 AM on 07/20/2012
Actually some of the highest infection rates, at least the last time I checked (early 2000s) were in Russia, not Sub-Saharan Africa.

I'd have to disagree with the staunch anti-mandatory testing viewpoint that the article's author professed but I know that many studies show it to not be entirely effective in prevention so...
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herdingcats2012
Trying to Control the Uncontrollable
11:05 PM on 07/19/2012
Finally--correlating our need to fight the spread of aids in the context of protecting human rights. Not long ago I heard an ad by Walgreens advertising they would now start performing aids testing. I was concerned. People at high risk of testing positive for aids are potentially THE most likely to be discriminated against if the results were inadvertently released. Does Walgreens have safeguards in place to protect patient privacy? Walgreens is first and foremost a retailer. I don't trust the retail industry to protect VERY sensitive patient information.
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09:33 AM on 07/22/2012
There is NO test for AIDS, there IS a test for HIV though. I think a HIV101 course is warranted for everyone including yourself. Nobody spreads AIDS, ONLY HIV. AIDS is the END result of HIV.
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Mike in Charlotte
Progressive and Christian...not an oxymoron
10:24 PM on 07/19/2012
Let's start with stopping the conflation of HIV and AIDS.
07:02 PM on 07/19/2012
HIV is the only Chronic Condition that is 100 percent preventable. You can not stop getting MS. You can not stop getting Breast Cancer. People do not want to take responsibility for their actions. People have free will to chose what they do with their lives and must face the consequences of their actions.
02:57 AM on 07/22/2012
It's not that simple, I'm afraid

HIV denialism, opposition to proper sex education, religious misinformation about the effectiveness of condoms, criminalisation of drug use etc...all contributes
04:41 AM on 07/22/2012
Criminalization of drug abuse makes AIDS...really?
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RedBirdy
A right delayed is a right denied
06:32 AM on 07/22/2012
I hope you're never infected, or with a partner who has been unfaithful and infected, because goodness knows it's not the simple. And the last thing you'd want someone telling you is ''face the consequences of your actions".
08:33 AM on 07/22/2012
My husband died from AIDS related complexes in 1991. He was infected before people knew how one receives the virus and it's causes. He didn't know that if you used a condom and protected safe sex practices chances are he would not get the virus. If he was negative and received the virus today, knowing what we know now and he chose not to use condoms or practice safe sex practices and he got the virus, it would have been a totally different story because he chose to ignore the knowledge that we have now. HIV is preventable. If you choose not to do everything to prevent it, then it is your choice.
06:22 PM on 07/19/2012
Translation the West needs to give more money to the world's poor.
02:58 AM on 07/22/2012
It'd probably be a more ethical use of funds than giving the money to destructive financial institutions and enormous military budgets.
the pariah
Author of "The Lean Pocket Diet"
05:02 PM on 07/19/2012
Do some research on how much money the US has spent on AIDS research. It is more than half of what is spent on ALL cancers combined yet there are 55x more deaths from cancer than AIDS.
10:59 AM on 07/20/2012
Isn't aids a little more noticeable than someone dieing of cancer.
the pariah
Author of "The Lean Pocket Diet"
12:21 PM on 07/20/2012
What are you talking about? It's dying, not dieing.
01:04 PM on 07/22/2012
Actually no. AIDS is a definition of an illness given to people who have 199 T-Cells or below or a group of illnesses classified as AIDS related illnesses. If you have 200 T-Cells or higher and no opportunistic diseases, you are HIV. People can die and be classified as HIV or be perfectly healthy such as Magic Johnson with AIDS. I suggest you look at people with Cancer and compare them to Magic Johnson and tell me who looks sicker.
02:58 AM on 07/22/2012
HIV is infectious, so it's understandable it would receive a lot of funds
01:05 PM on 07/22/2012
More people die from Tuburculosis or Hep C which is infectious.... and doesn't receive this kind of funds...
04:50 PM on 07/19/2012
Well the problems with getting better awareness of HIV and AIDs and breaking down the human rights barriers is that much of the ignorance to the disease and trampling of human rights is based on fear. This fear has come from government, organizations, from other people, etc. Fear will always trump human rights. Look at the Holocaust; is what happened to the Jews not brought on by fear, even if the fear was created by the Nazis and not based in reality? Same with the Japanese internment here in the U.S during WWII; people were rounded up based mainly on fear. Fear comes from the emotive part of the brain, and it's very hard to use reason to quelch that. Until the fear can be removed, it's going to be a steeper uphill battle.
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herdingcats2012
Trying to Control the Uncontrollable
11:19 PM on 07/19/2012
I think you've effectively identified why we need to focus on the issue from a human rights front. Fear. We have no idea how many people in our society are infected. I would like to submit the reason for this is because the fear of discrimination is so large people are not being tested. We can not hope to stop the transmission of HIV unless people are tested. Right now I don't even advocate for health care screenings for HIV like we do with mammograms or colon cancer because of society's current penchant to discriminate against people who test positive.
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HUFFPOST SUPER USER
Relentless rik
This country is SO screwed!
04:23 PM on 07/19/2012
I just wanna say, Navi, I loved you in 'Avatar'!
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Hedda Canty
cant type,or spell on most days...
03:49 PM on 07/19/2012
really some improvments have been made. u live with it and is controlled like any other diease. BUT...more is needed.and a whereness for tranmission. is still needed.
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Robert Cat
Low probability events occur
02:59 PM on 07/19/2012
We have bigger issues in this world to worry about than AIDS, like controlling the population.
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TeraWatt60
Cogito Ergo Sum
04:37 PM on 07/19/2012
The same Catholic Bishops whining about contraceptives for women also oppose the use of condoms even to stop AIDS...shows you just how skewed their priorities are...
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Robert Cat
Low probability events occur
08:00 PM on 07/19/2012
Of course, their thinking is skewed. These are adult men who are supposedly celibate, right? Why normal people would let such a group dictate to them about sexual matters is beyond me.
07:54 PM on 07/19/2012
AIDS does control the population.

But your essential point is not completely accurate...population growth is dropping all over the planet except in Africa and the Middle East. More TV is needed to stop the breeding. No, really.