1^st December 2019

World AIDS Day – Communities Make the Difference

As the 1^st of December is upon us, not only does it mark the start of a promisingly hot Summer, it marks World AIDS Day, with this year’s international UNAIDS theme being “Communities Make the Difference” and for Australia specifically, “Every Journey Counts.”

It is possible this presents two questions for you – What is World AIDS Day about? How has and how can the Jewish Community make a difference on this journey?

Firstly, World AIDS Day is a day for the community to support people living with HIV, to commemorate the lives we have lost to the AIDS pandemic caused by HIV and to raise awareness around the globe on the issue. HIV looks very different now than it did 35 years ago when the first cases were reported.

Becoming HIV positive was perceived as a death sentence because we knew so little about it and how to treat it. The virus would weaken the immune system to the point where it could not fight off an otherwise regular infection such as a cold, and it would move into an AIDS diagnosis, especially if exposed to more than one infection. Since the first cases were reported 35 years ago, 78 million people have acquired HIV and 35 million of them have died from AIDS-related illnesses.

Australia’s response to HIV and AIDS is considered to be one of the best in the world. We led the way with the incredible advancements and uptake of evidence-based treatment and prevention strategies. The implementation of needle and syringe programs removed HIV from largely affecting the injecting drug using population. The annual AIDS diagnosis in Australia has fallen from 953 cases at its peak in 1994 to about 50 cases in recent years. Currently, there are approximately 900 new infections each year, and with 28,500 people living with HIV, the vast majority never move to having an AIDS diagnosis, but instead live long, happy, productive and healthy lives.

We didn’t get to this place because we stopped having sex, stopped having babies, or used condoms every single time we had sex. We got here through relentless advocacy and enduring grass-roots activism. We got here through educating ourselves and each other about sex, gaining support from the government and community leaders to have open conversations about it, wide spread health promotion campaigns, reducing stigma and discrimination, increasing testing, implementing harm reduction strategies and of course major advancements in biomedical prevention.

One of the reasons Australia has done so well in reducing HIV transmissions is because of the wide range of prevention strategies available where individuals can choose what works for them. To name a few options available, they could be using condoms and lube, increasing testing frequency, taking PrEP (pre-exposure prophylaxis) which is an HIV medication you can take to prevent yourself from acquiring HIV, or PEP (post-exposure prophylaxis) which you can take within 72 hours after you think you’ve been exposed to HIV. There is also using an undetectable viral load (UVL), where someone who is HIV positive and on treatments has a viral load (aka the amount of virus in the body) so low that it cannot be detected by current tests. A positive person with an undetectable viral load cannot pass on the virus. This is the most effective prevention strategy available. It has been studied in large scale clinical research trials around the world, and is endorsed by the World Health Organization, The American Centre for Disease Control, and the Australian Medical Association.

The latest research has shown that if a person living with HIV is on proper treatment, they can live normal healthy lives and have a life expectancy similar to that of an HIV negative person, given all other lifestyle factors are the same. If HIV is no longer the death sentence that it once was, nor is it the scary and unknown disease brought by the grim reaper any longer, then why is HIV treated so differently? Why is there so much baggage associated with the virus when we utter its name, despite how far we’ve come? It doesn’t matter how you look at it, misinformation, judgement, stigma and discrimination will only ever cause more harm than good.

HIV is a virus and it doesn’t discriminate. There is a lack of education around how HIV is transmitted, which is in fact quite difficult as the blood of a person living with HIV needs to enter directly into the bloodstream of an HIV negative person in order to be transmitted – the virus cannot live outside the body. Then there is of course the harmful misinformation around things like it being a “gay disease”. Other than the stigma and physical impacts any infectious disease carries, more severely, stigma can be attributed to the disproportionate number of gay and bisexual men it affected over the course of the past three decades. Due to the biological, cultural, religious, social, behavioural and legal factors, HIV swept across the gay community like wildfire at the start of the pandemic and we were losing young gay men to AIDS too quickly to even understand what was going on. The gay community was in shock, under-resourced, afraid, and dying. The world’s initial response wasn’t to run to our aid, stand by our side and support our brothers. Instead, we were made to feel ashamed of who we were, discriminated against, pushed further into isolation resulting in severely impaired physical, mental and social health outcomes.

When anyone goes through a trying time, physically, mentally or even just trying to survive in a sometimes harsh and unjust world, their greatest lifeline is their community. The beliefs and attitudes of a person’s community and its leaders can make them or break them. It can change their world from a place they’d rather not live in, into a loving, caring and supportive one, where we can proudly embrace our humanity.

When HIV was faced with judgement, stigma and discrimination, it was the perfect recipe for devastation to ripple throughout the world, resulting in the global AIDS pandemic. It wasn’t just gay and bisexual men who were affected by this. In other parts of the world, brothers, sisters, fathers, mothers, sons and daughters were affected just as much. When any one of them were too sick to stand up for themselves and too tired to keep on fighting, it wasn’t just their peers who stood by their side, their communities stood strong to support them, advocate for them, fight with them and cry with them.

It is this sense of understanding how HIV has affected the world and people living with HIV that we come together on World AIDS Day. This then leads to the second question around the theme for World AIDS Day this year – Communities Make the Difference.

How has and how can the Jewish Community help make the difference in changing the world for the better?

Religious leaders and faith-based communities play such a significant role in how an individual feels about themselves, their healthcare-seeking behaviour, the support they receive, their resilience and their individual make-up on the whole. It is harder to talk about things like HIV and AIDS in more conservative cultures or faith-based communities because it tends to be related to sex, homosexuality and sin. This relationship between the two topics is a rudimentary assumption from misinformation and one that is anchored in discrimination.

In the Jewish faith, amongst many faith-based communities, it is declared as a cardinal sin if two men engage with each other sexually. However, on the other hand, the obligation to provide appropriate care for the sick is seen not only as one of the most universal obligations in Jewish law, but in fact an opportunity to emulate the Divine Attributes.

We can assume that there would be some positive experiences and some negative experiences growing up Jewish and gay. Some people may have been excluded from communities, families and from their faith whilst others may have been embraced. It can be difficult to get to an understanding of the complexities of believing in your faith and trying not to feel ashamed, but instead trying to reconcile the two so that you can be a proud person of Jewish faith and a proud gay or bisexual man.

Religion can play a central role in who we are, what we believe in and how we engage with each other. So, what do we do when we feel differently and conflicted with what our religion tells us? What do we do when we feel differently and conflicted with what our community is telling us? What do we do when we feel differently and conflicted with what our family is telling us?
We persevere.
We stay authentic to our true selves.
We move forward.
We reconcile our faith and our sexuality into the being of one person. It can take some time to get there, and everyone’s journey is individual, but it is something that we can all share in. By supporting our own communities of the LGBTIQ rainbow and our faith, we can come to a place whereby we support each other and help each other through the hard times. It is that community that we create that makes a difference!

There isn’t a need to discard faith because of who we are! There is no need to disregard who we are because of our faith! We can be both people and we can become stronger because of it! It is through this strength that the Jewish community has been part of the response to the HIV epidemic, and because of community groups such as Aleph Melbourne, that we can express our true selves, both from a sexuality and faith perspective.

When we look outwards, there seems to be some contradictory things, which is not unusual when it comes to community, faith and sexuality. The Israeli Defence Force officially supports openly gay soldiers, and has done so for over 20 years. Tel Aviv is considered one of the most gay friendly cities in the world. So why is there often hate towards the LGBTIQ community from leaders of faith, including the Jewish faith? Is it just an evolving change in attitudes that leads some people to try and hold onto established beliefs? Is it through a lack of education and awareness? What do you think it is? What is your experience?

Regardless of any debate, HIV does not discriminate and it affects everyone. Unfortunately, there is a lack of more specific data in Australia around HIV and the Jewish community, but in Israel, the cases of new HIV notifications dropped from 148 in 2017 to 123 in 2018 amongst gay and bisexual men who have sex with men. In fact, the increase in the overall number of HIV notifications between those years were entirely attributed to new cases amongst women, going from 115 in 2017 to 142 in 2018.

At the end of the day, HIV and AIDS predominantly affects the most vulnerable and marginalised populations across the world, whether it be indigenous people, refugees, women, children, those living in poverty, gay men and bisexual men, migrants or injecting drug users. They are the ones who have the least power and bear the brunt of the impact.

In light of World AIDS Day, it is important to remember that communities really do make the difference. Compassion, social acceptance, advocacy and access to emotional and spiritual support are some of the ways communities could help change the landscape of HIV and AIDS across the world – things that an individual can only get from their community.

Thorne Harbour Health is very eager to work with the Jewish community, to understand better how to best serve all LGBTIQ individuals in their overall health and wellbeing and make this a reality. We have Jewish volunteers across the organisation in Peer Education, policy development as well as one off events and are always open to developing new opportunities of engagement.

Remember, communities make the difference!

For now, let us celebrate, commemorate and advocate this World AIDS Day together.

Thorne Harbour Health

Resources:

[1] HIV in Australia : Annual Surveillance Short Report, University of New South Wales, Sydney; Kirby Institute. Sydney, NSW (2018).

[2] Number of New HIV Cases Up for Second Year in a Row. Toi Staff. (Published 16^th July 2019).https://www.timesofisrael.com/number-of-new-hiv-cases-up-for-second-year-in-a-row/
Accessed 27^th November 2019

[3] Fact Sheet – World AIDS Day 2019. UNAIDS (2019).
https://www.unaids.org/sites/default/files/media_asset/UNAIDS_FactSheet_en.pdf
Accessed: 27^th November 2019

[4] HIV and Stigma in Australia : A Guide for Religious Leaders, Australian Federation of AIDS Organisations. Newtown, NSW (2013).

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This article was commissioned by Aleph Melbourne for World AIDS Day 2019, and written and researched by Thorne Harbour Health Health Educator Jessie Wong.
A PDF version of this article can be downloaded here.