My Perspective: The 2018 International Conference on AIDS

By Linda H. Scruggs, Acting Director, NMAC’s Leadership Pipeline Program

A few weeks ago, I had the great opportunity to travel to Amsterdam, Netherlands to attend the 22nd International AIDS Conference (IAC), which I learned while in Amsterdam, “is the largest conference on any global health issue in the world.” The 2018 conference theme was “Breaking Barriers, Building Bridges.” The theme implores the HIV community to continue to maintain and expand its commitment to addressing social determinants of health using social justice and human rights frameworks to reach key populations. I was particularly interested in hearing about pre-exposure prophylaxis (PrEP) uptake and services, progress towards the 90-90-90 target, increasing capacity for test and treat via differentiated service delivery approaches, client outreach and retention methods, and responding to the criminalization of HIV transmission.

The importance of redoubling our efforts to remove harmful HIV criminalization laws

I must say I was also very excited to see that global HIV advocates and allies are working together to bring attention and to change policies that unfairly criminalize HIV. In addition to presentations in the Global Village and the main conference, HIV Justice Worldwide organized a pre-conference symposium, “Beyond Blame: Challenging HIV Criminalization,” which focused on identifying ways in which punitive laws and their enforcement can be rigorously challenged.

I have been following HIV criminalization domestically through the work of the SERO Project and the Positive Women’s Network-USA and how these bad laws have altered our right to disclosure, an often lifesaving decision for people living with HIV, particularly women. The advocacy community has been successful at changing the hearts and minds of members of the HIV community and even changing laws at the state level. As is also noted by these advocates, much remains to be done to ensure that people living with HIV as well as our brothers and sisters sitting in prison or awaiting processing through the criminal justice system are free from the draconian nature of these laws.

The diversity of people living with HIV who chose to lift their voices on this issue at AIDS 2018 profoundly moved me. It gave me an opportunity to hear the impact of HIV criminalization through a different set of lenses to hone in on how these bad laws are a significant deterrent to global and domestic efforts to end the epidemic. Fueled with a new sense of urgency, I have decided to make this one of the cornerstone issues for upcoming women initiatives NMAC will support this year.

The invisibility of women of African descent from developed countries at AIDS 2018

As I shift to another thought of AIDS 2018, I want to express my gratitude to the organizers of another event I attended specifically for and by women of African descent impacted by HIV. Women Now! under the leadership of SisterLove, in partnership with the Global Network of People with AIDS (GNP+), and HIV women networks from Africa and across the globe have taken up the leadership mantle to organize women of the African diaspora living with and affected by HIV. Over 125 women primarily of African descent from around the globe were in attendance at Women Now! 2018, a three-day Summit preceding AIDS 2018. At Women Now! 2018, I experienced powerful speakers, group discussions, and actions. One action, in particular, led to a representative from a global health organization committing to bring women, particularly women of African descent, to the forefront of the global HIV movement and ensure gender and cultural responses to ending the epidemic.

During this discourse, two concerns became clear to me during the course of this three-day summit. The first concern is the untold story of Black or women of African descent living with HIV who live in so-called developed countries (a.k.a., high-income countries). The second concern is the tension between Black women living with HIV from low-income countries and high-income countries resulting from how each group experiences HIV.

A. A story within a story. 
In principle and practice, it is crucial for the global community to hold high-income countries accountable for addressing the needs of countries in need of resources to fight the HIV epidemic. I support these efforts. The gains we have witnessed would not be possible without this support and the advocacy of many global HIV advocates and activist who made this happen. On the other hand, it is essential for the worldwide community also to acknowledge that many of the Black communities across the U.S. are experiencing not only disproportionate rates in their home countries but HIV rates of infection and mortality rates comparable to HIV rates in South Africa and other parts of Africa. We need our global brothers and sisters to advocate for a PEPFAR to address the health disparities of black and brown people in developed countries. Despite the scientific and service delivery innovations, Black people in the U.S., as around the globe, still have higher rates of HIV and higher rates of mortality. We need your support in our fight as well.

B. Same story but different perspective.
In the HIV discourse over the last five years, I have witnessed the disappearance of women living with HIV, explicitly black women living with HIV. Astonishingly, coming to Amsterdam revealed that black women living with HIV from high-income countries are also held to a different standard than our African sisters living with HIV. Some of this misperception could be how the HIV epidemic is characterized by high income vs. low-income countries with little to no flexibility allowed for consideration of impoverished communities and communities of color in these high-income countries. Racism and sexism work are structural factors, which affect the everyday lives of people of color and women across the globe.

I hope that as we continue to develop new programs and opportunities, that we be mindfully diligent to create meaningful platforms where we can learn about each other across the globe and devise plans for how we can meaningfully support one another. Over the next few months, NMAC’s Leadership Pipeline will look to develop new partnerships with women-focused organizations and networks to help and provide engagement to ensure that women of color are strengthened and provided the tools to create a new dialogue that moves us closer to ending this epidemic.