Scientific advances in HIV prevention and treatment, while welcomed and strongly encouraged, are wasted when marginalized communities disproportionately affected by HIV/AIDS are blatantly denied access to services or cannot access them safely. This is one of a handful of principles released in advance of the XIX International AIDS Conference (AIDS 2012) by a coalition of global organizations.

The principles, entitled “The Robert Carr Doctrine,” emphasize that HIV and AIDS are not simply public health issues, but rather human rights issues, particularly among socially, financially and politically marginalized communities—gay men and other men who have sex with men, sex workers, people who use drugs and transgender people. In effect, what's needed is a coordinated strategy on behavioral, social, structural and legal levels to ensure that scientific and public health advances are accessible to all.

“For the past thirty years, the global AIDS response has been characterized by ‘one size fits all' programs that fail to address the drivers of the epidemic among the world's most at risk populations,” said George Ayala, PsyD, Executive Director of the Global Forum on MSM & HIV (MSMGF). “Stigma, discrimination, violence, and criminalization block access to HIV services for gay men, sex workers, people who use drugs, and transgender people.”

The Carr Doctrine represents the first time that the global networks of key affected populations have come together to forge a shared strategy. Each network is largely made up of community activists and organizations, all working to address the epidemic among their respective constituencies.

“Scientific advances like pre-exposure prophylaxis are exciting of course,” said Mauro Cabral, Co-Director of Global Action for Trans* Equality (GATE). “But they will fail to make a dent in the epidemic among key affected populations if legal, social, and political barriers continue to impede access to services.  In order to create lasting change, science must be balanced with rights-based structural intervention – they are two sides of one coin.”