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December 7, 2007
PREVENTION CONVENTION
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Some pieces of the HIV prevention puzzle |
There was chatter between sessions at the Center for Disease Control and Prevention National HIV Prevention Conference this week about several high-profile media reports that yearly HIV infections could be up to 50 percent higher than the 40,000 a year the CDC had previously reported, and popular buttons distributed by the Campaign to End AIDS that asked "CDC: HOW MANY NEW INFECTIONS???" (many CDC staffers were seen slipping them into their bags). But the only official word was that folks will have to wait for an official word—the official CDC statement was that 'the findings are to come.'
"CDC does emphasize that the estimates are not yet final," said Dr. Kevin Fenton, CDC's director of the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention during a December 3 press briefing. "We do understand the strong desire by many of our colleagues that these estimates be released."
Dr. David Holtgrave, an expert on the effectiveness of HIV prevention who teaches at the Bloomberg School of Public Health at Johns Hopkins University put the mood of gathered activists well. "Whether there are 40,000 or 55,000 new infections—that number is too high," Holtgrave said to cheers at the Prevention Justice Mobilization rally December 4.
More than three thousand people, including government officials, CDC employees, researchers and advocates, gathered in Atlanta this week to discuss new and renewed HIV prevention efforts—with a particular focus on the epidemic levels of new infections among African-Americans and gay men. Gregorio Millett of the CDC reported that black gay men are now twice as likely to be infected with the virus then their white counterparts, even though they are equally likely to engage in risky behavior. Millett also reported that men who said they had been discriminated against when they were younger were more likely to contract HIV. One possible reason for the gaps: HIV-positive black men are less likely than whites to be on antiretroviral medications that lower viral load and can reduce infectivity.
A Tuesday conference session addressed the issue of "no identified risk." Many people—particularly women—who end up infected and diagnosed with HIV/AIDS have "no identified risk" because they don't know the risk factors of their partners. The National Women's AIDS Collective has done advocacy on this important issue; they are pressing for surveillance systems that include consideration of social networks and geography rather than merely mode of transmission —but there's been no luck thus far moving the CDC, partially because of inertia, and partially because of flat or decreased funding for CDC prevention programs.
CDC, Don't you see?...
But the reasons certain people and groups are more likely to be infected—and counted as infected— isn't just a statistical problem, but involves larger issues of social justice and changing the conditions in society that allow HIV to spread. This was the overarching theme during the Prevention Justice Mobilization rally, where hundreds of conference attendees and Atlanta-based advocates wore sashes, shined flashlights, blew whistles and held puzzle pieces ranging from "Harm Reduction" to "Health Care for All" to "Racial Justice" to "Drug Policy Reform" to "Full Funding" to "Honest Sex Ed" that together represented the solutions federal, state and local governments must take to stop HIV from spreading.
"If the CDC wants to know what to do to stop HIV, they just need to look at this puzzle," said master of ceremonies Waheedah Shabazz-El of ACT UP Philadelphia. "We need equality for women. We need treatment. We need real prison reform. We know that HIV prevention is more than just a condom." Highlighting all of these issues were dozens of speakers addressing different high-HIV-risk/high-HIV-impact groups—immigrants, transgender people, the incarcerated—literally dying because of the lack of HIV prevention.
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Holtgrave lost his voice, so Davids relayed his message of prevention justice |
And while each speaker highlight a problem, it was all summed up in a creative song to the tune of "The Twelve Days of Christmas":
And though CDC's Fenton told the Update "all programs would like to have more funding. The reality is that's not going to happen," PJM marchers would disagree.
"It is often said in Washington that you cannot solve a problem by throwing money at it. Well, when it comes to HIV infections in America, we've actually never tried," said David Munar, associate director for policy and communication at the AIDS Foundation of Chicago.
Most exciting about the rally was that it wasn't only the usual score of "activists" in attendance—case workers, researchers and government officials all came out to support the goals of prevention justice.
"There is simply not enough funding for people with HIV," said Janine Ross, a social worker in Maryland who was attending the conference. "When I heard about this rally I had to come, because I see that even with all the good information the CDC is trying to get across, it's not going to happen without funding."
"As an HIV-positive person I know that there has to be housing and supportive services in place in order to stop new infections," said greg-eugene, an outreach worker in Boston who attended the conference and the rally.
CDC officials were both privately and publicly sympathetic to the goals of the PJM. "It's great that we have colleagues and individuals who would shine the light on prevention. Structural and societal approaches to prevention and that there has been this reinfusion of energy," Fenton said. And the PJM leadership was excited that the conference organizers invited Atlanta-based community organizations to attend a CGO/NGO Village where they could eat and dance with conference participants.
The Prevention Justice Mobilization is a new advocacy effort inititiated by Community HIV/AIDS Mobilization Project (CHAMP) in collaboration with organizations such as ACT UP Philadelphia, AIDS Foundation of Chicago, and SisterLove. Housing Works and C2EA are endorsing organizations.
Prevention Justice is not just about addressing the CDC, said CHAMP Executive Director Julie David. "The CDC is part of the Bush administration, so they bear some responsibility. It's important that we develop a global strategy that makes sure everyone is taking the necessary steps to stop new infections."