Sunday, June 10, 2012
It's good to read that the Christian Science Monitor is taking an interest in an initiative from the International Network of Religious Leaders living with or Affected by HIV/AIDS (INERELA+). The initiative is called SAVE, which stands for: Safe sexual and skin-piercing behavior; Access to treatment; Voluntary counseling and testing; and Empowerment. (SAVE has also been covered by this blog and by the Don't Get Stuck With HIV blog.)
The ABC strategy (Abstinence, Be faithful, use a Condom; see the AVERT site for an interesting history) was pretty clapped out when Bush and his followers took it over, claiming that it was successfully used to reduce HIV transmission in Uganda (it wasn't). But when Bush and others insisted later that it was abstinence alone that made the biggest impact and that abstinence should receive the main emphasis (and the bulk of the funding), it became obvious that the smart HIV money would be on sex and sexual transmission. Big NGOs and the rest of the HIV industry did everything they could to climb on the bandwaggon. For some, coming from various church groups and former eugenics organizations, it wasn't even a difficult climb.
Sadly, the CS Monitor article doesn't move that far away from sexual transmission. Mentioning mother to child transmission, among those who believe HIV is almost always transmitted sexually, is often used to draw attention to the 'sexual behavior' of the mother or the mother's sexual partner, or both. HIV transmission rates have probably not changed that much in the past 10 years in East African countries that receive some of the highest levels of donor funding. Indeed, new infections in the US and several Western countries have remained the same for an even longer period. But this is a good start to moving away from the behavioral paradigm, the view that most HIV transmission (in African countries) is a result of heterosexual behavior.
One of those behind SAVE, Canon Gideon Byamugisha, is quoted as saying "achieving the UN goal of zero new infections, zero discrimination, and zero AIDS-related death will require a comprehensive strategy that addresses HIV in its entirety". He goes on: "ABC's flaw...is that it takes a moral and sexual approach only – a deadly approach in African cultures where stigma, shame, denial, discrimination and inaction are all too common reactions – and doesn't teach people the multiple strategies that can prevent the spread of HIV".
Not only are people seriously misinformed in thinking that all or most HIV is transmitted sexually, which means they are unlikely to know how to avoid non-sexual HIV risks, but they are also inhibited from being tested or even discussing HIV with others. Far higher levels of HIV testing are key to treating those who are infected and protecting those who are not infected, or who may be at risk of being infected. But for wider testing to have any benefit for HIV negative people, the main routes to infection need to be established.
Once everyone is in a position to learn how to avoid infection, through whatever route, HIV positive people should be able to avail of various treatment options, rather than having to keep their status a secret or put up with the sort of prejudice that has arisen against HIV positive people, and is reinforced by the insistence that it is almost always sexually transmitted. The Christian Science Monitor and others who wish to promote the interests of SAVE need to make things much clearer than they have done so far: knowing that someone is HIV positive does not give any insight into their sexual behavior or that of their partner. People face non-sexual risks through unsafe healthcare, traditional practices and unsafe cosmetic practices.
[For more about non-sexual HIV transmission, see the Don't Get Stuck With HIV site.]