22 November 2013

Getting to zero: young people set the agenda at AIDS congress

A migrant worker activist shares a joke with the HIV virus on the parade
© UNICEF EAPRO/2013/Andy Brown
I’ve been to many international conferences in my time and the word ‘fun’ doesn’t immediately spring to mind. But the 11th International Congress on AIDS in Asia and the Pacific (ICAAP), held in Bangkok this week, really was fun. This was largely because of the enthusiastic participation of young people and HIV activists from around the region.

As well as the speeches and debates you would expect at an event like this, there was a marathon, cultural performances, youth protesters and a noisy and colourful parade. The opening ceremony featured a performance by drummers from Thailand, China and Bangladesh, playing in their own national style, while children from Indonesia danced on stilts. A group of ‘Instagram reporters’ commissioned by UNAIDS went around capturing the sights for social media.

At the end of the first day, the young people and HIV activists gathered for a parade from the conference centre to Soi Cowboy in Bangkok’s notorious sex district, where they held a welcome reception. The parade took place to the soundtrack of loud pop music. Young people danced in the streets and waved banners calling for an end to discrimination against at-risk groups such as migrants and sex workers. It was led by a tall transvestite twirling a red umbrella. The atmosphere was celebratory.

And there is indeed much to celebrate. An AIDS-free generation once seemed like a far-off dream, but the world finally has what it takes to make this dream a reality. This means a generation in which all children are born free of HIV and remain so for the first two decades of life, from birth through adolescence and into adulthood. It also means that children living with and affected by HIV have access to the treatment, care and support they need to remain alive and well.

Tackling stigma

The Thai Youth Volunteer Group performing 'Growing up with HIV'
© UNICEF EAPRO/2013/Youkonton Ratarasarn
However, progress in the Asia-Pacific region has been uneven, with improvements for children lagging behind those for adults. Although new HIV infections among children in Asia have declined by 28 per cent since 2001, the pace of decline has slowed in recent years. Of the 350,000 people newly infected with HIV in the region in 2012 some 22,900 were children under 14 years of age, according to new figure released by UNICEF.

The data also shows that there are approximately 240,000 adolescents (10-19 years old) currently living with HIV in the region, including an estimated 58,000 newly infected in 2012. These adolescents face daily challenges ranging from access to health services, to stigma and discrimination from their peers.

To illustrate these issues, UNICEF Thailand supported a drama called ‘Growing up with HIV’ that was performed at the conference. It was written by young people living with HIV about the stigma and discrimination they face, and performed by youth volunteers. The drama took the form of a ‘play within a play’, where the actors watched a video of a play by HIV-positive children wearing masks, and discussed their own reaction to it.

After watching the play, one of the characters, ‘Tum’, reveals to the others that he is HIV-positive. “I realize now that all of you understand me,” he said. “I am tired of trying to avoid taking my medicine in front of you. I would like to disclose my HIV status and tell the truth to others to help them understand adolescents living with HIV.”

It was a moving performance and had the undeniable ring of truth to it.

Youth leaders


Tung Bui speaks at a youth advocacy session before the main conference
© UNICEF EAPRO/2013/Youkonton Ratarasarn
Between the formal sessions, I interviewed youth leaders working with at-risk adolescents in Myanmar, Nepal and Vietnam, including young gay men, transgender and former sex workers. One of these was 25-year-old Tung Bui from Vietnam, who has worked on HIV and AIDS prevention among men who have sex with men for four years.

“I came out to my mum when I reached my early twenties” Bui told me. “She kept asking when I would get married. One day I couldn’t take it anymore and I said ‘marriage is not going to happen to me because I’m not into girls. I’m attracted to guys’. I come from a small village and people don’t understand being gay. They call it ‘modern things’. My mum is still processing it. I managed to guide her through it: I explained what gay is, what transgender is. Now she has stopped talking about marriage.”

When Bui was first exploring his sexuality at school, he did not have access to information about HIV and AIDS. But when he went to college in Hanoi, he met a self-help group formed by other young gay men. “That was when I was born again and decided to be an activist for gay rights,” he said. “I got all the information I needed about HIV and AIDS. I was lucky to get it early enough. Then I started to do outreach to the park, bars and saunas to share this information with other young gay men.”

I also talked to ‘Swastika’ (not her real name), a young transsexual from Nepal. She spoke about the discrimination she faced when trying to access health care. “There are no HIV services for young transgenders in Nepal,” she said. “They don’t know where to go. Once, when I was very sick, I went to the hospital. They kept asking me for my menstruation date. I said ‘I don’t have one, I am transgender,’ but they just didn’t get it. So I left the hospital and got my medication elsewhere.”

Lost in Transitions

One of the photos taken by UNAIDS Instagram reporters at the conference
© UNAIDS/2013
On the last day of the conference, UNICEF launched a joint report titled ‘Lost in Transitions: Current issues faced by adolescents living with HIV in Asia Pacific’. Written by the Asia Pacific Network of People Living with HIV/AIDS (APN+) with support from UNICEF, this is the first report that specifically focusses on adolescence and HIV in the Asia-Pacific region.

“Adolescence is a difficult time for all young people, when they have to negotiate the change from childhood to adulthood,” Director of APN+ Shiba Phurailatpam said. “This can affect their adherence to medication and access to treatment. The groups particularly at risk in this region include young gay and bisexual men, young intravenous drug users, and young sex workers.”

Like many people at the conference, Shiba also spoke about his own experience. “I used to use drugs,” he said. “At the age of 22, I was diagnosed with HIV. I have asked young people living with HIV, who looks after them? They said ‘no-one: my mum died, my dad died’. If I didn’t have people to support me when I got my HIV result, I don't know what I would have done. We have to go out and bang on governments’ doors and make them address these issues.”

For me, the conference was an eye-opener. I was shocked by the stigma and discrimination that young people with HIV still face after decades of education and advocacy, but also inspired by their fighting spirit and determination to celebrate their lives and diversity. I left ICAAP feeling like an associate member of a very special community.

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The author
Andy Brown is Communication Consultant for UNICEF East Asia and Pacific

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