Washington welcomed the International AIDS Conference back to the United States this Sunday, after a twenty-two-year absence due to US policy that barred people living with HIV from entering the country. As most delegates began to queue for the IAC’s opening session, a group of about twenty young women, trans people and men successfully interrupted the opening press conference, wearing green Statue of Liberty crowns, sounding vuvuzelas and chanting “No sex workers? No drug users? No IAC!” The United States still refuses entry to people who sell sex or people who use drugs , groups that are among the most vulnerable to HIV transmission and who have the least access to prevention and treatment resources.
As the protesters filed out, Diane Havlir, conference co-chair, began her remarks again. “We’re here to talk about courage and big ideas,” she told reporters, as bursts of vuvuzela and and chants could be heard in the press room again. “All of us at this table will be judged for our actions.”
That judgment dropped well before the conference itself. “Historically, before an international AIDS conference comes to a city, it’s an opportunity for that city to change these discriminatory laws,” said Kelli Dorsey, executive director of Different Avenues. Dorsey was in part responsible for negotiating with the conference organizers to ensure that sex workers and other marginalized groups were represented. “But that didn’t happen here. So we continue to have to demand to be at the table.”
Representative Barbara Lee (D-CA), who worked to lift the HIV travel ban, did speak directly to the challenge issued from these excluded groups. “We need meaningful dialogue with sex workers, with men who have sex with men, with transgender people, with drug users.” She pointed to a bill (HR 6138) she introduced before the House just ahead of the conference, which would end existing US funding bans on programs that support sex workers, expand condom access in prisons and call for a review of laws that criminalize the transmission of HIV. “I don’t know how we will see an end to AIDS in our lifetime, but to do so, we must include those communities.”
Talk of ending the epidemic dominates the conference this year, with Ambassador Mark Dybul, who headed the AIDS response under President George W. Bush, claiming at the opening ceremony that “what was unthinkable just three years ago is now in sight: an HIV-free generation.” Secretary of State Hilary Clinton, who spoke Monday at the conference, pledged her support for an “AIDS-free generation,” along with $150 million in US funds.
Scientific breakthroughs in prevention and treatment have made this possible: in many regions of the world, fewer people are becoming infected, and fewer people are dying. But science alone won’t end this epidemic. “You can’t medicalize and pharmaceuticalize your way out of AIDS,” said Allan Clear, executive director of the Harm Reduction Coalition. “Doctors may provide pills, but if the economic and social environment in which people live doesn’t improve, we can’t end the the AIDS crisis.”
It’s a two-way street: violence, poverty and discrimination make people vulnerable to HIV, and also contribute to their marginalization within the AIDS prevention community itself, where they must fight not just the epidemic but for a place at the table. Phil Wilson, president of the Black AIDS Institute, speaking before a small gathering in the Global Village after his opening plenary, said it’s not enough, for example, for those conducting clinical trials to appeal to African-Americans to join them. “We need our people involved in doing the research, in reviewing the grants, in writing about these issues in the media.”
Where is the space for that community leadership to be recognized? Not on the main stages of the conference, where “vulnerable populations” may be mentioned, but not honored. The rote repetition—listing off “sex workers, drug users, men who have sex with men” and sometimes, though rarely, “transgender people,” as if ticking check-boxes on a Centers for Disease Control form—becomes tokenizing, even numbing, when not matched with a commitment to making space for these groups to shape the AIDS agenda. There is an enormous difference between being spoken of as someone to be protected from the epidemic, and being given equal space as a leader who is essential to ending the epidemic.
Leaving the opening plenary on Sunday, where the president of the World Bank, Jim Yong Kim, shouted out “ACT UP” and UNAIDS executive director Michel Sidibé reminded the room how they are “indebted to the brave Americans who birthed the AIDS movement,” delegates passed portions of the AIDS quilt pinned to the wall. Some squares are faded. Death dates go back to the early 1980s. There’s glitter and prayer and anger. They also feel dated, maybe mercifully so. One of the only new squares, shockingly, bears the Chevron corporate logo.
The quilt and the activists—will these become relics, something to be moved on from, as AIDS becomes history, too? Chevron might feel comfortable enough now with the disease to put their mark on the AIDS quilt, but comfort hasn’t won people much against AIDS.