Just got back from the International AIDS Conference in Mexico City where I worked with the Caucus for Evidence-Based Prevention to produce a daily newsletter covering each day's activities. Check out the Caucus website to see some of my mad editing skills, then look at the article below, also posted on RH Reality Check, covering a Caucus event with Elisabeth Pisani, author of The Wisdom of Whores.
All in all, it was a long, but productive week in Mexico City and now I'm taking some well-deserved (in my opinion) time off!
What are the Sacred Cows of HIV Prevention? (unedited version below)
“We need to be clear that this is the best researched disease in history. We know what to do to prevent HIV infection, but we’re not drawing a straight line between what we know and what we do,” stated Elizabeth Pisani, author of The Wisdom of Whores: Bureaucrats, Brothels and the Business of AIDS, to open Monday night’s satellite session sponsored by the Caucus for Evidence Based Prevention.
This session was a frank and honest discussion among advocates, framed around Pisani’s idea of the “sacred cows of HIV” (an analogy taken from drivers in India swerving to avoid cows in the road). What are the “sacred cows” standing in the way of true progress in the fight against AIDS?
There are religious groups that advocate for HIV policy based in ideology rather than evidence. Some cited the AIDS industry itself, that has framed AIDS as “everybody’s problem” in order to draw attention and funding, rather than focusing attention on the groups most at risk. The history of activism around HIV may be to blame as well, creating an anti-testing bias and a pro-treatment bias rather than a focus on prevention. There is also an assumption among public health advocates that people are rational decision-makers and will make rational decisions about their health (e.g., using condoms and clean needles), when the evidence is that when sex and drugs are involved, people are not rational at all.
The group also discussed the need to strengthen health systems in general. Are poverty reduction, food security and women’s empowerment issues also AIDS issues, or should they be kept separate from the AIDS discourse? As Ms. Pisani stated, “Why do we need HIV to fight against sexual violence?” Some in attendance liked the idea of using HIV as a catalyst for ensuring these basic human rights, but others thought that we should focus on the fundamentals of HIV prevention.
This discussion, originally scheduled for two hours, lasted far into the night and is only one of many discussions that need to be had to topple our “sacred cows” and promote HIV prevention based in scientific evidence.
