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Report of LIVING2008: The Positive Leadership Summit |
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LIVING 2008 – organized by the LIVING 2008 partnership - was a momentous event, the first gathering of positive leaders from around the world in five years. It was an opportunity to take stock of where the PLHIV movement stands, what its challenges are and how to react to them, and where to go from there. The preparations for LIVING 2008 included a gathering of 40 HIV positive leaders entitled “HIV+ Monaco” held in Monaco from 24-26 January 2008.
One of the main achievements of the Monaco meeting was the identification of four key advocacy themes around which the deliberations of LIVING 2008 would be centered. These four themes are: Universal access to HIV treatment, care and prevention, SRHR of PLHIV, Criminalization of the transmission of HIV, Prevention, with a focus on Positive Prevention. In addition, the LIVING 2008 partnership organized an e-consultation between June and July 2008 that engaged a diverse group of PLHIV from different parts of the world to discuss issues pertinent to the four themes of the Leadership Summit.
LIVING 2008 participants issued a clear call to action to all PLHIV around the world to become more involved, be it in becoming experts regarding their own health, actively requesting the enjoyment of their SRHR, or in making themselves knowledgeable regarding criminalization. This, however, will require further empowerment and capacity building for the PLHIV community.
In summary, LIVING 2008: The Positive Leadership Summit was a re-affirmation of PLHIV leadership. It successfully focused the attention on main issues of concern for PLHIV and created renewed momentum for the PLHIV movement. The challenge now will be to move forward and act on the recommendations issued by PLHIV from around the world.
You can download the complete report under the following links:
 Report: LIVING 2008: The Positive Leadership Summit (English) 1.15 Mb
Rapport du Sommet LIVING2008: The Positive Leadership Summit (Francais) 1.21 Mb
Informe de la Cumbre LIVING2008: The Positive Leadership Summit (Espanol) 1.21 Mb
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Statement on Positive Prevention |
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Positive prevention (PP) is an approach to prevention that seeks to increase the psychosocial well-being of PLHIV and encourage solidarity amongst and for PLHIV. Part of PP is to engage PLHIV to propagate HIV prevention through activities such as social marketing and peer education.
Traditionally, many public health experts have been defining the PP agenda within a non-holistic, non-human rights based framework that tends to be associated with blame and lays sole responsibility for primary prevention on PLHIV. There is also a sentiment that PP might be something that has been “imposed” on PLHIV. Because of this, communities of PLHIV themselves tend to have narrow perspectives of what PP is and do not necessarily see the benefits of being involved in PP. The challenge for communities of PLHIV - including women and those most affected– is to build consensus and define PP for themselves so they can develop effective, evidence-informed advocacy strategies to influence policy and services in this area.
There is a need to clearly state what PP means for PLHIV. Many PLHIV are not familiar with the term or do not have a good understanding of this approach to prevention. For PP measures to be successful, it will require buy-in from the PLHIV community, peer support, and opportunities for PLHIV involvement in the design and implementation of PP initiatives as well as a coordinated communication mechanism to ensure an informed and knowledgeable PLHIV community. What is crucial in this, is that PP needs to be based on a culture of shared responsibility, which means that the responsibility for avoiding HIV transmission is not only placed on the person living with HIV but on both partners and that there is an environment of open communication and equality in relationships (“we are all responsible for prevention”). The focus of PP should be on people’s well-being as a whole and not on “HIV positive versus HIV negative”; and that PP needs to be an empowering concept, not one associated with blame or shame.
In addition, there is a consensus that PP should be defined and owned by PLHIV - and not imposed and defined as a concept from outside the PLHIV community. Stigma and discrimination, which is still pervasive, needs to be tackled for PP to be successful.
Working Group Statement on Positive Prevention (English) 168.57 Kb
Working Group Statement on Positive Prevention (Espanol) 172.12 Kb
Working Group Statement on Positive Prevention (Francais) 169.93 Kb
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Statement on Sexual and Reproductive Health and Rights |
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With treatment and care becoming increasingly available, PLHIV are regaining their health, living longer, fulfilling lives, and planning for their futures. This includes decisions about sex, sexuality and the possibility of starting or expanding families. Despite this, there still prevails an underlying assumption that one’s sexual and reproductive life stops when one becomes HIV positive. Often society at large, health care workers, decision makers and even PLHIV themselves hold this assumption.
For a person living with HIV, dealing with sex means dealing with difficult issues at vulnerable moments and in vulnerable settings. Often people living with HIV are expected to disclose their HIV status before engaging in sexual relations – in some countries it is even a legal obligation, even though this may lead to (gender-based) violence. People living with HIV are expected to initiate and engage in safe sex strategies to prevent the transmission of STIs or transmitting HIV to one’s sexual partner(s). With regards to family planning, people need to be able to make well- informed decisions around conceiving, pregnancy, preventing mother to child transmission and breastfeeding.
In short, there is a host of complex issues that touch on the fulfillment of the sexual aand reproductive health and rights (SRHR) of PLHIV, their partners and families.
In terms of gaps, there is a range of SRHR issues for PLHIV where knowledge is insufficient and further research is needed. Among them are: the SRH needs of young people, especially young PLHIV; the needs of young people in relation to research on new prevention technologies; the effects of antiretroviral (ARV) therapies on HIV-positive young peoples’ physiological development, including SRH issues; HIV-positive transgender people’s SRH rights and needs; sodomy laws; discrimination of men who have sex with men (MSM) and homosexuality and its relevance with regard to epidemiological surveillance and appropriate and relevant services; and the advisability of male circumcision of PLHIV.
Also, while stigma and discrimination is becoming more subtle, it continues to be a barrier for enjoyment of SRHR by PLHIV.
Working Group Statement on Sexual and Reproductive Health and Rights (English) 176.62 Kb
Working Group Statement on Sexual and Reproductive Health (Francais) 181.89 Kb
Working Group Statement on Sexual and Reproductive Health and Rights (Espanol) 178.65 Kb
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Statement on Criminalisation of HIV transmission |
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Several countries have recently introduced laws to criminalise HIV transmission, or exposing another person to the virus. Prosecutions are increasing. A number of jurisdictions have used general laws against serious bodily harm in cases where someone is accused of knowingly transmitting HIV or willingly exposing others to HIV transmission.
Subject to controversy, these measures are sparking debate and concern among policymakers, legal and public health professionals, international organizations and civil society, on whether criminal law is applicable in such cases and if such application is accomplishing or damaging public health goals such as Universal Access to HIV prevention, treatment, care and support. PLHIV see criminalisation as a violation of their fundamental human, sexual and reproductive rights.
The vast majority of PLHIV does not want to transmit HIV and are concerned about transmission. To penalize the person living with HIV where transmission occurs discriminates against the person that is positive, in favor of the person that is negative when in fact both parties share responsibility.
A combination of evidence and experience compels the conclusion that criminalisation of HIV transmission is counterproductive to sound public health practice because it:
- Sends negative messages about PLHIV as “irresponsible” whereas, in reality, the vast majority of PHLIV deal responsibly with their infections.
- Discourages people from seeking HIV testing due to a climate of fear and shame.
- Promotes fear of having a healthy and safe sex life amongst PLHIV.
- Reduces solidarity for PLHIV.
- Increases stigma and discrimination.
However, how can the challenge of decriminalisation be achieved? Should the focus be on national action or on internationally concerted activities? Should GNP+ take a lead role in advocating for the decriminalisation of HIV transmission? If so, by doing what?
Working Group Statement on Criminalisation (English) 169.50 Kb
Working Group Statement on Criminalisation (Francais) 175.86 Kb
Working Group Statement on Criminalisation (Espanol) 174.61 Kb
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