“Social, state and symbolic violence keeps people away from care and prevention”

De triple therapy in 1996 with combinations of antiretrovirals to be taken every two months by simple intramuscular injection currently on the market, great advances have been made in the treatment of HIV. New prevention methods such as pre-exposure prophylaxis (PrEP) or self-test have also emerged to help people take charge of their health and reduce the number of new infections.

In forty years, our knowledge of the virus and the health of infected people has changed a lot. We now know that people living with HIV, on treatment, have roughly the same life expectancy as people who are HIV negative. Better still, they can have a very fulfilling emotional and sex life and no longer transmit the virus when they have an undetectable viral load.

So how can we understand that despite all the prevention tools at our disposal, more than 680,000 people died of AIDS around the world in 2020? How can we understand that today, even more than 10 million infected people are deprived of nonetheless vital treatments? How can we understand that more than 6 million people living with HIV do not know their HIV status and therefore cannot access the care they so badly need?

Soft political will

The answer to these questions we, the AIDS networks of people infected, affected and vulnerable to HIV, know all too well. In 2021, as at the start of the epidemic, AIDS continues to disproportionately affect gay and bisexual men, sex workers, transgender people, people who inject drugs, and migrants. According to the Joint United Nations Program on HIV / AIDS (UNAIDS), these communities represent 93% of new HIV infections outside sub-Saharan Africa.

In question, social, state and symbolic violence which keeps people away from care and prevention. It is difficult to protect yourself from HIV when carrying prevention materials, whether sterile syringes or condoms, can be grounds for arrest. It’s hard to talk to your doctor about your sexual practices when homophobia pervades all of society. Difficult to access antiretroviral treatment when its mere presence in a territory is considered illegal.

Very far from the ambitious global goal of eliminating HIV by 2030, this observation of failure is in fact the consequence of a weak will of certain political decision-makers, more quick to designate scapegoats than to respect their international commitments and fundamental human rights.

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