Theo Smart

Recent Activity

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  Theo signed the petition | 6 months ago

  Tell Holder: Stop State Laws that Threaten the Right to Vote
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  Theo signed the petition | 6 months ago

  Faces of the Famine: Tell Congress to Help Now
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  Theo signed the petition | 6 months ago

  Tell Congress: Pass the Respect for Marriage Act and Repeal DOMA
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  Theo signed the petition | 6 months ago

  Sign this petition and tell Tim you support him.
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  Theo commented on the article | over 2 years ago

  AIDS Advocacy- How to Do It, How Not To

  I definitely see Alanna’s point.

  
  

  And it seems obvious that the original idea was to show that someone who is physically desirable could be infectious.

  
  

  Contrast it to these French Ads from a couple years back: http://bit.ly/41VZmS . A lot of people loved these ads and thought they were quite effective.

  
  

  I, however, thought that they demonised people living with HIV as monsters.

  
  

  So I guess it is a matter of perspective.

  
  

  I remember a few years ago, there were people in the US, (even gay people with HIV especially in San Francisco) who were angry at pharmaceutical companies for portraying people with HIV as healthy and sexy in ads for antiretrovirals. The concern was that these ads were making prevention work more difficult, and potentially contributing to the spread of barebacking (unprotected sex). 

  
  

  I still find it hard to wrap my head around this, because for so long, the image of a PLWA was a frail man in a wheelchair with a catheter drip in his arm and sores on his face. You would see this motif repeated ad nauseum in the media, and, in SF at least, frequently on the street in the Castro. But I don't think that the drug ads changed that image, I think antiretroviral treatment did. But did people working in prevention in the US have such short memories that they really want to go back to stigmatising people with HIV? But from what many told me, for some who believe they are fighting a losing battle promoting safer sex, the answer seemed to be yes. I think they were tilting at the wrong windmills.

  
  

  But living in South Africa, where stigma and discrimination against PLHIV is still so profound (even among the white gay community who were affected long before the generalized epidemic) that many people are too scared to get tested and a positive diagnosis often leads to self-destructive behaviour, I think that images of people with HIV living happy healthy lives are desperately needed. In addition, it is important for uninfected people to realise that healthy looking sexual partners may in fact be HIV positive.

  
  

  That said, we still need to be careful that in our advocacy messaging that we don't play into other prejudices. Fueling misogyny or homophobia are obvious problems here. Another danger is that you may reinforce negative stereotypes of people living with HIV, dehumanise them, reducing them to mere ‘transmitters’ of virus.

  
  

  Portraying people with HIV as irresponsible vectors of transmission has had disastrous consequences. First, putting  the responsibility for HIV prevention solely on people with HIV allows people who believe they are uninfected to avoid taking personal responsibility for their own actions. It is in this context that transmission of HIV, and even failing to disclosure one’s status before sex, is increasingly being criminalized, and people with HIV are being imprisoned for having practiced unsafe sex even in the absence of transmission. In a recent case in Iowa, a gay man was sentenced to jail for 25 years after confessing that he had one episode of unsafe sex without disclosing his HIV status: http://criminalhivtransmission.blogspot.com/2009/05/iowa-gay-man-gets-25-years-for-one-time.html.

  
  

  One other issue when it comes to prevention campaigns, is whether they target populations really at risk in a country. I see that this ad originally comes from Italy, and I would think their prevention priorities really ought to be injecting drug users and men who have sex with men given that those have been the most common modes of transmission in that country. Lots of money has been wasted on prevention campaigns that primarily target people at rather low risk of infection, while ignoring those who are most at risk (who are often from marginalised populations).

  
  

  Of course, you can’t really look at one ad in isolation, but if this representative of the entire prevention campaign in that country, I’d say that they are probably missing the boat completely, and the money for these ads could probably be put to more effective use.

  
  

   

  
  

   

  
  

   

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  Theo commented on the article | over 2 years ago

  Why I'm Against a Global Fund for Maternal Health

  Although there clearly have been cases where programs with a single-issue focus have weakened health systems, I don't think that necessarily HAS to be the case. The Global Fund/PEPFAR were established to catalyze an emergency response and at the start, perhaps too little thought was put into how to set up HIV programmes without throwing already fragile health systems off-balance. But we know better now; and these institutions are evolving to adopt a health systems strengthening lens when planning and implementing programmes and interventions. To fulfil their mandate, this has to happen anyway, because HIV care and treatment programmes will only be sustainable, equitable and universal when they are decentralised to the primary care level. It simply can't be done without strengthening the health system.

  
  

  RE a Global Fund for maternal-child health: True, MCH also requires health systems strengthening & there is a very long laundry list of essential MCH activities. But many of the complexities you mention are just part of delivering any healthcare intervention in resource-limited settings (specialised human resources, often equipment (at least re diagnostics/lab), accessibility, financial/social barriers to care, transportation -- though rarely emergency). Addressing gender inequity, reproductive rights and sexual autonomy are also critical for the HIV prevention programmes being implemented by PEPFAR/Global Fund. These programs aren't just distributing pills.

  
  

  However, I think setting up a Global Fund for maternal-child health could inadvertently transfer to the new multilateral much of the national government's responsibility for providing essential MCH services (just as some 'focus' countries leave HIV to PEPFAR). And if you can't convince countries to allocate adequate resources for the health and survival of mothers and children, there is little hope of getting them to invest in 'health systems.' Of course, because of the sorry state of health systems, these countries do need help — starting with debt forgiveness and other policies to get countries to invest sufficient resources in their own health systems. This should lead to programmes that are home-grown and not dependant upon the whims of international donors.