AIDS 2012: Affirming Everyone, or Affirming No One?

Arriving at the XIX International Aids Conference, one cannot help but feel that our world is on the cusp of one of the most important accomplishments in recent history: an AIDS-free generation. Transmission rates are at an all-time low, anti-retroviral drugs are more effective than ever, and access to basic health care services across the developing world continues to expand. But in the face of such hopeful signs, there is another concern emerging that seems to be holding such progress at a standstill.

The presence of minority groups at this year’s conference has been nothing short of influential. With President Obama’s lifting of the ban on HIV-Positive immigrants prohibited from entering the country, a new wave of campaigns has reached the HIV/AIDS discourse. Sex workers and drug users alike have demanded this very same right, and what has become clear is that in order to overcome the final obstacles involved in the fight against HIV/AIDS, policies to improve the conditions of those groups at high-risk of contracting the disease must be enacted.

These groups have been identified by UNAIDS as men who have sex with men (MSM’s), drug users, and sex workers. Given that the disease manifests as a “concentrated epidemic” in these particular groups, much of the task of this year’s conference has revolved around meeting the needs of these vulnerable communities—a response that has been carried out by way of calls for ‘decriminalization’ and the ‘establishment of legal rights’.

Take for example one session that probed the question of whether or not sex work may be considered ‘work’. One presenter argued the analogy that if a woman can grow vegetables and sell them, she should similarly be able to sell her body for financial benefit, something that surely belongs to her. Implicit in the discussion on sex work is the premise that if sex workers face one of the highest risks of contracting HIV, then the necessary solution is to liberate those workers from the stigmas that surround their situation through the legalization, regulation, and ratification of their ‘profession’. Only by enforcing legal protections will the vulnerable situations that sex workers find themselves in disappear.

And so I pose the following question: Does such a position authentically address the real needs of vulnerable communities?

With regard to sex workers, many of whom cry out for safe working conditions and demand to be looked at with recognition of their human dignity, it is undeniable that the need to address this reality is central to the HIV/AIDS pandemic. But such a response inevitably begs the question: in order to properly affirm these groups caught in vulnerable situations, should it not also be our priority to elevate these communities out of these vulnerable situations? Rather than accepting these situations as ‘decent’ or ‘legally acceptable’, we need to promote development efforts that take men and women out of these conditions. Rather than handing a sex worker a condom and walking away, we need a consistent person-centred response, one that responds to the capacity of the person to make responsible choices.

At the heart of this confusion is a problem of affirmation. What has failed to be recognized at this conference is that the need to affirm vulnerable groups in the fight against HIV/AIDS requires an evidence-based approach that takes into account the importance of avoiding risky behaviour. To dignify work that is inherently unsafe is not an affirmation at all, but a misplaced prioritization of needs. As one former sex worker admitted herself: ‘I looked to the streets to find the father figure I never had.’ Instead of walking away, let us stay close to these groups, supporting efforts that encourage risk-avoidance, and put the person at the centre of his or her own empowerment.

Adam

Intern

Toronto, Canada