Monthly Archives: May 2009

Openness

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I am a firm believer that being open about our HIV status is a powerful tool to challenge stigma around living with HIV.

The fact that only a handful of women in the UK are willing to do it is a clear indicator that this is impossibly difficult.

I believe often women are not open about their status because they need to protect people they love, often their children and families. Other times they are just terrified of the consequences. The possible violence, or just the rejection and the isolation they would experience as a result.

I think that I had a ‘relative advantage’ in my openness. Firstly, my employer is an HIV organization, so it wouldn’t (at present at least!) affect my employment. Secondly my parents are both dead. So I don’t worry about upsetting them. Thirdly I am single and without children. I don’t have to be anxious about the consequences of my openness on others I care about. And above all,  I had incredible support from other women living with HIV here at PW as well as incredible role models like Angelina Namiba, Winnie Sseruma, Alice Welbourn, who also are women living openly with HIV.

One of the most exciting ideas from the Leadership and Accountability Committee meeting I participated to in preparation for the next International Aids Conference  is to make a call to political leaders in high prevalence countries to ‘come  out’ about their status. Is it possible that there isn’t anyone? I don’t think so.  

We had a very lively debate about this and some questioned: what would the point be? The point would be to show firstly that anybody can live with HIV, and secondly that you can live a normal life and even hold great responsibilities, like being a minister or an MP. I think this would have a huge impact especially in Africa where stigma is still at the highest levels. Obviously we are not planning to ‘Out’ anybody. But wouldn’t it be great if somebody in power said: ‘Yes I am HIV positive, so what?’

HIV and Your Body

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Last week end before I could even begin to recover from my brain squeezing in Vienna I was squeezed even further by participating in a 2 days training on HIV and your body organized by GILEAD.

What made the training bearable was that it was held in the marvelous city of Barcelona. Community activists from all over Europe were invited to participate and it was great for me to network with more positive European women who I hope I can get involved in chairing and speaking at sessions in Vienna 2010.

The training was very well run with equal contribution from HIV+ activists and doctors. I had a bit of a clash with an Italian doctor (I will not name names….) He was the typical Italian professor pompous and patronizing. What made me furious was that he kept saying that Lipodystrophy is reversible: ’You need a plastic surgeon….a good plastic surgeon, a personal trainer, and a nutritionist…’. I am a typical Italian woman and I exploded! I told him that I thought it was unfair to say to people that Lipo (as we call it, maybe to make it sound less scary)  is reversible…It may be preventable…But I know plenty of people who took the early HIV drugs (the ones which are most associated with this side effect:D4t Ddi, Indinavir, AZT) and have since had plastic surgery, changed their diet, exercised…but can not reverse what has happened to their body shape…Saying that Lipodystrophy is reversible is setting people up for failure! And it will also exacerbate the guilty feelings often associated with having become infected with HIV   (blame blame blame goes in our head and around us)… And I would also like to add that one of the greatest problems for PLHIV (people living with HIV) in the UK is poverty….Let alone finding a good plastic surgeon!

Anyway my big mouth is now well known Europe wide…Sometimes it is unbelievable to think that the first year I used to go to support groups I hardly dared to speak…

If you are not worried about getting depressed on how your HIV is affecting, your heart, liver, kidney, bones, and body shape check the HIV and your body website. It is also gives lists of useful questions to ask your doctor in order to have those organs checked properly.

One thing was clear to me by the end of the training: CD4 count and Viral Load are not the only medical exams we should worry about anymore. We have to worry about cholesterol, triglycerides, cardiovascular risk, mineral levels, osteoporosis, and much more As scientists expand their understanding about the long term effects of HIV and medications the management of our health is getting exceedingly  complex.

I really worry how people are going to cope with living with  all of this without the appropriate level of support, while organizations by and for people living with HIV in Europe are not strong enough.

Did you know?

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My mind is still buzzing from all the information and discussion I participated in at Vienna.

Some random facts and numbers on the International AIDS Conference stuck on my mind:

The last conference in Mexico cost: 20.000.000 USD. My head is spinning thinking of all those dollar bills! How many shoes is that….? 

However in 2010 the budget will be 15% or 20% smaller. So ,really, we need to think hard how we can make less more.

More then 20.000 people participated to the last conference.

9ooo paying participants

8450 scholarships

The conference organizers still aim to offer the same level of scholarships, but also expand virtual access with more and more hubs, local computers connected to the conference, from which people can listen and participate.

There were 136 hubs which followed Mexico from around the world…but none in the UK,

Eastern Europe and Central Asia will be the focus of Vienna 2010. Unfortunately they couldn’t find a place with the suitable infrastructures in those areas that – if you don’t know- have had the fastest growing epidemic in the world in the past 10 years, mainly lead by injecting drug use. The epidemic has been made much worst by the lack of access to  ARVs and harm reduction (clean needles, methadone etc.).

In Mexico only 3% of participants came from Eastern Europe and Central Asia, so we hope that Vienna, sitting (nearly) at the doors of Russia will make it easier for PLHIV from those areas to participate.

For those of you who speak Russian you will be happy to know that all conference materials and translations will be offered also in Russian.

However, realistically it is not expected that more then 6% of participants will be from Eastern Europe and Central Asia.

I try to be optimistic about the impact that this will have, and for now  I feel it is great that at least there is an initial intention to have people who inject drugs at centre stage.

But I am also fully aware that the change we seek is an arduous task. All I can think of is the quote by Margaret Mead

  ‘Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it’s the only thing that ever has

First Meeting in Vienna

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Now I  have decided to use this blog to record my experience of being part of the Programme Committee for the next International AIDS Conference which will take place in Vienna in July 2010.

How did I happen to be here?

My first International AIDS Conference was in 2006 in Toronto. I described that week as the worst week of my life! Days starting at 6 am with sessions until night, demonstrations, networking dinners, jetlag, being with other 20.000 people all day, the noise, the crowd, the amount of information to take in… One day I went back to my room early (around 5) thinking of taking a nap before having dinner with some other activists, but woke up the morning after. That’s how exhausted I was. I even missed dinner!

One of the most important momenst for me in Toronto was seeing Louise Binder, an HIV+ lawyer and AIDS activist speak at one of the last plenary sessions…Her opening words  ‘ I want to speak with you about power…the driving force behind the HIV epidemic today. Where power resides, the virus recedes. Where it does not, the virus thrives. Today, the virus is thriving…’

By the end of the conference I had a resolution. I had to manifest my power, OUR power. I knew that the work we do at PW had a lot to offer to this conference.  I told myself…I am not coming back to this hell unless I will be offering some of what I have learned…

Fast forward 2 years and in 2008 I had an abstract accepted for an Oral Presentation for the conference in Mexico. My abstract talked of how working together with ICW we had supported the advocacy and leadership skills of 25 Regional Coordinators, developing PozFem UK, the national network of women living with HIV.

So what next? I told myself…Maybe being part of making the conference happen…? Be careful what you wish for…. A friend I made in Mexico suggested I applied to be in one of the Track Committees. So I did. And so I got selected to sit in the Leadership and Accountability Track Committee.

Today during the first  brainstorming meeting we were asked what we hoped to achieve with the next conference and I told them the story I just told you.   I concluded that I want the conference to be an opportunity to develop leadership skills at the grassroots, especially among women.

I felt so intimidated today, everybody seems a professor, or working for UNAIDS or WHO and once again I doubted myself…. I have lived with HIV for 13 years volunteered and worked at PW for 10, I have visited positive women in prison for the past 8 years. But I still doubted my knowledge, experience, commitment and passion in front of so many ‘big’ people.  I know I shouldn’t. One week doesn’t go without me not listening from other women who live in so called ‘civilized’ Britain of horrible experiences about fear, shame, blame, rejection and physical and mental abuse and violence. And in spite of this I have seen how through the support they receive from other of us who live with HIV they learn to deal with whatever they are facing,  and sometimes even become activists.

I know that if I am not here talking about what I have heard from so many of us, in support groups, or when I go to  prison…who is going to do it for us? I hope that me being here will bring many more of us   to Vienna in 2010 not just as spectator but as central actors.

Well I better get off my soap box and go to bed now…I have a long few days ahead of me and I better be fresh and rested.

History Lesson: Gay Men and Activism

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Last month watching the Oscar winning film Milk made me reflect more deeply on the role gay men have had in creating and developing HIV activism. Milk is the moving life story of Harvey Milk, the first openly gay man elected to public office in San Francisco 1978, and his subsequent tragic assassination. The film made me reflect on the connections and influences between the movements for gay rights and the movement of People Living With HIV and AIDS (PLWHA). It also made me reflect on the present weaknesses of activism in the UK.

Of course the first connection between the movement of PLWHA and the gay movement is historical. In 1981 the first name for AIDS was GRID: Gay Related Immune Deficiency. The acronym was created by the Centre for Disease Control (CDC) following the death of a group of men in Los Angeles who were openly homosexual from PCP (pneumocystis carinii pneumonia), a type of pneumonia that at that time was ‘almost exclusively limited to severely immune suppressed patients,’ such as older patients or those receiving cancer chemotherapy. GRID was soon changed to Acquired Immune Deficiency Syndrome (AIDS) as the number of gay men dying continued growing, but other groups started dying inexplicably from similar infections, mainly injecting drug users and haemophiliacs.

Gay men came to the tragedy onset of the AIDS pandemic equipped with a lot of experience in fighting for their rights. Many of the men who were supporting Harvey Milk became in the 1980’s, AIDS activists, and set up organisations such as ACT UP – which I think has the coolest acronym in the history of AIDS activism, it stands for AIDS Coalition to Unleash Power!

The official birth of the Self Empowerment Movement of People with AIDS (PWA) – as it was called then, before HIV was discovered – was in 1983 in Denver during The National Lesbian and Gay Health conference in which the first manifesto for a political network of PLWHA was launched. The manifesto is known as the Denver Principles. I think you would agree with me that those principles are as valid as ever:

The Denver Principles

We condemn attempts to label us as ‘victims,’ a term which implies defeat, and we are only occasionally ‘patients,’ a term which implies passivity, helplessness and dependence upon the care of others. We are ‘People with AIDS.’ [sic]

RECOMMENDATIONS FOR ALL PEOPLE

1. Support us in our struggle against those who would fire us from our jobs, evict us from our homes, refuse to touch us or separate us from our loved ones, our community or our peers, since available evidence does not support the view that AIDS can be spread by casual, social contact.

2. Don’t scapegoat people with AIDS, blame us for the epidemic or generalise about our lifestyles.

RECOMMENDATIONS FOR PEOPLE WITH AIDS

1. Form caucuses to choose their own representatives, to deal with the media, to choose their own agenda and to plan their own strategies.

2. Be involved at every level of decision-making and specifically serve on the boards of directors of provider organisations.

3. Be included in all AIDS forums with equal credibility as other participants, to share their own experiences and knowledge.

4. Substitute low-risk sexual behaviours for those which could endanger themselves or their partners; we feel people with AIDS have an ethical responsibility to inform their potential sexual partners of their health status.

RIGHTS OF PEOPLE WITH AIDS

1. To as full and satisfying sexual and emotional lives as anyone else.

2. To quality medical treatment and quality social service provision without discrimination of any form, including sexual orientation, gender, diagnosis, economic status or race.

3. To full explanations of all medical procedures and risks, to choose or refuse their treatment modalities, to refuse to participate in research without jeopardising their treatment and to make informed decisions about their lives.

4. To privacy, to confidentiality of medical records, to human respect and to choose who their significant others are.

5. To die — and to LIVE — in dignity.

The film Milk also made me think about another strong connection between one of the crucial issues of the Gay movement and the movement of PLWHA. A central part of the film is when Harvey Milk has to deal with Proposition 6, an initiative to ban gays and lesbians from teaching in public schools. While addressing homosexuals around the US, Harvey Milk urges everybody to come out, so that all in society can realise that they know and love somebody who is gay or homosexual. Harvey Milk’s words made me realise the fact that the great number of people, just in the past few decades, who have come out as gay and lesbians has contributed enormously to an increase in the acceptance of gay and lesbian people in society, and the recognising and upholding of their rights. I am also painfully aware that we still have a lot of ground to cover and our society is still very homophobic. However, huge steps have been taken just in recent times, such as the legal recognition of gay marriages through civil partnership, in the UK. That advancement would have not been possible without the courage of so many homosexuals who in spite of society’s widespread prejudices have been open about their identity and vocals in reclaiming their rights.

Milk made me once again realise that being ‘out’ and ‘open’ about living with HIV is key if we are to eliminate HIV related stigma. It is only when people realise that HIV is not about ‘Us’ and ‘Them’, when everybody realises that they know and love somebody who is HIV positive or has been affected by HIV, that prejudice will diminish and maybe even disappear. This cannot happen until more of us are open about our status.

I know it is hard, I know it is impossible for some of us, who fear they will harm loved ones, or that they could experience rejection, isolation or even violence… However, this is what gay people too had to face and many of them in conjunction with HIV! Living openly with HIV is a crucial weapon to challenge the stigma and discrimination that are still rife in society. If we are not going to do it… Who is going to do it for us?

I don’t mean that we all have to go public and speak on the 6 o’clock news! But I believe every little act of openness is a manifestation of self-acceptance and a further step towards creating a more compassionate and supportive world for PLWHA. It may just start with a few friends, our neighbours, somebody we work with, our children, our families… Every time we disclose to more people safely, we become more empowered and we push prejudices and shame away.

So if you disclose to somebody new in the next few days, weeks, months or years… pat yourself on the shoulder because it is an important action for all of us living with HIV!

Reflecting on openness has made me realise that the group that have been most closeted about their HIV status are heterosexual men, especially white men (with a few exceptions mainly among haemophiliacs and injecting drug users). I guess the main reasons could be: firstly because of their general ‘advantage’ in society they are the ones who would lose the most (income, social status, opportunities for sexual partners etc.). Secondly, maybe, most men are brought up to express less their feelings and emotions and therefore stay longer in denial around many of the issues around HIV. Thirdly, they have been often demonised in the world of HIV as ‘vectors’ of infection, unwilling to wear condoms and the main cause of growing infections among women (who in return have often been ‘victimised’). Those are the main reasons I imagine, but I would be curious to know more.

Probably the small number of people who are open about their HIV status in the UK is also due to lack of support and a weak activist community. It is interesting to see that in the US, the National Association of People with AIDS (NAPWA) in collaboration with POZ magazine have launched this year a new initiative called the Denver Principles Project, which aims to recommit the HIV community and increase their membership. They are aiming to have 100.000 members by the 1st of December 2009, World AIDS Day. I would really like us, in the UK, to join the activists from the States and recommit ourselves to the Denver Principles; and, in order to do this, to create a Network of People Living with HIV. Of course, there are organisations that campaign and speak on our behalf. However, it is not the same thing as having our own voice, and such a network would make the existing campaigning organisation more effective. With the number of us living with HIV always increasing it is crucial that we form a network which includes HIV positive men and women of any sexuality and race… It is almost unbelievable we don’t have one yet! What are we waiting for?

For more info on the Denver Principle Project http://http://www.napwa.org/denverprinciplesproject