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World AIDS Day: Solidarity, Struggle—Even Celebration

While the global AIDS epidemic is leveling out, drug users and prisoners remain at high risk.

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An estimated 33 million people have HIV.
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By May Wilkerson

11/30/12

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December 1 is World AIDS Day, an international day of solidarity with all people with HIV. There are thousands of events worldwide, in every nation, ranging from loud protests to candlelight vigils; giant condoms and red ribbons are the order of the day. For many participants, especially those who have the virus, there is as much to celebrate as to mourn. The global fight against AIDS has made many advances over the past decade as Western nations, led by the US, finally invested resources in providing the hardest-hit regions—sub-Saharan Africa, India and Southeast Asia—with effective three-drug treatment. Even though demand far exceeds supply, HIV rates are leveling off in many countries, and new infections have been halved. Some advocates are even talking about an end to the epidemic; that's why the theme of World AIDS Day 2012 is "Getting to zero: zero new infections. Zero discrimination. Zero AIDS deaths."

Yet the same people who were at highest risk 10 years ago are still in crisis: injection-drug users, men who have sex with men, sex workers and prisoners. Together, these groups make up the majority of the world's 33 million people with HIV. Criminalized and stigmatized, these groups are often denied access to prevention and treatment, fueling the transmission of the virus. "There are still grave increases of HIV infections among drug users, which have led to new epidemics in countries where previously the epidemics were not driven by unsafe drug use," says Yury Fedotov, executive director of the United Nations Office on Drugs and Crime (UNODC). 

The War on Drugs has worsened the spread of HIV, according to a report earlier this year from the Global Commission on Drug Policy. Criminalizing drugs drives users into hiding and discourages them from accessing clean needles, early diagnosis and the best protection against HIV of all: drug treatment. Turning back the tide of infection does not require the legalization of heroin, however. HIV rates have dropped steadily in places like Western Europe and British Columbia, where needle exchanges and supervised injection facilities are sanctioned. In a global survey, cities without needle exchanges showed a 6% rise in annual infections, while those with syringe swaps saw a 6% drop. Yet these measures remain illegal in most countries, including the US. Opiate substitution treatments, like methadone, have also been linked to a 54% decrease in infections among IV drug users. Still, the UN's Fedotov is "optimistic" about the future of HIV prevention among the world's drug-using citizens: "We have all the tools at hand, but bold and courageous responses are required based on evidence, human rights and gender equality." 

To do your bold and courageous part to battle stigma and criminalization, find out about a World AIDS Day event near you at: www.aids.gov.

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