Prison Health is Public Health

Today at the XVIII International AIDS Conference in Vienna, for the first time a plenary session was dedicated to HIV in Prison.

Dmytro Shermebey, one of the leaders of the All Ukranian Network of  People Living with HIV opened the session. He spoke of his personal experience of spending nine years in a Ukrainian prison. While he spoke pictures of prisoners, and prison cells were projected on the massive screens in the plenary hall. Dark spaces filled with emaciated young men, barely over boyhood, with  spider arms, reminiscent of Auschwitz. Prison meant: hunger, lack of sanitation, overcrowding, lack of air. It is not surprising that to be able to cope with those conditions prisoners had to use the most powerful painkiller in the world: heroin. Harm reduction, drug substitution therapies, clean needles and condoms are not available in Ukrainian prisons, and in the majority of prisons around the world. Dmytro recounted how syringes were shared by prisoners. One blunt needle would be sharpened on a stone over and over again in order to be reused .  It is not surprising that HIV prevalence in the global prison population is always much higher then in the general population.

Today plenary showed the world that those young men were clearly not only deprived of their liberty, but also robbed of all dignity, food, and health. Those are all fundamental Human Rights.

Dymitro explained to us that he survived because he fought.  But, many of his friends have died and are still dyeing.

I have been visiting women living with HIV in prison since 2001, when I started working for Positively Women (now Pos UK). Dmytro’s presentation made me appreciate all the good things of British prisons: above all access to ARVs, methadone and, at least in the few female prisons were Pos UK has been doing outreach, peer support. However I also know too well how damaging, traumatizing, and disempowering the experience of prison is,  especially for women .

So many of the women I see in prison have tragic pasts; addiction, abuse – including sexual abuse – neglect, and poverty are recurrent themes. I believe many of them suffer from mental health problems.

One of the biggest problem about the situation of women in prison, even in the UK,  is that it is severely under-researched. For ‘security reasons’, everything about prison is very guarded.

From my experience of supporting hundred of women I can affirm that prison is very hard for any body, but the added burden and terrible anxiety of having to guard the secret of HIV makes it a lot harder.

In the UK prisons women are a fast-growing population. According to the Prison Reform Trust Report of 2006 in England and Wales, the number of women has increased by more of 200% in the past 10 years compared to a 50% increase in the number of men in prison during the same period. At present, there are more then 4,200 women in prison in the UK.

This increase in the UK follows global trends towards a greater use and popularity of imprisonment and a lack of interest in constructive alternatives such as non-custodial sentences. Those would be particularly relevant to drug offenses and non-violent theft. Drug offenders in particular, would be better dealt with by therapeutically addressing their addiction.

Prison has a tremendously harsh effect on women, for several reasons. Firstly, women offenders are often the sole carer of their children, (more often then male prisoners). Their imprisonment and separation from the children can cause major psychological traumas, which are very difficult for both the mother and the children. This has grave repercussion for all of us in the communities were those children live. If they are the head of their household, their incarceration could result in the loss of their home, and serious disruptions to the lives of the children.

Since there are fewer women’s prison, women are more likely to spend time in a prison which is far away from where they live, so that visits from family and friends are extremely difficult. Women in prison can experience profound isolation, which has an effect on their often already compromised mental health. Additionally, because there are few women’s prison, women convicted from a wide range of offences are often imprisoned together. This means that the overall regime will be determined by the maximum-security requirements of a very few high-risk prisoners. Overall, the prison system was designed to deal with male prisoners, because of this it actually often discriminates against women.

If you add to this bleak picture the hurdle of living with HIV, and often of being diagnosed, while in prison, it is clear that there is an extreme urgency for a radical prison reform that takes into account gender equity and the right to health of women prisoners.

A comprehensive reform of the criminal justice and prison system was called for in today’s plenary session by Manfred Nowak, the UN Special  Rapporteur on Torture. He stated: ‘Prison Health is Public Health’.

I applaud the International AIDS Conference for having dedicated for the first time a plenary to Human Rights violations in prison. However I hope that this is not a one off token session. I believe that it is crucial to discuss more of the gender dimension of prison and how it increases women’s vulnerability to HIV and negatively affects physical and mental health.  We still know so little about this, especially on a global scale. Hopefully we will do this in Washington in 2012.

Save Us From Saviors!

It is getting all a bit overwhelming.

The third day, Wednesday, the theme for me  must have been physical and emotional exhaustion. I wasn’t the only one.   Just by looking at people I could tell that many of conference participants were experiencing an energy low. It takes a lot to absorb all the enormous amount of information, ideas and emotions which are here.

In spite of this I managed to facilitate 2 sessions at the Women Networking Zone, one on women and networks and another a panel discussing the effects of laws criminalizing women’s sexuality.

I sat along women from Venezuela, Germany, South Africa, Malaysia and the US. We shared our different experiences of mobilizing and politicizing women in order to challenge laws that criminalize homosexuality, criminal prosecution of HIV transmission, and sex work.

At the end of the debate a sex worker from Malaysia took the microphone and said: “ I have been a sex worker for 15 years, suffered a lot of abuse from the police, and this is the first time I speak up. It has taken me 15 years. But I will continue when I go back to my country. Having met all of you has given me the strength to speak up’.

One of the overwhelming aspects of this conference is the amount incredible personal transformations that take place in front of your very eyes. It is like watching an accelerated films of a field of flowers blossoming.

I had some huge lessons from the sex workers movement at this conference. Today’s plenary ( Thursday) included an amazing multimedia presentation by Meena Saraswati Seshu of Sampada Grameen Mahila Sanstha (SANGRAM), who are promoting a rights centred programme in Western India.

SANGRAM works with sex workers, men who have sex with men (MSM), rural women living in poverty and young people. Sex workers have become involved as HIV educators. They go in the streets to teach truck drivers and the wider community about HIV, STDs and how to use condoms. Stepping up as educators has helped them to go from social pariah to leaders in the response to HIV.

Here is the SANGRAM Bill of Rights presented at the plenary:

1. I have the right to be approached with humility and respect.
2. People have a right to say yes or no to things that concern them.
3. People have a right to reject harmful social norms.
4. People have the right to stand up and change the balance of power.
5. People have the right not to be rescued by outsiders who neither understand them nor respect them.
6. People have the right to exist how they want to exist.

Save us from saviors!

Rights Here, Rights Now

Tuesday at the International AIDS Conference has been dedicated, for me,  once again to increase the voice and visibility of women and girls living with HIV.

But before I go into what I have done let me tell you that one of the great news that was announced this week is the results of a large trial on microbicides using Tenofivir (an ARV).

A  Microbicide is  a woman controlled prevention method. It can be a gel or a cream, or even a ring, that when applied to the vagina stops HIV transmission, and sometimes can also prevent other STDs. If you have never heard about them, it  is because we still don’t have an effective one. This is why this research is so important.  At this point in the trial effectiveness reported was around 39%, however it is probably higher, because adherence wasn’t very high in the long-term, but this is a behavioural problem that hopefully can be addressed.

Personally it was a fantastic day, but a bit nerve-wracking. In the afternoon I co  facilitated a workshop, with the help of Angelina, Sophie and Harriett,  entitled ‘Women Living with HIV Getting Involved with the Media. Why Bother?”

The workshop was held in the Women Networking Zone, an amazing space in the Global Village dedicated to foster debate and action about important issues for women and girls. The area is delineated by a washing line where bras and nickers are hanging. For me this washing line highlights  the intimate and personal aspect of women’s discussion and political involvement.

Here are some images:

The workshop focused on understanding what we can gain by becoming more visible in the media and in building skills for women to feel confident at giving interviews. As an end result  we wanted also to have  some interviews by women who participated in the Vienna conference to be published in a twin edition of Positively Women Magazine (in English) and DHIVA magazine (in German). At the end of the workshop 6 women volunteered to be interviewed. How is that for increasing the voice and visibility of HIV positive women?

The Women Networking Zone also hosted the launch of WeCare + , a newly established European and Central Asian network of women living with HIV.

At night I had the most nerve wracking and exhilarating time of my life. I was scheduled to lead the Human Rights Rally alongside Julio Montanier, the president of the International AIDS Society, Michel SIdibe Director of UNAIDS and Rolake  Odetoyinbo, an amazing woman living with HIV from Nigeria. There were many more amazing activists and politicians leading the march, but unfortunately I do not remember everybody’s name.

We marched through the historical center of Vienna. We were a crowd of thousands and thousands of people. Black, white, gay, sex workers, trans-gender, male, female and anything in between. We arrived in the beautiful Heldenplatz, at sunset,  and we were shoved on stage to make our speeches before the singer and activist Annie Lennox performed.

Here is my speech:

I am Silvia, I am a woman living with HIV.

Today I would like to talk to others who like me share their bodies and their minds with HIV.

Here in Europe we are lucky enough to have access to treatment. But, we all know too well that it takes more then a handful of pills to live with HIV.

Yes the virus in our blood can now be undetectable, but stigma is almost everywhere.

Many of us live lives of fear and shame. Women like me even fear to start a relationship or feel shame about what people think of us if we have babies. We still fear to be rejected by our families and loved ones.

And it is not only fear. It is also reality. Many of us still experience discrimination even when going to see a family doctor or a dentist.

Those of us who are in prison can be bullied, and attacked, without protection from those who are responsible for them.

I could go on and on with the violence and lack of support which is still the daily reality for many of us.

Today I would like to ask you, you who are HIV positive like me: what is the answer to this? What part can we play?

Personally I made the choice in 2005 to be open about my status. It is one of the most powerful tools I have to challenge stigma and to stand up to any discrimination.

It is our birthright to be treated with dignity and respect, but it is our responsibility to demand that others fulfill this right.

Stigma will not end if we are invisible.

Women and girls what do we want?

Human Rights Now!

Leadership

Silvia Petretti and Vuyiseka Dubula

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HE THEME of Monday, the first day of the conference, for me has been leadership. Maybe it is because I was facilitating a workshop on developing leadership skills for women living with HIV, with my comrades Angelina Namiba and Inviolata Mmbawavi.

During the session we tried to address the issue of openness. We asked participants: on a scale of one to ten.  How open are you about your status? Where would you like to be? What needs to happen for you to move just one point on this scale?

After those questions we aimed to build a tree of action with post-its on a flip chart.

We asked participants:

What can you do personally to move forward and be more open as an HIV positive woman leader?

What can you do to move forward as a leader with the support from other people living with HIV?

What do you need to campaign for your government to do?

The aim of this exercise was to inspire a process of moving from the personal, to the collective to the political, and understand how all those elements are part of one continuum.

Those questions kept resonating in my head and manifested during the course of the day.

The plenary featured Vuyiseka Dubula the Director of Treatment Action Campaign, the organization instrumental in making HIV treatment affordable in developing countries: thanks to their tireless campaigning. She exemplified the power of openness.

A South African HIV positive woman from the township advocating for Positive Health Dignity and Prevention. This is an approach to prevention that acknowledges equal responsibility of negative and positive people in the transmission of HIV. People with HIV in this paradigm are not seen as mere vector of infection but as actors who can promote prevention, within a context where human rights are fully respected.

Bill Clinton also spoke at this first plenary. He may no longer  be the President of the USA , but made a very strong call for political action and for continuing funding the epidemic. Clinton spoke for nearly an hour and it would be impossible for me to capture his incredible skills and charisma as a public speaker.

Among the many things he mentioned was the need for new fund raising strategies such as those adopted for Haiti earthquake, where a huge number of people gave small amounts, through text messages and the internet.

Obviously he had to speak quite a length on how it is crucial at this point in history, in which we have reached some tangible goals, not to retreat because of the economic crisis.

He made once again the point that the economic argument for promoting Public Global Health, needs to be made stronger: “Health Care is not just a right is an economic investment,” he said.

To conclude his speech he made a ‘bucket list’,  things he would love to see happen before he kicks the bucket: “What I really care about is to see my grandchildren, an for all grandchildren of the world to grow to know their grandparents.” We have done good but we need to do better if we want those two generations to stay healthy and meet.

Bill and Vuyseka represented for me, some answers to the personal and political questions about leadership I had asked the participants of my session. Even though Clinton had been harshly criticized while he was in power, for doing very little for people with HIV.

My question on what we can do as people with HIV to move our leadership forward was addressed in the last session of the day: GIPA at the Grassroots Level and Beyond. GIPA means: Greater (and Meaningful has been subsequently added) Involvement of PLHIV.

It was historically born in the Denver Principles in 1983, and signed as a full declaration by 42 countries in 1994. GIPA means that PLHIV should be involved at all level of decision making in the response to the epidemic.

During this session many examples of collective action by PLHIV were exemplified. The most striking for me was the Ukrainian Network of PLHIV, one of the largest networks of PLHIV in the world with over 200.000 members,  100 of them are open about their status.

They are the principle recipients of the 6^th round of funding from the Global Fund. In spite of the fact that most of its members are or have been drug users (a group not exactly famous for political action and expressing power) they have made ARV’s and drug substitution therapies a reality in their country.

It has been another amazing day here in Vienna. One of the most moving events has been that at the end of our session on leadership two women, one who had been positive for 17 years, and one for five, disclosed their status to the group. It was very emotional, but it was also an honour to witness those two women take their first step towards leadership.

Opening Ceremony

The Opening ceremony was a long drawn affair as usual with 20,000 people  from 185 countries in attendance.

I was moved by the speaches of the Russian activists Sasha Volgina and Vladimir Zhoviac. Their presentation was titled ‘We are dying less but we are dying faster’ and drew attention on the struggle of drug users in Eastern Europe and Central Asia.  Only 1 in 100 drug user  has access to ARVs.

Here is a poster that was on the that was on the toilet door.

Overall the update on the epidemic was quite optimistic with reports of 10 out of 20 high prevalence countries where  there has been a 25% reduction of new infections.

The opening also included a very good session by Dr Sharon Lewis on  Progress For a Cure, which is quite an amazing thought.

Political presence was good with speeches from Austrian Ministry of Health and the President of Austria.

Demonstrations from activists were really vocals and highlighted the need to continue to invest in AIDS, in spite of the recession. How come governments found money to bail out banks, but there are insufficient funds  to really make universal access to treatment, prevention and care a reality?

Here are some images on the protest:

Baptimism of Fire

It is 8:45 on a Sunday morning and I am sitting in a session room. The theme of the session is ‘Gender Gaps Stigma and Sex’. Sunday mornings don’t get much better then this, right?!

Sophie, Rebecca and I have just arrived yesterday, but we are wasting no time. The conference has not even started yet, but  our  Rebecca  has her first presentation at an International AIDS Conference, so obviously  Sophie and I want to be there to support her.  It is a great session that highlights the progress of the Stigma Index around the world. In a   nutshell the Stigma Index  is a  global  participatory research by and for HIV+ people to measure levels of stigma.  This session focuses  on how stigma manifests itself in the lives of women in different countries.

It was clear from all the presentations that  stigma affects women very heavily in the domestic domain and that it is strictly linked to gender violence. Now that I read my notes some of the statistics  give me goosebumps.In Dominica Republic 34% of women has been shoved or pushed by their partners in the last 12 months and 11% has been attacked with a knife, a gun or another weapon.

But stigma doesn’t just express itself  as violence in intimate relationships. It is chilling, but it is reported that health providers, and especially family planning clinics,  are the ones who  proactively discriminate against HIV+ women. In the Dominica Republic 30% of women were advised to be sterilized after testing ( but only 17% of men).  What is more horrific is that one of the condtions of provision of ARV’s  for women was sterilization. This was reported  by 21% of the women interviewed. The picture portrayed by the speaker from  Bangladesh wasn’t much different. Shockingly  84% of those interviewed reported that they had taken the decision of not having children. We still do not have the results of Stigma Index research in high prevalence countries like Zimbabwe or South Africa, but they will probably add more lights on the links between HIV related stigma, gender violence and obstacles to access safe sexual health and reproductive services for women with HIV.

Finished this session we jumped in a taxi to take part in a satellite session on “Criminalization of HIV exposure and transmission: global extent, impact and way forward’. How is that for a Sunday lunch?

This was another heavy session featuring speakers from the UK, South Africa, Canada and UN. It was really valuable because it alerted me to the GNP+ Global Criminalization Scan which is attempting to report all the cases where PLHIV are prosecuted for criminal exposure and transmission in the world. Up to now 600 prosecutions  have been reported, but this probably is an underestimated. What is really scary is that in the past 10 years more then 20 countries have introduced new laws to prosecute HIV transmission. Another important resource that was shared in this session was the booklet 10 Reasons Why Criminalization Harms Women, by the Athena Network. There would be a lot more to say about this session, but I am running out of time and I need to go to the conference opening session. If you are interested in the theme of criminalization please refer also to Edwin Bernard excellent blog Criminal HIV Transmission.

By for now…! Hey,  here is a picture of me before entering the conference centre this morning. I should probably take another one at the end of the conference, kind of before and after…Hopefully I will be able to pace myself and it will not look too bad!

Activism and shoes

I am about to pack for my trip to the International AIDS Conference in Vienna and I am having a personal crisis.

What should I pack? I know it is frivolous, but if I don’t look ‘good’ (at least to my standards) my confidence goes. And I need all the confidence I can gather to facilitate the many sessions I have been asked to. Plus, it takes lot of guts to face the 25.000 people who will be there.

All public speaking trainings I have taken have drilled into my head that 90% of communication is not verbal, and that how we look, how we move, how we sound is actually extremely important in delivering our messages. So, there you go, it is not just mere vanity.

Above all I believe it is important for me, as a woman publicly living with HIV, not to look as a victim: This is why I am thinking of packing an extremely large number of high heel sandals. How could I possibly feel or look like a victim when I am towering everybody from my 5 inches heels?

Still it is a difficult choice. I look at my (never too) many shoes and ask them: who will come with me? My golden sandals, with a cone heel at a precarious angle, those grey stiletto pumps, so chic, of my vertiginous open toe boots? They all look gorgeous and they all seem to say: “Me! Me! Me! Take me to Vienna!” I look at them and sigh. I can not. It’s impossible. Deep inside me , I know. I can not stay up from 6 in the morning until late at night, running across the endless corridors of the conference centre in those shoes. I would get blisters, twisted ankles, fall badly, need a stretcher and an ambulance.

So I turn to my wedges, to my gladiator sandals, even to the blue flip-flops and the pink Birkenstock. I acknowledge that even if I don’t feel I really belong to them, I do need them now. I stack them in the suitcase, with a hint of sadness.

There. The shoes are sorted. This packing business is going to be harder then I thought…

You can find out what really goes into preparing for an AIDS conference on Open Democracy , which is featuring a number of blogs focusing on women and HIV at AIDS 2010. .

Human Rights and HIV

‘Human Rights are inscribed in the hearts of people; they were there long before lawmakers drafted their first proclamation’

Mary Robinson, former president of Ireland and of the United Nation Commission on Human Rights. She stepped down as  patron of the International Community of Women Living with HIV/AIDS this Autumn.

What are Human Rights?

Regardless of who we are, where we live, what we do every human being has rights. They belong to everyone. Human rights address many aspects of our everyday lives from the right to food, shelter, education and health to the right to freedom of thought, religion and expression.

The core values that are the foundation of Human Rights are: fairness, respect, equality, dignity, autonomy, universality and participation.

History of Human Rights

The concepts and ideas behind human rights are universal. They were not born in the West but they have been present throughout history in different societies and civilizations; Christianity, Buddhism, Shamanism, are underpinned by very similar values and ideas. The French Revolution, the Feminist movement of the Suffragettes, the liberation struggle of many African and Latin American nations from colonial powers, the Civil Rights movement by the Afro-American people and the fight against Apartheid were all Human Rights struggles.

Human Rights as we know them were born in the 20^th century as a response to the crimes committed during the Second World War: in particular the persecution of Jews, Gypsies, Travellers, Communists and Gay people by the Nazis. In 1948 states came together at the United Nations to agree to the ‘Universal Declaration of Human Rights’ (UDHR) the most renown Human Rights document.

The declaration of Human Rights was just a ‘declaration’ it was not legally binding, so was followed up by numerous international treaties in which states agree to apply the various rights included in the declaration. These treaties include: the International Covenant on Civil and Political Rights and the International Covenant on Economical Social and Cultural Rights.

In the UK we also have our own domestic human right laws which are contained in the Human Rights Act (1998).

The Rights contained in the Human Rights Act (HRA) are:

• The right to life
• The right not to be tortured or treated in an inhuman or degrading way
• The right to be free from slavery and forced labour
• The right to liberty
• The right to a fair trial
• The right to no punishment without law
• The right to respect for private and family life, home and correspondence
• The right to freedom of thought, conscience and religion
• The right to freedom of expression
• The right to freedom of assembly and association
• The right to marry and found a family
• The right not to be discriminated against in relation to any of the right contained in the European Convention of Human Rights
• The right to education
• The right to peaceful enjoyment of possessions
• The right to free elections

The fact that those Human Rights are legally covered in the HRA means that in the UK the state and by extension all public authorities, like for example the NHS, have the obligation to respect, protect and fulfil those rights.

Respect: means that the state must not carry out human rights abuse (such as a Government that would not allow HIV positive prisoners to have access to HIV prevention or treatment would be violating human rights).

Protect: means that the state must protect individuals and groups against human rights abuses by others (for example the state has a duty to protect HIV positive people from discrimination).

Fulfil: means that the state must take positive steps to make human rights a reality in people’s lives (for example adequately fund services that provide treatment and care to people living with HIV).

Obviously not all of those rights are absolute, some of them can be limited by the state in particular circumstances: for example the right to liberty can be limited if one commits a crime and has to be imprisoned.

Unfortunately, especially us who live with HIV know that our human rights are often not respected, not only around the world but also here in the UK. The Stigma Index (2009), a piece of research conducted by people living with HIV to measure the levels of stigma and discrimination in the UK, showed that almost 25% of people interviewed had experienced discrimination in the health services.

In spite of the fact that human rights are breached in the UK, and all over the world, it is essential that we have them recognised by law. Human Rights can be regarded as a minimum standard below which the state cannot go and also as a set of goals for the improvement of those minimum standards.

Above all it is important that we remember that even if very often human rights are not respected, their violation doesn’t take them away from us. Human rights are part of who we are as human beings; we are born with them, and can never be taken away.

Human rights and HIV

There is obviously a very strong link between HIV and Human Rights. HIV activists around the world have been advocating that an effective response to the HIV epidemic can only happen with full respects of Human Rights.

So which articles of the Human Rights Act are most relevant to us who live with HIV?

• Right to be free from discrimination

The state has a duty to include HIV in all anti-discriminatory laws, addressing the needs of those infected, affected, or vulnerable to HIV so that they are not disadvantaged. It also must protect groups particularly vulnerable to HIV such as women, children, gay men, intravenous drug users and sex workers. Violations of this right are rife, for example: many countries still don’t allow HIV positive people to enter their territory (e.g. China, Dubai and until recently USA).

• Right to privacy

Information on HIV status is confidential, medical records can only be shared with consent, HIV testing needs to be anonymous and voluntary.

• Right to health

PLHIV have a right to access health services, including GPs, dentists, family planning and sexual health services. Everybody has a right to access confidential and anonymous HIV testing, Women living with HIV have a right to access support and care to prevent mother-to-child transmission. Prisoners are entitled to the same level of prevention and care that people in the general population (condoms, clean needles, ARVs), of course this doesn’t always happens, even here in the UK.

• Right to be free from inhumane and degrading treatment

In the UK there is a strong debate about the violation of this right. Advocates have been using this article (Article 8 ) to support the claims of HIV positive asylum seekers, who would get sick and die if deported to countries where they will not be able to access ARVs and/or where they will not be able to receive appropriate support and care for example because they have no family or relatives left. However as treatment has been made more available in developing countries many of those claims have been refused, in spite of the fact that often people are on treatments that are not available outside of Europe, or that in their country ARV’s supply is extremely patchy and unreliable.

• Right to life, liberty and security of person

This is another right to protect HIV positive people from being forcefully isolated (e.g. quarantine). It also reinforces the duty of the state to provide appropriate treatment, prevention and care to everybody with HIV or vulnerable to HIV.

• The right to marry and have a family

This is an important right for people with HIV and one which is often violated. Women living with HIV around the world have been pressurised to have abortions or even sterilised without their consent. At present a group of Namibian HIV positive women are taking their government to court on human rights grounds for enforcing sterilisation of HIV positive women. The state has a duty to provide access to HIV friendly reproductive services including: assisted conception, adoption and fostering. Integration of HIV services and the provision of sexual health and reproductive services is based on human rights and has been a priority on the advocacy agenda of HIV positive women activists for a long time.

It is extremely important that we, people living with HIV, are aware of how the Human Rights Acts protect us and that it should not be taken for granted. The new Government has spoken about abolishing the Human Rights Act and replacing it with a Bill of Rights. One of the crucial differences between the two would be that while the Human Rights Act protects everybody on British soil, the Bill of Rights would only protect British citizens and, maybe, members of the EU, leaving migrants and asylum seekers, and especially those who are HIV positive, vulnerable to even more mistreatment, poverty and isolation.

This article was possible thanks to at training on Human Rights provided by the British Institute of Human Rights (BIHR) to PozFem UK the National Network of Women Living with HIV. If you want to learn more about how to use Human Rights the BIHR has developed an online resource: Human rights in action – a toolkit for change:

Law on Trial

On Saturday 3^rd of July I was invited to speak at the event Law on Trial  at  Birkbeck College. My comments followed a lecture by Simon Watney, an hugely inspiring activist and academic, author of the seminal book Policing Desire.  I must admit: I was very nervous of speaking among all those high flying academics!

 I focused my comments on how HIV, poverty and the current policy context are affecting women living with HIV in the UK.

Around 30.000 women are currently living with HIV in the UK and their numbers have been steadily growing since the beginning of the epidemic. It is concerning  how current policy, such as the 10 years old sexual health and HIV strategy, ignores the vulnerability produced by gender inequity and gender violence. 

In the UK poverty and immigration policies marginalize women and make them vulnerable to abuse. Many women supported by Positively UK have been in the immigration system for years, living on 30 pounds vouchers a week.  Some of those HIV positive women are pushed by their economic circumstances to be in relationships that can support them economically.  They would not choose those relationship if they were economically independent. We could call this sex work, even if it doesn’t happen in the streets or in brothels.

When a woman enters such an unequal relationship it becomes very difficult to protect herself. For example negotiating condoms and disclosing her status could provoke rejection or violence. This context is an obstacle to become more open about living with HIV, it promotes stigma, and can make HIVpositive women potentially more vulnerable to be taken to court for HIV exposure and transmission.

I have done out-reach in prison for the past ten years and one of the most worrying trends that I have witnessed is the growing number of immigrant women imprisoned because working with false papers. Those are hard-working women who had never committed a violent crime (or any crime) in their lives. They have broken UK laws not by stealing, but by working. Earning money is a necessity. Their income is mainly needed to support HIVpositive relatives and children back in their countries.  Those women are often taken from prison directly to detention centres to be deported to countries where HIV treatment is still not available.

Within this context it is appalling that organizations like Positively UK, which have been very successful in developing the voice, visibility and advocacy skills of women living with HIV, have to struggle to continue their work.