Reflections from the 2008 Ecumenical Pre-Conference and the International AIDS Conference
Written by Rev. Mike Schuenemeyer
Rev. Mike Schuenemeyer, Executive Director of UCAN, the United Church of Christ HIV and AIDS Network, attended the HIV and AIDS conferences July 31-August 8 in Mexico City, Mexico. The following are his reflections from his experiences there.
July 31, 2008
Are we an HIV and AIDS competent church?
We gather as Christian just before the International AIDS Conference
to hear God's word,
to feel the Spirit blow over us
so we gain courage and support from one another.
We gather here in Mexico City, with as variety of gifts,
a host of projects and proposals,
an astounding array of possibilities,
and souls full of hope
ready for God to work in us,
ready for us to work for God and God's people.
We rise and sing.
These words offered in the opening worship captures well the spirit of the 500 or so people gathered for the Ecumenical Pre-Conference to the International AIDS Conference, under the theme: Faith in Action, Now! The spirit and energy among the participants is strong and enthusiastic, the commitment is deep and abiding, the testimonies of the struggle are powerful and heart-wrenching, and the witness to what God is doing throughout the world is moving and grace-filled. At such an event, one might expect there to be significant energy for working together to respond to HIV and AIDS, but what seems different at this meeting is the energy is joined by the broader HIV and AIDS service community. That may bode well for increasing the capacity and quality of response faith based organizations (FBO) are able to make.
To be sure, there is good news to lift up. in addressing this pandemic--gains faith communities have played an integral part in achieving. From supporting grassroots community based care to addressing stigma and discrimination. From developing theologies which under gird the mission to engaging best practice prevention programs, FBOs are doing amazing work.
At the same time, the song is not only one of celebration for the positive gains of recent years, it is also one of lamentation for the opportunities missed and the significant challenges FBOs continue to face on the front lines of response. Although FBOs are a playing a significant role in the world-wide response to HIV, they are not continue to struggle to access the resources they need to fully realize their potential not only in terms of funding (a very critical concern), but also in terms of utilizing their networks, facilities and volunteers. This challenge was brought home in a powerful way in the first day's afternoon plenary focusing on children and HIV and the closing worship which remembered all the children living with and affected by HIV and AIDS.
According to the 2008 Report on the global AIDS epidemic (UNAIDS) the number of children younger than 15 years living with HIV increased since 2001 from 1.4 million to 1.6 million. Almost 90% live in sub-Saharan Africa. Since 2003, the rate of annual AIDS deaths among children has also begun to fall, due to treatment scale-up and programs to prevent mother to child transmission. The total number of people living with HIV worldwide is now estimated at 33 million. Sub-Saharan Africa continues to be the hardest hit, with 67% of all people living with HIV and 72% of the world's AIDS deaths. The epidemic continues to grow and recent gains indicate that if we continue to scale-up our efforts, we can effectively stop the spread of this disease, provide universal access to treatment and offer compassionate care and support to all those living with and affected by HIV.
It is clear from the energy and spirit here, that the response of faith communities is a key to achieving this mission. There are two fundamental questions for our churches. Is my church an HIV and AIDS competent church? What is our next step in our response to the HIV and AIDS pandemic?
August 1, 2008
The already and not yet character of HIV and AIDS
We already know how to prevent the spread of HIV, but we have not yet taken the action required to do it. We already know how to effectively treat persons living HIV, improving both the quality and length of life. We already know that stigma and discrimination creates an environment that fuels this disease but we have not yet broken the silence in many places, providing people with vital information to protect themselves and others against infection. We already know that the African American community is seeing HIV infection rates disproportionate to their population in the US but the US does not yet have a comprehensive plan for addressing the epidemic in this country.
We already know that women and girls in many parts of the world, including some places in the U.S., are vulnerable to gender based violence, creating significant risks for infection, but we have not yet effectively addressed the predatory sexual practice among some men or cultural dynamics that create a distorted and unhealthy masculinity which fails to respect and empower women and girls to have control over their own bodies.
Our Christian tradition speaks of the already and not yet character of our faith in a way that brings hope in the midst of difficulty. We know that we God's beloved children, worth of dignity and respect, but that we have not yet fully realized God's realm in our midst. Even when we find ourselves in the pit of life, as the Psalmist laments, we know that the pit is not the place God intends for us to be. Our resurrection faith inspires us to trust the power of God to make a way out of no way.
Bishop Mark Hanson, Presiding Bishop of the Evangelical Lutheran Church of America and President of the Lutheran World Federation, challenged the Christian church and especially religious leaders, who are already recognizing the harm done by the church in the way many have contributed to AIDS related stigma and discrimination. Bishop Hansen told participants the religious community has so shunned and shamed those living with HIV that our first steps must be public acts of repentance. Then, in his own act of humility and public repentance washed the feet of Sophie, a young woman who charged faith communities to stand against stigma and discrimination.
Hansen went on to say that he is tired of religious leaders speaking of people living with HIV only as objects of our compassion, rather than full participants in our communities of faith. Daring Christian communities to become as radical in our love and inclusion as Jesus was in his life and ministry, Hansen charged the church to reject the notion that human sexuality is a church defining and thus church dividing concern. You can watch his remarks online at: http://www.kaisernetwork.org/health_cast/hcast_index.cfm?display=detail&hc=2821.
It is clear, strides have already been made, including addressing stigma and discrimination, but it is also clear there is an awfully long way to go.
Prayer from Saturday's afternoon worship:
God already on the road,
already calling disciples
already pronouncing judgment
already offering comfort
already looking for compassion already daring love,
already breaking through boundaries,
already making us whole,
already whispering our names,
already breathing in us a new sprit,
already opening our eyes,
already changing our hearts
already demanding our lives,
already wrecking our foregone plans,
already offering us forgiveness
already giving us life,
catch us up to you
so we are caught up by your vision
and catch others to join you
on the road,
embracing those others reject,
through Jesus Christ. Amen.
August 2, 2008
Faith in Action Now against Homophobia and Discrimination
Thousands of people from gathered at the foot of the Angel de la independencia," the famous landmark topped with a guilded angel that most people associate with Mexico City. A giant rainbow flag rolls in the breeze, held by several Mexican men in red t-shirts. They are at the front of the throng of activists pulsing to the steady drum cadence building the energy and spirit for a march down the historic Paseo de la Reforma avenue in the Centro Historico district. Youth and Seniors, men and women, indigenous, immigrants and visitors from across the globe, gay, straight and transgender people prepare to march to the Zocalo in 1st International March against Stigma, Discrimination and Homophobia.
Although Mexico has some very gay friendly communities and there is a vibrant gay community in Mexico City, it is also known for its homophobia and violence against lesbian, gay, bisexual and transgender persons. The government has not completely come through with all the public policy protections needed to fight effectively fight homophobia and discrimination and there is frustration in the air because a political declaration supporting the march has stalled. Nevertheless, Mtro. Emilio Alvarez Icaza Longoria, the President of the Commission on Human Rights of Mexico City joined the march. The day before the march, Longoria addressed the Ecumenical Pre-Conference and eloquently challenged people of faith to do more in the fight against stigma and discrimination. He encouraged us to work for human rights, which includes full equal rights for same gender loving and transgender people.
Homophobia, hostility or fear of gay people and homosexuality, drives the HIV epidemic by creating fear and silence. Where there is silence, people don't get the information they need to make responsible, healthy decisions. It stigmatizes people, inhibiting HIV testing and thus delaying treatment for those who may be positive. When people don't know their HIV status, they are more likely to spread HIV to others without knowing it.
About 20 of us from the Pre-Conference, with "Faith in Action, Now" banners in hand, are there to march, as well. As we found a place near the front of the march, I look around and saw several banners representing faith communities. It reminded me of the pride marches in many cities, including Cleveland, which often place affirming communities of faith at the front to make clear that there are people of faith engaged in this struggle for justice, too. This march is not just for Mexico City, it is to protest homophobia and discrimination around the world.
Because faith leaders and communities have often been the source of homophobia and discrimination, heaping shame and guilt on same gender loving and transgender people, it felt especially good to be there, putting our faith in action in solidarity with all those who are stigmatized because of who they love and to call for changes to make church and society a safe and just place for all.
Same Gender Loving and Transgender People of Faith Present a Statement to the Ecumenical Pre-Conference
A major theme at the Ecumenical Pre-Conference has been the challenge of addressing issues of sexuality in doing effective HIV education and prevention. Many panelists have raised the struggles faced in many faith communities which have been resistant to addressing human sexuality in a comprehensive way. I have been struck by the consistently negative way in which so many participants talk about sex and sexuality. So often any message is prefaced by words about sin and sinners. I can't count the number of times remarks have been prefaced by, "We are all sinners…" and then comes the comment about sexual behavior. Such negativity isn't reserved for same sex relationships, it is negative about any sexual relationship. But when it comes to addressing same sex sexual relationships what gets expressed is that we are dealing with sin and sinners. This has consistently been implied if not directly stated.
The rhetoric of the meeting, however, has sought to be inclusive and many leaders have worked hard to speak about acceptance. What has been missing from the vast majority of speakers and participants is language that is positive about sex and sexuality, and truly affirming and inclusive of persons who are same gender loving or transgender. While many hold such values, there has been a silence, a fear, that many participants would take offense and leave the table.
Last night I convened an informal caucus and networking meeting of 21 gay, lesbian, bisexual, transgender and allied participants who gathered to talk about what they were experiencing at the Ecumenical Pre-Conference. I asked them what they woudl like to affirm about the experience, what concerns they were having, and after some discussion, I asked what, if anything, they would like to do. What came out of the discussion was put into a statement which I was given the opportunity to present to the participants at the close of the Pre-Conference meetings today. It was the first time in the history of the Ecumenical Pre-Conference that the affirmations and concerns of same gender loving and transgender people of faith were voiced from the plenary podium. The following is the statement which was presented:
A Statement to Leaders and Participants in the Ecumenical Pre-Conference
from the Gay, Lesbian, Bisexual, Transgender and Allies Caucus at the Pre-Conference
Saturday, August 2, 2008, Mexico City, Mexico
A Christian faith is a celebration of the Gospel of love. As participants in the Ecumenical Pre-Conference we have the amazing opportunity to celebrate our diversity and find solidarity in our unity.
We acknowledge and affirm the generally positive, inclusive spirit in the conference. Leadership in this meeting has shown us a path toward greater understanding and acceptance of those most at risk for HIV infection.
We are grateful for leaders like Bishop Mark Hanson who are calling the Christian church to engage the struggle to be more inclusive; and that unlike 2006, sexual orientation and same gender loving and transgender people are being named in the discussions.
In the spirit of this conference's model of dialogue and challenge, same gender loving, transgender and allied participants who are part of this community challenge ourselves and the community to recognize that there is a significant journey ahead.
Seeking the partnership of all those gathered here and in the wider Christian church, we raise the following concerns:
- Perspectives that recognize that sexuality is a good gift from God, that our God-given bodies are good and that healthy and responsible sexual expression is good have been missing from the conversation.
- Same gender loving and transgender people of faith are spoken of as if we are not in the room, often addressed in "us" and "them" terms. There have been no openly gay or same gender loving or transgender panelists and no workshops engaging with same gender loving and transgender people of faith and faith-based gay affirming outreach programs.
We advocate the following:
- For other religious leaders and faith based programs to embrace the call of faith leaders and other speakers at this conference in their challenge to the Christian church to be more inclusive
- For each of us to be accountable for our language
- To include sex positive perspectives and create safe space for dialogue
- To include open, same gender loving and transgender persons on the planning team for future ecumenical events.
Our love of Christ unites us, the God we worship empowers us, the diversity of this community enriches us and we pray the various convictions we hold do not keep us apart.
CDC Releases New Data - HIV epidemic in the U.S. is worse than previously thought
Today the CDC released new data which shows the HIV epidemic in the U.S. is worse than previously thought, The CDC is reporting that an estimated 56,300 people were infected with HIV in 2006 and that this number of annual infections has been close to the annual average since the late 1990's. The CDC had been reporting that there were around 40,000 new infections annually, so this new number represents a 40% increase from the previous reports. [Link to CDC press release: http://www.cdc.gov/media/pressrel/2008/r080803.htm]
The report identified two communities bearing most of the burden of new infections: gay, bisexual and other men who have sex with men (MSM) of all races and ethnicities (53% of all new infections) and African American men and women (45% of all new infections). Infections among African Americans were 7 times higher than whites and 3 times higher than Latinos, a group also disproportionately affected.
The report demonstrates once again that our work is far from over. The time is now to put our faith in action and work together to maximize our efforts to stop HIV and provide the care and support needed by all those affect by and living with HIV.
August 5, 2008
Stop the Violence
Commitment, dedication, working together, scale-up, building and accessing capacity are all some of the common themes that are consistently raised throughout the course of this meeting. And the one word raised without fail is leadership; leadership at every level, government, civil society, religious, at the grassroots, at the grass-tops, and in all sectors of society. In fact, in 2007 the World AIDS Campaign established leadership as their primary focus for World AIDS Day under the umbrella theme, "Keep the promise to stop AIDS."
At the IAC, the World AIDS Campaign has invited key leaders from the various sectors of HIV and AIDS response to participate in 90-minute leadership encounters. These moderated conversations have been between groups that have often struggled to work with each other, such as AIDS ambassadors from government and sex workers, media and positive networks. Several dialogues between faith leaders have been part of this, such as faith and youth, faith and positive networks, and faith and leaders working with MSM (men who have sex with men) in the AIDS response. I was invited to participate in the encounter between faith leaders and MSM leaders. Our task was to explore the opportunities and challenges, identify opportunities for strategic leadership and collaboration.
The religious leaders around the table were persons that held what UCCers would call "opening and affirming" values, although their faith institutions were in varying stages of the "open and affirming" journey. But It was clear from the outset of the conversation that learning to work in an interfaith context is critical, especially in addressing global issues. Although the religious leaders all came from Protestant Christian traditions, the MSM representatives included persons with Hindu, Buddhist, Muslim, Christian Orthodox and Anglican religious experiences. Sadly, some shared that because of the strong anti-gay positions of their faith traditions or faith community they had felt force to sever their institutional ties without abandoning their own personal spirituality.
A number of issues were raised, including helping religious leaders and pastors encourage support to families not to reject their children when they learn their HIV status or their sexual orientation, the importance of language and speaking out of the values of dignity and respect for all persons, even those with whom you disagree. Stopping the violence against persons because of their real or perceived sexual orientation or gender identity was identified as one all faith leaders should rally around. It would be good to think that we could even agree to do no harm, but given the differing values on what harm is, the bottom line, we felt, was that religious leaders could at least join across traditions and across the world stop the violence.
Religious leaders ought to be willing to confront advocate that all levels of government create and enforce policies that protect their same gender loving and transgender citizens. The marginalization caused by stigma related to sexual orientation and gender identity, as well as, HIV related stigma and discrimination is a primary driver of HIV throughout the world.
The World AIDS Campaign will be publishing a report from these encounters and will be following-up with leaders to determine next steps. I look forward to our participation.
In varying degrees all had experienced hate speech from religious leaders in their community and some of which included the call for violence against same gender loving and transgender persons. They also experienced religious leaders who worked to block their prevention efforts and shut down their programs.
PEPFAR and other US HIV and AIDS programs are great, but where is the US domestic commitment?
The US leadership and commitment to the global AIDS pandemic is making a significant contribution the progress we are seeing around the world in access to education, prevention, treatment and care. However, on the home front the news is not so good, especially in light of the new CDC data about new HIV infections in the US, identifying alarming increases among African American men and women and among gay, bisexual and other men who have sex with men (MSM).
On Tuesday the Black AIDS Institute held a press conference to release their new report, Left Behind: A Neglected Priority in the Global AIDS Epidemic. Urging immediate action to address the growing AIDS crisis in Black America, Phil Wilson, CEO of the Black AIDS Institute, said that if Black America were a county unto itself, "Black America would have more people living with HIV than the total HIV population of seven of the 15 PEPFAR countries.
Wilson was joined by Congresswoman, Barbara Lee (D-Oakland, CA), Dr Helene Gayle, CEO of CARE USA, Pernessa Seele, CEO of The Balm in Gilead, Dr. Jacob Gayle, Vice President of the Ford Foundation and Ms. Sheryl Lee Ralph, actor and activist, who called on the US government to show the same concern and extensive assistance to Black America it shows to PEPFAR countries.
UCAN's experience in our partnership with the Riverside Church in NY, Trinity UCC in Chicago, Victory Church in Stone Mt., GA, and City of Refuge UCC in San Francisco bears out the message of the Black AIDS Institute's report. We join their call for more prevention funding and increased access to testing, treatment and care. We applaud the decision of the Clinton Foundation announced by Bill Clinton at the IAC to redirect some of its funding to address HIV needs in the US. UCAN looks forward to partnering with UCC congregations and other groups and organizations to realize our capacity to make a difference.
August 6, 2008
Looking to the Future – It's In Our Hands
HIV is still very much in a dynamic phase which indicates that we are still at an early stage of the epidemic, despite the unprecedented achievements in medical science, treatment and care. Trends in infections, research, treatment and care continue to evolve. The virus has proven to be one of the most daunting microbes ever faced. Preliminary reports on research from the last International AIDS Conference in Toronto showed promise that a vaccine was on the horizon. Those hopes have since been dashed. Although the ability to manage HIV through treatment continues to improve, the ability of HIV to hide from the immune means that persons living with HIV will need to continue their drug therapies, even though the virus may be undetectable.
The ultimate goal is to eradicate the virus completely until that becomes possible, the next best thing is to have no new infections and everyone living quality lives. To achieve no new infections will require significant investment in evidence based, combination prevention strategies, i.e., one single mode of prevention, even if it is evidence based, will not be adequate. The most effective prevention strategy must combine various prevention efforts that are proven to work. Prevention efforts must be sustained over the long term. Education programs like the UCC's, "Affriming Persons, Saving Lives" which offers comprehensive HIV and sexuality education across the age span is one example of a faith-based program that can be used over the long term.
To achieve quality of life for everyone will require reaching the goal of universal access to treatment and care, not only in terms of HIV and AIDS, but also in terms of essential medical services. That will require an effort on a scale we are challenged to imagine, in light of recent data from UNAIDS that shows for every 2 people who go on anti-retroviral treatment (ART) there are 5 new infections. In other words, we could double our current effectiveness, doubling the number of people on treatment or cutting by half new infections, and we still would not be winning the race. The 3X5 goal (3 million people on treatment by 2005) was achieved in 2007, but there are more than 33 million people estimated to be living with HIV worldwide.
A phrase repeated many times throughout this conference is that there is no silver bullet for a cure, treatment, care or prevention. Just as combination drug therapy is the most effective treatment protocol for managing HIV infection, it will continue to require everyone to use a combination of efforts over the next several decades to effectively stop HIV and provide the treatment and care needed by those affected and living with HIV.
Peter Piot, Executive Director for UNAIDS, reminded us today that how we envision the future determines how we live today. If we envision a future without HIV and AIDS, we must invest in that future with our resources and efforts today. We should be thinking of that investment in every sector of society in terms of the way we think of pension funds, which are designed to meet needs we know will be there in the future, rather than in terms of an insurance plan which is designed to address crises which cannot be predicted.
It is a false myth that the epidemic in the 80s and 90s was the hard part and that the hard part is over. The reality is that the hard part is still coming as Africa comes to terms with a generation that has been lost to AIDS and as we continue to see a growing epidemic even in the wealthiest nations, like the US. The truth is, and this is no pipe dream, we have the capacity to realize the vision of stopping AIDS and promises have been made to achieve it. The question that remains is do we share the vision, will we make good on our promises. As people of faith, we have an important role to play, but will we play it? The general silence currently present in most of our congregations indicates that we have not yet committed to realizing a world without AIDS. Ultimately, the answer to the question about the future of HIV and AIDS is in our hands. I pray everyday that history will record that this generation and this church woke-up to the reality of HIV and AIDS and responded to meet the challenge with the unprecedented generosity and effort God is calling for.
August 8, 2008
End of Conference Reflection and Summary
The 2008 International AIDS Conference came to a close today. There were no breakthrough announcements about a cure or a vaccine, but there were bits of good news about treatment and increases in access to treatment which have extended the length and increased the quality of life for millions of people living with HIV on anti-retroviral treatment around the world. At the same time, the conference consistently brought home the message that even with the enormous response already made, an even greater response is needed just to keep pace with the epidemic, much less to gain ground against it.
Other consistent themes from the conference included:
- Faith communities can and need to play a more significant role in the response to HIV and AIDS, using their networks of relationships to fight stigma and discrimination and for prevention and care.
- The importance of collaboration (thus the theme of the conference, Universal Action Now!).
- Combinations of approaches are the most effective in prevention efforts, including the critical need to invest more in evidence based prevention, such as:
- Comprehensive sexuality education
- Condom availability and consistent proper use
- Reducing stigma and discrimination
- Engaging efforts for harm reduction
- HIV Testing, HIV testing and more HIV testing (only 40% of people in the U.S. know their HIV status [CDC]).
- Studies from Africa show male circumcision may reduce HIV infection among men by as much as 60%. More studies are needed and it is uncertain what that means for countries where male circumcision is already common, such as the U.S. (80%). However, circumcision is no excuse to have unprotected sexual intercourse (vaginal, anal or oral).
We were reminded of the global data, that there are an estimated 33 million people living with HIV worldwide (UNAIDS 2008) and for every 2 people who go on treatment there are 5 new infections. In other words we are losing badly the battle for universal access to treatment.
We received a new report from the U.S. CDC indicating that for the past several years the annual number of new infections has been underreported by 40%. The new data says there are 56,300 new HIV infections in the U.S. per year, more than 1 million people living with HIV (about 0.5% of the total U.S. population) and 250,000 of them are not aware they are HIV positive.
In the U.S., the prevalence of HIV in the African American/Black community is a disproportionate 2%, 4 times the national prevalence, and the total number of infections exceeds those in 7 of the 15 countries receiving funds from PEPFAR (the President's Emergency Plan For AIDS Relief). Infections among gay, bisexual and other men who have sex with men (MSM) in all racial groups is the only category of infections that has continued to rise in the U.S. since the early 90's. There are disproportionate infection rates among young, African American/Black and Latino MSM in comparison with other age and racial/ethnic groups. Congresswoman Barbara Lee (D-CA) along with other leaders and activists are calling for a domestic PEPFAR and a national HIV and AIDS strategy for implementing a more effective response to the HIV epidemic in the U.S.
Although there are still daunting challenges in the struggle stop HIV and AIDS and care for all those affected and living with HIV, there was considerable optimism throughout the conference. Even without a cure or a vaccine, the light at the end of the tunnel are the opportunities we all have to scale up our efforts
- to provide universal access to treatment,
- invest in the prevention of new infections and
- address the stigma, discrimination and other drivers of this epidemic.
All of this is doable and within reach, but to achieve it, we must make up the gaps between what we are doing and what we are capable of doing.
In the coming weeks, UCAN (the UCC HIV and AIDS Network) will be assessing our strategies and communicating about how to get involved. We are already available to help leaders, churches and other organizations assess their HIV and AIDS competencies, develop a plan of action and determine next steps. Stay connected to our web site, www.ucc.org/ucan and watch for the next issues of UCAN News and UCAN Stop AIDS eNews to learn more about what UCAN is doing, including what is being planned for General Synod 27 in Grand Rapids, MI, June 2009. We are always eager to hear about what you are doing so please send your news, including personal stories, programs, activities, sermons, liturgies, questions and comments to firstname.lastname@example.org.