As Montreal gears up to host the biggest leaders in global health, it is our hope that Canada will go well beyond provision of international aid, and find a way to harness the abundant scientific talent in Canada. Doing so will not only amplify the financial contributions by Canadians, but also show our global solidarity.
Fifteen years ago, Twesigye Jackson Kaguri, a native Ugandan, was living the American dream -- until his brother, and then his sister, died of HIV/AIDS. Coming face to face with the scale of Uganda's HIV/AIDS pandemic, Kaguri took the $5000 he had saved for a down payment on his own home and built Nyaka Primary School.
Many women around the world are placed in situations where they are often unable to negotiate with their partners to be faithful or to use condoms. Stepping it up for gender parity requires that women have access to a range of HIV prevention options, including those that they can use without partner involvement if they choose. Recent advances in oral pre-exposure prophylaxis have contributed to an expanding set of options, and two weeks ago, the results of two vaginal microbicide trials were released, taking us one momentous step forward along this path.
The presence of gender inequality becomes apparent within the communities of CAP-AIDS Uganda's CBO partners upon observing gender disparities in domestic labour and unpaid work, access to capital, as well as land and housing rights. These women are breadwinners, caregivers and active agents of community development who are entrenched in the social welfare of family, friends and neighbours.
Why is it that in a world where HIV is treatable and preventable young women are still getting infected and not being tested? In my opinion it is because women are still made and treated to be secondary in this world. There is a pressure put upon us to be perfectly satisfied even with the greatest tragedies. We are silenced, shamed if we speak up and sometimes in some places, even killed if we speak up.
Recent studies indicate that people living with HIV have an increased risk of developing cardiovascular disease. Although a number of pharmacological strategies under investigation should help minimize this risk, behavioral interventions, such as physical activity and exercise, also can lower the risk. However, as with anyone living with a chronic disease, questions will arise whether or not it is safe to exercise with HIV. The answer is a resounding YES.
The vulnerability of Black Canadians to HIV is highly complex and requires a better focus on prevention, education, harm reduction and testing. Our biggest challenge is the high and especially persistent levels of HIV stigma and homophobia in our communities. These attitudes severely limit our success in engaging Canada's Black communities in a dialogue about HIV, and get in the way of our HIV prevention, testing and treatment efforts. This is what our awareness day is all about. We want to both celebrate our successes and make an objective assessment of where our community is at in this fight to engage people in HIV prevention.
High profile disclosures of HIV status, like Charlie Sheen's, remind us of just how far we've come in treating HIV in the past 30 years. HIV is now a chronic disease like diabetes, heart disease or emphysema. However, there are still questions -- such as can people with HIV really live normal, healthy lives?
Many of us think of HIV/AIDS as an issue affecting other countries. But an HIV epidemic in Canada? An estimated 75,500 Canadians are living with HIV, with seven new infections occurring every day. While these numbers are concerning, Canada's overall rate of new infections is still lower than the global average. What these numbers don't show, however, is that HIV has reached epidemic levels in key populations across the country.
Women living with HIV must contend not only with the possibility of rejection, shame, or violence if they disclose, but also with the fear of criminalization. The law provides abusers with another tool for blackmail and further violence, even in cases where a woman disclosed. All the partner has to do is claim she didn't. It's important to generate strategies, such as electronic or paper documentation of disclosure, to protect women living with HIV from harassment, blackmail, abuse, criminal charges, and prosecution, all of which are fueled by the law. They need ways to look out for themselves physically, emotionally, and legally.
Thato knew the risks of unprotected sex in Lesotho, a small mountainous kingdom landlocked by South Africa, a country baring the title of the world's second highest prevalence of HIV. She always used condoms, until that night. She watched as the nurse pricked her finger and the blood spilled onto the HIV test strip. She waited the painful 10 minutes it takes for the the strip to reveal one red line for HIV-negative and two for HIV-positive. The reality of her status hit her and she could no longer speak. Her words, "I am positive," seemed to hang in the space and time.
I was born on May 21st 1993 with H.I.V. In my world this was the scariest thing imaginable. Not the actual virus. I was fortunate enough to learn I could physically live a long relatively healthy life. The stigma has kept me forever afraid. But my disclosure saved my life. That's not the case for everybody and I think it's important we all have a choice. Whatever choice that is, let yourself be happy. Let yourself feel no shame. I am not living with H.I.V, H.I.V is living with me.
The fact that there are still approximately 2 million people around the world who receive an HIV-positive diagnosis each year only accentuates how important it is to scale-up proven combination prevention approaches. Equally important is the scale-up of investments to find a safe, effective and affordable vaccine and multi-purpose prevention technologies.
HIV infection is decidedly no longer a death sentence, and no longer a major inhibitor of quality of life. HIV-positive people can live long and healthy lives. For those with access to care, some sex educators now talk about HIV infection as more of a nuisance to be managed than than a life-altering diagnosis.
UNAIDS has embraced the ambitious goal of ending the AIDS by 2030, and this has now been formally endorsed within the United Nation's Sustainable Development Goals agenda. On World AIDS Day, UNAIDS will be calling for the world to achieve: "Zero new HIV infections. Zero discrimination. Zero AIDS-related deaths."
Mandatory minimum sentences for possessing drugs for personal use do not make Canadians safer. They will not improve the health of our economy, the safety of our streets, or the well-being of communities throughout Canada. The inevitable overcrowding of Canadian prisons will not only increase tension and conflict in prisons, but also cost taxpayers billions of dollars.