HIV Prevention and Support

The global HIV (human immunodeficiency virus) response has increasingly become intertwined with [Page 416]action research. Due to many unique historical factors, the global HIV movement is rooted in social justice, human rights and activist ethics. This has resulted in global health policies that advocate for the active participation and inclusion of people living with HIV, and those who are most affected, in research and policy development. As a result, action research has been widely employed to support the production of knowledge that is consciously informed and/or led by the lived experiences of those most affected by the virus. The varied methodologies within action research aim to ensure collaborative and participatory processes. These inclusive practices have become a vital component of HIV intervention development and evaluation, which have led directly to informing policy and calls for social change to mitigate the impacts of HIV around the world.

HIV is the virus that leads to AIDS (acquired immunodeficiency syndrome). The epidemic of HIV and AIDS is one of the largest global health crises that the world has ever known. To date, more than 30 million people have died from AIDS-related causes. At the end of 2010, there were 34 million people living with HIV around the world.

The spread of HIV follows paths of inequities and is exacerbated by social disparities. People who have long been marginalized in society often face the greatest impacts of HIV. The populations most affected by the global epidemic include women, young people, gay men, people of colour, people who use illicit drugs, people in prisons, sex workers, transgender people and people living on low incomes.

To adequately address the devastating impacts of HIV, the response aims to both prevent its further spread and treat, support and care for the people who have acquired the virus. In the past, these varied approaches could be seen independently or in tension with one another. But today, prevention, treatment, care and support interventions are primarily viewed as mutually complementary. As such, HIV prevention itself is defined as involving a combination of diverse interventions aimed at curbing infections, including those that are behavioural (promoting condom use and other harm reduction interventions), biomedical (increasing access to testing and antiretroviral treatments) and structural (facilitating supportive policy and legal environments and addressing economic inequity and cultural and social factors that lead to vulnerabilities for people affected by and living with HIV and AIDS).

HIV treatment involves ensuring consistent access, quantity and quality of antiretroviral therapies for people living with HIV and the treatment of opportunistic infections that arise from living with a compromised immune system.

HIV care and support often involve programming and interventions such as psychosocial and mental health services, nursing, home care, information and educational supports, training and capacity building.

Those first to respond to the crisis in the 1980s were a diverse range of HIV-infected people, their friends and activists in gay, lesbian, bisexual and transgender communities in North America. In an environment of state inaction towards the devastating crisis, there was a lack of government or institutional recognition, support and funding. Despite this, a strong and vibrant activist and community self-care response evolved to counter the institutional AIDS stigma, homophobia and racism towards those most affected by the emerging virus. During this time, a wide range of community organizations evolved to respond to the crisis, and due to intense social movement organizing and activist pressure, some political leaders began to acknowledge their responsibility to respond.

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