23 July

The AIDS quilt

`Twenty-five years after the first panel was sewn in memory of Marvin Feldman, the AIDS memorial quilt returned to Washington yesterday.  It was a fitting start to the World AIDS Conference, putting the task ahead in the next five days in sobering context.'

`The Quilt has been on constant display somewhere in the world from the days those early panels were sewn by people grieving loved ones lost to HIV.

Each panel is three feet by six feet – roughly the size of a grave. The Quilt now covers almost 1.3 billion square feet, and if laid end to end, the panels would stretch for 55 miles.

Laid out on the National Mall they are a powerful call to action and an inspiring, heart-breaking statement of loss, love, pride and grief.

Walking round them yesterday, as a roll-call of names was read out from the stage, I was struck by the beauty, creativity and endless variety of the panels.

It’s impossible not be moved by this early response to HIV, and the vision of people determined to inspire action in the face of a terrifying epidemic.

We’ve come a long way. Treatment keeps people alive in countries that can afford it. Few new panels are sewn now.

But have we lost something along the journey? Are we still able to humanise the impact of HIV, to count its personal cost?

Or do we rely too often on the crutch of statistics, of numbers diagnosed, as the backbone of our narrative today?

In that context, The Quilt is much more than a beautiful memorial, it’s still the call to action that it’s ever been.

As I head into the first sessions of the World AIDS Conference this morning I’ll take that question with me, and hope to find some of the answers inside.'

Ken Mayer research

`If you're a black man having sex with men (MSM) in the US, you and your peers make up 1% of the population. You're also in the group accounting for 20% of new HIV infections.

This stark fact prompted researchers to look further into the reasons behind these high rates of HIV infection and their findings, presented to the conference, contained some surprises.

Eighty-eight % of the men taking part in the study had no prior HIV diagnosis, and 96% agreed to test for HIV, gonorrhea, chlamydia and syphilis at the start.

Researchers grouped the men into three categories - those with an existing HIV diagnosis, those with a new diagnosis, and those who tested negative for HIV.

The men with an existing diagnosis were more likely to identify as gay, and were also older than the negative men, as well as more likely to be unemployed and living in poverty.

They were also more likely to use poppers, to have another sexually transmitted infection (STI) and have a religious affiliation.

The men newly diagnosed with HIV, were more likely to have had undiagnosed and untreated HIV for some time - a chronic infection. They were also older than the HIV negative men, and again, poverty and unemployment was a significant factor.

Ken Mayer, an author of the research said "In these men, having another STI increased their risk of HIV two-fold. If they had more than one STI, their risk increased six-fold."

Researchers pointed to an urgent need for culturally tailored HIV prevention methods for black MSM. They also recognised that anti-poverty measures are vital, and suggested that the US could learn lessons from successful credit unions running in many African countries.'

Sir Elton John

`Every World AIDS Conference attracts one or two delegates who are well know faces from the worlds of politics and entertainment.

They are very welcome, and provide a little additional sparkle for those who haven't yet made it to the global village (where sparkle abounds).

On Monday, the conference was addressed by someone known around the world for his musical gifts - Sir Elton John. But it wasn't his talent on the piano delegates packed out the main hall to hear. It was his views as the founder of the Elton John AIDS Foundation which funds HIV projects in the UK and overseas.

His passion was evident as was his frustration with prejudice and inaction. He talked of the power of love to halt the epidemic and to support those living with HIV around the world.

"It sickens me, all this hate, all this fear" he said, before going on to hail the efforts of people all over the world, often working against extreme prejudice and injustice.

"I know that Jesus is smiling down on them, whatever the Vatican might say" he added, to cheers and applause from the floor. And he urged governments to do more, faster, to end the spread of HIV. "American could put a stop to HIV in a heat-beat" he said.

It was an impressive, informed performance from someone who cares deeply for the work that he funds.

In the UK, his foundation's largest UK grant went to our charity, Terrence Higgins Trust. It funded www.myhiv.org.uk an incredible interactive online service to help people living with HIV to live healthy lives.

MyHIV also hosts one of the largest, most vibrant online communities of people with HIV, facilitating peer support, advice and friendship to the newly-diagnosed and those who have had HIV for years. It's a remarkable service, making a real difference to the lives of people with HIV in the UK every single day.

So, thank you, Sir Elton, for coming to Washington to share your passion and insight. You struck exactly the right chord. '

Genevieve Edwards
Executive Director of Communications, Fundraising, and Health Improvement

The beginning of the end?

`The message rang out loud and clear on this first day of the 2012 International AIDS Society Conference in Washington D.C. – this was to be the Conference that heralded the beginning of the end of AIDS. Dr. Anthony Fauci set the scene in the opening plenary session by highlighting the biomedical milestones of the epidemic, with the incredible advances made in anti-retroviral treatment over the last fifteen years.'

`These advances have brought us to the point where treatment is able to stop the virus in its tracks not only within the person that is living with HIV, but that it does so to the extent that effective viral suppression also halts possible transmission to an unborn child or a sexual partner.

However, he was clear that there was much more work needed to reduce the current levels of onward transmission and to diagnose the millions that do not yet know they have the virus, a recurrent theme throughout the day, including in Sir Elton John’s keynote speech, which pleaded for love and compassion to bring an end to the epidemic and the social injustices that fuel it.

Following an impassioned speech from the CEO of the Black AIDS Institute on the need to deal more effectively with the domestic epidemic, US Secretary of State Hillary Clinton re-affirmed President Obama’s commitment towards creating an AIDS-free generation. While (unsurprisingly for an International AIDS Conference) she was greeted with protest from a section of the audience, the standing ovation she received and her acknowledgement of the history of activism in the AIDS response enabled her to set out the many steps that will be needed to translate this commitment into a reality.

Whilst also acknowledging the difficulties in getting to zero new HIV infections, zero discrimination and zero AIDS deaths, many of the Community Program sessions also sounded notes of cautious optimism.

Increasing accountability and taking a human rights-based approach

Effective biomedical strategies were recognized as showing great promise in preventing onward transmission and reducing community viral load, but the need to protect and strengthen human rights was a recurring theme in relation to how this strategy would need to move forward.

Accountability and genuine community engagement and partnership in designing, implementing and disseminating research trials and prevention strategies were highlighted in a number of sessions, echoing Sir Elton John’s call for a humane and compassionate response that includes those communities which are most affected throughout the world and who are often the most disenfranchised and marginalized.

The Regional Session for Eastern Europe and Central Asia offered a demonstration of what happens when this approach is not taken, where punitive laws on drug use and refusals to implement harm reduction strategies are resulting in the region’s status as the area in the world where the epidemic is increasing most rapidly.

Similarly, punitive laws in relation to homosexual acts in Africa and the Caribbean were highlighted as being an area of great concern where ensuring access to care and treatment are concerned. The next days of the conference will have no shortage of discussions of these issues and the need to take a different approach if meaningful progress is to be made within all sections of the population.

Several sessions demonstrated some of the tools to advocate for this change and for the greater involvement of people with HIV and key affected populations. These ranged from policy and advocacy resource tools to the use of social media to inform and educate, to challenge stigma and discrimination and to effect change.

In the Youth track as well, participation, engagement and Leadership development were the keywords in ensuring that the younger generation is able to take ownership and personal responsibility in playing their part in the response.'

Garry Brough
Policy & Public Affairs
Membership Officer