The Good the Bad and the Ugly: AIDS 2014

As with most things in life, the 20^th International AIDS Conference (IAC) and its associated events, were full of “highs,” but neither void of the “lows,” nor the “really lows” for that matter. Here I’ll recap the good, the bad, and the ugly of the 2014 Ecumenical Advocacy Alliance (EAA) Interfaith Preconference and International AIDS Conference based solely on my opinion as a three time participant of both events.

The Good

The Interfaith Preconference brought together the world’s foremost faith leaders in HIV and AIDS to address what most faith groups are reluctant to discuss: faith, stigma, sex, and HIV. The preconference had representation from the Jewish, Buddhist, Christian and Hindu communities but also offered a high level panel discussion in conjunction with the Catholic Preconference, which included the likes of Dr. Luiz Loures and Dr. Deborah Birx. To conclude the Interfaith Preconference, the EAA highlighted the voices of young adults for the first time in my history of attending, which is a move in the right direction for faith communities and the HIV and AIDS discussion in general.

The 20^th International AIDS Conference had its highlights as well. With headliners in the field of HIV medical research abound, the latest advances in the fight to end AIDS were brought to the stage; information presented publicly for the first time in some cases. Government dignitaries were present, most notably Bill Clinton who has been a regular at IAC and a faithful partner in the AIDS epidemic vis-à-vis The Clinton Foundation. He delivered a well scripted report of the work of the Foundation and subsequent progress in the quest to end AIDS, encouraging the international community to redouble its efforts in the fight as we are closer than we’ve ever been to getting to zero. By my assessment, there was far less science and far more social justice focus during AIDS 2014, which I see as a benefit to the majority of stakeholders in the AIDS epidemic: people living with HIV, and advocates – mostly people who are not medical science professionals. This shift in attention can be seen as the International AIDS Society’s (IAS) realization that we now have the science to treat HIV, and must concentrate more on treating people by reducing stigma, changing behaviors and altering attitudes. I was delighted to see workshops addressing gender based violence, criminalization of high risk populations, HIV in prisons, and even a workshop focused specifically on men who have sex with women (a joke was made that this was the first time a workshop was held for men who have sex with women given the high rate of HIV transmission among men who have sex with men (MSM) and subsequent increased attention). As a faith representative I was equally pleased to see 8 faith related workshops during the main conference, the most since my participation in 2010 and 2012, and if I had to guess, probably the most ever.

The Bad

Although the world’s foremost faith leaders in HIV response were present at the Interfaith Preconference, they were the same leaders who’ve been out front since my introduction to the faith and HIV arena. If this was your first experience at such a forum you left encouraged and excited about what you were hearing from the faith community, but if you’ve been doing the work for a while, you realize there have been few new voices added to the conversation over the years. The dialogue held before each IAC around faith and HIV creates the illusion that faith ambassadors around the world are truly stepping up as the preconference theme, “Stepping up in Faith” suggests, when in reality there is a minority of committed leaders consistently engaged in the work. This is no fault of the EAA or those who continue to be present, but a testament to how far we’ve come by faith, and how much farther we still have journey to fully integrate our churches, synagogues, temples, and mosques in the conversation on HIV, faith, sex, and stigma. Likewise, despite the efforts of the EAA to highlight the voices of young people in the closing plenary of the Interfaith Preconference, young voices are largely absent from the faith +HIV dialogue as are new voices. The Evangelical Lutheran Church in America (ELCA) has consistently been well represented during the preconference by its young adult delegation, often supplying the full complement of registrants under the age of 30. This year the Young Women’s Christian Association (YWCA) also had a substantial presence of young people, but 2 organizations out of the many in the world is a poor representation of the quarter of people living with HIV and AIDS in the world under the age of 30. Again this is not an issue for the EAA to solve, rather a deeper issue of the faith community’s need to engage youth and young adults more intentionally.

The main blemish on the face of the IAC was the host continent: Australia. While the city of Melbourne itself was a wonderful host, Australia was a difficult destination. It’s an expensive trip, and participation suffered as a result. But that’s out of Australia’s control, so no harm no fouls. What is within their government’s control is the process in which citizens of visiting countries may enter into Australia. The IAC normally averages an attendance upwards of 20,000 people, but this year’s registration fell well short of that number at only 12,000 participants. Again, the distance and cost of the trip was part to blame, but at a conference where African Nationals are sometimes the largest demographic present, the process under which African Nationals were required to undergo in order to be granted travel visas to Australia, was prohibitive. Anyone not an Australian citizen is required to have a visa to visit Australia. As a U.S. citizen, the process for me involved filling out an online application that took all of five minutes, resulting in instant approval of an electronic visa that did not require me to leave the comfort of my home to visit an Australian embassy. However, African Nationals interested in traveling to Australia had to go to Johannesburg, South Africa to receive their visas. If you are familiar with the continent of Africa, you understand that travel to Johannesburg isn’t logistically or economically feasible for citizens of countries outside of South Africa. Those African Nationals who might have had the means to travel to Joburg still had to deal with the high possibility of being denied a visa. Therefore many African Nationals who intended to attend AIDS 2014 were not able to do so due to a prohibitive process for entry into Australia. I spoke with many Australian citizens about this and they noted this to be a black eye for a country trying to shed its xenophobic reputation. The bright side: AIDS 2016 will be in Durban, South Africa where I anticipate a rebound in African and international participation.

The Ugly

The Interfaith Preconference also suffered from the challenges of journeying to Australia. What usually is a participation of 250 or more registrants, the Interfaith Preconference boasted a registration of roughly 100 people; but that wasn’t the main concern. Of those 100 or so participants, nearly all of them were of Christian faith; not very interfaith for an Interfaith Preconference. Nonetheless, between the preconference, interfaith worship service, and faith track during the main conference, we managed to hear from the Jewish, Buddhist, Christian, Islam, and Hindu communities either by direct representation or by proxy.

By far, the lowest moment of the IAC happened before the conference even began in the skies over the Ukraine/Russia conflict zone when flight MH17 was downed by a missile fired as a result of what’s believed to be mistaken identity. We quickly learned that many of the passengers on the plane were delegates headed to Melbourne for the IAC, including world renowned HIV expert and former IAS president, Joep Lange. Needless to say this sad and unfortunate event completely changed the tone of a conference that otherwise gathers every two years to celebrate life. The impact was felt right away during the opening ceremony that usually has the feel of an international party, but felt more like a memorial service as moments of silence, tributes, and solemn song were abundant. Many of the persons lost were not only colleagues of those present, but close friends of a lot of the keynote speakers. Throughout the week, each speaker appropriately honored their colleagues in their own special way, sometimes including personal photos with the victims in their presentations before sharing their research. While lives were lost to the lament of the AIDS community, years of knowledge in HIV and AIDS research was lost to the world. Ironically, Ukraine/Russian has the highest rate of new HIV infections in Eastern Europe and Central Asia, and the solution to their fast growing epidemic may have been lost in their blunder. To say the least, a grey cloud hovered over the Melbourne Exhibition Centre during the IAC, but the IAS did its best to honor the lives of those lost in a way they would be proud of; by carrying on with AIDS 2014 in spite of the tragedy, because the best way to honor them, is to continue the work they began.

El Fin

Doctors have a saying: “If there are no ups and downs in your life, it means you are dead.”

The 20^th International AIDS Conference and its associated events were not short of ups and downs, but life was present all around us, even in the wake of death; people LIVING with HIV, not dying. HIV and AIDS is no longer a death sentence, and even as many died trying to advance the work being done in the field, millions more will live as result of their sacrifice. AIDS 2014 was much more than a medical science conference; it was a gathering to celebrate humanity; a time to not just focus on HIV treatment, but people treatment; an opportunity to not just share the statistics, but to share the stories. AIDS 2014 was about “Stepping up in Faith” and “Stepping up the Pace,” leaving no one behind in the fight against AIDS. I look forward to continuing the good fight at AIDS 2016 in Durban, South Africa.

Out Front: A Call to Action for U.S. Churches in the HIV/AIDS Response

The closing plenary of the EAA Interfaith Preconference of the 20^th International AIDS Conference featured young adult voices in the fight against HIV from different contexts around the world. Panelists included a young woman from India who is living openly with HIV and a young man from Togo who is an actor and peer educator in the reduction of HIV in young men who have sex with men (MSM). I had the pleasure of joining them as a representative of the United States context where I talked about the tasks of the Christian Church in equipping ourselves for the HIV/AIDS journey beyond 2015.

If the Church is to remain relevant in the fight against HIV in the United States and in the world, the Church must improve its outreach to youth and young adults. It’s no secret that Millennials are all but absent from the Church, not because young people don’t believe in God or don’t desire a connection with something or Someone higher than themselves, but because the traditional Church has failed to reconcile its 2000 year old theology with the present day context and realities that Millennials struggle to navigate. The inclusion of youth and young adults in the Church not only is imperative for the survival of an aging institution, but it’s paramount in the Church’s efforts to end AIDS because HIV is reality for young people in the United States and in the world.

In 2014, HIV and AIDS is a reality for 1 in 4 young person’s age 13-24; expand the age range to 29 and the number increases to 1 in 3. Young people are at particularly high risk of HIV infection for a number of reasons including but not limited to: sexual discovery, drug and alcohol experimentation, unprotected sex, and lack of sex education. The equation of immature sexuality under the influence of state altering substances with insufficient education on how to protect one’s self = increased susceptibility to HIV infection. The Church can be and should be a first responder in addressing these challenges in the development of young people, however the Church cannot minister to or intercede on the behalf of a generation of people it does not have access to. So, if the Christian Church is to continue to have a foothold in the fight against HIV/AIDS in the United States and in the world, the Church much address its antiquated presence in the present day context of youth and young adults, especially as it relates to sex and sexuality.

Sex and sexuality have long been taboo topics within the Church, yet both are inextricably linked to HIV/AIDS. Therefore the Church must engage in healthy dialogue about sex and sexuality if it is to endure in the HIV and AIDS journey beyond 2015. The Rev. James B. Nelson explains in his book ‘Between Two Gardens’ that, “Sexuality and spirituality are inseparable elements of full personhood…” One cannot exist without the other and qualify as the wholeness of the body of Christ. Sexuality is a gift from God. Likewise one cannot discuss HIV and AIDS without discussing sex and sexuality because both/and make up the wholeness of the epidemic. The gift of HIV to the Church is that it has forced us to deal with the deafening silence on sex and sexuality in communities of faith. If HIV was cured today, the Church would still be mute on sex and sexuality, tomorrow. The Church must utilize this opportunity that HIV has given, to discuss the theology of homosexuality, for example, by studying the history of our religious texts, understanding the context under which the text was written and the people the text was written for; then use that bible study to inform conversations around homosexuality in today’s context. Such dialogue allows the Church to equip the next generation of theologians for the HIV and AIDS journey beyond 2015.

The Church would then be in a better position to minister to the demographic most affected and infected by HIV in the U.S.: men who have sex with men, specifically young MSM of color. Many mainline denominations in the States have a long standing history in delivering HIV services internationally, however domestic provisions have been few and far between. Black Churches in particular have been limited in the HIV/AIDS domestic response largely due to stigma and lack of resources. Unfortunately, the few inclusive Black led faith based HIV/AIDS capacity building organizations that had resources have been shut out for the next 5 years, as no Black led ASO or CBO was funded by the Centers for Disease Control for the next cycle. Considering the rate of HIV infection among Black Americans, and understanding the importance of cultural competency when providing services to a target population, Black Churches and faith based organizations are left to depend on each other for assistance. If the Church is to maintain a meaningful presence in the HIV response, it must truly become “Church;” collaborating and participating in ecumenical resource sharing that recognizes the value in community healing, and ignores the differences in denominational doctrine.

Someday HIV will be eradicated in the United States and in the world, and the question will be asked: Where was the Church in all of this? Will they say we were failing to reach youth who desperately needed guidance and grace? Will they say we were too busy arguing over how God feels about homosexuality, while millions of people died? Will the story be that we had all the resources and skills necessary to reach those most impacted by the disease, but failed to work together as one Holy Communion? Or will they say people of faith were there from the beginning to end? I choose the latter. The end of AIDS is in front of us, and I believe the faith community will be a key role player in its finale; so long as we can leave behind our collective differences, and get behind our united front: life, and life abundantly. End AIDS.

How the West Was Lost

The 20^th International AIDS Conference (IAC) is the largest gathering of clinicians, scientists, activists, advocates, journalists, government officials, and people living with HIV in the world, to address the global pandemic of AIDS.

Historically, this event has been heavily attended by African Nationals, with registration of African Nationals sometimes accounting for half of the total participation at the IAC; and rightfully so. Africa accounts for 25 million of the 35 million people living with HIV, equaling 71% of the epidemic worldwide. With 10% of the world’s population, 20% of the world’s overall health burden, but only 3% of the world’s healthcare providers, Africa is heavily burdened by malaria (#1 most deadly disease in Africa), tuberculosis, and HIV/AIDS with an inadequate supply of care to address this massive burden. As one result, Sub-Saharan Africa accounts for 8 of the top 10 countries in the world with the highest number of people living with HIV.

India ranks 3^rd, which probably isn’t hard to believe considering AIDS is largely a disease of poverty, with 30 million of the 35 million people infected globally being of low to middle income countries as are India and Africa. What you may, however, find hard to believe is that the United States ranks 9^th in the world in number of person’s living with HIV; the only high income country to make the top 10. When we think about disparity of any kind within the global village, the narrative almost always lies in the gap between the “haves” of the global north and west and “have not’s” of the global south. Thusly, it’s natural to never consider the United States in discussions associated to poverty, disease, civil unrest and any other social ill when compared to the rest of the world. Unfortunately the HIV epidemic in the United States is not one we can afford to lose in the midst of the larger global pandemic, or for that matter – in the midst of the largest gathering for HIV and AIDS in the world, the IAC.

An estimated 1.3 million people are living with HIV/AIDS in the U.S. with approximately 50,000 new infections and 18,000 AIDS related deaths annually, totaling ~619,500 deaths since the beginning of the HIV/AIDS epidemic in the early 80’s. Injection Drug Users (IDUs) account for 8% of new cases of HIV infection and 16% of people living with HIV in the U.S., but primary transmission remains to be through sexual intercourse, predominately among men who have sex with men (MSM) at 63% of new infections and nearly half of all persons living with HIV. Furthermore, HIV not only affects MSMs at an alarmingly disproportionate rate, but new infections are overwhelmingly among blacks who make up 44% of all new infections and people living with HIV/AIDS while only accounting for 13% of the total U.S. population.

Much has changed since the discovery of AIDS in 5 White homosexual men in the summer of 1981. The face of HIV in America is now Black America. The Black AIDS Institute reports that if Black America were its own country, it would rank 16^th in the world in HIV/AIDS cases, ahead of Ethiopia, Haiti, and Botswana – a country that once had the highest prevalence of HIV on earth. This largely explains the United States’ position in the world as a leader in the number of people living with HIV. 4 key factors contribute to the epidemic among Black Americans:

1. High prevalence of HIV: Blacks are more likely to be exposed to the virus because of the existing heavy burden of HIV in the Black community where intra-racial partnering is the highest among ethnic groups (Blacks are more likely to partner with other Blacks)
2. High prevalence of Sexually Transmitted Infections (STIs): Blacks are more likely to be infected with other sexually transmitted diseases which increases the susceptibility of HIV transmission.
3. Stigma: There is an innate distrust of the healthcare system among Blacks (Tuskegee Experiment) limiting the interactions between Blacks and access to HIV prevention, testing, diagnosis and treatment. Homophobia is pervasive in the Black community where MSM are 51% of new infections among blacks and 73% of new infections in black men, stigmatizing a key population from knowing their status and seeking treatment.
4. Social determinants: High rates of poverty, lack of access to healthcare, racial discrimination, incarceration, and illiteracy persist in Black America and drive a raging epidemic throughout the American African diaspora.

How then was the West lost? The United States has been a leader in funding the fight against HIV globally, but has failed to take care of home first, before saving the rest of the world. One of the badges being distributed by activist groups at AIDS 2014 reads, “Save us from the savior;” in this case the United States. We are at a critical tipping point in the fight against HIV and AIDS worldwide, but whether or not the momentum tips backward or forward, hinges upon our ability to leave no one behind as stated by the IAC sub-theme. That also goes for the millions of people living with HIV/AIDS in the United States.

Words of wisdom from a flight attendant: “Secure your own oxygen mask first before assisting others.” Words to live, and die by.

Stepping up in Faith

http://iacfaith.org/preconference

The interfaith pre-conference on HIV to the 20^th International AIDS Conference hosted by the Ecumenical Advocacy Alliance brought faith leaders from all over the world together to caucus around the theme, “Stepping up in Faith.”

Faith groups have often been criticized as one of the main drivers of stigmatization and discrimination relative to HIV and the at risk populations the virus largely affects. This is often an accurate criticism unfortunately, but to be fair, following global government and NGO support, faith communities account for the delivery of the most HIV and AIDS services worldwide. So it makes sense for communities of faith to have a seat at the table in the HIV and AIDS discussion, granted faith communities recognize their role in fueling the disease through stigma.

The interfaith pre-conference was an attempt to address this harsh reality head on, highlighting the faith community’s successes but acknowledging its failures during the opening plenary titled: “Our Journey with HIV So Far: Lessons from Our Past to Shape the Future.” This diverse panel of same gender-loving and/or HIV+ faith leaders offered first-hand accounts of what it means to be a religious leader living a life that the very same faith often stigmatizes.

This opening panel discussion offered a seamless segue into 12 workshops throughout the weekend where 4 of the workshops were centered specifically on stigma reduction, including:

1. Addressing Homophobia and HIV-related Stigma through Scripture and Spirituality
2. Engaging Business Sectors, Social Media and Community to Overcome AIDS Stigma and Discrimination
3. Mobilizing Local Faith Communities to Eliminate Stigma
4. Stigma Must be Replaced

There were also healthy discussions about faith-based comprehensive sexuality education which is a much needed dialogue within our churches, mosques, temples, and synagogues in order to reduce the stigma associated with sex + faith. Many times during the preconference we heard, “sexuality is a gift from God,” which often drew applause yet also garnered awkward silence even among some the most progressive religious leaders in the world. This speaks to the work we as people of faith still have ahead of us in reconciling our relationship with sexuality and faith, especially as it relates to the HIV and AIDS epidemic.

There is no doubt that communities of faith have a significant role to play in the fight against HIV and AIDS, but we must not allow life taking theologies, ideologies, and doctrines to get in the way of the life giving grace, love, and compassion that faith has to offer to those infected and affected by HIV and AIDS. One participant said it best, “We can’t wait to figure out how God feels about HIV. We’ve got to act first, and worry about the theology later, in order to save lives.”

Introducing #ELCAAIDS2014

Held every two years, the International AIDS Conference (IAC) is the largest regularly-scheduled event addressing HIV and AIDS, providing extensive opportunities for sharing and networking across all levels of care and response to the epidemic. This year’s conference is held in Melbourne, Australia, from the 20^th to 25^th of July 2014. The theme of the conference is “Stepping up the Pace”.

The Ecumenical Advocacy Alliance (EAA) held an Interfaith Pre-conference from July 18-19, 2014 with the complementary theme: “Stepping up in Faith.”  The pre-conference is designed to engage faith-based participants of the IAC in networking, skills building and exploration of challenges posed to the faith community by the HIV pandemic. The main sub-themes for the pre-conference are “Health, Dignity and Justice,” grounded in a faith context. The IAC will also offer a faith track comprised of workshops and sessions, some of which will be hosted at the EAA’s “Faith Networking Zone” in the Global Village.

Both events provide opportunities for the engagement of young adults. It is well known that young people ages 15-25 years old make up half of all new HIV infections. Understanding this to be a great learning and advocacy opportunity for young people, the IAC significantly reduces the registration fee for students and persons under the age of 26, urging the participation of young adults. At previous IACs young people have come together and formed their own caucuses, presented working papers, and met with leaders to advocate for policies that address their needs. Therefore, the International AIDS Conference has become an excellent avenue for the ELCA and the LWF to engage young adults and offer leadership opportunities in the fight against AIDS. The ELCA has been committed to the sponsorship of young adults to attend the IAC and related interfaith events and continues that commitment at AIDS2014. This exposure has enabled young adults to be a part of the global ecumenical movement touching not only people in their local communities but peoples of the world.

Furthermore, young adult participation at AIDS 2014 is a component of a larger vision within the ELCA to create a critical mass of social justice minded young people across a multitude of issues including HIV and AIDS. ELCA Young Adult Ministries in conjunction with World Hunger, Congregational and Synodical Mission, Young Adults in Global Mission (YAGM), Peace Not Walls Campaign, and others are working together to mold a collaborative way of lifting up and supporting young adults across units in areas of justice ministries. The International AIDS Conference, United Nations Commission on the Status of Women (CSW), Peace Not Walls Young Adult Leadership Training in the Holy Land, and YAGM are all elements of the ELCA Young Adult Cohort designed to create platforms that allow young people to engage issues and create plans for advocacy and awareness in their local contexts. Young adults are a cross cutting commitment in the operational plan of the Churchwide organization and these collaborations strengthen this commitment.

So, without further ado, meet the ELCA young adults and staff present at AIDS2014 and follow our time together here and on social media via @ELCAAdvocacy, @ELCAYoungAdults, #ELCAAIDS2014, #faithAIDS2014 and #AIDS2014.

• Ulysses Burley. Ulysses is a clinical research associate at the Northwestern University Feinberg School of Medicine and a member of the Campaign for the ELCA Steering Committee. He was present at the development of the ELCA Young Adults Cohort at the UNCSW and will offer leadership to this event on behalf of that program.
• Richard Adkins. Richard was born and raised in Washington D.C. and recently graduated from the University of Maryland with a bachelor degree in accounting. He is deeply involved with HIV/AIDS through Children National Medical Center where he sits on their community advisory board. He also volunteers with Youth Haven, a program of LSS of the National Capital Area.
• Rachel Hunstad. Born in Fargo, but raised in Minneapolis, Rachel is a graduate in nursing at Concordia College in Moorhead. She has worked as a registered nurse in Fargo and served as a YAGM in South Africa, working with HIV/AIDS in her placement there.
• Elishua Greenwood. Recommended by Lutheran Social Services of the National Capital Area, Elishua is one of the young adults from Lutheran Grace, and the youngest member of the delegation at the age of 18. Elishua says, “Often times it is the young people who are most reluctant to get treated or even tested for HIV. Having youth at the forefront of this fight may slow down the rate of infection because young people listen to young people.”

 ELCA Staff include:

• Ms. Stephanie Berkas. Stephanie is the manager for the ELCA YAGM program. She will be offering leadership of the cohort experience, along with Ulysses and has experience-related to HIV/AIDS from her time as a YAGM in South Africa.
• Ms. Christine Mangale. Christine is the program coordinator at the Lutheran Office for World Community (LOWC) at the United Nations in New York—an office shared by the LWF and the ELCA. She is originally from Kenya where she worked with the youth program of KELC and is on staff with ELCA GM. She is featured in the Campaign for the ELCA video.
• Dr. Rebecca Duerst. Rebecca is program director for health care in ELCA GM. She is also a member of the group developing the next round of UN Sustainable Development Goals on behalf of civil society groups.
• The Rev. Dr. Chandran Paul Martin. Chandran is the consulting regional rep for south/south Asia in ELCA Global Mission. He has also formerly worked in leadership with the LWF.

“God’s work. Our hands.”