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+TALK: VINAY P. SALDANHA

Because of dangerous inequalities we are not on track to end AIDS” @saldanhavp from @UNAIDSGLOBAL joins @karljschmid on a special #WorldAIDSDay episode of +Talk to sound the alarm & discuss a new report which shows that #HIV discrimination, stigma & criminalization are literally killing people.

Check out the full transcript below.

VINAY
Really, these are the really practical inequalities that are not only preventing the world from ending AIDS, but these are the inequalities that are killing people.

KARL
Hello there, welcome to Plus Talk on Plus Life, where we’re all about turning positive into a plus and today is a very special World AIDS Day edition of Plus Talk. And we are lucky to be joined by the UNAIDS US liaison in Washington DC, Director Vinay Saldanha. Good to see you, sir.

VINAY
Hi Karl, great to see you and thank you for this amazing opportunity.

KARL
Of course, thanks for making the time. Of course, today, December 1st is World AIDS Day and just a couple of days ago the UNAIDS World AIDS Day report for 2022 came out. Before we dive into what was in the report, what the findings are, tell us about what this report is and where does the data come from.

VINAY
Sure, so first, let me say that we are sounding the alarm bell as the United Nations as UNAIDS that, because of Dangerous Inequalities, which is the title of the UNAIDS World AIDS Day report this year, the world has set some ambitious targets to end AIDS by 2030. But precisely because of those inequalities, we’re actually not on track to end the AIDS, and some urgent work needs to be done. It’s not hard, it’s not complicated, but it really is urgent to get the world back on track to end the AIDS by the end of 2030.

KARL
Yeah, and I’m gonna, we’ll come back to in a minute about how this relates directly to us here in the United States, but this is a global battle, it is a global fight. Inequalities, inequities, these are words we hear tossed around over and over, especially here in the States. But to your point, globally, there are three specific areas that the report talks about when it comes to inequalities. Why don’t you run us through them briefly and talk to us a little bit more about that.

VINAY
Sure, Karl, thanks. And really, these are the really practical inequalities that are not only preventing the world from ending AIDS, but these are the inequalities that are killing people every day. They’re putting people who should be able to live a full healthy and normal life protected from HIV infection and unnecessarily putting them at risk for HIV. And in particular, for our audience, for your audience, these are the same inequalities that are keeping people who are already living with HIV away from life-saving, scientific breakthroughs that can inform them that they are diagnosed with HIV, give them access to life-saving antiretroviral treatment, make sure that they are reaching what we call undetectable levels of HIV. In other words, so they can live a happy and full life not worrying about the fact that they have HIV, because they’re protected from ever developing AIDS. They will be protected from even the stigma, the discrimination and the self fear of transmitting HIV to their sexual partner. But for people to be able to benefit from these scientific breakthroughs, we have to address these inequalities. It’s just not acceptable that decades into this epidemic you still have some parts of the population around the world in Sub-Saharan Africa, in Asia Pacific, here in the United States, where some parts of the population have access to these life-saving breakthroughs and other parts of the population are still being left behind. And in terms of the groups we’re really focusing on in the UNAIDS report, first and foremost, it’s inequalities faced by key populations. So if you are a man who has sex with other men, if you are a sex worker, if you’re a transgender person, if you are a person who uses drugs, the laws and access to services are such that you are still being left behind. And you have to make a special effort in order to just access life-saving health services. And it shouldn’t be this way, because we need to address these barriers and ensure that key populations who are manyfold at higher risk for HIV, for AIDS-related death and simply because of who they are and who they love. And there shouldn’t be laws and unnecessary barriers and discriminatory practices that keep people who need these services the most from being able to access it, access the services, stay alive, stay healthy, and really contribute to a full-fledged happy, healthy society and contribute to ending AIDS by 2030.

KARL
Yeah, I have to say in reading the report, one of the alarming findings that I found was that it said that every two minutes an adolescent girl or young woman acquired HIV in 2021. Vinay, how is that possible in 2021?

VINAY
It’s really, it’s both incredible that it’s still happening and very frustrating, because we have the tools to protect every or avoid and avert every new HIV infection. And the majority of the new HIV infections amongst adolescent girls and young women are still happening in Sub-Saharan Africa. So you’ve got amazing programs that are really in place today. Thanks, first and foremost, to the generosity and support of the American people through PEPFAR, through the Global Fund to fight AIDS, tuberculosis and malaria. These programs have changed the trajectory for so many Sub-Saharan countries in Sub-Saharan Africa that have gone from seeing HIV and AIDS as a risk to their demographic future to their future stability, to their economic prosperity. And today they’re actually, on track to end AIDS, but we still have a disproportionately high number of adolescent girls and young women in these same countries in Sub-Saharan Africa for whom they are still at risk for HIV. And not only because they don’t have access to condoms or information, but also because they don’t have an opportunity to complete secondary school. And it’s been proved in a number of studies that simply access to a secondary school education for adolescent girls and young women not only gives them a completely different future armed with a very strong education, but gives them access to the kind of education, the kind of confidence, the kind of life skills that they need to protect themselves lifelong from the risks of acquiring and living with HIV.

KARL
Yeah, and we are talking Sub-Saharan Africa there and another interesting finding I found in the report was how just sort of masculinity and these sort of masculinity norms of how men and young men approach health and wellbeing. Oh, I don’t need to go to the doctor, because that makes me look weak. That is actually having an effect on the rate of infections, not just there. But I would imagine that translates to here in the United States too, right? Vinay, there are a lot of communities in a lot of parts of this country where on the DL we just don’t talk about it.

VINAY
Absolutely, these are precisely the kinds of inequalities that are reinforced by unhealthy masculinities. And what do we mean? It’s this kind of macho attitude that men and even boys are so healthy and will always remain healthy and therefore they don’t need the additional education. They don’t need to go to a clinic, they don’t need access to HIV testing or health testing for a number of other potentially dangerous infections and illnesses and viruses. And as a result, we have the data that shows even in Sub-Saharan Africa, where for most of the let’s say the general population, the adult population 16 to 49, overall, there’s been a lot of progress. And the majority of people who are living with HIV know their HIV status, are diagnosed, on treatment and reaching undetectable viral loads, but exactly the same group, adolescent boys and men, are still falling behind and they don’t have access, because probably because we know many of the programs are not set up specifically to address these men, these unhealthy masculinities. Specifically, target adolescent men and boys, but also make sure that the same effort and laser focus that we’re putting into saving the lives of adolescent girls and young women are also being put into saving the lives of young men. And here in the United States in particular, where the vast majority of new HIV infections are not only continue to be amongst men who have sex with men and transgender persons, but also the majority of them are either men and or LGBTIQ persons who may identify as being men or be in the process of gender identification or are still in transition and they’re simply falling out of the system. The health and the social services are not catching up to where they are in their lives. And as a result, HIV infection, knowledge of their HIV status, access to pre-exposure prophylaxis, prep, condoms are not the top thing on their minds unfortunately. And so, this requires a real about face and seriously taking into consideration these inequalities that are leaving people behind unnecessarily. It would be one thing if as we heard the outstanding amazing Tony Fauci say just yesterday, we can still end the AIDS even without a vaccine, but we have to get the heavy lifting done. We have to address some of these harmful, dangerous inequalities that are still holding the world behind and holding whole communities behind, even here in the United States.

KARL
Yeah, and another factor is criminalization laws that certainly, in this country, surrounding HIV disclosure, me as a healthy undetectable HIV positive man I can be thrown in jail for not disclosing my HIV status to a sexual partner. Even though the science shows zero risk of transmission. So you’ve got laws like that in this country, which stop people from talking about it. And then if we go to other countries where homosexuality is illegal. So decriminalization is another big part of it, isn’t it?

VINAY
Absolutely, in fact, it’s really so frustrating that we as the United Nations are still working with 68 countries around the world where, which continue to criminalize same sex relationships. Criminalize people for who they are and who they love. And this we’ve seen time and time again, this is precisely why in many of these same countries the HIV response is still being held back, or men who have sex with men in these countries and transgender persons in these countries are still being left behind. Because when someone is criminalized simply for being gay or having sex with another man they will be extremely hesitant to come forward and access life-saving HIV prevention, pre-exposure prophylaxis or prep or access antiretroviral treatment. And if these are the services that communities and individuals need to stay alive, we need to make it as easy and nonjudgmental and as accessible as possible for anyone regardless of who they are. Whether they’re a documented migrant, whether they’re a man who has sex with men, whether they are an injecting drug user, or whether they are identify as a heterosexual person. It doesn’t matter.

KARL
Right.

VINAY
There should be no stigma associated with HIV or the risk of acquiring HIV. But for them to be able to access these services and these amazing scientific cutting-edge prevention tools and treatment tools that we have available, we need to really remove these discriminatory laws, these punitive laws that are really holding the world back and hold communities back from ending AIDS.

KARL
What can we look forward to here? I don’t want this just to be a negative conversation. We’ve got a lot of work to do, but what should we be celebrating and looking forward to as well, Vinay?

VINAY
Well, let’s start with things to celebrate here in the United States. On World AIDS Day there is a red ribbon hanging in the north portico of the White House. The Biden Harris administration is showing so much consistent leadership on HIV domestically through the office, the Domestic AIDS Office, internationally through PEPFAR under the leadership of Ambassador John Nkengasong and HIV, even politically in the United States, I would argue is one of the few issues that continues to receive consistent bipartisan support from the House, from the Senate, from Republicans, from Democrats. And this is saving lives both here in the United States and around the world. So that’s so important to continue that bipartisan support, political support for HIV, until the job is done, until we end AIDS by 2030.

KARL
Vinay, in the last few moments I’ve got you, it is World AIDS Day today. What advice, what can every day folks at home, whether they know someone who’s affected by HIV or not, what can people who go, you know what, I should do something. I wanna do something, I wanna help change this narrative, I wanna help us reach that target of 2030 of ending AIDS. What simple advice do you have for everyday people that would mean change would come about?

VINAY
Thanks, Karl. I think, Karl, it really is quite simple. We can spend billions of dollars and have millions of tablets available to try and put the world on track to end AIDS, but nothing is as precious as treating someone who, because of who they are or who they love needs to be treated the same way we would like to be treated. Free of stigma, free of discrimination, and to be able to treat someone with dignity and respect and ensure that they have access to these life-saving services. It’s not that expensive, in fact it’s free. It doesn’t cost anything at all, which is why I think it’s priceless. So on this World AIDS Day, let’s really focus on equalize and treating everyone with the same equality and respect that we expect others to treat us with.

KARL
Well, as I say, see me, not my HIV. Vinay Saldanha from UNAIDS, thank you so much for taking the time on what I know is a very busy day for you. Good chatting to you, sir.

VINAY
Thank you, a pleasure. And stay happy, stay healthy, stay positive and equalize.

KARL
I love that. That is gonna do it for this very special World AIDS Day edition of Plus Talk on Plus Life. If you want more information or you wanna check out the global report, you can head over to our website pluslifemedia.com. And remember to follow us across social. We are @pluslifemedia. Until next time, thanks for watching. We’ll see you soon.

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