A Busy Day: Integration, Communication, and Aging
July 20, 2010
Deputy Director and Senior Fellow, Global Health Policy Center
Day One – AIDS 2010 is officially open. It feels a bit like being at the races, and the starting gate has just risen. If you’re going to have even the slightest chance of getting to every interesting panel, meeting the speakers you want to talk to, and catching the latest workshop or poster session, you’re going to have to move quickly, very quickly. And what about all the interesting research papers, advocacy brochures, and other items you pick up? Better bring an empty bag.
The opening plenary session was packed and featured discussions related to prevention as well as drug policy and harm reduction. Former U.S. President Bill Clinton offered the keynote lecture, discussing the Clinton Health Access Initiative and efforts to promote access to treatment in developing country settings.
As the plenary concluded and delegates searched for the next panel, compared notes, and debated the ”treatment is prevention” paradigm in the hallways, a second round of symposia got underway. I attended a panel analyzing the contributions of HIV/AIDS programming to population services and health system strengthening. The giant hall was relatively crowded, and the speakers representing institutions in North America, Europe, and Africa offered a mixed assessment of the issue. Many started from the premise that the influx of vast sums of money for work on HIV/AIDS originally generated fears within health communities that the topic would draw attention and resources away from other health issues. Focusing on programs based, in large part, in sub-Saharan Africa, most speakers noted that, in fact, HIV/AIDS programs have been successful in attracting patients to a wider range of health services than before. They suggested that integrating services may be an even better way to address the multiple needs of HIV/AIDS patients in one setting. At the same time, some speakers cautioned that in many cases the analysis is preliminary, based on limited data sets, or anecdotal. However, there seemed to be consensus that the question is worth pursuing in greater depth, particularly in order to understand the broader implications of PEPFAR and Global Fund programming, not to mention country contributions to vertical programs.
The first round of lunchtime poster sessions featured a broad selection. I decided to drop in on a conversation regarding new uses of the media in communicating about HIV/AIDS. The five-minute presentations summarized work focused on issues ranging from the changing nature of testimonials by AIDS patients in Canada to youth-developed art and HIV/AIDS prevention outreach materials in Honduras. A talk regarding networks of HIV positive female journalists in southern and eastern Africa was particularly compelling, as it highlighted the women’s courageous efforts to reduce stigma and discrimination associated with HIV by writing or broadcasting openly about their own status and incorporating information about the day to day lives of people living with HIV/AIDS into the mainstream press.
The theme of HIV/AIDS and aging has come up several times over the past few days – for example, during the AIDS diplomacy session on Sunday one member of the audience applauded the ambassadors’ interest in incorporating youth into diplomatic efforts but warned that the population with HIV/AIDS is aging and that its needs and contributions must also be considered. In an afternoon symposium focused on the long term implications of HAART, scientists addressed this issue in detail, focusing on the ways in which HIV infection and/or treatment can complicate or contribute to many conditions associated with aging, including cardiovascular disease, renal failure, cognitive impairment and bone density loss. Acknowledging the fact that the topic of AIDS and aging has only recently been integrated into the general discussion, one speaker spoke of “coming out” as a geriatrician some ten years earlier but said he is now gratified to see so many researchers focused on the complex intersection of HIV infection, the development of chronic, non-communicable diseases, and aging. There was consensus among panelists and many in the audience that this field will require considerably more investigation as greater numbers of people living with HIV/AIDS approaches age 50 and beyond.