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A Realistic Look at Microbicides

Lori Heise is Director of the Global Campaign for Microbicides.

Talk of microbicides was the pulse of the 2006 International AIDS conference in Toronto, Canada. Microbicides moved from the sidelines to center stage, a paradigm shift of bold proportions. All who have worked hard to articulate the need for user-controlled prevention should feel proud and savor this moment. Congratulations!

Reaching this tipping point also means that we now need to adjust our messages. For the past fifteen years, the microbicide movement has focused on building the enthusiasm and momentum necessary to gain the attention, respect, and commitment of world leaders. If we are concerned about the long term success of our enterprise, however, we must help individuals develop realistic expectations regarding this new technology. As advocates with advanced knowledge and training in the field, we have a critical role to play in shaping future discourse.

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HIV Testing and Reproductive Choice – How Did The Rights-Based Approach Play Out?

Any reflections on the XVI International Conference on AIDS are necessarily subjective, as each person reporting attended different sessions, had different goals and talked to different people at different times. Nevertheless, taking the various perspectives into account can give us a more comprehensive view of what transpired in Toronto.

Advocates for women’s and rights issues can rightly take pride in having focused at least some attention on topics that were relatively neglected, such as female-controlled (at least to some extent!) barrier methods (female condoms, microbicides, diaphragms and cervical caps) and violence against women.

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Advances for Women at the International AIDS Conference

Jennifer Kidwell is the Communications Assistant for the International Women's Health Coaltion.

Thanks to Bill Gates, microbicides may soon become a household word. At the International AIDS Conference (IAC) last week, calls for “women’s rights” and “gender equality” were issued not just by the Gates, but also Stephen Lewis, Bill Clinton, and others. Even a few women made the news.

The Toronto meeting was my first IAC. I’d expected overwhelming chaos, but I’d underestimated the richness of the dialogue taking place. For me, the most powerful lessons actually emerged not from the major newsmakers, but other channels behind the scenes.

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Delivering on the Promise of the International AIDS Conference

Congresswoman Barbara Lee co-authored legislation establishing PEPFAR in 2003, and was the lead author of the Global AIDS and Tuberculosis Relief Act of 2000 which helped establish the Global Fund. Most recently, Congress passed and President Bush signed into law legislation authored by Lee to focus foreign assistance for children orphaned and made vulnerable by HIV/AIDS. She has represented California's ninth Congressional District since 1998.

Last week I had the opportunity to participate in the XVI International AIDS Conference in Toronto, Canada. This was my fourth such conference since I was elected to Congress in 1998, and like many conferences before this one I was again impressed by the diversity of people, approaches, and issues that were raised.

I was specifically in town to speak on two issues that are really important to me: the HIV/AIDS crisis in Black America, and the increasing vulnerability of women and girls to this disease.

AIDS is devastating the African American community. According to the Centers for Disease Control African Americans now make up more than 50% of all new HIV/AIDS cases diagnosed each year. As Julian Bond the chairman of the NAACP made clear in this recent op-ed in the Washington Post "AIDS is now in our house. It's now our problem, and we must come up with solutions."

As part of a series of events at the conference with the Black AIDS Institute and prominent African American leaders, we announced a "National Call to Action and Declaration of Commitment to End the AIDS Epidemic in Black America."

Everyone has a role to play in stopping this disease, and that is a responsibility I take seriously in approaching my work in Congress.

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Making the Connection II: Gender-based Violence and HIV

Maria de Bruyn is the Senior Policy Advisor for Ipas.

"Gender-based violence and HIV: making the connection" was the theme for an evening satellite meeting convened by the International Community of Women Living with HIV/AIDS (ICW) and the ATHENA Network. Chairs Sofia Gruskin of Harvard University and Mary Robinson, former president of Ireland now with the Ethical Globalization Initiative, invited panelists from Africa, North America and Latin America to speak about intersections between gender-based violence (GBV) and HIV. Other delegates then offered information on approaches they used, challenges they faced and ideas about how to move forward.

Awino Okech (Mother Tongue, South Africa) called on those present not only to address HIV infection resulting from domestic and sexual violence, but also violence in response to women's voluntary or involuntary disclosure of their positive HIV status. She also asked for honesty in addressing the fact that some women become positive because they, like men, choose to have extramarital relations; a focus on sexuality needs to be added to our analyses.

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Desperately Seeking Condoms in Toronto

Naina Dhingra is the Director of International Policy at Advocates for Youth and serves on the Developed Country NGO Board Delegation of the Global Fund.

Throughout the International AIDS Conference, I've repeatedly heard about how the U.S. government is the largest buyer of condoms. Yet, at the same time, youth and people from PEPFAR countries kept telling me that, back home, access to condoms is a major issue. So where exactly are the condoms? Well, after a week at the conference in Toronto, I've decided that all the condoms are clearly right here. Over the week, I've amassed a sizable collection of at least 75 different types of condoms in all different colors and packaging. My favorites have been the goodies from UNFPA and MTV. UNFPA packaged a male and female condom together in brightly colored pouches usually used to carry jewelry. The MTV Staying Alive initiative packaged them in pocket containers, like the kind that carry mints, and gave them out at last night's premier party of their 48fest films – their project where young people were given cameras to develop films about AIDS in 48 hours.

So what seems to be the issue? If hundreds of thousand of condoms can get to Toronto, why aren't they getting to young people in PEPFAR countries? Is the U.S. government so stuck on the myth that condoms will actually cause young people to have sex?

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What Happens in Vegas Doesn’t Always Stay in Vegas

This week, a Ugandan pastor was in Las Vegas giving talks about AIDS. Martin Sempa is a long-time AIDS activist who credits abstinence-only programs and Christian values (like fidelity and matrimony…not so much care for the vulnerable) for Uganda's success in the fight against AIDS.

Now you may be thinking: AIDS… International activist… wait a second – why wasn't he in Toronto at the International AIDS Conference? Oh yeah, it's because "hatred of motherhood and the family, a pathological fear of fidelity and sexual continence and loathing of traditional Christian values are the defining forces in the international fight against AIDS" – not a place for a guy like Sempa.

Avoiding Toronto because of expected hostility to his message, Sempa spoke from Las Vegas. Maybe you've heard of it? City of casinos, nude dancers, Elvis impersonators and quickie weddings, nicknamed "Sin City." Seems like kind of a funny place for a pastor to take haven from those wacky International AIDS activists and speak out about "Christian values" and preventing HIV, doesn't it?

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Time to Deliver for Women and Girls

Adrienne Germain is the President of the International Women's Health Coaltion.

A lot of the buzz from Toronto this week centered on women, led by the "Bill and Bill show," and especially the Gates' attention to microbicides.

Microbicides will be a key HIV prevention tool, but no technology is going to end this pandemic. Girls' and women's vulnerability is driven by discrimination in education, employment, and property rights, and by sexual coercion and violence. These fundamental issues – and ways to fix them – were not on the lips of most of the conference "star power."

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Girls’ Education in Burkina Faso

Fimba is from Burkina Faso. He is representing the Guttmacher Institute's Protecting the Next Generation Project at the conference.

I participated in a very interesting session entitled "Leadership in Girls Education: An Essential Component of HIV Prevention". The panelists were Josée Verner from Canada and Jeanette Kagami from Rwanda. This session spoke about something that affects my daily life at home and for which I struggle with my colleagues from my youth network to do as much as we can to address the situation of girls in Burkina Faso.

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Young People and Sexuality: the Unspoken Taboo

Patricia is from Uganda. She is representing the Guttmacher Institute's Protecting the Next Generation Project at the conference.

Borrowing from the opening remarks of the co-chair of the session "Young People and Sexuality: the Unspoken Taboo," it was interesting that we didn't have a youth panelist. The topic of young people and sexuality has always been controversial and raises a lot of debate. This session has been very interesting coming from a country and society where the topics discussed raise eyebrows and in some situations a tendency to not even want to talk about it. Yet, it's becoming a real issue that needs to be addressed. The panelists talked about and shared their findings on sex tourism in Kenya, HIV among male migrants, urban youth culture and MSM in Jamaica, the risks, homophobia and related questions.

I work for an organization that boldly studies issues of sexuality and it has not been an easy thirteen years. Many people were hesitant about talking openly about sexuality for fear that it would increase sexual activity among young people and thereby accelerate the HIV infection rate. Over the years, though, continuous sensitization, advocacy and experience-sharing about the benefits of open discussion and dialog about sexuality have helped people come to appreciate the importance of talking about sexuality to young people. The times have changed. Yet some people in our society do not want to accept that people be free to express themselves without judgment.

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