The first World AIDS Day was observed in 1988 with the intention of mobilising the world against the rapid spread of a deadly virus, HIV, that had no effective treatment or cure. Over three decades on, the largest-ever global disease response has achieved unprecedented results. Every year on 1 December communities from across the globe unite—to remember those who have died, to raise awareness of HIV, to combat stigma and make their response. In 2019 the theme is ‘Communities make the difference’, providing an important opportunity to acknowledge the indispensable roles that our communities have played and continue to play in their response to HIV and AIDS at international, national and local levels.
Communities contribute in a number of ways, ensuring that their response remains relevant and is grounded, keeping people at the centre and leaving no one behind. They do this through their leadership and advocacy. Communities come in all shapes and sizes and they include peer educators, networks of people who are living with or have been affected by HIV, counsellors, community health workers, door-to-door service providers, civil society organisations and grassroots activists, nurses and other health and social care providers.
World AIDS Day provides an important vehicle to highlight the role of communities at a time when reduced funding is putting the sustainability of services and advocacy efforts at risk. When communities are mobilised they have the real potential to address those barriers that prevent the delivery of services in and by the community. Communities have strong advocacy roles to play and this is needed more now than ever, as the swingeing cuts that health and social care services have experienced take their toll on people using services and those who are striving to deliver them. In England the local authority public health budget has been cut by £700 million in real terms between 2014/15 and 2019/20. These cuts to funding have a knock-on effect leading to sexual health service budgets being cut by 25% (Terrence Higgins Trust, 2019). It is imperative to ensure that HIV and AIDS remain on the political agenda, that human rights are respected and that decision-makers and commissioners are held to account.
Stigma around HIV still blights the life of many people. There is a cyclical relationship between stigma and HIV and this vicious circle needs to be turned into a virtuous circle. People who experience stigma and discrimination do so on a daily basis, in schools, universities and the workplace. Overtly and covertly they are marginalised and as such made more vulnerable to HIV, while those people living with HIV are more vulnerable to experiencing stigma and discrimination. Each year in the UK over 4300 people are diagnosed with HIV; 1 in 5 people living with HIV say that they have needed help with loneliness and isolation (Positive Voices, 2018). A former British and Irish Lions captain, when announcing he had HIV earlier this year, said that he had been living in fear of the press publishing details of his HIV status after threats were made to him about revealing it (Davies, 2019). We know that discriminatory attitudes towards people with HIV are a global problem (Avert, 2019). Myths and misinformation still abound regarding HIV and AIDS—there is an ongoing need to address fears and change attitudes. This stigma and discrimination can even mean that people can be denied health services. Understanding, embracing and providing a human rights approach to HIV and AIDS is in the best interests of public health and as such is central to eradicating stigma and discrimination.
Each year on World AIDS Day we are reminded that AIDS is not over. There is still a need to raise money, increase awareness, fight prejudice and improve education.