Agenda 5 – intervention by Andrew Spieldenner, incoming North American delegate

Intervention Agenda Item 5. Way forward to achieving Sustainable AIDS results

Delivered by Andrew Spieldenner, United States People living with HIV Caucus, Observer

Thank you for the opportunity to speak, Madame Chair.

In the North American context, our HIV epidemic has been characterized by massive disparities along the lines of race, gender, sexuality and other characteristics such as migration, employment in sex work, experience with drug use, and HIV-criminalization. We do not have a generalized HIV epidemic and we struggle against “general population” HIV prevention and services that do not take into account the specialized needs of key populations.

One solution in the US context was the development and ratification of the Minority AIDS Initiative in 1998, which is a government-sponsored legislation. Since 1999, the Minority AIDS Initiative has distributed funds directly to Black, Latino, Asian and Pacific Islander, and Native American projects through several funding arms. These arms have strengthened HIV care and services for racial/ethnic minorities, as well as enhance innovative initiatives such as the violence and health initiative, which funds 6 projects across the US to examine the link between violence and HIV vulnerability in African American communities. Minority AIDS Initiative has also been used to bring together community and governmental partners to address multiple health issues affecting racial/ethnic minorities.

While the Minority AIDS Initiative has done important work, it was ratified at a time of relative political goodwill towards HIV and affected communities. Unfortunately, with its focus on race, other intersectional identities have not had the same focus of sustained funding. It would be important to scale it up and expand to include key populations, including those who are consistently left behind like Black and Latino people, people of trans experience, sex workers, people who use drugs, immigrants and migrants, and people who have been imprisoned.

I do understand that the Minority AIDS Initiative represents a domestic policy intervention: one that does not carry the “gag rule” associated with other US-based funding. What the Minority AIDS Initiative does teach us is that funding for key populations is possible and necessary through various in-country models like formal legislation. The Minority AIDS Initiative also points to the importance of ongoing (it’s been funding annually since 1999) investment in community-led programs as well as community/government public health partnerships. The Minority AIDS Initiative demonstrates one way that transition plans can be developed for effective HIV responses in-country – through legislative protections and ear-marked funds towards addressing key population needs.

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