Michele Breveglieri, the association's health director, is in South Africa to follow the work: "Combined prevention is key to curbing the HIV epidemic. But a comprehensive strategy is needed."“
The AIDS2016 World AIDS Conference, which returns to Durban, South Africa after 16 years and will conclude on July 22, has already begun yesterday with several pre-congress conferences.
Following the conference, Arcigay's Michele Breveglieri, head of health and HIV, attended today's "Action + Access: Rights and Demands of Gay and Bisexual Men in the Global HIV Response," a pre-conference focused primarily on the right of gay and bisexual men to access treatment, services, and prevention. The pre-conference opened with a presentation by Jose Antonio Izazola of UNAIDS on the global economic cost of discrimination against LGBTI people: "Homophobia costs us globally between $63 and $184 trillion in reduced productivity and healthcare costs.".
Numerous presentations were held on the role of homophobia and transphobia in the epidemic, especially but not only in middle- and low-income countries. In general, there was a strong focus on a comprehensive, combined prevention strategy, combining strategies for testing, access to PrEP, attention to the needs of minorities, early treatment and reduction of community viral load, counseling and prevention strategies using apps and new technologies, access to "community" services designed to meet the specific prevention needs of gay and bisexual men and trans people, sexual health, and the destigmatization of pleasure and sex.
But it is above all PrEP, in its various aspects of effectiveness and concrete dissemination and real-world application, that dominates, with several presentations demonstrating the growing and inescapable importance of this new prevention tool for gay and bisexual men. Presenting his simulation study based on data from Taiwan, Dr. Chi-Tai Fang estimated that providing PrEP to only the most at-risk gay and bisexual men would eliminate the epidemic among men who have sex with men in Taiwan: "In reality, a strategy that combines annual HIV testing for those most at risk, PrEP to them, and immediate initiation of treatment for all those diagnosed with HIV would be sufficient.".
Activists have distributed countless "red cards," warning signs to protest the prevailing hypocrisy that leaves alone precisely those who need it most, be they gay and bisexual people or the poorest people on the planet: "No More Rhetoric! No More Hot Air!", "We speak for ourselves!", "Your morals are killing us!", "BLAH BLAH BLAH." Since UNAIDS launched the 90-90-90 target (901 diagnosed, 901 in treatment, 901 with undetectable viral load) to be achieved by 2020, the realization of this strategy seems like a pipe dream in many parts of the world. HIV organizations, gay and bisexual men, and people living with HIV will be able to shout with "red cards" that without concrete action, talk about targets is just bullshit ("bullshit!").
“"Today we could truly overcome the epidemic among gay and bisexual men, as well as its double stigmatization effects, but we lack the concrete political will," comments Michele Breveglieri. "A few days ago, data from the Partners study were published, further demonstrating that when an HIV-positive person is on effective treatment, their infectivity is zero. Different strategies for accessing HIV testing and sexual health services in general are being tested around the world, increasingly based on the crucial role of associations and activists from affected communities. PrEP is rapidly changing the prevention landscape, and the most sensible and effective ways of offering it to gay and bisexual men are being tested. This and much more is called combined prevention, but without a comprehensive strategy, we will not reach the goal. Arcigay is here and working towards this strategy. Most of the associations fighting HIV are there. In Italy, dramatically, the political will is lacking, and therefore the institutions and the funding are lacking," concludes Breveglieri.“
