“We need to be clear that this is the
best researched disease in history. We know what to do to prevent HIV
infection, but we’re not drawing a straight line between what we know
and what we do,” stated Elizabeth Pisani, author of The Wisdom
of Whores: Bureaucrats, Brothels, and the Business of AIDS.
This session, sponsored by the Caucus
for Evidence-Based Prevention, was a frank discussion among advocates,
framed around Pisani’s idea of the “sacred cows of HIV” (an analogy
taken from drivers in India swerving to avoid cows in the road).
What are the “sacred cows” standing in the way of progress in the
fight against AIDS?
Religious groups that advocate for policy
based in ideology rather than evidence may be one. Or the AIDS
industry itself, which has framed AIDS as “everybody’s problem”
in order to draw attention and funding, rather than focusing attention
on the groups most at risk. The history of HIV/AIDS activism may be
to blame, creating anti-testing and pro-treatment biases rather than
a focus on prevention. There is also the assumption that people
will make rational decisions about their health (e.g., using condoms
and clean needles), when the evidence is that people are not rational
aboutsex and drugs.
The group also discussed the need to
strengthen health systems in general. Are poverty reduction, food
security and women’s empowerment issues also AIDS issues or should
they be kept separate? As Pisani stated, “Why do we need HIV
to fight against sexual violence?” Some liked the idea of using HIV
as a catalyst for ensuring these basic human rights, but others thought
the fundamentals of HIV prevention should be the focus.
This discussion is only one of many that
are necessary to topple our “sacred cows” and promote HIV prevention
based in scientific evidence.