AIDS 2016: Justice Edwin Cameron addresses delegates at Durban AIDS conference

I owe my life to you, says judge

19 July 2016

“The fact that I am here today at all is a tribute to the activists, researchers, doctors and scientists in the audience,” Judge Edwin Cameron told delegates to the Durban Aids conference, delivering the Jonathan Mann memorial address. He asked sex workers and transgender people to join him on stage. His godson Andy Morobi also addressed the conference.

It is a great privilege and an honour to be here. At the start of a very busy conference, with many stresses and demands and anguishes, I want to start by asking us to pause quietly for just a few moments.

It has been 35 years since the Western world was alerted to Aids. The first cases of a baffling, new, terrifying, unknown syndrome were first reported in the northern summer of 1981. The reports were carried in the morbidity and mortality weekly reports of the CDC on 5 June 1981.¹

These last 35 years, since then, have been long. For many of us, it has been an arduous and often dismaying journey.

Since this first report, 35 million people have died of Aids illnesses² – in 2015 alone, 1.1 million people.^³

We have felt the burden of this terrible disease in our bodies, on our minds, on our friends and colleagues, on our loved ones and our communities.

Aids exposes us in all our terrible human vulnerability. It brings to the fore our fears and prejudices. It takes its toll on our bodily organs and our muscles and our flesh. It has exacted its terrible toll on our young people and parents and brothers and sisters and neighbours.

So let us pause, first, in remembrance of those who have died –

those for whom treatment didn’t come in time
those for whom treatment wasn’t available, or accessible
those denied treatment by our own failings as planners and thinkers and doers and leaders
those whom the internal nightmare of shame and stigma put beyond reach of intervention and help.
These years have demanded of us a long and anguished and grief-stricken journey.
But it has also been a journey of light – a journey of technological, scientific, organisational and activist triumph.

So we must pause, second, to celebrate the triumphs of medicine, science, activism, health care professional dedication and infrastructure that have brought ARVs to so many millions.

Indeed, the fact that I am here today at all is a tribute to the activists, researchers, doctors and scientists in the audience.

Many of you were responsible for the breakthroughs that led to the combination anti-retroviral treatment that I was privileged to start in 1997 – and which has kept me alive for the last 19 years.

I claim no credit and seek no praise for surviving. It felt like an unavoidable task.

All of us here today who are taking ARVs – let us raise our hearts and humble our heads in acknowledgement of our privilege – and often plain luck – in getting treatment on time. That treatment has given us life.

So let us pause, third, to honour the doctors – the scientists – the researchers – the wise physicians and strong counsellors who have saved lives and healed populations in this epidemic.

As important, fourth, let us pause to honour the activists, whose work made treatment available to those who would not otherwise have received it.

We pause to honour the part, in treatment availability and accessibility, of angry, principled and determined activists, in South Africa’s Treatment Action Campaign and elsewhere. For millions of poor people, their anger brought the gift of life.

Without their courage, strategic skill and passion, medication would have remained unimaginably expensive, out of reach to most people with HIV. They led a successful campaign that saved millions of lives.

The fact that many millions of people across the world are, like me, receiving ARV treatment, is a credit to their work.

They taught us an important lesson. Solidarity and support are not enough. Knowledge and insight are not enough. To save lives, we need more. We need action – enraged, committed, principled, strategically ingenious action.

They refused to acquiesce in a howling moral outrage. This was the notion that life-saving treatment – treatment that was available, and that could be cheaply manufactured – would not given to poor people, most of them black, because of laws protecting intellectual property and patent-holders’ profits.

The Treatment Action Campaign and their world-wide allies frontally tackled this. They changed the way we think about healthcare and essential medicines access.

What is more, without the Treatment Action Campaign, President Mbeki’s nightmare flirtation with Aids denialism between 1999 and 2004 would never have been defeated.

Instead, the TAC took to the streets in protest. They demanded treatment for all. And when President Mbeki proved obdurate, they took to the courts.

Because of my country’s beautiful Constitution, they won an important victory. Government was ordered to start making ARV treatment publicly available.

Today my country has the world’s largest publicly provided anti-retroviral treatment program.⁴ More than 3.1 million people, like me, are receiving ARVs from the public sector.⁵

I am particularly proud that when someone with HIV registers for treatment in South Africa, they should not be asked to show an identity document or a passport or citizenship papers. That is as it should be. The imperatives and ethics of public health know no artificial boundaries.

In the sad history of this epidemic, the triumphs of Aids activists, on five continents, are a light-point of joy.

So there is much to celebrate. I celebrate the joy of life every day with the medication – which keeps a deadly virus effectively suppressed in my arteries and veins, enabling me to live a life of vigour and action and joy.

But we must not forget that Aids continues to inflict a staggering cost on this continent and on our world.

What is more important than my survival, and that of many millions of people in Africa and elsewhere on successful ARV treatment, is those who are not yet receiving it.

There still remains so much that should be done. More importantly, there still remains so much that can be done.

Too many people are still denied access to ARVs. In South Africa, despite our many successes, well over six million people are living with HIV. And, though about half of South Africans with HIV are still not on ARVs,⁶ from September this year ARVs will be provided to all with HIV, regardless of CD4 count.

Globally, of the 36.7 million people living with HIV at the end of 2015, fewer than half had access to ARVs.⁷

Worse, the pattern of ARV availability is one that reflects our own weaknesses and vices as humans – our prejudices and hatreds and fears, our selfish claiming for ourselves what we do not grant to others.

Most of those still in need of ARVs are poor, marginalised and stigmatised – stigmatised by poverty, sexual orientation, gender identity, by the work they do, by their drug-taking and by being in prison.

Dr Jonathan Mann, to whom this lecture is dedicated, did pioneer work in recognising the links between health and human rights. He stressed that to address Aids, “we must confront those particular forms of inequity and injustice – unfairness, discrimination – not in the abstract, but in its specific and concrete manifestations which fuel the spread of Aids.”⁸

He recognised that the perils of HIV are enormously increased by laws that specifically criminalise transmission of HIV and exposure of another to it. This was also confirmed by the wonderful and authoritative work the Global Commission on HIV and the Law has recently done.

These laws are vicious, ill-considered, often over-broad and intolerably vague. By criminalising undefined “exposure”,⁹ they ignore the science of Aids, which shows how difficult HIV is to transmit.¹⁰ Apart from driving those at risk of HIV away from testing and treatment, they enormously increase the stigma that surrounds HIV and Aids.

Across this beautiful continent of Africa, men who have sex with men (MSMs) remain chronically under-served. They lack programs in awareness, education, outreach, condom provision and access to ARVs. As a recent study by Professor Chris Beyrer and others has shown, we have the means to end HIV infections and Aids deaths amongst men having sex with men. Yet “the world is still failing”.¹¹

For this, there is one reason only – ignorance, prejudice, hatred and fear. Theworld has not yet accepted diversity in gender identity and sexual orientation asa natural and joyful fact of being human.

Seventy eight countries in the world continue to criminalise same-sex sexual conduct. Thirty four of them are on this wide and wonderful continent of Africa.

It is a shameful state of affairs. As a proudly gay man I have experienced the sting of ostracism, of ignorance and hatred. But I have also experienced the power of redeeming love and acceptance and inclusiveness.

We do not ask for tolerance, or even acceptance. We claim what is rightfully ours. That is our right to be ourselves, in dignity and equality with other humans.

Discrimination on the ground of sexual orientation or gender identity is a colossal and grievous waste of time and social energy.

As our beautiful Archbishop Desmond Tutu has said, when we face so many devastating problems – poverty, drought, disease, corruption, malgovernance, war and conflict – it is absurd that we waste so much time and energy on sexual orientation (“what I do in bed with whom”.)¹²

The sooner we accept the natural fact that gender and orientation diversity exists naturally between us, the quicker we can join together our powers of humanity to create better societies together.

The same applies to sex workers. Sex workers are perhaps the most reviled group in human history – indispensable to a portion of mostly heterosexual males in any society, but despised, marginalised, persecuted, beaten up and imprisoned.

Sex workers work.¹³ Their work is work with dignity.

Why do people do sex work? Well, ask a sex worker –

To buy groceries, and pay their rent, to study, to send their children to school, and to send money to their parents and extended family.
It is hard work. Perilous work. Sex workers have a tough, dangerous job. They deserve our love and respect and support – not our contempt and condemnation.

They deserve police protection, not exploitation and assault and humiliation.

More importantly, they deserve access to every bit of HIV knowledge and power that can protect them from infection and can help them to protect others from infection.^¹⁴

Pre-exposure prophylaxis (PrEP) works for sex workers.¹⁵ It should be made available to them, as a matter of urgent priority, as part of all national Aids treatment programs.

In September 2015, the World Health Organization, recognizing PrEP’s efficacy, recommended that PreP be provided to all “people at a substantial risk of HIV,” including sex workers.^¹⁶

When we in South Africa launched our three-year National Sex Worker HIV Plan in March 2016, we proposed providing PrEP to sex workers. WHO recognized South Africa as the “first country in Africa to translate this recommendation into national policy.”¹⁷

Beginning last month (June 2016), the first programs began providing daily PrEP to sex workers in South Africa.¹⁸

Criminalising sex workers is a profound evil and a distraction from the important work of building a humane society.¹⁹

Especially vulnerable too are injecting drug users. Upon them are visited the vicious consequences of perhaps the most colossal public policy mistake of the last 80 years – the war on drugs.

The vulnerability of injecting drug users is evident in the high percentage of injecting drug users with HIV. Throughout the world, of about 13 million injecting drug users, 1.7 million (13%) are living with HIV.^²⁰

They are denied elementary life-saving services. This is not on the supposedly “dark” continent of Africa – but in the United States of America. If you want an example of evidence-ignoring public policy, that causes loss of life and injury, and spread of HIV, do not look complacently to President Mbeki’s South Africa twelve years ago – look to the United States of America, now, and the federal government’s refusal to make needle substitution available to IDUs . While the US government’s decision to partially lift this ban on federal funding for needle exchange programs earlier this year is a welcome development, this decision was only spurred by an outbreak of new HIV cases among drug users in the United States,^²¹ and the delay has undoubtedly resulted in preventable HIV infections.^²²

Injecting drug users living with HIV are further denied access to treatment. And the United States and Canada, healthcare providers are less likely to prescribe ARVs for injecting drug users, because they assume that IDUs are less likely to adhere to treatment and/or will not respond to it. This is in spite of research showing similar responses and survival rates for those who do have access to ARVs.^²³

We know exactly what we have to do to tame this epidemic.

We have to empower young people and especially young girls, to make health seeking choices when thinking about sex and when engaging in it.^²⁴

We have to redouble our prevention and education efforts.

Prevention remains a key necessity in all our strategies about Aids.

Second, we have to test, test, test, test, test, test and test. We cannot promote consensual testing enough. Testing is the gateway to knowledge, power, understanding and action.

Without testing there can be no access to treatment. The more we test, the more we know and the more we can do.

Testing must always be with the consent of the person tested. But we have to be careful that we do not impose unnecessarily burdensome requirements for HIV testing.

HIV is now a fully medically manageable disease. Consent to testing should be capable of being implied and inferred. We must remove barriers to self-testing.

I speak of this with passion – because, by making it more difficult for health care workers to test, we increase the stigma and the fear surrounding HIV.

We must make it easier to test, not harder. Gone are the terrible days when testing was a gateway only to discrimination, loss of benefits and ostracism.

In all this, we must be attentive to the big understated, underexplored, under-researched issue in the epidemic. That is the effect of the internalisation of stigma within the minds of those who have HIV and who are at risk of it.

Internalised stigma has its source in outside ignorance, hatred, prejudice and fear.

But these very qualities are imported into the mind of many of us with HIV and at risk of it.

Located deeply within the self, self-blame, self-stigma and self-paralysing fear are all too often deadly.^²⁵

We must recognise internalised stigma. I experienced its frightening, deadening effects in my own life. Millions still experience it. We must talk about it. And we must find practical ways to reduce its colossally harmful effects.

And, most of all, we must fix our societies. As my friend and comrade, Mark Heywood, has recently written, we have medically tamed Aids. But we have not tamed the social and political determinants of HIV, particularly the overlapping inequalities on which it thrives – gender, education, access to health care, access to justice. That is why prevention strategies are not succeeding.

A better response to HIV, Mark rightly says, needs a better world. Governments must deliver on their human rights obligations. Activists and scientists must join struggles for meaningful democracy, gender equality and social justice. Activists must insist on equal quality education, health and social services; investment in girls and plans backed by money to stem chronic hunger and malnutrition.²⁶

But, to end, I want to return to the light points in our struggle against the effects of this disease over the last 30 years.

I want to end with a thrilling fact – this is that, unexpectedly, joyously, beyond our wildest dreams, perinatal and paediatric ARVs have proved spectacularly and brilliantly successful.

First, let us rejoice that perinatal transmission of HIV can be completely eliminated. It was about this that the Treatment Action Campaign fought President Mbeki’s government all the way to the Constitutional Court, the Court in which I am now privileged to sit.

Now we know how effectively we can protect babies at birth and before birth from infection with HIV.

In South Africa, the rate of mother-to-child transmission of HIV is now reduced to 4%.²⁷ Worldwide, in 2015, 77% of all pregnant women received treatment to prevent perinatal transmission of HIV.²⁸

Last year, Cuba became the first country to eliminate mother to child transmission of HIV entirely.^²⁹ In 2016, Thailand, Belarus, and Armenia have also reached this milestone.^³⁰

More even, fifteen years ago we didn’t know how well babies and toddlers would tolerate ARVs.

We didn’t know just a decade ago how young children born with HIV would thrive on ARVs.

And would they take their ARVS? Would they grow to normalcy?

Instead of this uncertainty, we now know, triumphantly, that ARVs work wonderfully for children born with HIV.

I want to rejoice in the beauty and vigour of my godson Andy Morobi. Andy and I became family twelve years ago, at the end of 2004.

He is young, energetic, ambitious and enormously talented. He was born with HIV. He has been on ARVs for the last eight years. Like me, he owes his life to the medical and social miracle of anti-retroviral treatment.

I want to end on another light point. I want to honour the treatment activists from Africa, Europe, North America, South America, Australasia and Asia, who fought for justice in this epidemic.

I want to honour them, like Dr Jonathan Mann, to whom this lecture is dedicated. Like my mentor, Justice Michael Kirby of Australia, for their energy and courage and determination and sheer resourceful and resilience in fighting for justice in this epidemic.³¹

And I want to end by celebrating the fact that we have sex workers here this morning. They are wearing the T-shirts in the slide a few minutes ago. The T-shirts say: “THIS IS WHAT A SEX WORKER LOOKS LIKE”.

And, most of all, as a gay white man who has lived a life privileged by my race and my profession and my maleness, I ask that we celebrate the astonishing courage of transgender activists, of lesbians and gay men across the continent of Africa and in the Caribbean.

They are claiming their true selves. They do so often at the daily risk of violence, attack, arrest and imprisonment.

They have the right to be their beautiful selves. They are claiming a right to be full citizens of Africa, the Islands and the world. They have done so at extraordinary risk.

They know that they cannot live otherwise.

It is to these brave people that this conference should be dedicated: to the sex workers, injecting drug users, migrants, lesbian, gays and transgendered people, the children, the activists, those in prison, the poor and the vulnerable.

It lies within our means to do everything that will ensure whole lives and whole bodies for everyone with HIV and at risk of it.

All it requires is a passion and a commitment and a courage starting within ourselves. Starting within each of ourselves. Starting now.

Thank you very much.

For footnotes please see original articles in GroundUp

Justice Edwin Cameron: Keynote Speech to Beyond Blame @ AIDS 2016

Justice Edwin Cameron’s closing keynote speech to Beyond Blame: Challenging HIV Criminalisation, a pre-conference to AIDS 2016, held on Sunday 17th July 2016 in Durban, South Africa, convened by HIV JUSTICE WORLDWIDE.

BEYOND BLAME
Challenging HIV Criminalisation @ AIDS 2016, Durban

(29 min, HJN, South Africa, 2016)

On 17 July 2016, approximately 150 advocates, activists, researchers, and community leaders met in Durban, South Africa, for Beyond Blame: Challenging HIV Criminalisation – a full-day pre-conference meeting preceding the 21st International AIDS Conference (AIDS 2016) to discuss progress on the global effort to combat the unjust use of the criminal law against people living with HIV.

Attendees at the convening hailed from at least 36 countries on six continents (Africa, Asia, Europe, North America, Oceania, and South America).

Beyond Blame was convened by HIV Justice Worldwide, an initiative made up of global, regional, and national civil society organisations – most of them led by people living with HIV – who are working together to build a worldwide movement to end HIV criminalisation.

The meeting was opened by the Honourable Dr Patrick Herminie, Speaker of Parliament of the Seychelles, and closed by Justice Edwin Cameron, both of whom gave powerful, inspiring speeches. In between the two addresses, moderated panels and more intimate, focused breakout sessions catalysed passionate and illuminating conversations amongst dedicated, knowledgeable advocates

France: Grindr proposed HIV filter raises fear it could be used as a new tool to target and criminalize HIV

English version (Défilez plus bas pour la version française)

Filtering for HIV status on Grindr? A proposal that is going down badly.

A questionnaire sent by the dating app for gay men to some of its users raises fear of stigmatising HIV-positive men.

Being able to search men’s profiles based on their HIV status is the idea submitted by Grindr, the most famous gay dating geo applications in a questionnaire sent out recently to some of its 10.5 million users.

Vincent received the questionnaire when connecting to the App and completed it, although he found some of the questions “very troubling.” They all revolve around HIV: information on the current HIV status of users, their sexual practices, proposal to send reminders to encourage regular screening … But among them one question in particular creates controversy:

“How would you react if Grindr allowed you to filter the men you see based on their HIV status? ”

“Not only does it send a very bad signal about the perception of HIV, but it does not create a sense of real security, it is a false protection,” notes Mathieu Brancourt, editor of AIDES.

“Grindr would not be able to verify the information”

He pointed out this questionnaire on Twitter after denunciation by several US users (including bloggers Josh Robbins and David Myles). He added: “It would be based on declarative statement, Grindr could not verify it. ”

What credibility could we give it in reality, knowing that only one American out of 10 knows that he is HIV-positive and that “the bulk of the contamination occurs in people who do not know their status,”highlights Rémi, the Leader of the commission for serophobia LGBTphobia-Act-Up Paris?

Mathieu Brancourt questions the purpose and the risks involved, particularly with regard to the criminalisation of HIV transmission, “This information could for example be exploited legally in the context of situations in which a man claiming to be seronegative transmit HIV to someone else. ”

The app designer themselves assume responsibility for the “uncomfortable questions”

Questioned by Rue89, a representative of the company ensures that it seeks only to “promote education”:

“We observed a significant increase in user profiles openly discussing their HIV status and the dates of their tests.

Since it is not part of our profile options to date, we are investigating with users to determine both if they wish to share this information, and how to avoid stigmatisation and provide appropriate support. Sometimes this involves asking awkward questions. ”

We have however received no confirmation as to the actual implementation of the option and the launch date if applicable.

“It’s stigmatizing”

Among the users we interviewed, Grindr’s survey is going down badly. “With regard to the filter, I am vehemently against it. It’s conter-productive and discriminatory. One population is de facto dismissed, “says Hugo, 20 years old.

“The idea of being filtered through that test bothers me a lot. I’m already not very comfortable with the filters on these applications in general, here it goes much too far for me, “added Donald, 25 years old.

Julien (his name has been changed on request), 18 and HIV negative, “it is stigmatizing. Just because the app caters to gay does not mean they should indicate whether they have AIDS or not. ” However he admits: “If the function existed, I would tend to filter out the positive users.”

“People ask me if I’m clean ‘

Fred, 48, HIV-positive since 1986 and non-infectious, does not try to hide his HIV status:

“I say when I’m asked. It regularly happens that the boys cut the conversation short. They are idiots who are totally ignorant about HIV. ”

Beyond the problematic issue of filtering by HIV status, the Grindr survey has the merit of highlighting how HIV is still a taboo and a misunderstood subject.

“I never ask for the HIV status of the men I meet,” says Vincent, HIV-negative, 42, “but many people ask me if “I am clean “, which in reality means nothing.

I think this information should be shared especially if you have borderline practices, not always using condoms and such. But by having safer sex consistently, the issue is not important for me. ”

Fred only sleeps with positive men

Although he finds the idea of a filter totally unacceptable, Fred acknowledges that he prefers to sleep with HIV-positive men like him.

Primarily because it does not want to deal with the fear and thoughts of those who think he is infectious even though his viral load is undetectable, but also because he knows that he can have sex without a condom safely:

“People with HIV on treatment have blood tests every three months. It’s safer for my health and it makes me more comfortable with my sexuality. ”

In terms of prevention, dating applications – regularly accused of playing a part in the increase of STDs and STIs -have an important role to play among a population particularly affected by the epidemic. “Especially as practices without a condom are spreading,” notes Vincent. “Not a day goes by without someone proposing it to me. ”

Barebacking

“Barebacking”, the practice of having unprotected sex voluntarily, is commonly suggested on apps. In 2014, men who have sex with men represented 42% of cases of HIV diagnoses in France.

“Today, an HIV-positive person who is on treatment is not infectious, this is the point that should be insisted upon with users,” raises Rémi of Act-Up Paris.

He educates users on dating apps sites via profiles created for the association, like Etienne Fouquay, in charge of New health strategies and digital activism for AIDES. For him, “this is obviously the place to be.”

He explains : “We offer discussions or individual interviews to users. With the appreciation of geolocation (on Grindr for example), we can promote screening activities we lead with mobile vans in the area. ”

On Hornet, the date of the last screening

AIDES volunteers however work more or less underground and do not benefit from the official support of apps.

“It even happens that users report us and Grindr regularly deletes profiles. Each time, it is like an obstacle course. ”

AIDES however was able to negotiate the opening of popups – for which they pay – on the app, including prevention information.

But all the brands do not have the same policy, added Etienne Fouquay “Hornet and Scruff have a much more proactive approach and want us to work together. ”

On Hornet, several users told us, it is for example possible to display the date of the last screening. This is what Donald does: “I mention it to encourage people who visit my profile to do it regularly. It is unfortunately not possible to indicate the last testing date without disclosing one’s HIV status, so I check that I am HIV negative. ”

Testing kits

“It seems to me that indicating one’s status publicly on these apps could be a good thing. This may eventually allow to demystify the thing while being aware of the duty to protect oneself. However, it can also act as a deterrent. So giving it publicly yes, provided that it is a choice, “says Hugo meanwhile.

Ultimately, the ideal for AIDES would be to be able to have official profiles for the organisation on apps. “We will also send home testing kits to people via apps,” explained Stephen Fouquay.

The latter option has already been set up with Grindr in Los Angeles. Through the application, 56 African-American and Hispanic men, the populations most affected by HIV, have recently been able to receive screening kits. Among them, 69% had not been tested in the past six months. So rather than a filter by HIV status, when will this type of initiative arrive in France?

Filtrer les séropositifs sur Grindr ? La proposition qui passe mal

Un questionnaire envoyé par l’appli de rencontres gay à certains de ses utilisateurs laisse craindre une stigmatisation des hommes séropositifs.

Pouvoir rechercher des profils d’hommes en fonction de leur statut sérologique lié au VIH. C’est l’idée soumise par Grindr, la plus connue des applications de rencontres gays géolocalisées, dans un questionnaire envoyé ces derniers jours à certains de ses 10,5 millions d’utilisateurs.

Vincent l’a reçu en se connectant à l’appli et l’a rempli, bien qu’il ait trouvé certaines questions « très gênantes ». Celles-ci tournent toutes autour du VIH : renseignements sur l’actuel statut sérologique des usagers, sur leurs pratiques sexuelles, proposition d’envoyer des rappels pour inciter à des dépistages réguliers… Mais parmi elles, une en particulier crée la polémique :

« Comment réagirais-tu si Grindr t’autorisais à filtrer les hommes que tu vois en fonction de leur statut sérologique ? »

« Non seulement ça envoie un très mauvais signal concernant la perception des séropositifs, mais ça n’instaure pas un sentiment de sécurité réel, c’est une fausse protection », fait remarquer Mathieu Brancourt, rédacteur pour l’association de lutte contre le Sida Aides.

« Grindr ne pourrait pas le vérifier »

Il a signalé ce questionnaire sur Twitter après sa dénonciation par plusieurs utilisateurs américains (dont les blogueurs Josh Robbins et David Myles). Il ajoute : « Ce ne serait basé que sur du déclaratif, Grindr ne pourrait pas le vérifier. »

Quel crédit pourrait-on en effet y accorder, sachant par ailleurs qu’un Américain sur dix ignore qu’il est séropositif et que « le gros des contaminations se fait chez des personnes qui ne connaissent pas leur statut sérologique », comme le souligne Rémi, responsable de la commission LGBTphobie-sérophobie d’Act-Up Paris ?

Mathieu Brancourt s’interroge sur le but recherché et les risques encourus, notamment au regard de la pénalisation de la transmission du VIH : « Ces informations pourraient par exemple être exploitées juridiquement dans le cadre de situations où un homme se déclarant séronégatif transmettrait le VIH à quelqu’un d’autre. »

L’appli assume ses « questions gênantes »

Interrogée par Rue89, une représentante de l’entreprise assure que cette dernière ne cherche qu’à « favoriser l’éducation » :

« Nous avons observé une augmentation significative de profils d’utilisateurs discutant ouvertement de leur statut VIH et des dates de leurs tests.

Etant donné que cela ne fait pas partie de nos options de profils à ce jour, nous enquêtons auprès des usagers pour déterminer à la fois s’ils désirent partager cette information, et les moyens d’éviter la stigmatisation et de fournir un support approprié. Parfois, cela implique de poser des questions gênantes. »

Nous n’avons en revanche pas obtenu de confirmation quant à la mise en place effective de l’option et à la date de lancement le cas échéant.

« C’est stigmatisant »

Chez les utilisateurs que nous avons interrogés, le questionnaire de Grindr passe mal. « S’agissant du filtre, je suis farouchement contre. C’est contre-productif et discriminant. On écarte de facto une population », commente Hugo, 20 ans.

« L’idée d’être filtré sur ce critère me dérange beaucoup. Je ne suis déjà pas très à l’aise avec les filtres sur ces applications en général, ici ça va beaucoup trop loin pour moi », ajoute quant à lui Donald, 25 ans.

Pour Julien (son prénom a été changé à sa demande), 18 ans et séronégatif, « c’est stigmatisant. Ce n’est pas parce que l’appli s’adresse aux gays qu’ils doivent indiquer s’ils ont le Sida ou pas ». Il reconnaît néanmoins : « Si la fonction existait, j’aurais tendance à filtrer pour enlever les utilisateurs positifs ».

« On me demande si je suis clean »

Fred, 48 ans, séropositif depuis 1986 et non-contaminant, ne cherche pas à cacher son statut sérologique :

« Je le dis quand on me le demande. Il arrive régulièrement que des garçons coupent court à la conversation. Ce sont des crétins qui ont une méconnaissance totale du VIH. »

Car au-delà de la question problématique d’un filtre par statut sérologique, l’enquête de Grindr a le mérite de mettre en lumière à quel point le VIH est encore un sujet tabou et méconnu.

« Je ne pose jamais la question du statut sérologique aux hommes que je rencontre », confie Vincent, séronégatif de 42 ans, « mais nombreux sont ceux qui me demandent si je suis “clean”, ce qui, au fond, ne veut rien dire.

J’estime que c’est une information à partager surtout si on a des pratiques borderline, avec une rupture de capote ou autre. Mais en ayant des rapports systématiquement protégés, cette question n’a pas d’importance pour moi. »

Fred ne couche qu’avec des séropositifs

Bien qu’il trouve l’évocation d’un filtre totalement inacceptable, Fred reconnaît qu’il préfère ne coucher qu’avec des hommes séropositifs, comme lui.

Avant tout parce qu’il ne veut pas s’infliger les peurs et réflexions de ceux qui le pensent contaminant alors que sa charge virale est indétectable, mais également parce qu’il sait qu’il pourra avoir des rapports sans préservatif en toute sécurité :

« Les séropositifs sous traitement ont des prises de sang tous les trois mois. C’est plus sûr pour ma santé et ça me met plus à l’aise avec ma sexualité. »

En matière de prévention, les applications de rencontre – régulièrement accusées de participer à l’augmentation des MST et IST – ont justement un important rôle à jouer chez un public particulièrement touché par l’épidémie. « D’autant plus que les pratiques sans préservatif se généralisent », relève Vincent. « Il ne se passe pas une journée sans que l’on m’en propose. »

Barebacking

On parle notamment de « barebacking », cette pratique qui consiste à avoir des relations sexuelles volontairement non protégées, couramment suggérées sur les applis. En 2014, les hommes ayant des rapports sexuels avec des hommes représentaient 42% des cas de découvertes de séropositivité en France.

« Aujourd’hui, une personne séropositive qui est traitée n’est pas contaminante, c’est sur ça qu’il faudrait insister auprès des usagers », soulève Rémi d’Act-Up Paris.

Il sensibilise les usagers de sites et applis de rencontre via des profils créés pour l’association, tout comme Etienne Fouquay, chargé de mission Nouvelles stratégies de santé et actions numériques à Aides. Pour lui, « c’est évidemment là qu’il faut agir ». Il explique :

« Nous proposons des discussions ou des entretiens individuels aux utilisateurs. Avec la plus-value de la géolocalisation (sur Grindr par exemple), nous pouvons promouvoir des actions de dépistage que nous menons dans des camions aux alentours. »

Sur Hornet, la date du dernier dépistage

Les bénévoles de Aides interviennent néanmoins dans une certaine clandestinité et ne bénéficient pas de l’appui officiel des applications.

« Il arrive même que des usagers nous signalent et que Grindr supprime régulièrement nos profils. A chaque fois, c’est un parcours du combattant. »

Aides a toutefois pu négocier l’ouverture de fenêtres pop-up – payantes – sur l’application, comprenant des informations de prévention.

Mais toutes les marques n’ont pas la même politique, ajoute Etienne Fouquay : « Hornet et Scruff ont des démarches beaucoup plus volontaristes et veulent que l’on travaille ensemble. »

Sur Hornet, nous font remarquer plusieurs utilisateurs, il est par exemple possible d’afficher la date de son dernier dépistage. C’est ce que fait Donald :

« Je l’indique pour inciter les gens qui visitent mon profil à le faire régulièrement. Il n’est hélas pas possible d’indiquer la dernière date sans dévoiler son statut sérologique, donc je coche que je suis bien séronégatif. »

Kits de dépistage

« Il me semble que donner publiquement son statut sérologique sur ces applications peut être une bonne chose. Cela peut éventuellement permettre de désacraliser la chose tout en ayant conscience de l’obligation de se protéger. Pour autant, cela peut aussi agir comme un effet dissuasif. Donc le donner publiquement oui, à condition que cela soit un choix », tranche quant à lui Hugo.

À terme, l’idéal pour Aides serait de bénéficier de profils associatifs officiels sur les applications. « Nous allons également envoyer des kits de dépistage au domicile des personnes via les applications », explique Etienne Fouquay.

Cette dernière option a d’ores et déjà été mise en place avec Grindr à Los Angeles. Grâce à l’application, 56 hommes afro-américains et hispaniques, populations particulièrement touchées par le VIH, ont récemment pu recevoir des kits de dépistage. Parmi eux, 69% n’avaient pas été testés dans les six derniers mois. Alors, plus qu’un filtre par statut sérologique, à quand ce type d’initiative en France ?

Originally published on rue89

USA: Criminalisation advocates explain why using the right language is key to success

Jennie Smith-Camejo, the communications director of Positive Women’s Network – USA, stood at the podium at the second HIV Is Not a Crime conference on HIV criminalization in May. Behind her was a PowerPoint presentation with several examples of recent egregious headlines about people living with HIV.

“Woman With HIV Convicted of Biting Sister During Fight,” screamed one. “Man With HIV Assaults Hospital Employee,” read another. “Suspect Threatens to Transmit HIV to Police Officer,” announced a third.

“You don’t really hear [much] about HIV in the news anymore,” Smith-Camejo noted as she flipped through these headlines. “So, if these are what you’re seeing and hearing, what would you think?”

That is the challenge for people fighting HIV criminalization laws. How do you push past the fear and panic around HIV transmission when click-bait headlines dominate media coverage?

There’s no one opinion about what kind of messaging is most effective. For some, using language that appeals to their audience’s core values has been effective. Others reject that strategy, instead demanding more inclusive, intersectional messages that do not leave out the most vulnerable, such as sex workers and trans people.

“When you’re talking to people outside the HIV community, you have to think about what they’re thinking and hearing,” stated Jennie Smith-Camejo, the communications director of Positive Women’s Network – USA, an advocacy network of women living with HIV. “People’s views on policies and issues are more shaped by emotion than reason,” Camejo-Smith noted. But advocates have the power to appeal to these emotions. Using stories can change hearts and minds in ways that cold hard facts often do not, she said.

Jennie Smith-Camejo gives one example of messaging that appeals to a more conservative audience. When talking to people who may not care about the injustices of police profiling of trans women or HIV criminalization, she points to the way in which Cyd Nova, the harm reduction coordinator at the Saint James Infirmary, a clinic for current and former sex workers, frames the issue of policing as one that interferes with personal responsibility and protecting public health:

Trans women are disproportionately profiled and targeted by law enforcement for harassment and arrest. And because of policies like [using] condoms as evidence, trans women often face a choice between protecting themselves and their partners from HIV and risking arrest.

Effective messaging can sometimes prevent a harmful legislative amendment from even reaching the floor.LaTrischa Miles is a board member of Positive Women’s Network – USA, as well as the founder and president of Grace, a faith-based support group in in Kansas City for women affected by and living with HIV. When she learned that Missouri legislators planned to introduce a bill that would make it a crime for a person with HIV to spit at someone, she and other activists sprang into action. They contacted legislators and debunked the myths about saliva and HIV transmission. “Because they heard from us in the community, they didn’t even bring it forward for the hearing,” Miles recalled.

In Colorado, members of the Mod Squad and Senator Pat Steadman utilized language that appealed to a broader political spectrum as they pushed SB 146, a bill that repealed two criminalization statutes and reformed another. Instead of talking about criminalization as an injustice that needed to be eliminated, Steadman appealed to conservative values, such as personal responsibility. “We talked about barriers that criminalization poses to testing, treatment and public health,” Steadman stated in a celebratory address. “The biggest thing to take on is people’s fear and ignorance.”

To combat stigma and hammer home the importance of changing the law, Steadman’s talking point became: “The criminal law is a clumsy and ineffective tool for protecting public health.”

Advocates also shifted their messaging. Barb Cardell, a long-time HIV activist and member of the Colorado Mod Squad (“Mod” is short for modernization), recalled that the group had initially called themselves the HIV Decriminalization Task Force, then the STI Grassroots Modernization Alliance.

“We didn’t change anything else we were doing,” recalled John Tenorio, a rural Mod Squad member. Simply changing their name brought them more respect and support.

In Colorado, it appears that the shift worked. Steadman and the Mod Squad faced little opposition to repealing and reforming the criminalization statutes. (Instead, Steadman noted, the sticking point was the provision allowing minors to be tested and treated for HIV without parental consent.) SB 146 passed in both houses of the legislature and is now awaiting the governor’s signature.

But not everyone agrees with shifting the message to appeal to more conservative audiences. “You have to think about decriminalization — true repeal of these outrageous laws. Don’t talk to me about modernizing things to make them sound better. I am not here to wait years and years and years for this to happen,” said Maxx Boykin, an organizing co-chair of the Chicago chapter of Black Youth Project 100 (BYP100), a national organization of 18- to 35-year-old black activists, and a community organizer at AIDS Chicago. He tied HIV criminalization to the pervasive state violence against black people, particularly black youth. “You have to stop criminalizing who I am, who my friends are.”

Appeals to modernize laws will not stop the collision of criminalization faced by those marginalized by race, gender identity and poverty, he explained. “I have to talk about how [criminalization] disproportionately affects black people,” Boykin told TheBody.com. He draws parallels between HIV criminalization laws and the disparities in crack-cocaine sentencing. It’s a parallel that those already organizing against police and state violence understand all too well.

He also challenges people to think about criminalization as a whole, tying HIV criminalization to issues of racism and mass incarceration as well as explaining how people living with HIV are treated in prison and what HIV criminalization actually looks like.

Marco Castro-Bojorquez, a documentary filmmaker, community organizer and member of the steering committee for the U.S. People Living With HIV Caucus, arrived in the United States from Mexico 20 years ago. For him, an intersectional analysis needs to be present in every discussion.

“It’s difficult to talk to people about race and class,” he told The Body.com. “But you need to do it when talking about any injustice.” These conversations can be difficult, he acknowledged. “White people get offended or angry or sad,” he said. For them, he said, “it’s important to check your privilege and make sure you are not making us [people of color] responsible for your feelings. People don’t understand the amount of energy it requires for us [to explain racism and other injustices we face].”

He concentrates his energies on working with people who feel the brunt of marginalization the most — people of color, immigrants and trans people. In 2015 he helped launch Venas Abiertas: Una Red de Inmigrantes Latinxs Viviendo con el VIH/Sida (Open Veins: A Network of Latinx Immigrants Living With HIV/AIDS) for HIV-positive Latino immigrants to advocate for their needs and work with allies.

When Castro-Bojorquez talks about HIV criminalization, he’s often met with shock that such laws even exist. He recalls repeated conversations with his best friend. “He could not believe you could have sex with someone, use a condom, not transmit anything and still be thrown in jail,” he recounted. The two continued to have conversations about criminalization — and Castro-Bojorquez’s work to end it. “Now he’s super-knowledgeable about it,” he said.

Castro-Bojorquez also cautions against the tendency to characterize certain statutes as “not so bad,” explaining that “any law that criminalizes HIV is bad.”

Regardless of the words they choose, advocates say the message needs to be clear and not veer into other topics. Mark King, the blogger behind My Fabulous Disease, learned this firsthand.

In 1992, when Magic Johnson first announced that he was living with HIV, King was the newly appointed communications person for the Los Angeles Shanti Foundation, which provided emotional support for people dying from AIDS-related complications. Johnson’s announcement inevitably sparked office gossip, including speculation about which AIDS organization Johnson might endorse as well as the fact that Elizabeth Taylor had sent Johnson flowers, King recalled. That gossip was still buzzing when the phone began ringing with press requests. “I was young and stupid,” King recounted and, when he spoke with a reporter from the Los Angeles Times, he began chattering away, repeating the office gossip.

The next day, the Los Angeles Times ran King’s statements about Elizabeth Taylor and the rivalry for Johnson’s support among AIDS organizations. “I gave the reporter the story he wanted to write — about the competition among agencies — rather than the message I was supposed to deliver,” King recalled 24 years later. The lesson? “Hold on tight to your message and repeat it over and over so they can’t put in some stupid quote about Elizabeth Taylor.”

Victoria Law is a freelance writer and editor. Her work focuses on the intersections of incarceration, gender and resistance. She is the author of Resistance Behind Bars: The Struggles of Incarcerated Women.

Originally published in The Body

Mexico: 150 police officers undergo training in HIV, AIDS and STIs in Oaxaca

English Version (Scroll down for Spanish text)

COESIDA Trained Municipal Police in HIV, AIDS and STIs

To contribute to the full training of Public Safety officers, from 4 to 8 July, staff of the State Council for the Prevention and Control of AIDS (COESIDA) trained around 150 members of the Municipal Police Force in Oaxaca de Juarez, in HIV, AIDS and other sexually transmitted infections. Ofelia Martinez Lavariega, head of the Training Department of COESIDA said that, for the third consecutive year, the workshops were conducted through the Police Academy, in coordination with the Commission for Public Safety, and Traffic and Municipal Civil Protection.

“The goal is to continue the work of awareness, prevention and detection of HIV we have carried on since 2013,” she said, while noting that only last year 120 officers were trained. This year the number of participants grew to 150, reflecting the interest in being trained in issues related to HIV and AIDS, such as masculinity and sensitive language, issues which closed the workshops this year . “This last issue is very important if we consider the characteristics of their work, and the fact that police officers have to deal with key groups – sex workers, trans* people – and that sometimes they do not know how to treat them, and without meaning to, come to violate their human rights, “said Martin Trápaga Sibaja, COESIDA trainer and psychologist.

In 2015, the Commissioner of Public Safety, Traffic and Municipal Civil Protection, José Luis Echeverria Morales, stressed the importance of carrying on with such activities which undoubtedly contribute to the integral training of security forces in the capital’s City Hall. “Today we witness greater interest from public safety officers in the workshops. Initially, the majority had no knowledge about the basic information about HIV, AIDS, about modes of transmission and even about the correct way to put a condom; but now, each time there are more who join the program and also to convey the messages to their peers, take them home and that’s very important, “he said.

In addition to the participation of psychologist Martin Trápaga Sibaja, the police officers were trained by Doctor Angeles Pérez Silva and Psychologist Angelica Castro Pineda, who invited them to exercise their sexuality responsibly and with a shared responsibility.

Capacita COESIDA a policías municipales en materia de VIH, Sida e ITS

A fin de contribuir a la formación integral de las y los elementos de Seguridad Pública, del 4 al 8 de julio, personal del Consejo Estatal para la Prevención y Control del sida (COESIDA) capacitó a alrededor de 150 elementos de la Policía Vial y Municipal de Oaxaca de Juárez, en materia de VIH, sida y otras infecciones de transmisión sexual. Ofelia Martínez Lavariega, jefa del Departamento de Capacitación del COESIDA, indicó que por tercer año consecutivo los talleres se realizan de manera coordinada con la Comisión de Seguridad Pública, Vialidad y Protección Civil Municipal, a través de la Academia de Policía.

“El objetivo es continuar con el trabajo de sensibilización, prevención y detección del VIH que hemos hecho desde 2013”, señaló, al tiempo de destacar que tan solo el año pasado fueron capacitados 120 elementos. Para este año –dijo- el número de participantes creció a 150, lo que refleja el interés por estar informados sobre temas relacionados con el VIH y sida, tales como la masculinidad y lenguaje sensible, con los que se clausuraron los talleres de este año 2016.

“Este último tema es muy importante si consideramos que por las características de su trabajo, las y los policías tienen que lidiar con grupos clave -trabajadoras y trabajadores sexuales o personas trans- a quienes en ocasiones no saben cómo tratar, y sin pretenderlo, llegan a violentar sus derechos humanos”, sostuvo Martín Trápaga Sibaja, psicólogo capacitador del COESIDA.

En el año 2015, el Comisionado de Seguridad Pública, Vialidad y Protección Civil Municipal, José Luis Echeverría Morales, resaltó la importancia de dar seguimiento a este tipo de actividades que sin duda, contribuyen a la formación integral de los elementos de seguridad del Ayuntamiento capitalino.

“Hoy vemos un mayor interés de los elementos de seguridad pública en los talleres. Al principio, la mayoría desconocía la información básica sobre el VIH, el sida, las formas de transmisión e incluso, la forma correcta de colocar un condón; pero ahora, cada vez son más los que se suman al programa y además de transmitir el mensaje entre sus compañeros, lo llevan a sus hogares y eso es muy importante”, aseguró. Además de la participación del psicólogo Martín Trápaga Sibaja, las y los policías fueron capacitados por la médica Ángeles Pérez Silva y la psicóloga Angélica Castro Pineda, quienes los invitaron a ejercer su sexualidad de manera responsable y compartida.

Liga tomada del portal OaxacaCapital.com http://oaxacacapital.com/dependencias/capacita-coesida-a-policias-municipales-en-materia-de-vih-sida-e-its/

Canada: Activist Christian Hui on why HIV criminalisation harms us all

US: Democratic Party pledges to "address HIV criminalization laws" in its 2016 draft party platform

Democratic Party Comes Out Strong for LGBTQ Equality in 2016 Party Platform

HRC Blog by post by Stephen Peters

Today, the Democratic Party released its draft 2016 party platform, including key provisions that focus on improving the lives of LGBTQ people and advocating for full equality.

“This is the most LGBTQ-inclusive platform of any major U.S. party,” said JoDee Winterhof, HRC’s Senior Vice President for Policy and Political Affairs. “We will continue to work with the Democratic Party to ensure the most robust platform for LGBTQ Americans. From protecting LGBTQ young people to ending the epidemic of violence against transgender people to passing an explicit and comprehensive federal non-discrimination law to bringing about an AIDS-free generation, the platform addresses many of the major challenges facing our community today.”

Here are some of the highlights:

LGBT Rights

Democrats applaud last year’s decision by the Supreme Court that recognized LGBT people— like every other American—have the right to marry the person they love. But there is still much work to be done. LGBT kids continue to be bullied at school, a restaurant can refuse to serve a transgender person, and a same-sex couple is at risk of being evicted from their home. That is unacceptable and must change. Democrats will fight for comprehensive federal non- discrimination protections for all LGBT Americans and push back against state efforts to discriminate against LGBT individuals. We will combat LGBT youth homelessness and improve school climates, and we will protect transgender individuals from violence. We will promote LGBT human rights and ensure America’s foreign policy is inclusive of LGBT people around the world.

Civil Rights

Democrats will always fight to end discrimination on the basis of race, ethnicity, national origin, language, religion, gender, sexual orientation, gender identity, or disability. We need to promote civility and speak out against bigotry and other forms of intolerance that have entered our political discourse. It is unacceptable to target, defame, or exclude anyone because of their religion, race, ethnicity, national origin, or sexual orientation.

HIV and AIDS

Democrats believe an AIDS-free generation is within our grasp. But we know far too many Americans still suffer, which is why we will implement the National HIV and AIDS Strategy, increase research funding for the National Institutes of Health, cap pharmaceutical expenses for people living with HIV and AIDS, address HIV criminalization laws, and expand access for HIV prevention medications, particularly for the populations most at risk of infection. Abroad, we will make the President’s Emergency Plan for AIDS Relief more effective and increase global funding for HIV and AIDS prevention and treatment. Democrats will always protect those living with HIV and AIDS from stigma and discrimination.

Supporting our Troops

[…]Democrats welcome and honor all Americans who want to serve and will continue to fight for their equal rights and recognition. We are proud of the repeal of Don’t Ask, Don’t Tell and the opening of combat positions to women. Our military is strongest when people of all races, religions, sexual orientations, and gender identities are honored for their service to our country.

Racial Justice

Democrats will fight to end institutional and systemic racism in our society. We will challenge and dismantle the structures that define lasting racial, economic, political, and social inequity. Democrats will promote racial justice through fair, just, and equitable governing of all institutions serving the public and in the formation of public policy. We will push for a societal transformation to make it clear that black lives matter and there is no place for racism in our country.

Gun Violence Prevention

With 33,000 Americans dying every year, Democrats believe that we must finally take sensible action to address gun violence. While gun ownership is part of the fabric of many communities, too many families in America have suffered from gun violence. We can respect the rights of responsible gun owners while keeping our communities safe. We will expand background checks and close dangerous loopholes in our current laws, hold irresponsible dealers and manufacturers accountable, keep weapons of war—such as assault weapons—off our streets, and ensure guns do not fall into the hands of terrorists, domestic abusers, other violent criminals, and those with severe mental health issues.

Webinar: HIV Criminalization Attitudes and Opinions of the American Public (Sero, 2016)

Presenters: Sean Strub and Dr. Rosita Thomas

Advocates fighting to end HIV criminalisation reach a global TV/web audience on The Stream

Last night, HIV criminalisation advocacy reached a global audience on both TV and the internet with The Stream, on Al Jazeera English.

During the 30 minute programme, HIV criminalisation survivor, and Sero advisory board member, Ken Pinkela appeared with co-hosts Malika Bilal and Omar Baddar in the Washington DC studio to discuss his case and the role HIV stigma played in his unjust prosecution and wrongful conviction.

He was joined via Skype by ARASA’s Executive Director, Michaela Clayton, who discussed the impact of HIV criminalisation on women in southern and eastern Africa.

Anand Grover, Senior Advocate at Supreme Court of India, founder of India’s Lawyers Collective, and a former UN Special Rappporteur on the Right to Health highlighted the many human rights concerns with a punitive approach to HIV prevention.

I was also on programme, highlighting the work of the HIV Justice Network and citing data from our recent report, Advancing HIV Justice 2.

Contributions were also seen from US HIV advocates Shawn Decker and Nina Martinez, and Colorado Senator Pat Steadman who worked with the Colorado Mod Squad to recently completely overhaul HIV criminalisation in Colorado.

Watch the entire programme below or on the The Stream’s website.