Lack of Access to Evidence-based HIV Prevention and Care
Is a Fundamental Violation of Human Rights
AIDS 2010 Delegates, Speakers and Organizers Call for an End
to the Passive Neglect and Active Denial that Thwart Access
to Lifesaving Health Services, Information and Tools That Fuel the HIV Epidemic
22 July 2010 [Vienna, Austria] - The appalling lack of access to scientifically proven interventions
for key populations at risk -- including sex workers, men who have sex with men and people who
use drugs - and the lagging scale up of simple and inexpensive treatment regimens to prevent
vertical transmission of HIV reflect persistent, underlying human rights violations that threaten
future progress on AIDS, according to organizers of the XVIII International AIDS Conference taking
place in Vienna this week under the theme of Rights Here, Right Now.
"To deny a woman the tools and information she needs to protect and care for her own health and
that of her child is to deny the value of their lives," said Dr. Brigette Schmied, AIDS 2010 Local Co-
Chair and President of the Austrian AIDS Society. "Gender inequality puts women at greater risk
for HIV and also means that sufficient resources are not being provided to implement even the
simplest and most effective interventions," she added. Fewer than one-half of pregnant women in
low- and middle-income countries who require care to prevent vertical transmission have access.
The disconnect between currently available knowledge and access to HIV prevention and
treatment services for people who use injection drugs in Eastern Europe and Central Asia has also
emerged as a key conference theme. Though injecting practices fuel the region's epidemic, access
to scientifically sound strategies, including needle and syringe exchange programmes and opioid
substitution therapy, are scarce and even illegal in many locations, including Russia.
"In Eastern Europe, just a few kilometres from Vienna, drug use is driving the AIDS epidemic," said
Dr. Julio Montaner, AIDS 2010 Chair, President of the International AIDS Society and Director of
the B.C. Centre for Excellence in HIV/AIDS in Vancouver, Canada. "The Vienna Declaration calls
on the world to move beyond fears and prejudices to take scientifically-proven steps to save lives,"
he added.
Laws that criminalize injecting drug users, men who have sex with men and sex workers remain
widespread, though evidence presented at the conference and elsewhere indicates clearly that
such approaches undermine, rather than advance, public health goals. As a result of such laws, as
well as stigma and discrimination, members of these communities have significantly reduced
access to both treatment and prevention services.
The consistent call throughout AIDS 2010 for the extension of human rights protections as a
central tenet of the global response to AIDS was amplified by today's three plenary speakers, one
of whom delivered the annual Jonathan Mann Memorial Lecture.
Combination HIV Prevention: Moving from Debate to Action
Dr. Carlos Cáceres (Peru) of the Institute of Studies in Health, Sexuality and Human Development
presented examples of combination prevention initiatives, including aspects of their design, impact
figures and cost. Combination prevention includes biomedical interventions, behavioural and
structural approaches. The concept maintains that a single prevention intervention is less effective
than a combination of efforts that address multiple issues on several levels.
He said that combination prevention is increasingly considered a "sensible" way to move toward
universal access to HIV prevention, treatment, care and support. Cáceres argued that combination
prevention is evolving into a rich concept that is comprehensive, strategic, and evidence- and
human rights-based. The added value of combination prevention strategies would help the concept
become a guiding principle of the HIV response.
Vertical Transmission
Dr. Elaine Abrams (United States) of the International Center for AIDS Care and Treatment
Programs at Columbia University's Mailman School of Public Health called for a new era in the
prevention of mother-to-child transmission (PMTCT). While some countries have demonstrated
more noteworthy successes in this area over the last several years, large numbers of children
remain at risk for HIV infection in most high-burden countries. Abrams said that failure to attain
more substantial achievements in this area can be attributed primarily to a constricted approach to
PMTCT centered on HIV testing and simplified antiretroviral prophylaxis regimens. Although an
estimated 60,000 to 70,000 pediatric infections were prevented through PMTCT in 2007, 1,200
children per day are still infected with HIV.
Abrams said that a shift from a narrow focus on preventing transmission to one that embraces the
comprehensive, long-term health needs of women, children and families is necessary to reach a
perinatal transmission rate of less than 5% by 2015. Key advances needed to achieve this goal
include the rapid geographic expansion of prevention and treatment services, increased
awareness of the human rights of PLHIV, and innovative strategies to prevent new infections in
young girls and women.
No Excuses: A Living Experience of the Struggle for Rights - Jonathan Mann Memorial
Lecture
Meena Saraswathi Seshu (India) of Sampada Grameen Mahila Sanstha (SANGRAM) presented
examples of rights-centred responses to the HIV epidemic using real-life stories of programmes in
western India shaped by the participation of sex workers, men who have sex with men (MSM),
rural women living in poverty and young people. Too often, programmes that claim to be committed
to rights-centred responses do not reflect that commitment, she argued.
Seshu said that the sex workers' involvement in shaping HIV education and health services helped
them go from social pariahs to leaders in the HIV response while gaining community respect.
Through this evolution, the community found the strength to challenge generations of entrenched
discrimination and abuse against MSM, overturn social norms that impeded young people's access
to comprehensive sexuality education, and bring to the centre of its collective consciousness the
hidden problem of violence against women. Seshu noted that while the stories she presented arise from the Indian perspective, the challenges overcome using rights-centred language, tools and
strategies are similar to those faced in many parts of the world.
Visit www.aids2010.org for complete programme information and comprehensive online coverage,
as well as a link to the Vienna Declaration, the official declaration of the XVIII International AIDS
Conference, which calls for a reorientation of international drug policy.
About the AIDS 2010 Organizers
AIDS 2010 is convened by the IAS, the world’s leading independent association of HIV
professionals, in partnership with a number of international, regional and local partners.
International partners for AIDS 2010 include:
• Joint United Nations Programme on HIV/AIDS (UNAIDS), including its co-sponsors, the World
Health Organization (WHO) and the United Nations Office on Drugs and Crime (UNODC)
• International Council of AIDS Service Organizations (ICASO)
• Global Network of People Living with HIV/AIDS (GNP+)/International Community of Women
Living with HIV/AIDS (ICW)
• World YWCA
• Caribbean Vulnerable Communities Coalition (CVC)
Local and regional partners for AIDS 2010 include local scientific leadership and:
• City of Vienna
• Government of Austria
• Aids Hilfe Wien
• Austrian AIDS Society
• East European & Central Asian Union of PLWH (ECUO)
• European AIDS Clinical Society (EACS)
• European Commission
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MEDIA CONTACTS
Regina Aragón (Rome)
International AIDS Society
regina.aragon@gmail.com
+43 699 172 85 713
Christian Strohmann (Vienna)
AIDS 2010 Local Secretariat
christian.strohmann@aids2010.org
+43 699 181 73002
Scott Sanders (Washington, DC)
High Noon Communications
scott@highnooncommunications.com
+43 699 172 84 833
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