Sex workers, lion condoms and HIV self-testing

Report from the 18th International AIDS Conference in Africa (ICASA) in Harare (November/December 2015)

Sex worker corner at 2015 ICASA

More than 7,000 HIV experts convened for the 2015 International AIDS Conference in Africa (ICASA) in Harare. Under the theme ‘AIDS in Post 2015 Era: Linking Leadership, Science & Human Rights’ many discussions focused on the role of key populations, which also caused some controversy at the conference.

‘Leaving no one behind!’ UNAIDS‘s slogan is more relevant than ever: 37 million people worldwide are living with HIV. Among those, 26 million people are located in the Southern African region. Several countries and key populations are particularly affected. For instance, 80% of commercial sex workers in Johannesburg are living with HIV. It is for this reason that the South African government will start implementing its national strategic plan on HIV among commercial sex workers.

7,000 HIV experts gather in Harare

Against this background, the 18th International AIDS Conference in Africa (ICASA) took place in Harare, Zimbabwe, from 29 November to 4 December 2015. More than 7,000 experts, researchers, policy makers and AIDS activists engaged in discussions on a broad range of topics covering the role of HIV/AIDS in the new SDG Agenda, HIV-related stigma, legal systems, human rights as well as advocacy. UNAIDS’s visionary ‘90-90-90 targets’ represented another focus of discussions. According to these targets, by 2020 90% of all people infected with HIV should know their status, 90% of all people diagnosed with HIV should have access to antiretroviral therapy (ART) and 90% of people accessing ART should have suppressed viral load. By achieving these targets, an end of the epidemic by 2030 is likely, but this requires reaching those populations which have so far been neglected by the AIDS response. Several sessions also discussed which lessons can be learnt from the AIDS response for dealing with other diseases such as Ebola or non-communicable diseases. In this regard, close cooperation with civil society organisations was particularly mentioned.

German Development Cooperation, through GIZ representatives, and its partner organisations were well represented at the conference: In total, 9 technical cooperation programmes from Zambia, South Africa, Zimbabwe, Namibia, Mozambique and Germany presented their approaches using various formats such as oral and poster presentations or interactive join-in circuits. Youth, government and UN representatives exchanged their views on demand and supply of adequate service delivery in local health systems during a satellite event of GIZ’s regional programme on the implementation of the Eastern and Southern Africa Initiative to promote youth-friendly health services and comprehensive sexuality education. A second satellite event hosted by the BACKUP Health initiative organised a panel discussion on health systems strengthening in the context of the Global Fund to Fights AIDS, Tuberculosis and Malaria.

Boosting prevention and therapy

Lion condoms

The 18th ICASA was characterised by numerous inputs from representatives of key populations at high risk of acquiring HIV, particularly sex workers and men who have sex with men (MSM). In line with the slogan ‘Nothing for us without us’, sex workers emphasised that programmes must not be run for them but with them in order to achieve the 90-90-90 targets. At present, however, social and legal burdens hamper the meaningful involvement of key populations in respective HIV programming.

UNFPA’s ‘Condomise!’ campaign also caught the attention of many participants through the introduction of ‘African-themed’ contraceptive products, namely zebra-patterned condoms and illuminated lion condoms. There was also strong promotion of female condoms.

Despite visible progress, comprehensive coverage of anti-retroviral therapy (ART) in Africa remains a distant dream. Even though approx. 11 million people are already on treatment in the region, this represents less than half of the people in need of life-saving ART. Use of voluntary testing, lifelong treatment and the prevention of mother-to-child transmission of HIV continue to create challenges. Most people living with HIV are not aware of their status and treatment remains not only relatively expensive but also complicated in its regimen. In some countries, transmission of the virus during delivery or breastfeeding period can only be prevented in 1 out of 3 mothers living with HIV. New approaches for self-testing (similar to over-the-counter pregnancy tests) are providing hope. Diagnostics and therapeutic measures require continuing innovation. The ICASA was an opportunity to analyse the latest available options and to discuss them among producers and implementing stakeholders.

Self-determined sexuality

According to Mr Parirenyatwa, Minister of Health and Child Care, Zimbabwe, it is now time to respond to the challenges posed by AIDS through realistic interventions including those targeting commercial sex workers as well as progressive legal frameworks. Unfortunately, simultaneously to his promising statements, the ‘Sex Worker Corner’ and a booth of MSM representatives were shut down by public officials. Following verbal protest by many ICASA participants, the booths could be reopened. As a result of this incident, participants felt even more encouraged to express their right to self-determined sexuality and health as demonstrated amongst others by South African Reverend Phumzile Mabizela: ’Sex ist not just creation, it is also recreation!’

Further information:

Official conference website:

By Karolina Luczak Santana and Wiebke Kobel, GIZ

December 2015

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