With a gathering of 38 enriching interventions, the publication “Responses to AIDS in Brazil: enhancing the debate III (Annals)” is the third seminar-based collection of a series that ABIA has been holding since 1999, called “Enhancing the Debate”. These seminars are interdisciplinary, interregional, and intersectoral and seek to disseminate information, strengthen the mobilization and participation of the Brazilian society to respond to HIV. It fits in with ABIA’s intent to capacitate key (governmental, civil, academic, and medical/health) sectors in dealing with HIV/AIDS by facilitating its understanding in all its aspects, but also, in a time of uncertainties for the future of an exemplar policy success to address the epidemic, it serves as an act of political resistance. The publication dates from 2019, a crucial year to understand conservatism in Brazil: a strong distrust and reluctance by the government towards civil society institutions is enacted to disrupt inclusion of diversity in human, reproductive and sexual rights.
First section of the publication is dedicated to civil society itself underlying present weaknesses as a way to reflect on new paths to grow stronger. Authors emphasize the legislative, financial and ideological obstacles that prevent civil society from taking action efficiently and suggest potential fronts and new workhorses to lobby on that are based on an intersectional and human-right based approach, something that needs to be dusted off.
Second section is centered on stigma, discrimination and structural violence regarding HIV/AIDS both within the HIV/AIDS movement and at an institutional level. Different types of society malfunctions are introduced: from discrimination to Afro-Brazilians, to the desexualization of homosexuality, passing through poverty, gender and sex work, the next step demanded by authors for the HIV/AIDS movement needs to be intersectionality in a way that every subjectivity is counted. Both the movement and the HIV/AIDS policy need to take more effectively into account the needs of audiences that have so far remained on the fringe.
Third section urges the need to juxtapose prevention with the principle of living sexuality in the way that most pleases the individual. It discusses how bareback and risk reduction practices are changing their meaning with the arrival of PEP and PrEP; the concept of drug harm reduction, an important right for in the HIV/AIDS field, which is at risk in the new conservative context. It also emphasizes the importance of combined prevention and proposes strategies for a better inclusion of the variety of situations where to apply prevention and the plethora of prevention methods, including internal condoms.
Fourth and final section is dedicated to the medical care of people. From the pros and cons of the incorporation of HIV/AIDS care in primary care to the crisis of the HIV care continuum in current Brazil, different authors warn about how treatment must go beyond the idea of undetectability and reflect on the structural causes of its absence/abandonment: access to drugs and patents, health professional preparation to deal with HIV/AIDS, the needs of specific categories of people living with HIV/AIDS such as women, the use of proper language while talking about treatment. Also, it introduces two optimistic examples of organizations that fight for better care, such as the Working Group on Intellectual Property and the Fiocruz’s projects focused on the health of travestis and trans women.
Read the publication (Portuguese)