Combating discrimination was the main focus of the international Aids conference held in Cape Town this week. Justin Pearce reports
BURIED in the agenda of this week’s Cape Town International Conference for People Living with HIV and Aids was a session entitled “Identities”. Delegates split into interest groups — sex workers, heterosexuals, drug users, lesbians/gays, transvestites/transexuals, migrants, youths — to voice their particular concerns.
The international nature of the conference added to the diversity: there were delegates from the United States, which has led the world in Aids activism, and from central Africa, which is where the epidemic started and where infection rates are highest. They were joined by delegates from Asia, where the epidemic is relatively new but spreading fast.
In North America, it was gay men who were first hit by Aids, and Aids activism grew out of gay activism. In Asia, the epidemic is popularly associated with sex workers. In Africa, notions of “high-risk groups” are meaningless, as the epidemic devastates whole families — the World Health Organisation estimates African Aids cases to account for 70 percent of the 4,5-million cases worldwide.
The conference, held in Cape Town, was organised by the Global Network of People Living with HIV/Aids. On the surface, the delegates had very little in common beyond being infected with the virus.
“The aim of the conference is to provide an environment for people with HIV to feel secure, to give them an opportunity to speak in a way they can’t speak at home,” said conference chair Shaun Mellors.
Significantly, this was not a medical conference. Asked about their most pressing concern in attending the event, delegates from all over the world were almost unanimous: combating discrimination.
As South African Aids activist Prudence Mabela pointed out, “Aids is a very political disease”. This observation cuts both ways: on the one hand, it means people’s experience of HIV and Aids is overwhelmingly determined by the kind of society they live in; on the other, it means discrimination is something which all people with HIV have to face.
“As soon as you have HIV, people assume you’re a prostitute anyway,” said US delegate Marlene Diaz.
Discrimination is discrimination whether you’re a drug user in Berlin or a single mother in the Northern Transvaal — even if the strategies which you use to combat that discrimination may be vastly different.
Mabela spoke of how the notion of counselling — sacred to Western popular psychology — was alien in many African cultures: “You sit down with them and ask them how they feel, and they will say ‘I feel nothing’. They need to learn that problems must be shared.”
With African women at particularly high risk from HIV – – infected women in Africa outnumber infected men by six to five — educators face the monumental task of reshaping traditional attitudes to gender roles and
“You say, ‘don’t let your husband sleep with you without a condom’ — and she comes back to you the next day with a bruised eye,” Mabela said.
This week’s conference was the seventh of its kind, and the second to be held in a developing country. The first five conferences were held in Europe or North America, with First World concerns dominating the agendas. Hence the decision to hold future conferences in the developing world.
At this year’s conference, 40 percent of the delegates were from Africa, and another 40 percent from Asia, the Pacific, and Latin America.
The 20 percent who came from Western Europe and North America — the regions that are best equipped with the resources to support people with Aids and HIV — showed a willingness to pass on whatever skills they could, without being prescriptive.
“We have no intention to recolonise the world,” remarked German delegate Carsten Schatz.
Mellors wondered whether the diversity of experience was too great to be accommodated in a conference of this kind. “Some people who are here from developing countries don’t even understand the difference between HIV and Aids,” he said, suggesting that in future years the educational function of the conference ought to take place at regional rather than global level.
But, he added, “we are trying to make this year’s conference as practical as possible for people from the South”.
The conference agenda included discussions on how to set up income-generating projects to help break the cycle of HIV infection, unemployment and poverty.
Discrimination in the job market against people with HIV is particularly acute in developing countries where poverty is endemic. People don’t dare disclose their HIV positive status for fear of being ostracised by family, friends and employers, and because of this secrecy there is nothing to counteract the prejudices that prevail.
Silence in turn leads to denial — lack of awareness about the epidemic leads to a situation where people refuse to believe that educational materal about HIV transimission is relevant to them.
Intervention by those in power cannot provide an outright solution to the epidemic, but it can help to break the vicious cycles which have seen the epidemic spinning out of control.
Delegates universally praised Minister of Health Dr Nkosazana Zuma for implementing a policy of non- discrimination against people with HIV when employing new Health Department staff. Mellors expressed the hope that other departments and the private sector would take their lead from Zuma in combating discrimination.
On the other hand, South Africa’s Department of Home Affairs took flak for stamping foreign delegates’ passports with visas that indicated they had come to South Africa to attend a gathering of HIV-positive people. “Now I am not sure whether I will be able to visit a country such as the US which has a policy of excluding people with HIV,” said a Russian delegate.
The United Nations, too, has taken cognisance of the need for non-medical intervention in the crisis.
“HIV transmission takes place in a particular social environment,” observed Dr Peter Piot, executive director of the new Joint United Nations Programme on Aids. “We need to create an environment that is conducive to safe sexual behaviour and drug use.”