World AIDS Day: A Call to Action

Anthony J. Santella, DrPH, MPH, MCHES

Master of Public Health Program Department of Health Professions School of Health Professions and Human Services Hofstra University Hofstra Dome 126, Hempstead NY 11549, USA; E-mail: Anthony.Santella@hofstra.edu

December 1st is World AIDS Day (WAD); a time to raise awareness about the Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) and reflect on the lives of those living with and affected by the pandemic. In 2015, over 30 years after the first cases of HIV/AIDS were diagnosed, it is important to continue to bring recognition to the pandemic through WAD and other strategic initiatives. We are still facing a pandemic and we must remain vigilant. This paper addresses the history of WAD and examples of how governments and organizations around the globe unite people and raise awareness.

HIV/AIDS PANDEMIC

The United Nations estimates that globally approximately 37 million people are living with HIV and that around half of all people are living with HIV (PLWH) do not know their status, thus preventing them from accessing care and treatment. In 2014, over two million individuals became newly infected with HIV and 1.2 million people died from AIDS-related illnesses. Despite high rates of HIV/AIDS, especially in developing countries, we have made significant progress in prevention, care, and treatment. For example, 15 million PLWH are taking combination antiretroviral therapy. Globally, new rates of HIV infection have decreased by 35% since 2000 and there has been a 42% reduction in AIDS-related deaths since 2004. In order to curb the pandemic, the Joint United Nations Programme on HIV/AIDS (UNAIDS) has a three-prong goal to achieve by 2020: 90% of all PLWH will know their HIV status, 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy, and 90% of all people receiving antiretroviral therapy will have viral suppression.¹

HISTORY OF WORLD AIDS DAY

The WAD initiative was established by the World Health Organization (WHO) in 1988 to facilitate the exchange of information among governments, community-based organizations, PLWH, and the general public. The idea to start WAD was developed in 1987 by two WHO public information officers named James Bunn and Thomas Netter who were assigned to the Global Programme on AIDS. In January 1988 after a meeting of international health ministers in London, an event attended by health leaders from all around the world, it was decided that a large-scale event was necessary to bring greater awareness to the HIV/AIDS pandemic facing our global society.²

Bunn, an ex-American journalist from San Francisco, made the December 1st recommendation for a number of strategic reasons. First, 1988 was a presidential election year in the United States. Coming off the heels of a major election, Bunn thought news journalists would take advantage and bring to light the first global event in the fight against HIV/AIDS. Secondly, it was right before the holidays, typically a “dead spot” in journalism as people are gearing up for holiday and other end-of-year celebrations. These two occurrences made it an optimal time for the inception of the first WAD.³

WHO organized WAD events, developing the annual themes and activities, until 1996, when these responsibilities were assumed by UNAIDS. In 1997 UNAIDS created the World AIDS Campaign to increase HIV/AIDS awareness and to integrate HIV/AIDS information on a global level.⁴ In 2004, the Campaign became an independent body, functioning as a global advocacy movement outside of the United Nations and outside of Geneva.⁵

WORLD AIDS DAY EXAMPLES

WAD has become a universal call to action, recognizing our collective potential to create change while acknowledging the tremendous progress that has been made. During 2011-2015, the WAD theme has been “getting to zero”: zero new HIV infections, zero discrimination, and zero AIDS-related deaths.6Below are some examples of how governments and other organizations implement WAD initiatives:

United States

In June 2014, New York Governor Andrew Cuomo established a blueprint containing three major steps to ending the HIV epidemic in New York State: (1) identifying persons living with HIV, (2) linking and retaining those diagnosed individuals into health care, and (3) providing access to Pre-Exposure Prophylaxis (PrEP) for high risk persons to help them stay negative.⁷ At Hofstra University in Long Island, New York, we are partnering with a community-based organization (Pride for Youth, a program of the Long Island Crisis Center) to hold a research dissemination symposium where we will share results from an academic-community research partnership where we conducted an HIV and sexual health survey of young men who have sex with men (YMSM) to raise awareness on knowledge, attitudes, and perceptions of YMSM.

Canada

In Canada, in addition to WAD, December 1st is also the start of Aboriginal AIDS Awareness Week; a time of reflection on the impact of HIV/AIDS on their native people. Various events will take place to inspire hope, remember those who have passed, and acknowledge the groundbreaking science that has informed HIV prevention and treatment. These events include, but are not limited to: concerts, fundraisers, sex kit creations, HIV and social determinants workshops for women, and candlelight vigils.^8,9

Ghana

The 2015 WAD commemoration in Ghana will begin on November 3rd, to commence a month long period of awareness, advocacy and testing events. Noting the remarkable successes of decreasing HIV infection among children and preventing motherto-child transmission of HIV, the Ghana AIDS Commission announced Ghana’s 2015 WAD theme, Fast Track: Meeting the Health Needs of Children towards an HIV-Free Generation. These successes come at the end of the five year Strategic Plan for HIV/AIDS. As Ghana transitions into the National Strategic Plan 2016-2020, it is cognizant of the advantages of partnerships to help to complement the services provided.^10,11

Slovenia

Recognizing that more than half of HIV infections in Slovenia were detected late, the National Institute of Public Health, the WHO in Slovenia, and the Ministry of Health held a conference last year to confront the accessibility and availability of HIV testing. The conference also focused on how to eliminate stigma and discrimination that may significantly contribute to late HIV detection. Additionally, a group of medical students developed an initiative called Project Virus where they informally discussed safe sex at the popular Prešeren Square in Ljubljana.¹²

South Africa

Last year, South Africa reminded us that stigma and discrimination still serve as major deterrents for testing and treatment seeking. Despite the improvements made with regards to HIV treatment, stigma counters the fight against the HIV epidemic by hindering individuals from seeking testing and other prevention, care, and treatment services. Often times, HIV stigma and discrimination leads to homelessness and family abandonment, unemployment, emotional distress, and other driving factors that can be burdensome. This year’s WAD events titled Zero Stigma and Discrimination are taking place against the backdrop of South Africa hosting the 21st International AIDS Conference in July 2016.¹³

Switzerland

Due to the vast amount of people unaware of their HIV status, the International Labour Organization Headquarters in Geneva, Switzerland, building on their “Getting to Zero at Work” initiative, has aimed to have five million workers tested by 2015. This initiative also protects the labor rights of those living with or affected with HIV. This initiative is a global public-private partnership involving governments, employers and workers to ensure access to testing, counselling and treatment for workers, their families and communities.^14,15

A CALL TO ACTION

As a global community fighting HIV/AIDS, there are many things we can do to contribute to WAD. First, make sure all of your community partners and stakeholders learn about HIV/AIDS. The AIDS.gov website is a comprehensive, user-friendly web tool with information about prevention, care, and treatment. Second, show your support for PLWH. This can be done by wearing a red ribbon, the global symbol for HIV/AIDS, on December 1st and other times throughout the year. Finally, attend a local WAD event. Better yet, volunteer and/or donate for a WAD event to support a local HIV/AIDS service organization. Put your knowledge and skills into action!

CONFLICTS OF INTEREST

The authors declare that they have no conflicts of interest.

ACKNOWLEDGEMENT

The authors thank Corinne Kyriacou, PhD, MPH for her editorial suggestions and feedback.

1. UNAIDS. 2014 global statistics. Website: http://www.unaids.org/sites/default/files/media_asset/20150714_FS_MDG6_Report_ en.pdf 2014; Accessed November 2, 2015.

2. Smith L. World AIDS Day 2014: History, HIV facts and ‘Aids-free generation’ theme. International Business Times. Website: http://www.ibtimes.co.uk/world-aids-day-2014-history-hiv-facts-aids-free-generation-theme-publish-midnight-sunday-1477138 2014; Accessed November 13, 2015.

3. Cure AIDS Report. HIV/AIDS awareness days & cure for AIDS day. Website: http://www.cureaidsreport.org/international-curefor-aids-day/ 2006; Accessed November 13, 2015.

4. American Psychological Association. December 1 is World AIDS day. Website: http://www.apa.org/pi/women/resources/newsletter/2010/12/aids-day.aspx 2010; Accessed November 13, 2015.

5. UNAIDS. Accountability; main message on World AIDS Day. Website: http://www.unaids.org/en/resources/presscentre/featurestories/2006/october/20061020interviewmarcelvansoest 2006; Accessed November 14, 2015.

6. World Health Organization (WHO). WHO campaigns? Website: http://www.who.int/campaigns/aids-day/2013/event/en/ 2013; Accessed November 1, 2015.

7. New York State Department of Health. 2015 Blueprint to end the AIDS epidemic. Website: http://www.health.ny.gov/diseases/ aids/ending_the_epidemic/docs/blueprint.pdf 2014; Accessed November 1, 2015.

8. Canada’s Source for HIV and Hepatitis C Information. World AIDS Day 2015. Website: http://www.catie.ca/en/world-aids-day 2014; Accessed November 14, 2015.

9. Canada’s Source for HIV and Hepatitis C Information. What’s happening in your community for World AIDS Day? Website: http://www.catie.ca/en/world-aids-day/events 2014; Accessed November 14, 2015.

10. Ghana AIDS and HIV Commission. 2015 World AIDS Day press release. Website: http://ghanaids.gov.gh/gac1/pubs/2015%20 WAD%20Press%20Release.pdf 2015; Accessed November 14, 2015.

11. Ghana News Agency. Ghana Launches 2015 World AIDS Day. Website: http://www.ghananewsagency.org/health/ghana-launches-2015-world-aids-day–96668 2015; Accessed November 14, 2015.

12. World Health Organization Europe. World AIDS Day events in Slovenia focus on prevention and early testing Website: http:// www.euro.who.int/en/health-topics/communicable-diseases/hivaids/news/news/2015/01/world-aids-day-events-in-slovenia-focuson-prevention-and-early-testing 2014; Accessed November 2, 2015.

13. South African Government. World AIDS Day. Website: http://www.gov.za/world-aids-day-1 2011; Accessed November 3, 2015.

14. UNAIDS. ILO World AIDS Day campaign focuses on closing the gap in the workplace Website: http://www.unaids.org/en/ resources/presscentre/featurestories/2014/december/20141201_ILO_WA 2014; Accessed November 2, 2015.

15. International Labour Organization. VCT@WORK: 5 million women and men workers reached with voluntary and confidential HIV counseling and testing by 2015 Website: http://www.ilo.org/aids/WCMS_215899/lang–en/index.htm 2011; Accessed November 2, 2015