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Staying the course of eradicating HIV/Aids
What we need to do straight away
We need to stop detaching the human face from the way we engage in HIV-related interventions. We need to understand that when we decide to work towards eradicating HIV/Aids there are human beings involved. “We must never forget that any woman or man always has a particular race or ethnic background, class identification, age, sexual orientation or preference and religion. The combination of these identities will inform and modify each of them separately and in combination with each other. Race, class and sexuality are each modified, qualified and informed by each other characteristics or identities that comprise the individual and no one of them can exist in isolation,” (Rothenberg, page iii). In the fight to eradicate HIV/Aids there is need to “adopt a model for thought that posits continuums, complexities and embraces contradictions,” (Rothenberg, page iv).
Squarely facing vulnerabilities unique to HIV; ideas on staying the course of eradicating HIV/Aids
It is coming to four decades since the first HIV/Aids diagnosis. Many observations have influenced the way interventions are provided. Gone are the days when fear of sharing eating utensils with persons living with HIV/Aids formed basis for isolation, discrimination and neglect by those who were supposed to have given care. Gone are the days when it was thought coughing or sharing clothes or a mosquito bite causes HIV.
Some vulnerability case scenarios (building the broader perspectives)
1. Juliet is a 22 year old pregnant woman with 2 other children. Both children were fathered by different men. Her recent male partner beat her that she had to be hospitalized. In the hospital, Juliet was diagnosed with HIV/Aids and TB. Planned interventions include: providing care for person; managing trauma; enrolling Juliet to medications and care that will stop transmission of HIV to the unborn; linking with welfare support, police and legal bodies.
2. Koala is an HIV/Aids intervention organization. It is planning its HIV/Aids clinical trials networks partnerships. It is involved in extensive consultations with policy makers, religious bodies, researchers, clinicians, nurses, patient advocates, community care workers, community-based resource persons, activists, and people living with HIV or at risk for infection. The planned activities include: garnering support; building referral mechanisms,mobilizing and enrolling volunteers; the treatment and prevention of other opportunistic diseases such asmalaria, tuberculosis and hepatitis which are significant co-infections for people who are infected with HIV or at risk for infection.
3. Shaka is a 35 year old man, an asylum seeker and is living with HIV/Aids. He sought the services for HIV-related illnesses but he is very irregular in getting his refills. He is not used to the new country and he finds it hard to break through the existing support clubs. He has defaulted many times. It is likely he is taking on a poor retention and adherence commitment path. Previously he had a high CD4 count. Only the next available test will show his true CD4 count now.
4. Jerome is an activist and has just read a report from CDC: PrEP, or Pre-Exposure Prophylaxis, is breakthrough in HIV prevention medication to come out in the last two years. Truvada the first PrEP drug, was approved by the FDA last summer. When taken daily, it can prevent transmission of HIV 99% if taken every day. Even if taken only four times a week, its effectiveness remains as high as 96 percent. He is now wondering how to use this information to modify knowledge and practices. He is one of those who advocate for embracing the new trends fighting HIV.He wants to widely report and celebrate this breakthrough about PrEP.
5. Monogamy, fidelity, delaying sex, testing, treatment, consistent condom use, use of lubricant in anal or painful sexual intercourse and care for persons living with HIV/Aids are some of the enduring HIV-related strategies and interventions.
Do we still need criminalization as we eradicate HIV/Aids?
Is criminalization a beneficial strategy against HIV/Aids?
What we need to address:
1. Address issues of domestic relations, male-female power and control.
2. Address stigma and discrimination in the wider policy and program context.
3. Address the minority, asylum seekers and immigrant issues in contemporary society.
4. Establish infrastructure for dialogue, practices and the broader perspectives around sexual relations and lifestyles.
5. Establish enduring partnerships and networks to address HIV/Aids beyond borders.