Former U.S. President Bill Clinton during his speech" 'Put Patients Health First to Improve Outcomes and Programme Efficienty.' Photo Credit: International AIDS Society/Steve Forrest.

[Ed. Note — Contributor Michael Harney is writing to us from the International AIDS Conference in Melbourne, Australia. This is his fourth contribution from the conference this week. Follow other updates from Harney here.]

MELBOURNE, Australia — Former President Bill Clinton, now head of the Clinton Health Access Initiative (CHAI), spoke on Wednesday at the XX International AIDS Conference. CHAI is a foundation helping to fund the fight against HIV, TB and Malaria.

An introductory video narrated by Clinton’s daughter Chelsea featured a Cambodian child named Basil first seen as an infant sickened with AIDS being held by Clinton, and now a healthy pre-adolescent thanks to anti-retroviral treatment (ARV) made available through CHAI. The foundation has been scaling up affordable access to these life-sustaining medications since 2002 in low and middle income countries such as Cambodia. 650,000 children worldwide are now receiving ARVs.

To begin his address, however, Clinton decried the downing of Malaysian Flight MH17, and said the world is at a tipping point to decide between a brighter or bleaker future for all humanity. He was briefly interrupted by protesters chanting “Clinton – End AIDS with a Robin Hood Tax,” which refers to a proposal to implement a 0.1% tax on financial transactions that could raise up to $35 billion (US) toward healthcare needs around the world.

Clinton thanked the protesters, noting that International AIDS Conferences have become a movement where protests can be constructive. He went on to mention some of the challenges facing young people around the globe  — “As many as 50 percent of pediatric HIV infections occur during the breastfeeding period” even after successfully bringing a child through birth without infection. Nutritional needs for newborns must be addressed if mothers cannot afford to provide alternative sustenance.

Meanwhile, the U.S., he reminded us, has seen a 13 percent increase in HIV infections among young men who have sex with men (YMSM). “Stigma and discrimination are actually on the rise,” continued Clinton, “especially among LGBTQ people  — conditions that should no longer exist.”

The former president’s reference to youth as a key population at risk for HIV infection fits a theme being highlighted throughout the conference sessions, and in the Global Village, where the Youth Pavilion is the primary networking space for young people at AIDS 2014.

In a later session entitled “Thinking Through Risks in Everyday Lives — Framing the Future for Adolescents and Young People,” Dr. George Patton, Australian researcher and co-moderator stated, “Health needs are considerable and our programs are inadequate.”

Other researchers described findings of interconnected and overlapping risks of infection including alcohol, violence, abuse, sexual activity, mental health, incarceration, intravenous drug use, and social marginalization.

Additional points made by presenters included:

  • HIV risks must be “contextualized” in any reasonable response, i.e. community norms such as social positioning and education levels may normalize risk aversion, or risk exposure. Re-scripting sexual behaviors and traditions may help.
  • Societal views of “masculinity and power” enter into relationships, and may blur roles in negotiating safer sexual practices.
  • Parental consent to healthcare screenings for HIV and STIs is required in many countries and should be discontinued, according to recommendations in UNICEF’s systemic review addressing youth issues around HIV risk.

Young people call for their inclusion in the process to form programs and policies designed for them – “Nothing about us without us.” as is heard in numerous contexts throughout the conference.

UNICEF, Save The Children, Youth Rise, the International Harm Reduction Association (IHRA), and programs like the Melbourne Youth Force are trying to address the issues, though data collection is especially difficult in younger age groups.

As researcher Maria Phelan of the IHRA quoted, “People count when people are counted.”

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Michael Harney is an educator with WNCAP (Western North Carolina AIDS Project), an HIV/AIDS advocate and supporter of Needle Exchange programs. He occasionally contributes his writings on various subjects...