PEPFAR’s new strategy on HIV uses stigmatising language

By Shaun Mellors

Director Knowledge and Influence, International HIV/AIDS Alliance

The ambitious new strategy of the US President’s Plan for AIDS Relief uses language that has no place in the global HIV response.  

<p>Participants at a workshop in Haiti analyse the causes and consequences of stigma and discrimination to create images for a future exhibition</p>Participants at a workshop in Haiti analyse the causes and consequences of stigma and discrimination to create images for a future exhibition © 2004 Ken Morrison / HCP / Alliance

As a person living with HIV, I am disheartened and disappointed by the way the strategy describes us.

PEPFAR’s strategy for accelerating HIV/AIDS epidemic control (2017 – 2020) brings back stigmatising language from the dark ages of the AIDS response. It states: “PEPFAR will support programs that significantly decrease the number of HIV-positive positive [sic] transmitting individuals through the suppression of their viral load…” and, “Pursued in combination, these strategies will reduce the amount of HIV that is circulating in the populations…”

At the International HIV/AIDS Alliance, we believe this language reinforces the concept of people living with HIV as vectors of disease and reverses progress made on the meaningful involvement of those most affected, in the response to HIV.

Involving people living with HIV

The Greater Involvement of People Living with HIV principle and the Positive Health, Dignity and Prevention framework have been fundamental to an effective response to HIV, by fully involving people living with HIV in their health and the response as a whole.

It is shocking and disheartening to see PEPFAR use such stigmatising language when it should be upholding principles it once thought essential.

There is robust evidence pointing to stigma as a key driver of this epidemic, particularly among populations most affected by HIV such as men who have sex with menpeople who inject drugs and sex workers.

For those of us working to end AIDS by 2030, it is vital that we have a united approach to tackling stigma, which includes using language that does not make things worse for those most affected by the disease.

The Alliance promotes and supports a person-centred approach to HIV to increase access to quality HIV services which must be embedded in a rights-based and community led approach.