August 14, 2006—At 7:00 this morning, a couple thousand women took over downtown Toronto in yellow t-shirts (except for a multi-national cluster of sex workers in royal blue). Their march was a bright, vivid sketch of the gender-based issues now driving so much of the HIV epidemic, from domestic violence and marriage itself to prison health care and the unique factors threatening young girls.
The picture gradually went full-color as the first full day of the International AIDS Conference unveiled exhaustive research and lofty debates on where HIV and this generation of scientists and advocates are headed now.
We present a few highlights from this first day of the 16th and biggest-yet world AIDS meeting:
If you thought some governments "got it" and others did not, guess again. Countries with rising HIV infection rates among men who have sex with men (MSMs) include several that had early success with prevention, such as Senegal, Cambodia and Thailand.
Reaching those particular men with the right messages and resources is an uphill battle for some governments, but in more permissive societies it's tricky too. Which is where Gay Cruise comes in…
That's the name of a Dutch online education project that works with the safe sex "attitudes" and "skills" of gay and bisexual visitors to a dating site. "Chatboy VIP" and "Gossip by the Pool" are real-life scenarios presenting the visitor with beefy cartoons and multiple-choice pop-up screens where they have the opportunity to offer advice when safe sex issues come up.
One of the more testy discussions underway at IAC this time around involves a widespread push to implement so-called routine testing, whereby patients can "opt out" of taking an HIV test but otherwise receive it as part of their general health care.
"Everything has changed in HIV except the testing models," argued Donna Futterman of a Bronx-based Adolescent AID Program in support of routine testing.
On the other side, Gregg Gonsalves of the AIDS and Rights Alliance for Southern Africa urged researchers to look at trends toward HIV criminalization in several countries. Considering the way consent rules and counseling are loosened as part of routine testing, he asked: Might people get caught up more easily in some tricky legal situation?
The U.S. Centers for Disease Control is among the advocates for routine testing, but also researchers in Botswana, where it's now government policy and a major study recently suggested more Botswanans were rolling up their sleeves. Those findings were interpreted and re-interpreted today. Among the questions: What if Botswana had not had access to inexpensive HIV meds from India? Would people be this interested in any kind of testing?
"Bills" Clinton and Gates are both here at the conference this week, and today they showed up together, tipping their hats to what they described as the significant successes of the Bush Administration's President's Emergency Plan for AIDS Relief (PEPFAR) and calling for ever greater focus on anti-HIV discrimination.
"We've got to continue to fight stigma and got to stop people… from being afraid of being tested," said the former president.
As for U.S. and Canadian policies at home? "We have no reason to be smug or sanctimonious in North America," warned Canadienne Louise Binder of Ontario's Voices for Positive Women.
Check out Linda Villarosa's report on the state of HIV in the African-American community for more about that. And look out for tomorrow's POZ.com coverage, including treatment reporting from AIDSmeds.com.