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GayLatino Declaration about the use and application of pre-exposure prophylaxis (PrEP)

GayLatino Declaration about the use and application of pre-exposure prophylaxis (PrEP)

access_timeNovember 15, 2016 02:05 pm

We GayLatino Network take a stand about the use and application of pre-exposure prophylaxis (PrEP) in the population of gay and bisexual men and men who have sex with other men (MSM) in Latin America and Hispanic Caribbean because we want to divulge our stance on an issue which occupies the social imaginary in different intensities.

We agree that PrEP works but we expose our points of view because we must collectively define who will be the beneficiaries, the methodology's implementation, and public policies for the effective instrumentation in our countries.

 

Our main aim is to promote less infections especifically among gay and bisexual men and MSM by using condoms, pre-exposure prophylaxis (PrEP), other preventive measures or combinations of such preventive measures. We advocate preventive measures supported by science, based upon evidence and discussed with the communities in which they would be implemented.

 

- PrEP, unlike other methods -including condoms-, cannot prevent other sexually transmitted infections. Nevertheless, we believe PrEP expands the way in which our sexuality can be safer regarding HIV transmission.

 
- We believe all public policy directed to populations (like National AIDS programs present in our countries) must be defined and designed differently that the ones directed to individuals.

 
- We urge States to take action in the elaboration of these policies, with solid financing, without stigmatization of any kind and with a clear cooperation with civil society in its implementation and that they be regarded as goods of public interest.

 
- Therefore we prepare this declaration collectively agreed and we focus, as a network of gay and bisexual men and MSM, on our bodies and experiences.

 

- These (our) bodies and experiences are political in our constructions and personal relationships as well as in our organizational involvements. They are -at the same time- battlefields, pleasure fields and love fields.

 
- We understand that free exercise of sexuality is a human right as long as all bodies involved are free of all ideological, moral, medical or religious corset.

 
- We are against the understanding that sex without condom (bareback) is a moral crime. On the contrary, we reaffirm that we need to find a clearer way of generating a new concept regarding to what we have known until now as safe sex and use of condom. As well as the real limitations that the use of condom infer in the pleasure of sexual relationships in some of us.

 

- We need to redefine the concept of pleasure understanding the individual decisions in sexual expression and the benefit of the emergence of PrEP.

 

- We do not pretend that this declaration covers the entire universe of analysis regarding PrEP in all population and we do not seek this declaration to be about the access to antiretroviral treatment (ARV) in general. We start from a consciousness -and responsibility- that allows us necessary caution to define an analysis independent of any interest from pharmaceutical or political sector.

 
- This declaration is made under the understanding that safeguarding health and wellness of gay and bisexual men and MSM living with HIV in Latin America and the Hispanic Caribbean whether they decide to take ARV or not. It is compatible with human rights, dignity and self-determination which allow people to take decisions that benefit their health and wellness and those of their partners.

 
- In accordance with our vision of a Latin America and Caribbean that respect, protect and celebrate the lives of gay and bisexual men and MSM, and it agrees with the respect of freedom for the people to be the way they want to be, to construct their identity they way they perceive it, to feel the way they want to feel and to relate with others respecting the sexual orientation of those involved. Within this conception, we regard all these as human rights.
 
- Prevention of HIV must not be seen as an independence focus, in contrast or competing between ARV and the health and wellness of the person taking it. Provision of RAV as a prevention (PrEP) must not violate the rights of people to health, information, free determination, consent or confidentiality.
 
- We are against a single patent holding rights on PrEP and we demand governments, international entities and medical corporations to stimulate research for the development of generics, thus promoting a decrease in costs and a greater supply. GayLatino Network agrees with the experiences now being undertaken in some countries. PrEP's cost must not be an obstacle for people deciding to use it.
 
- We take as an example the implementation of contraception, that was successful as a population measure in public health or family planning when there were many options adapting to the lives, risks, needs, desires and preferences of different women and they had the opportunity to choose those options.
 
- To reach this consensus that governs the spirit of this declaration we have taken into account social, cultural, ethnic, political and religious differences that attain us as members of the same territory and the same Network.
 
- PrEP's use has different implications regarding human rights, resource allocation and planning and integration of attention and treatment of HIV in the countries of the region.
 
- In many of these countries, gay and bisexual men and MSM, as well as key populations, have the worst access to services in HIV in part due to social penalization and stigmatization. Benefits cannot be guaranteed unless these barriers are eliminated.
 
- There must be guarantees against pressure, coercion, and/or legal threats, in the name of public health, that some governments may apply to people who do not wish to access to PrEP. We are against public health measures that are applied or proposed based upon obligation.
 
- Acknowledgment of the efficiency of biomedical prevention methods and their integration into existing programs can be an opportunity to reconsider and/or question community norms that are not sufficiently protective, that are difficult or impossible of holding for some people or that are counterproductive. In general these norms have required 100% adherence to a strategy such as use of condom or have defined sex without condom (bareback) as insecure in all contexts.
 
- Benefits of PrEP are little known by people who do not live with HIV but are still vulnerable to the infection. Current and potential sexual partners of people living with HIV need precise and clear information about the effect to PrEP to reduce risks of HIV transmission and healthcare providers need training to offer them. This in order to strengthen their capacities and to be protected against the infection and to take responsibility of one's own sexual health and that of the partners.

 

As Gay Latino Network we do this declaration claiming our activism for our health and public health as well as our belonging to different organizations in response to HIV in the countries we live, in the region and the world.

 

Our Latin voice is a responsible and testimonial one. It becomes a cry denouncing and demanding action. It is also diverse and represents the way we relate to each other, our sexuality, our love and pleasure. We agree with Foucault in that “pleasure is also part of our culture” beyond our political cultural and social desires. This declaration is based upon a broad concept of respect to pleasure.

But also in the certainty that States must be present in all this policy and we civil society organizations must demand them.

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Simón Cazal

Co-Fundador y Director Ejecutivo, SOMOSGAY