XIX International AIDS Conference

THBS02 Eliminating HIV Infections by Targeting Inequities: Addressing Social Determinants of HIV Disparities
  Bridging Session
Venue: Session Room 6
Time: 26.07.2012, 14:30 - 16:00
Chair: Laurie Garrett, United States
Social determinants of health contribute to the unfair and avoidable differences in health status seen within and between countries. Achieving universal, sustained access to needed HIV services depends on accurately identifying interconnected social factors that impede access, and on fomenting social change to redress them. While the importance of social factors is recognized, social scientists and public health practitioners note that tracing and measuring the causal impact of 'upstream' social determinants, (e.g. poverty, gender discrimination, and violence) on HIV is not straightforward. Without unequivocal evidence of their HIV impact, investing resources in structural interventions to tackle major social issues of equity, citizenship, and justice remains contentious. This session brings together scientific, policy, and community perspectives on the opportunities and challenges of addressing social determinants of health to achieve HIV outcomes.


The state of research in identifying, measuring, and evaluating social determinants of health and HIV

C. Caceres, Peru

Speaking from a human rights perspective

M. Clayton, Namibia tbc

Speaking from the perspective of PLHIV/community engagement

E. Johnson, United States

Challenges and opportunities in analyzing and implementing the evidence in programme and policy efforts

N. Simelela, South Africa

Questions and answers

Rapporteur report

CPC report by Andrew Spieldenner

HIV is fueled by social determinants of disparities, but there is little understanding of how these forces interact.  The session was done in a talk show style mode, where presenters sat and spoke to the audience until we were able to ask questions.  The moderator presented some simple questions to the audience: who lives in a country where men and women have the same rights? What about the gay community and the heterosexual community? What about drug users?  The field of social determinants is complicated, and must be parsed out in terms of those that directly affect HIV (e.g. HIV criminalization, needle exchange) and those that are ancillary to the HIV epidemic (e.g. poverty reduction, gender equality).  By separating out these areas, public health practitioners and community providers can better target and resolve issues.

Epidemics can differ widely.  Many populations who experience a concentrated epidemic – like substance users, African American women, gay men, trans-women – also suffer through additional burdens of social disparities including employment inequality, social marginalization and lack of educational opportunities.  In generalized epidemics, resources must be focused slightly differently and acknowledge that the health care system may not be sufficient to meet this need.  Community mobilization around a range of health disparities remains an essential part of addressing social determinants in HIV.  One of the real challenges to addressing social determinants is the time for the investment: in many cases this can be 3-5 years minimum.  The evidence behind community mobilization efforts must be done at the local level rather than the national, as each jurisdiction will have different characteristics that construct the social determinant.



    The organizers reserve the right to amend the programme.

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