People living with HIV

GENEVA, 6 November 2014—UNAIDS welcomes Namibia’s Supreme Court decision to uphold the Namibian High Court finding that three women living with HIV were subjected to coercive sterilization in public hospitals without their informed consent.

“This is a great victory for all women in Namibia and the world. This decision reinforces the right to sexual and reproductive health for all women, irrespective of their HIV status,” said UNAIDS Executive Director Michel Sidibé.

The Supreme Court’s dismissal of the appeal follows the 30 July 2012 ruling of the High Court of Namibia—in the first formal court case of its kind in Africa—that medical practitioners have a “legal duty to obtain informed consent from a patient” and that the health service provider could not forcibly obtain consent during labour.  

UNAIDS worked closely with civil society and other key partners in the AIDS response in Namibia to ensure that the voices of the women affected were heard. UNAIDS calls on countries to investigate and address all reported cases of forced sterilization as well as other legal and social practices violating the basic rights of all people in health-care systems.

Women and girls, irrespective of their HIV status, should have access to information and be empowered to exercise their sexual and reproductive health rights. UNAIDS will continue to mobilize governments and communities to ensure that everyone has access to HIV prevention, treatment, care and support services. 

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

Oral pre-exposure HIV prophylaxis (PrEP) has been shown to be up to 90% effective in preventing HIV infection among people who take it consistently. However, the United States of America is the only country in which PrEP is licensed and recommended for use within HIV prevention programmes. 

In order to find ways to bridge the gaps between evidence and policy-making processes, UNAIDS, AVAC and WHO organized a meeting during the 2014 HIV Research for Prevention (HIV R4P) conference, which is taking place from 28 to 31 October in Cape Town, South Africa. HIV R4P is the world’s first scientific meeting dedicated exclusively to biomedical HIV prevention research.

Participants

The meeting brought together representatives of ministries of health and national AIDS councils from Kenya, Mozambique, South Africa, Uganda and Zimbabwe, PrEP researchers and participants from research and demonstration sites where PrEP is currently being delivered, funders and drug manufacturers, and HIV activists.

Key messages

• PrEP is being used in several demonstration projects across eastern and southern Africa, covering a wide range of populations, including serodiscordant couples in Kenya and Uganda, sex workers in Zimbabwe and men who have sex with men in Kenya and South Africa.
• In order to be used more widely, PrEP must be part of a comprehensive prevention strategy with associated milestones and success indicators that have been defined with policy-makers. The Kenyan Prevention Roadmap already includes the possibility of PrEP.
• Costs and cost-effectiveness models remain key, as are the selection of populations for which PrEP should be offered and the choice of an appropriate delivery model. The Sisters clinics, which provide a dedicated service for sex workers in Zimbabwe, are acceptable to many sex workers and fit within a government strategy.
• The early stopping of the PROUD PrEP study demonstrates that within the sexual health services of the United Kingdom of Great Britain and Northern Ireland there is a strong demand for PrEP and that it is feasible to identify people at greatest risk.
• Demand is now beginning to grow in African communities and needs to be stimulated among those who would most benefit and would be most likely to use PrEP.
• Policy-makers in health and other government departments need more information on PrEP presented in a way that they can use, as well as opportunities to discuss their specific concerns, for example on PrEP safety studies or measures to improve adherence.
• More needs to be understood about the costing of PrEP. This demands greater understanding of who would use PrEP, how they would use it and where they would access it.

A “one-stop-shop” health centre in Hanoi is providing integrated HIV and other healthcare services that are achieving progress and maximizing investments in the AIDS response in Viet Nam. Hanoi’s South Tu Liem district health centre is a model that the Viet Nam Authority for HIV/AIDS Control plans to replicate in high-burden areas of the country.

“Today I saw three things which will help not only Viet Nam but also other countries; integration and decentralization of services; a patient-centred approach; and peer support,” said UNAIDS Executive Director Michel Sidibé during a tour of the health centre. “It is important to bring people together from different social backgrounds and support them to become actors for change for HIV.”

The health centre provides a full range of HIV services to key populations, including people who inject drugs, sex workers and men who have sex with men. It is also the primary healthcare centre for the district’s general population. More than 500 people are receiving antiretroviral treatment and more than 300 people who inject drugs are on methadone maintenance therapy. The health centre also has peer outreach services, including needle and syringe distribution, HIV counselling and testing, tuberculosis diagnosis and treatment, prevention of mother-to-child transmission, as well as home-based care and peer support for treatment adherence.

Integration and decentralization of HIV service delivery systems, including health systems strengthening, is one of the strategic priorities put forward by Viet Nam’s new Investment Case for an optimized HIV response. The Investment Case, developed by the Minister of Health with support from UNAIDS and other development partners, aims to improve the effectiveness, efficiency and sustainability of the national response as international donors reduce their support to rapidly developing Viet Nam.

During a meeting with Mr Sidibé the Minister of Health Nguyen Thi Kim Tien said that Viet Nam is committed to following the Investment Case and increasing the domestic budget for the HIV response. However, she said Viet Nam needed the continued support of the international community to achieve global HIV targets. “We are faced with some challenges and difficulties, but we will try our best and work to sustain the HIV response and make greater achievements,” said Nguyen Thi Kim Tien.

The Investment Case finds that integration and decentralization will save money and help sustain HIV services by avoiding parallel spending on infrastructure, human resources and commodities; taking advantage of the health system’s existing cost efficiencies; creating links between related services; and facilitating referrals.

This approach will also help address some of the concerns that civil society have in Viet Nam. People living with HIV and key populations at higher risk of HIV infection worry that less donor funding could mean reduced access to affordable services.

“I’ve been on antiretroviral treatment for 10 years and I feel very good, like many other people,” said Nguyen Xuan Quynh, 41. “I heard that international support will end soon and maybe we must pay. But most of us are very poor.”

As part of his two-day official visit to the country, Mr Sidibé also met with leaders of civil society networks. He urged them to continue raising their voice on the issues that matter most, and to work closely with the public healthcare system to play a greater role in the provision of lower-cost and higher-impact HIV services.

A new report on Tuberculosis (TB) released on 22 October by the World Health Organization shows that 9 million people developed TB in 2013, and 1.5 million died, including 360 000 people who were living with HIV.

The Global Tuberculosis Report 2014 highlights that while the number of TB deaths among people living with HIV has been falling for almost a decade—from 540 000 in 2004 to 360 000 in 2013—early case detection, antiretroviral treatment, preventive therapy and other key activities need to be further scaled-up.

According to WHO, one of the keys to reducing the number of deaths from HIV-associated TB is early case detection through the provision of HIV testing to all TB patients and routine TB screening among people attending HIV care. In 2013, 48% of TB patients had a recorded HIV test result and only half of those estimated to be co-infected with HIV-related TB were identified. Since 2012, WHO has recommended antiretroviral therapy (ART) for all TB patients testing positive for HIV within the first 8 weeks of initiation of TB treatment (and within 2 weeks of TB treatment for TB patients with profound immunosuppression). From 2012 to 2013, HIV treatment coverage among recorded TB patients rose encouragingly from 60% to 70% but this still represents less than a third of those estimated to be living with both TB and HIV.

Uptake of isoniazid preventive therapy (IPT)—which prevents people living with HIV from developing active TB—is rising slowly, the report finds. However, while the provision of IPT is increasing in Africa, only 21% of countries globally and 14 out of the 41 high burden TB/HIV countries reported provision of IPT to HIV positive people in 2013.

The implementation of collaborative TB/HIV activities has not evolved evenly across countries. The report stresses that further scale up of collaborative TB/HIV activities could be facilitated by joint TB and HIV programming, which would help to overcome constraints, promote synergies and achieve efficiency gains, especially between TB and HIV programmes.

WHO recommendations on the activities needed to prevent TB in HIV-positive people and to reduce the impact of HIV co-infection among HIV-positive TB patients have been available since 2004. These include establishing and strengthening coordination mechanisms for delivering integrated TB and HIV services; HIV testing for all patients with presumptive and diagnosed TB, providing antiretroviral therapy and co-trimoxazole preventive therapy to all HIV-positive TB patients, providing HIV prevention services for TB patients, intensifying TB case-finding among people living with HIV, offering IPT to people living with HIV who do not have active TB, and preventing the transmission of TB infection in health care and congregate settings.

The report concludes that despite encouraging progress, reaching the global target of halving deaths from HIV-associated TB is at risk, if countries don’t intensify the collaborative HIV/TB activities.

Two of the major networks of people living with HIV in the Indian Ocean region have merged. The decision, which is aimed at strengthening civil society participation in the AIDS response in the Indian Ocean islands, was announced during the 13th Indian Ocean Colloquium on HIV and Hepatitis, which concluded on 10 October in Saint-Gilles-les-Bains, Réunion.

Ravane+, which means uniting people living with HIV, and Femmes Positives Océan Indien will work together under a single network—Ravane Océan Indien—in advocating for the rights of people living with HIV and those most vulnerable to HIV infection. The network will focus on advocating for equitable health care and public services for people living with HIV and creating an enabling policy and legal environment for populations at higher risk of HIV infection, including men who have sex with men, sex workers and people who inject drugs.

The newly appointed President of Ravane Océan Indien, Ronny Arnephy, stressed that although each island has specific challenges in the HIV epidemic, having a common goal will bring greater opportunities for stronger advocacy and representation from civil society.

For the past 12 months, the two networks—with technical and financial support from UNAIDS and other partners—have been working together in refining the details of the merger, including defining the vision, operational modalities and workplan for 2015. 

MELBOURNE, 21 July 2014—Ten exceptional community-based organizations have won the 2014 Red Ribbon Award for their inspiring work in reducing the impact of the AIDS epidemic. They were presented with the prestigious prize in a special session at the 20th International AIDS Conference (AIDS 2014) in Melbourne, Australia. The Red Ribbon Award is the world’s leading award for innovative and outstanding community work in the response to the AIDS epidemic.

Community-based organizations have shown the world how to mobilize for change in the AIDS response and the Red Ribbon Award recognizes their transformative achievements.

“In villages and townships across the globe, communities have taken matters into their own hands and come up with innovative solutions to what often appear as insurmountable problems in the AIDS response,” said UNAIDS Executive Director Michel Sidibé. “I congratulate the winners of the Red Ribbon Award 2014 for their courage, determination and dedication. Their leadership and cutting-edge thinking have brought us to where we are today.”

The 2014 winning organizations are from the Democratic Republic of the Congo, Guyana, Indonesia, Iran (Islamic Republic of), Kenya, Lebanon, Malawi, Nepal, Ukraine and Venezuela (Bolivarian Republic of). Almost 1000 nominations from more than 120 countries were received by the Red Ribbon Award secretariat, which is hosted by UNAIDS in partnership with other United Nations organizations, AIDS 2014, the Global Network of People Living with HIV, the International Community of Women Living with HIV/AIDS, the International Council of AIDS Service Organizations and Irish Aid. A global panel of civil society representatives selected the finalists from a shortlist determined by regional panels. Each of the winning organizations will receive a US$ 10 000 grant and have been invited to participate in AIDS 2014.

At the Red Ribbon Award special session, the winners were congratulated by Epeli Nailatikau, President of Fiji, Nafsiah Mboi, Minister of Health of Indonesia, Dr. Jarbas Barbosa, Vice Minister of Health of Brazil, Dame Carol Kidu, former Member of Parliament of Papua New Guinea and Jan Beagle, Deputy Executive Director, Management and Governance, UNAIDS.

President Nailatikau said, “This award honours the incredible innovation taking place at the grass roots. I am proud to give this award to organizations whose actions in the communities they serve truly make a huge difference to people affected by HIV.”

The Red Ribbon Award was first presented in 2006 and since then has been handed out every two years at the International AIDS Conference. This year there were five award categories. The 10 winners are listed below by category.

Category one: Prevention of sexual transmission

Action pour la Lutte contre l’Ignorance du SIDA (ALCIS) is a community-based organization founded in 1999 to prevent sexual transmission of HIV among young people and men who have sex with men in the context of sex work. It is the only organization in the Democratic Republic of the Congo to organize sex workers and men who have sex with men into solidarity committees that represent a collective and cooperative entity.

Marsa Sexual Health Centre provides marginalized sexually active young people, women, lesbian, gay, bisexual, transsexual, transgender and intersex people (LGBTI) and people living with HIV full access to sexual and reproductive health services.

Category two: Prevention among/by people who use drugs

Ehyaye Hayyate Sarmad is best known for its Red Ribbon Prison, which has provided treatment for drug users and organized workshops on sexual and reproductive health. Ehyaye Hayyate Sarmad is one of the first organizations in the Islamic Republic of Iran to work in the field of harm reduction and HIV in the prison system.

Dristi provides services and support to women who use drugs in Nepal. The organization is run by women who are former drug users and is dedicated to reducing the harmful impact of drug use through advocacy, treatment and support. 

Category three: Treatment, care and support

Life Concern Organization (LICO) helps to improve the health and development of marginalized and vulnerable populations in Malawi. Since February 2009, LICO has worked to empower and lead an engaged community that can make informed decisions in the Rumphi district of northern Malawi. 

Cherkassy Regional Branch of All-Ukrainian Network of PLWHA started as a self-help group to support the HIV-positive community. Over the past 12 years, the organization has worked to create systematic change at the regional level and to improve the quality of life through treatment, diagnosis and accompaniment for people living with HIV.

Category four: Advocacy and human rights

Society against Sexual Orientation Discrimination (SASOD) is dedicated to the eradication of homophobia in Guyana and throughout the Caribbean. SASOD has worked to repeal discriminatory Guyanese laws, change local attitudes about the LGBTI community and end discrimination in the government, workplace and community.

Perssaudaraan Korban Napza Indonesia (PKNI) is a leading national network representing the common priorities of 25 self-organized drug user groups across 19 provinces in Indonesia. PKNI was established in 2006 to address stigma, violence, discrimination and violations of human rights towards people who use drugs.

Category five: Stopping new HIV infections among children and keeping mothers alive, women’s health

Girl Child Counseling Women’s Group is a grass-roots women’s group that focuses on bringing together all community members to address the high rate of new HIV infections among women of childbearing age in Matunda, Kenya. The group vision is “A HIV free generation in the Matunda location.”

AC Mujeres Unidas por la Salud was created as a nongovernmental organization in the Bolivarian Republic of Venezuela in 2003 and is led by 35 women. Over the past years it has become an organization of reference at the national level for women living with HIV as a result of their efforts. It provides spaces where women can receive counselling, information and support.

For further information about this year’s winners and the Red Ribbon Award, please see the Red Ribbon Award website at www.redribbonaward.org.

The 2014 Red Ribbon Award on Social Media

Facebook: https://www.facebook.com/redribbon2014/timeline

Twitter: https://twitter.com/2014RedRibbon

About the Sponsors

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners to maximize results for the AIDS response. Learn more at unaids.org and connect with us onFacebook and Twitter.

UN partners

The UN partners involved in the Red Ribbon Award initiative bring together the efforts and resources of all UNAIDS Cosponsors and the UNAIDS Secretariat.

AIDS 2014

The XX International AIDS Conference (AIDS 2014) is the premier gathering for those working in the field of HIV, as well as policy makers, persons living with HIV and other individuals committed to ending the pandemic. It is a chance for stakeholders to take stock of where the epidemic is, evaluate recent scientific developments and lessons learnt, and collectively chart a course forward. AIDS 2014 will be held in Melbourne, Australia from 20 to 25 July 2014. (www.aids2014.org). The International AIDS Society is the convener and custodian of the conference.

Global Network of People Living with HIV

GNP+ is the global network for and by people living with HIV. GNP+ advocates to improve the quality of life of people living with HIV. Driven by the needs of people living with HIV worldwide, GNP+ supports people living with HIV through their organizations and networks. GNP+ works to ensure equitable access to health and social services, by focusing on social justice, rights and more meaningful involvement of people living with HIV in programme and policy development – the GIPA principle. (www.gnpplus.net)

International Community of Women Living with HIV/AIDS

ICW Global emerged to look for answers facing the desperate lack of support, information and services available for women living with HIV. The organization promotes the leadership and involvement of women living with HIV in spaces where policies and programmes are developed and implemented and where the decisions that affect the life of thousands of people who live with the virus are made. The vision is for a just world where women living with HIV are leaders in HIV programmes and policy and realize their universal rights. They dream of a world where women, young women, girls, adolescents living with HIV have full access to care and treatment and enjoy all of their rights: sexual, reproductive, legal, economic and health, regardless of culture, age, religion, sexuality, race or socio-economic status. (www.icwglobal.org)

International Council of AIDS Service Organizations

Founded in 1991, the International Council of AIDS Service Organizations’ (ICASO) mission is to mobilize and support diverse community organizations to build an effective global response to end AIDS. This is done within a vision of a world where people living with and affected by HIV can enjoy life free from stigma, discrimination, and persecution, and have access to prevention, treatment and care. The ICASO network operates globally, regionally and locally, and reaches over 100 countries internationally. (www.icaso.org)

Irish Aid

Irish Aid is the Government of Ireland's programme of assistance to developing countries. Its aid philosophy is rooted in Ireland's foreign policy, in particular its objectives of peace and justice. The international development policy "One World, One Future" reflects Ireland's longstanding commitment to human rights and fairness in international relations and is inseparable from Irish foreign policy as a whole. The Irish Aid programme has as its absolute priority the reduction of poverty, inequality and exclusion in developing countries, with a strong geographic focus on Sub-Saharan Africa. Improving access to quality essential social services such as health, education, services related to HIV and AIDS, and social protection is seen as key to the realisation of human rights, the reduction of poverty, hunger and inequality and the promotion of inclusive economic growth. (http://www.irishaid.gov.ie)

About the Red Ribbon Award

The red ribbon is a global symbol in the movement to address AIDS. The Red Ribbon Award, presented every two years at the International AIDS Conference, is designed to honor and celebrate community based organizations for their outstanding initiatives that show leadership in reducing the spread and impact of AIDS. The award is a joint effort of the UNAIDS family and as such, this year it will place particular emphasis on the organization's newly approved global priority areas of action.

The Red Ribbon Award was first given in 2006 and has recognized 85 organizations from over 50 different countries since then as leading community-based responses to AIDS. Such organizations lie at the heart of the response to the AIDS epidemic – displaying extraordinary courage, resilience and strength in addressing one of the greatest challenges of our time. Using creative and sustainable ways to promote prevention of sexual transmission, and prevention among people who use drugs, provide treatment, care, and support to people living with HIV and demonstrating innovation in the face of stigma and discrimination through advocacy and human rights, and stopping new HIV infections in children and keeping mothers alive, and taking care of women’s health, these examples of community leadership are showing us in practical terms how to reverse a global epidemic – one community at a time.

Law confirms no restrictions on entry, stay or residence and guarantees access to treatment for all.

GENEVA, 24 July 2014—UNAIDS welcomes new HIV legislation in the Comoros that protects people living with HIV from all forms of discrimination and reinforces an enabling legal environment for prevention, treatment, care and support programmes.

The new law, which came into force in June 2014, explicitly protects the free movement of people living with HIV and prohibits any restriction on entry, stay or residence based on HIV status.

Among other provisions, the law guarantees that HIV treatment is available to nationals and non-nationals living with HIV. It also ensures that people in prisons and other closed settings have access to HIV prevention and treatment services. Mandatory HIV testing as a condition of employment and termination of employment because of a person’s HIV status are prohibited.

“More countries need to follow the bold and inclusive example of the Comoros, ensuring that no one is denied opportunities because of their HIV status,” said Michel Sidibé, Executive Director of UNAIDS. “Comprehensive HIV prevention and treatment programmes, underpinned by an enabling legal environment, will help make it possible to end the epidemic by 2030,” he added.

With the recent clarification received from the Government of the Comoros, UNAIDS counts 38 countries, territories and areas that still have HIV-related restrictions on entry, stay and residence.