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Tackling moral judgments about sex and sexuality is vital for HIV prevention
Roger Pebody, 2014-07-25 10:00:00
Scientific advances in biomedical prevention and treatment will not reach transgender people,
men who have sex with men and other populations with the greatest needs without
parallel efforts to improve human rights, the Filipino activist Laurindo
Garcia told the 20th International AIDS Conference in a powerful
plenary speech yesterday.
He noted that since the last conference, two years ago,
progress on human rights has been reversed. We have seen more homophobic laws
passed; more violence, persecution and threats from states; and more exclusion
from families and societies. In this context, HIV and STI rates have been
persistently high among men who have sex with men and trans people.
“And I personally have witnessed more grief-stricken posts
on Facebook,” he said. “People posting about seemingly healthy young men dying
As well as the epidemic of HIV infection, there is also an
epidemic of hate. In this context, access to basic prevention services is
limited and improved HIV testing, pre-exposure prophylaxis, or treatment as
prevention are unlikely to have much impact. “In 81 countries around the world,
the idea of a health intervention for trans people, gay men and other MSM is to
beat us up or throw us in jail.”
He suggested a new research agenda for the International
- “An intolerance vaccine” that could be dispensed to every
politician, bureaucrat or religious leader on their first day of work.
- “A condom that can protect us from violence… I admit, it
might be a little awkward and wobbly to walk in. But that’s much better than
being beaten up.”
- “Post-hate exposure prophylaxis,” allowing people to
self-medicate after exposure to hateful, homophobic or transphobic language, whether
from religious fundamentalists, Fox News or family.
Putting aside these “dreams of absurdity” he said that there
were steps that health professionals and community leaders can take now – to
protect people from violence, to ensure access to health and treatment, to
make spaces more inclusive, and to appeal for more empathy from everyone.
He said that key principles for health advocates need to
include choice (as it has been in the women’s health movement), harm reduction
and pleasure. Rather than just focusing on sexual health risks, health
professionals need to acknowledge love, pleasure and desire – the reasons
people seek sex out. Moreover, the risks of sex are not just sexually
transmitted infections, but also emotional and physical risks.
“Humans will continue to struggle or be fascinated with the
tension between desire and reason, the tension between risk and pleasure,” he
said. Health advocates also need to navigate this tension as they re-engage with
the communities they work with. “If we
don’t then we risk being branded as out of touch with the reality of life.”
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