Marginalised populations still drawing the short straw on HIV

Winnie Ssanyu Sseruma
149128792 209x300 Marginalised populations still drawing the short straw on HIV

Volunteers lay out the AIDS Quilt on the National Mall 23 July, 2012 as part of the 19th International AIDS Conference

Yesterday was the first full day of the 19th International AIDS Conference, and it started off with a quick breakfast in the Positive Lounge. The lounge is a safe space set up for positive people attending the conference to come to for relaxation, rehydration and generally taking a break from the hectic conference as and when they need to.

I met a young Ugandan man there who went by the nickname ‘Supercharger’. He told me he was an entertainer who has dedicated his life to raising HIV awareness through his songs. He said that he was supposed to have travelled with some young adolescents he usually sings with, but the visas didn’t come through because he applied a little too late. As a Ugandan myself,  I asked his opinion about the HIV situation there and he said that, while the young people are very informed, Ugandan adults lacked information because they are indifferent and complacent.

I quickly went on to the first plenary session which had an array of very influential speakers, including Dr. Anthony Fauci, the most famous HIV Champion, Secretary of State Hillary Clinton, and Phill Wilson, the President of the Black AIDS Institute, as well as a black gay man who had living with HIV for more than 30 years! I cannot even begin to do justice to the presentations of these three individuals in this blog, but I would recommend to anyone interested in HIV to go online and read what they had to say. I can promise that you will be inspired. Although I found what all three speakers had say interesting, I was particularly moved by Phill Wilson as he described the HIV situation in the US and the impact on black communities.

Throughout the course of the last week, I have been learning a lot about HIV in the US and I have to say that I have found some of the statistics really frightening. The US has just over one million people living with HIV – the highest number in the developed world – and according to some sources, an American is infected every 10 minutes. The majority of Americans living with HIV know they have the virus, 40% are in care, and 36% of are on HIV treatment. Tragically, 325,000 do not have health insurance and do not qualify for Medicare, although the Affordable Care Act – what some people in the US have termed ‘Obama Care’ – has provisions that would improve the lives of people living with HIV.

When it comes to the African-American population, things are much worse. The rate of new infections for black men is six times that of white men, much, much worse for black men having sex with men. As for black women, the rate of getting infected is 15 times that of white women. HIV-related illnesses remain one of the major causes of death within this population, which is not that much different from some of the countries in Sub Saharan Africa with high HIV prevalence rates. It seems that there are gaps at every step from prevention, retention in care and treatment – leading some experts to say that America’s HIV epidemic has officially fallen through the cracks.

Other groups that are increasingly more vulnerable to HIV (and not just in the US) are migrants. The issue of HIV as it relates to migrant population seems to have picked up momentum at this conference.  But the very definition of exactly who is included in the migrant category is a challenge in itself. According to a discussion paper circulated ahead of a satellite session on Responses to HIV & Migrants in Western Industrialized countries, on Sunday 22 July, migrants from countries with high HIV prevalence are much more affected by HIV than the general population in their host countries. This situation is partly a result of the high HIV prevalence in countries of origin for migrants but the enormous challenges that migrants face in the host countries can make them even more vulnerable. Migrants find it difficult to navigate health systems in their host countries or face restrictions accessing healthcare, as well as facing many other social barriers, language issues, stigma and discrimination and poverty.

What tends to happen is that many migrants present late with HIV, get detained or deported to their countries of origin and, at worst, die from HIV-related ailments because of numerous barriers to care and lack of policies to monitor what is going on in migrant communities.

There is a renewed call to governments in the US, Canada and Europe to come up with policies that help improves the lives of migrants and makes them less vulnerable to HIV. The discussions present a good opportunity to do right by communities that policy makers have been reluctant to do anything about. My big hope is that the glimmer of light at the end of the tunnel is genuine and not an oncoming train, as one of the sayings goes.

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