Taking it to the streets and virtual highways: For we cannot be contained

 

Taking it to the streets and virtual highways

 

Professor Kirby from Australia loudly noted several times during a session at the International AIDS Conference that it was “time to get real.”   It is time to press forward and hold politicians, legislative bodies and fellow community members accountable to the tenets of human rights and health equity.

 

Today I presented on our Twitter research showcasing the double-edged sword of the twitterverse. It may very well decrease overt acts of stigmatization but it also allows a substantial space (that is used) to be angry at those very vulnerable populations that need our support if we are to reach a world without AIDS. Twitter can damp down stigmatization and it can also heighten stigma’s reach.   Hashtag activism is huge and can have real-world consequences such as Arab Spring yet it can lead to a lot of noise about a subject with no substantial real-world impact such as the #bringbackourgirls twitter campaign.   Just this very morning a new twitter campaign was begun called #bringthemhome to urge that the bodies of those that died on the downed Malaysian flight be brought back home.   This is the equivalent to “taking it to the virtual highway”. Continue reading

The meaning of community and saying “No More to Exclusion”

The meaning of community and saying “No More to Exclusion”

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No more to exclusion, bigotry and AIDS; a phrase running through the city streets and consciousness of Melbourne. Today in Melbourne the Global MSM Forum Summit was held as part of the precursor activities of the International AIDS Conference. It was held at the beautiful and majestic Town Hall giving an extra weight of solemnity to the proceedings.  For it was a packed house that sadly had a few slated speakers that died on Malaysian plane brought down over Ukraine.  The sessions thus began with a heavy heart and a minute of silence.

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A tale of two “public health” cities in response to AIDS

A tale of two “public health” Cities in response to AIDS

Let us start with the conclusion in terms of reaching a world without AIDS: science must intersect with and be married to social justice. The two worlds of public health science and community response need to be synchronized and interdependent.

Today we attended the New York Academy of Science event titled: Science, Community and Policy for Key Vulnerable Populations. The event was co-sponsored by UNAIDS right as the United Nations’ Open Working Group sessions on sustainable development goals are being pondered and debated. AIDS remains a global issue and as such continues to impact disproportionately vulnerable populations. Specifically, at the event it was posited that there are three epidemics: young girls, injection drug users in eastern Europe, and gay men world wide. Most likely it is children and gay men (men who have sex with men-MSM) who are not accessing treatment. Discriminatory legislation, for example, in Nigeria creates an unsafe environment in which gay men don’t dare get care. As a matter of fact, there are 82 countries have penalized MSM activity. There is a need to make these epidemics a “mainstream issue.”

As part of the opening remarks, Dr. Luiz Loures noted we are entering a new phase and there is a need for new partnerships. He was in New York at the very beginning of the epidemic where he saw his first AIDS case in 1982. He made an effort to understand the social aspects of AIDS at the time. He was in tune with the men in the community to give him a very different perspective from that of being a critical care doctor. What was astounding at that moment in time was that the people affected by the disease took on the reins in responding to AIDS. Such a community ownership of a disease was unprecedented at that time. However, as the epidemic took hold there was a need for more than a scientific and community on-the-ground response. UN Secretary General Kofi Annan established the global fund in the ’90s. Today we are spending 17 billion a year globally.

We are now entering fourth phase, per Dr. Loures. He noted that we are entering the “post science phase” where we can take this epidemic to the end. It is not the virus anymore that is holding us back. We now know how to respond.

The main aspect that differentiates this phase is a particularly acute challenge. We face the fact that the likelihood of accessing treatment, prevention technologies and knowledge is not the same for everybody. If you live in the Russian Federation, for example, there is a higher likelihood you won’t access treatment if you are an injecting drug user.

This new phase pushes us forward in thinking about social justice in more depth and more nuance. Science must not only focus on which biomedical advances work but science must investigate the what, who, when and why of our three global epidemics. Science, broadly and dynamically speaking, must help us understand why people are left behind. We need to more specifically understand who is vulnerable. We must ask ourselves what more can we do and what are the points for action? We have to find a way to make research understandable and relatable. The when is now. It is not so much about scaling up our efforts, although its still an issue, considering that 15 million people will be on treatment by 2015, but the need is 30 million. The fundamental point is to understand who is not getting treatment, where they are, why are they not getting treatment and what we can do.

We pose to you, dear reader, how can science help us bring people into care and reach equity? How do we get past the tale of two cities wherein community and science don’t walk hand-in-hand?

As Dr. Chris Beyrer noted “when HIV is anywhere, HIV is everywhere.” There are no neighborhood, city, state or country borders when it comes to HIV.

Inspired by this new phase in the fight against HIV and a need to consider geographies as well as the daily prompt.

Post and photo by
Miriam Y. Vega, Ph.D @miriamyvega
Emily Klukas, MPH @em_klukas

The Not-So-Long Trek

It’s that time of year again where Commission staff make the trek from NYC to Albany for our annual conference, Reunion Latina. If you ask someone who has attended over the years what they look forward to there, you might hear them describe “Trainings, seeing old friends, workshops, meeting new friends, legislative briefs, and …dancing!”  This long-standing tradition has morphed over time as communities, policies and circumstances around disease have shifted. Addressing health disparities and the social factors that keep these disparities alive is paramount to making a dent in the HIV epidemic. While we have known this for years, Reunion Latina is giving social determinants the spotlight.
Reunion Latina

Why are we seeing over a third of Latinos who are diagnosed with HIV progress to AIDS within a year? Folks are testing late in the disease. Years after initially contracting the virus. Why are people getting the HIV test late in the disease?

Instinctively many people would answer this question by looking at the person getting tested. Why didn’t you go to the doctor when you felt sick? Don’t you care about your health? Your families’ health? This is instinct a lot of times. We see getting a test as a behavior, and we all have control over our behaviors, right? Yes, but there’s more than that. And that is what we are focusing on when we talk about social determinants of health.

Did you know that as an ethnic group Latinos are also the least likely to have health insurance? One out of three Latinos across the nation does not have insurance.

No insurance you say? Well can’t someone just pay for the test? In New York State, 24% of Latinos are living below the poverty line – which for an individual means making less than $11,670 per year. In New York. Where the average rent in NYC is over $3,000 per month.

I think you are getting the point. Income, education, employment, housing, neighborhood, school system, culture, stigma – all these things shape the health-related decisions we make. All these things mentioned above are barriers.

But we can’t stop there. What we are doing in Albany right now is two-fold. We are not only trying to break down the barriers (or find some way around them) but also looking at what supports us in our lives so we can make healthy choices. What parts of our neighborhood make our lives better? Friends? A long walk to the train that keeps us a little more active?

Think about it for a moment and let us know. What keeps you from making “healthy choices”? What in your life supports you?

Written By: Emily Klukas
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And then there were a hundred!!!

We have posted our 100th blog article and we want to take a moment to thank all of our followers! The Institute for Hispanic Health Equity has been blogging for the past year with the intention of raising awareness and discussion on bridging the gap in health disparities throughout the United States and Puerto Rico. A big thank you to all our readers and followers for helping us spread the word!

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