At a tipping point: making sure no one is left behind

I met a nurse from Ukraine on a bus to visit the Victorian Aboriginal Health Service (more on that later), she said that only 25 per cent of people who need ARV (anti-retroviral treatment of HIV) are getting them. Later on, during a session about reforming drug policies to end the HIV and AIDS epidemic among people who inject drugs, I learned that since Russia annexed Crimea more than 800 people were kicked out of a methadone program.

It is due to a difference in national policy between Ukraine and Russia – Russia doesn’t support opiate substitution treatment (methadone treatment) and has limited needle exchange.

A doctor who is here from Poland, who specializes in HIV and infectious disease, was telling me that in their society a strong religious thread – mainly Catholic – has prevented people from talking about HIV, from getting tested. The epidemic she sees is predominately among gay men, sadly young gay men.

Of every $100 spent on HIV from donors, only one per cent (or $1) is spent on programming around sex workers. Of those dollars, many are spent on faith-based organizations, which may or may not support sex work. A group of sex workers who interrupted the morning plenary session are trying hard to get this message out.

Indigenous people are over represented in HIV statistics in many countries, and until recently their voices were not heard.

There is not a lot of commonality between those people but until each of those groups are recognized for their individual needs in the HIV/AIDS epidemic, the tide will not turn.

This was the message from Global Funds’ Mark Dybul. He says we are at a tipping point and with specific strategies (which will require all nations to actually pay the money from their commitments) we can move towards the end of AIDS.

Lest this comes across as far to Pollyanna in its simplicity, there are actually small movements underway to change the global approach to HIV to a more specific one.

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Floor at the Victorian Aboriginal Health Service.

During that trip to the Victoria Aboriginal Health Services in Melbourne, we learned services are for the Aboriginal community by the Aboriginal community. The perfect example of the tide changing is a package of condoms with a snake on it.

The box was designed by an Aboriginal young man to appeal to his counterparts. Inside are three condoms, one red, one yellow and one black – the colours of the Aboriginal flag. Since the health service started handing these condoms out, the uptake of condom use and conversations about safe sex have increased. Not bad for a simple design change.

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