AIDS, the Developing World and HIV Testing

J0321082 On Sunday, there will be a convening of the XVI International AIDS Conference in Toronto.  Because of U.S. restrictive policies on the entry of HIV positive persons into this country, it is no longer held here.  This will be Canada’s third (Montreal and Vancouver previously hosted.)

It is customary for the conference to be addressed by the hosting head of state.  Canada’s prime minister has declined.  That, in and of itself, is a signal that there is a problem with the attitude of developed nations vis a vis developing nations. 

I will be attending the conference and will post from there each day on scientific and social issues.  There are a lot of them.

One issue that is important to me is that of HIV testing.  In this country, prior to the introduction of antiviral therapies that dramatically changed the landscape of AIDS in this country and most developed nations, people had little or no reason to be tested for HIV.  That test, came long before viable medical therapies.  To test, only meant that you were marked for discrimination.  People need more incentive than therapy, they need to know that they are protected if they do take a test.

Fortunately, in the United States, not only did we have access to the pharmaceutical company discoveries that revolutionized treatment, we also had a very activist community that insisted on protections for people who were HIV positive.  Those protections were the product not only of the activist community, but of politicians who took the right stand and ensured that the stigma of AIDS was diminished, if not eradicated.

To be successful in the developing world, where the disease burden is greatest, we face the prospect of great stigma.  Scientific advances, access to new medications and the building of healthcare infrastructure is not going to be enough if there is to be success in the developing world against AIDS. 

An HIV test in this country before protections was not simply a medical test.  It was a test of your relationship with your friends, your partner, your community, your church and your family.  An HIV test tested all. 

Therefore, it is important that while we have safeguards now in place here, care has to be given to nurturing a more receptive environment to testing.  Prejudices and stigma have to be addressed.  Especially governments, who had much to learn from our experience must act.  To accomplish that it is the obligation of all involved, from government to NGOs to industry. 

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