This week, the general assembly of the U.N., along with educators, advocates, activists, researcher, and healthcare professional from civil society around the world are gathering in New York for the U.N. High Level Meeting on AIDS. This meeting was called last December by a resolution adopted by the General Assembly to assess the progress being made in implementing the 2001 Declaration of Commitment on HIV/AIDS and the 2006 Political Declaration on HIV/AIDS.
On the first day, I attended a session entitled "Full Enjoyment of Human Rights by All: Vulnerable Groups Social Exclusion and Progress towards Universal Access." This was co-organized by amFAR, the Global Forum on MSM and HIV, UNDP, and the UNAIDS Secretariat.
The title made me think about the word "all". Obviously, we want human rights for all, for everyone – and it seems like we use this word as a euphemism at times to express that inclusivity. Like those progressive religious congregations that use it to subtly let LGBT individuals know they are welcome. While it’s a far cry from the loud rallying of the early LGBT movement’s "We’re here. We’re queer. Get used to it," it can be necessary to open doors, start conversations, and reach those individuals such as those who identify as MSM (men who have sex with men) who may not identify as LGBT.
The problem is that in many countries around the world, these groups get swept up into the all, becoming invisible in and of themselves, and we end up not knowing nearly enough about them.
And so, visibility of men who have sex with men and other LGBT individuals emerged as the central and reverberating theme of the session. Despite the astounding prevalence rates of HIV among MSM, gay men, and transgender individuals as compared to general adult populations around the world, they remain glaringly invisible. Invisible in the epidemiological data, in government gathered national HIV/AIDS surveillance data, in the country progress reports to the U.N. high level meeting, and in so many countries, cultures, towns, and families.
The end result is that we don’t know enough about how many individuals need prevention, care, and treatment services. We don’t know how many have been reached by these services. We don’t know what types of programs and services work best.
We just don’t know enough.
Stigma fuels this invisibility, allowing these individuals to be easily dismissed or forgotten. At the same time, the invisibility fuels the stigma because solid policies and programs must be based on evidence. In the absence of evidence the response can never be as robust or effective as it must be, and policies and programs are more vulnerable to influence from ideology and hypermoralism.
Surveillance data must be disaggregated, epidemiological studies of MSM, gay and transgender populations must be conducted with the same rigor as any other populations, and governments must include surveillance criteria regarding percentages of MSM, gay, and transgender populations reached.
When we say all, we should mean it, and we should have the data to back it up.