VSO Papua New Guinea’s Health Programme Manager writes about what he learned in thought-provoking debates at the International AIDS Conference in Melbourne, Australia.
By Sanjay Singh: July 25th, 2014
Labels are important when it comes to planning HIV programmes, but they can also prove controversial. This was the topic of the day in a session which included panellists representing sex workers from Papua New Guinea, an injecting drug user from Nepal, a first nation woman from Canada and a gay man from Africa. We came together to discuss what constitutes a ‘key population’ – specifically, could the labelling of sex workers, injecting drug users, men having sex with men as ‘key population’ lead to more stigmatisation?
Using the term ‘key population’ is intended to enable focused interventions and facilitate resource allocation. However, labelling people in this way can arguably reinforce the misconception that just by being a sex worker, gay or an injecting drug user, they are responsible for spreading HIV infection.
In my opinion, it should not be about the individual and his or her identity. If people take safety measures that mitigate the risk of HIV infection, then their activities are no different from any other behaviours that are within what society accepts as ‘normal’.
The issue is further exacerbated by the use of other similar terms which are commonly used to identify and categorise people, such as ‘most at risk population’, ‘vulnerable population’, etc. As a sex worker from Papua New Guinea pointed out, “The use of these many terms are confusing. Let us decide and define who we are.” I can’t help but agree.
This session, and many others, reminded me of the importance of listening to each other and applying learning from each other. An interesting discussion of particular relevance to our health programme in Papua New Guinea focused on the question of what can be done to reduce “loss to follow-up”. In many countries, more and more people are apparently failing to start Anti Retroviral Treatment (ART) following a confirmed HIV diagnosis. There has also been a rapid increase in the number of people who stop taking their ART medication. This is a big problem in Papua New Guinea and elsewhere, because defaulting on ART increases the resistance of the virus to the medication and can also have a financial impact on health systems.
We heard a great example of innovation in HIV programme evaluation in Tanzania, which points towards a solution to this problem. I was happy to hear that the introduction of IQ Tools is helping trace follow-up cases across health facilities in one region of Tanzania. My VSO health programme team are beginning a project to address loss to follow-up, and so I was very happy to hear about this innovation that we can learn from and potentially also apply here in Papua New Guinea.
For more information on VSO’s programmes supporting HIV and AIDS services, please see vsointernational.org/what-we-do/health
To find out more about VSO’s work in Papua New Guinea, please see: vsointernational.org/papua-new-guinea
