Women and youth sidelined in HIV/AIDS agendas

The highest incidence of HIV infection and AIDS death is among young people, most specifically young women - but you would never say so looking at the average format of an AIDS conference. The agenda is still being set by those from countries of low HIV infection who are stuck in a paradigm relevant to Europe and the USA, (but hardly at all to southern Africa, as an example), of HIV infection mostly being caused by injection drug use, sex work or homosexual relationships.

It is a paradigm that evaporated a decade ago - now the highest rates of HIV
infection are being fuelled by very early sexual activity, a reluctance by parents or elders to discuss sex with children and teens, governments that are in denial, sexual violence, and programmes that focus on condoms instead of condoms WITH monogamous behaviour and fewer sexual partners.

Take the International Conference on Home and Community Care held in Thailand in December 2001: issues around youth were relegated to a separate, side-conference sponsored by the Ford Foundation. A noisy demonstration by young Thai people calling for their voices to be heard was met by smiles - concern would have been more appropriate. Women's issues were haphazardly slotted in. There was not a single discussion on how women are being turfed out of their family homes when they announce they are infected - as happens in most countries of highest HIV infection. How do you deliver home-based care to people who are homeless?

The Durban AIDS conference in 2000 saw sexual violence on the agenda for the first time. It is now common cause that the inability of women to say "NO" in countries of high infection, plus high figures for rape and sexual violence, and the ?“virgin cure?” myth, are fuelling the pandemic; raped women and children who are infected with HIV as a consequence need very particular care - this has not made it onto a single AIDS conference agenda ANYWHERE in the world yet. Why not? The only shame there should ever be around rape is on the part of those who fail to act to stop it.

I recall no AIDS workshop that has delivered in an interesting, practical way, tips on effective ways to disclose - to friends, family or workmates. In many countries in Southern Africa, a woman is threatened with a beating, rejection or even death if she discloses - how can we help her, and others like her, and men and young people to disclose without fear?

The time of AIDS testimonies has come to an end. Twenty years into the epidemic, we know the heartbreak and personal anguish of those who discover they are HIV-positive, and yet AIDS conference after AIDS conference is devoted to lengthy sessions of testimonials. We need to move into a new era in AIDS conferences - a testimonial is only valid if it serves to illustrate a point, if there is a lesson we can learn from it. And that lesson must be something we can all act upon, that we can all use in helping others.

In less than two years, there will be 100 million HIV-infected people, we have no time for testimonials - our task now is fast-track solutions. And an AIDS conference that does not have the issues facing women and young people (teenagers) at the top of its agenda is a conference that does more good to hotel owners, conference organisers and airline representatives than the more than 40 million infected people, and the millions more affected people across our world.