In 1994, the principle of Greater Involvement of People with HIV/AIDS (GIPA) was created by the United Nations, and this was later amended to the Meaningful Involvement of People with HIV/AIDS (MIPA). The purpose of this principle is to empower people living with HIV to have a greater say in the strategic direction and implementation of all things related to the HIV response. Therefore, MIPA ensures there is a respectful community dialogue that challenges stigma and promotes the healthy well-being of people living with HIV.
QPP are supportive of the MIPA principle and are keen to highlight the benefits of people being aware of their own HIV status – something that is possible if we are able to shift the negative perceptions about what it means to be HIV positive, which are an unfortunate consequence of the early AIDS epidemic when the world was unprepared and unaware of what HIV was and how it could be treated. These days, it’s a very different picture: treatment for HIV can be as little as one pill per day, and people living with HIV now continue to live a long, healthy and fulfilling life. While PLHIV may suffer treatment side effects and require regular health monitoring, the outcomes of these are greatly enhanced when HIV is detected early. This means that the earlier you are diagnosed with HIV, the better your individual long term health outcomes will be.
One of the great challenges for HIV prevention is that many people who are HIV positive, do not know it. These are the people who are at the greatest risk of transmitting HIV further, as they undertake risky behaviours believing themselves to be HIV negative. As well as this though, these undiagnosed people are at risk of serious HIV related co-morbidities because they are unaware of the damage being done to their body as a likely result of a high viral load.
What we need to do as a community is work together to reduce the stigma associated with HIV, because this stigma prevents people from testing for HIV as often as they should out of fear for the result they may receive. The MIPA principle is a way of challenging these perceived fears of a positive result, as PLHIV can reframe the need to test for HIV for the health benefits associated with an early diagnosis and potential for early treatment – something that has never previously been available.
By following the MIPA principles and allowing PLHIV to be involved in the development and implementation of HIV prevention, we can finally remove the 1980s face of an AIDS diagnosis and promote the more accurate 2014 face of what it means to be HIV positive.
An important aspect of this shift is the promotion of HIV prevention being a shared responsibility. As stated in the QPP discussion paper ‘HIV Transmission, The Law and Public Health’ we need to encourage “a shared responsibility for the complex factors that surround the behaviours associated with transmitting or contracting HIV.” It is therefore just as important for an HIV negative person to take responsibility for their own health and maintain their HIV negative status. An element of this responsibility is being aware of the options available to protect themselves and being aware of their need to test.
QPP believe that people are more likely to participate and act responsibly by undergoing regular testing in a non-judgemental environment if they are aware of the individual health benefits associated with an earlier HIV diagnosis.
With all the advances we have had in testing, that allows you to find out your result in 20 mins, and all the advances in treatment, which allows PLHIV to live a long and healthy life, there is no longer a reason to fear HIV testing and to fear the possibility of an HIV diagnosis. Removing this fear however, does not remove the responsibility we all have to prevent the transmission of HIV. To learn more about living with HIV in 2014, check out the ‘Talking About HIV’ short films at www.qpp.org.au/talking.