Analysis Sexual Health

Youth Activism at AIDS2012: Leading the Way to an AIDS-Free Generation

Debra Hauser

Millennials represent the first generation that has never known a world without HIV and AIDS, and I fully believe that they will be the generation of leaders to finally and decisively turn the tide against this global pandemic.

Part of Rewire’s coverage of the International AIDS Conference, 2012.

Tens of thousands gather this week for the 19th International AIDS Conference in Washington, DC.  Thousands of young leaders and activists in the fields of health care, public policy, and education are among them, all committed to keeping up the fight until we reach an AIDS-free generation.

Millennials represent the first generation that has never known a world without HIV and AIDS, and I fully believe that they will be the generation of leaders to finally and decisively turn the tide against this global pandemic.

One might expect resignation from Millennials that HIV and AIDS will always be a part of the global landscape – after all, for them it always has been – but, in fact, the opposite is true. For the first time in decades, we can finally see a path to a world with no new HIV infections, and young people are frustrated that our society has met this challenge with neither the full force of our financial, educational, and scientific resources, nor political will.

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They have every right to be impatient and angry.

HIV and AIDS continues to disproportionately affect young people. In the United States, an estimated one-third of new HIV infections are among young people ages 13-29. Globally, young people ages 25 and under experience 40 percent of new HIV infections.

It is no surprise that those most vulnerable to many of society’s ills are also the most vulnerable to HIV.  Young women in sub-Saharan Africa are up to eight times as likely to be HIV positive as men.  A young Black gay man in the U.S. has a 1-in-4 chance of being infected by age 25. In the U.S. and around the world, young men who have sex with men face stigma and discrimination and also are at high risk of HIV.

Despite the devastating impact of this plague, Millennials are pushing for bold steps forward.

They believe government should play a stronger role:  63 percent of Millennials believe the government should spend more on HIV and AIDS vs 47 percent of Boomers and Seniors.  Half want public schools to do more to help solve the problem. And they want schools to provide comprehensive sex education that covers information about contraception and condoms.

Millennials also are taking responsibility to protect their own health: globally, HIV prevalence among young people is falling in 16 of the 21 countries most affected by HIV – a decline that has coincided with decreases in sexual risk-taking among young people. But, a lack of resources continues to fuel the epidemic among youth, including here in the United States.

Millennials are mobilizing their peers to pressure governments, corporations, and nonprofits to commit to an AIDS-free generation by increasing investments, shifting resource allocation, and garnering political will. And, not content with the pace of change, young leaders are creating new institutions and movements of their own.

As the oldest Millennials turn 30 this year, they are on the cusp of leading an even more profound cultural shift. Already, half of Millennials want more information on talking about HIV with kids, and they are beginning to raise their own children with a new set of values around HIV and AIDS. As Millennials ascend to positions of power and leadership in society, and as they become parents themselves, they have a unique opportunity to empower a widespread cultural shift regarding sex, sexuality, and sexual health.

Last week, young activists and leaders from around the world joined together in Washington, D.C., as YouthForce 2012. After more than a year of planning – nearly all of it led by youth activists themselves – these young people convened prior to the International AIDS Conference to finalize their policy platform, coordinate their advocacy efforts for the conference, and mobilize to ensure that young people’s voices, perspectives, and ideas shape the outcomes of the IAC itself.

But these young people cannot do it alone. We must have the courage to stand beside them to fight for societal recognition that young people have the right to accurate and complete sexual health information and confidential, affordable health care services; that all young people deserve our respect – and a seat at the table – for the role they are playing to end the pandemic; and that the U.S., as a leader in the global fight against HIV, has the responsibility to ensure that those receiving U.S. funds domestically and abroad provide young people with all of the tools they need to safeguard their sexual and reproductive health. Yet, all too often, young people are ignored or caught in the crosshairs of controversy and politics. Government policies and funding restrictions often stand in the way: in the United States the percent of youth receiving HIV education in schools has declined since 2005, while around the world only one-third of young people have comprehensive knowledge of HIV. Condoms are highly effective at preventing HIV, but in the United States and abroad, restrictions are placed on providing information about and distributing condoms to sexually active youth. Recent studies have found that early treatment of HIV reduces the risk of transmission by 96 percent, yet the vast majority of countries – including the United States – have no comprehensive plan to ensure that people living with HIV have access to the life-saving treatment they need. Our current approaches are too often limited in scope, short-sighted, and politically safe – and young people are paying the price. We must do better. Only by fully investing in young people – in their health, their education, and their leadership – can we create the “generational firewall” it will take to truly reach an AIDS-free generation and ensure young people’s overall well-being.

Which is why Advocates for Youth, along with eleven other founding partners, announce the creation of National Youth HIV & AIDS Awareness Day and call on President Obama, Congress, and the U.S. Department of Health and Human Services to formally recognize this important day in prioritizing young people in the fight against HIV and AIDS. April 10, 2013 will mark the first annual nationwide observance of the day. Each year, National Youth HIV & AIDS Awareness Day will provide youth activists, public health organizations, and their allies an opportunity to hold our leaders accountable for realizing an AIDS-free generation.

Millennials are deeply committed to building an AIDS-free generation. They have the power and the will to prevent HIV. We can all help make this dream a reality. If we are smart enough, determined enough, and courageous enough to work alongside them.

To join the call of youth activists for President Obama, Congress, and the U.S. Department of Health and Human Services to officially recognize National Youth HIV & AIDS Awareness Day please visit: www.AdvocatesforYouth.org/YouthAIDSDay.

Culture & Conversation Human Rights

How One Couple Is Putting Bathroom Safety on the Map

Ryan Thomas

Like the Negro Motorist Green Book, the Safe Bathrooms map is not so much a novelty but a vital resource to protect the safety of its users at a time when history is repeating itself in a way that is marginalizing an already vulnerable population.

This piece was published in collaboration with Generation Progress.

North Carolina Gov. Pat McCrory (R) seems to think it’s a governor’s duty to classify which men and women are the “real” ones and which aren’t. Because of this, he has put the lives of all of North Carolina’s trans residents at risk by signing HB 2 into law.

Last week state legislators proposed changes to HB 2, but those changes do nothing to mitigate an unabashed blastoma of transphobia that is now lawfully spreading at a vicious pace.

In response to HB 2, droves of businesses and musicians have boycotted the state in hopes of stopping this unmitigated discrimination toward trans people from moving any further.

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People have banded together to show their support for the trans community, and businesses across the state and country have declared themselves safe havens for trans-identifying individuals by submitting to the Safe Bathrooms map.

The map’s creators—River William Luck, a trans community activist, and his partner (and as of recently, fiancée), web design specialist Emily Rae Waggoner—both live in Boston, but the fight to protect trans rights affects them on a deeply personal level: They’re both from North Carolina.

When HB 2 was signed into law, Luck says, “I was on guard, because I’ve been told I’m in the wrong bathroom my entire life as a masculine-presenting female for more than 30 years.”

Now his home state has become one big ”Do Not Enter” sign for him and his friends still there. Luck’s reaction, however, was not one of helplessness. His instinct, which he learned to follow after years of experiencing and bearing witness to bigotry, was to bind the community and help strengthen it through tangible acts of love and support.

One Reddit commenter likened the map to the Negro Motorist Green Book of the 1930s to 1960s, which was published to help Black travelers in the United States find safe passage in times when racial persecution was legal. Like the Negro Motorist Green Book, the bathrooms’ map is not so much a novelty but a vital resource to protect the safety of its users at a time when history is repeating itself in a way that is marginalizing an already vulnerable population.

Before the Safe Bathrooms map, Luck started mailing hundreds of buttons from the #IllGoWithYou campaign to friends and family back home. The #IllGoWithYou campaign was developed as a means for allies to offer solidarity and protection to transgender and non-binary individuals. By wearing a button, participants pledge to stand up and speak up during instances of harassment and physical endangerment.

“This is my way of paying it forward,” Luck says. “What I’ve done is buy a shit ton of buttons and if someone wants one, I send them one. If they can’t afford it, I send them one. If they want to know more about it, I write them a note and ask people to pick up more.”

His reasoning is simple: “I would have given anything to have seen one of these when I was in North Carolina.”

Luck’s meaningful gestures extends to the clothes he wears, as he frequently can be found sporting a t-shirt that says “No Hate in Our State” or a tank top with the words “Proud Transman” printed in bold. River models several lines of what he refers to as “activism wear,” as a product ambassador a variety of labels including a Greensboro, North Carolina-based company called Deconstructing Gender, and another called Proud Animals.

It’s actually the former that planted the seed for the Safe Bathrooms map, as Luck and Waggoner were inspired by the photos of gender-neutral bathrooms posted on the company’s Instagram account. While the two were talking to Deconstructing Gender’s founder and CEO Avery Dickerson, who was transitioning at the time, Waggoner said, “Wouldn’t it be nice if there was a map of safe bathrooms where trans people could go without hassle?”

And so with Waggoner’s web design expertise and Luck’s social media skills, the Safe Bathrooms map came to life as a child of both necessity and wishful thinking. As they built it, the people came in droves: businesses, affected community members, and media alike.

With over 200 businesses included to date, the two have put together a functioning survival guide for trans residents and travelers who also possess bladders.

Waggoner shared one email with Rewire that she received from a man who owns an architecture firm in Maine, who requested to have his business be included on the map:

I, therefore this business, stand for equality, acceptance, and kindness to all. As a gay man, and one living with HIV for 30 years now, I know too well that indifference to discrimination, condoned cruelty, and legalized oppression are terminal illnesses. These behaviors killed the dreams, and injured the very souls of our young, and further darkened the roads the rest of us continue to travel. It must stop.

To be included on the Safe Bathrooms map, businesses need simply fill out this form and verify their trans-friendliness with a photo of a gender-neutral bathroom placard or other clear form of expression. Upon approval, businesses are represented on the map as a roll of toilet paper. For those lacking, the Safe Bathrooms website goes one step further and shows businesses where they can obtain gender-neutral bathroom signs for their private spaces.

Waggoner and Luck know personally how useful such a map can be. Waggoner says she’s had to stake out bathrooms to make sure the coast is clear, like a Secret Service member. One time, she says, “We were in a restaurant waiting to use the bathroom. We could feel the tension in the air and feel the stares. And it became very uncomfortable because people at the bar were openly just watching which bathroom River was going to go into. And we feared for his safety and our safety.”

Luck continues, “We ended up having to leave and go to a friend’s house so I could use the bathroom and detoured the whole evening plans so I could pee safe.”

Clearly the problem won’t end once HB 2 and other anti-trans laws like it are repealed. The attitudes that brought these policies into being still exist and must be dealt with. But, as Luck attests, there is a definite support system of love and acceptance in North Carolina. He found it in Greensboro as a music teacher at New Garden Friends School, a Quaker school. “They were so open and embraced diversity that I could be an out lesbian,” says Luck.

Greensboro has very distinct pockets of support, which is where a lot of the safe bathrooms appear on the map. But even in places less supportive deeper south, Waggoner notes there are still good friends to be found: “It’s been cool to see some of the small-business owners in some of the more rural towns popping up. Like in Salisbury, North Carolina. It’s really brave of them to do that—to be the first in their town to speak up and say something, and be the first on the map.”

The outpouring of support may be having an effect: University of North Carolina President Margaret Spellings recently gave a statement saying that she would not enforce HB 2 or change any of the school’s current provisions. Spellings did originally plan to enforce HB 2. It wasn’t until U.S. Attorney General Loretta Lynch declared the state in violation of civil rights and threatened to cut up to $4.8 billion in federal funding to the school that Spellings changed her position (and McCrory sued the federal government).

Before Spellings changed her decision, students from various on-campus alliance groups held loud protests outside of buildings in which she was attending meetings, in efforts to sway her judgment. Students at schools across the state affected by the law are making their opposition known.

On a K-12 level, there are organizational efforts through nonprofit Gay-Straight Alliance groups such as Time Out Youth, which offers resources and aid to LGBTQ minors living in inclusive North Carolina and South Carolina school districts. Its website lists student rights, including the rights to gender expression, confidentiality, and respective pronoun usage, as well the right to attend school functions and report on instances of bullying (which state public schools are required by law to deal with).

Luck has spent most of his life traveling against the grain of society’s intolerance–from a misunderstood kid living with his grandparents, to a determined and proud trans man working hard to end the ritual persecution of his fellow person.

Growing up in North Carolina in a conservative Baptist household, Luck remembers being called a “tomboy” and being told “not to act like a boy” as young as 3 years old. Luck attended and was eventually kicked out of a Christian high school for identifying as a “lesbian” (this was before he identified as trans). Luck says he’s been working steadily since he was 13, when his first job was at a Chick-fil-A.

In college, Luck had a psychology professor who taught that homosexuality was a disorder.

“I remember sitting in the class waiting for someone to say something, because I didn’t want to say anything,” Luck says.

After going to the head of the psych department, and then the head of the school, Luck managed to get the homophobic lesson pulled from the syllabus.

“That was a time in my life where I realized if I didn’t say something, no one would. And so I had to. That’s when my activism really started,” Luck says.

Coming to Boston for grad school, Luck found his new home to be much less critical of his outward gender appearance, and found true love in his partner. Luck says Waggoner accepted and supported his transition every step of the way—from coming out (a second time) as transgender, to life-affirming surgeries and ongoing treatments, to his sweeping romantic proposal involving a trip to New York City, a rare Harry Potter book, and a cleverly inserted engagement ring.

Luck and Waggoner hope to expand upon all the ground they’ve covered in North Carolina and take their Safe Bathrooms map to national and international levels.

Luck says he wants to ultimately see the whole state of North Carolina become “a giant roll of toilet paper.”

“We’d [also] love for it to grow to be an international thing, especially given all the anti-LGBT sentiments in other countries. Because we’re everywhere. And everybody needs to have that access,” he says.

The two do have an app in the works to accompany their Safe Bathrooms map, which they hope to give a Yelp-like interface to allow community members to find safe bathrooms on the go, and review and share their own individual bathroom experiences.

All of this work points to a very simple goal: to make it so trans people don’t have to endure daily humiliation exercises to find a toilet that comes with no strings attached.

“The bottom line is … I’m a human being who happens to be trans. But before I would label myself trans, I would say I’m an activist, an actor, a student, an artist, a musician, a good partner, a good relative … All these other qualities that define me that have so much more weight,” says Luck.

To show support for the trans community and be included on the Safe Bathrooms map, visit SafeBathrooms.club.

Commentary Human Rights

Tackling Zika: Have We Learned Our Lesson on Rights?

Luisa Cabal

Local governments and public officials should look to the reproductive rights and HIV and AIDS movements for insights into the ways in which they can more effectively center the needs of those most marginalized while fighting the Zika virus outbreak.

Read more of our articles on the Zika virus here.

The Zika virus outbreak and the increase of babies being born with birth defects seemingly linked to the mosquito-transmitted disease have generated a series of prescriptions from governments of the most affected countries about what people need to do and not do. These include asking women to delay pregnancies—until 2018 in El Salvador, for example.

Sadly, these recommendations do not match what is in the realm of possibility for many women living in or near Latin America, the region from which we hail. We propose instead local governments and public officials look to the reproductive rights and HIV and AIDS movements for insights into the ways in which they can more effectively center the needs of those most marginalized while fighting this crisis.

Calls to delay pregnancy in several countries where the Zika virus has spread have revealed gaps in health systems resulting from unfulfilled demands for sexual and reproductive health-care services. While women in Latin America generally have access to contraception—a real demonstration of decades of activism and leadership—in some Central American countries such as Guatemala, over 26 percent of married young women who do not want to become pregnant have an unmet need for birth control, and therefore are at risk of an unintended pregnancy.

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In the regions that have seen a spike in Zika cases, there are also high rates of sexual violence. The World Health Organization reports that one in three women experience violence in her lifetime. Those rates in Peru, where health officials in late January confirmed the nation’s first case of Zika, appear to be higher: A 2005 report found more than half of women in Lima and Cusco experienced physical or sexual violence by a partner some time in their life.

Without access to contraception, many women, including some young girls, will experience unintended pregnancies. And once pregnant, women and girls do not have control over their own reproduction as the laws provide limited options for termination. In countries that have very restrictive abortion laws, women and girls face an even greater health crisis should they experience an unintended pregnancy, become infected with the Zika virus, and want an abortion.

In light of this situation, how realistic is it to expect the public to delay their pregnancies as they are prescribed to do? Is this top-down approach to tackling a health-care emergency grounded in the realities and needs of women? Are policymakers once again “instrumentalizing” women to solve a threat or a global challenge?

Activists have known for a long time what is needed at a structural level to ensure that women’s health and rights are respected and promoted. Reproductive rights and HIV and AIDS advocates have said it all along.

The response demands long-term commitments to three rights pillars: First, access to information and services. Women need access to information about the virus, including how to prevent transmission. They also have a right, as UN bodies have argued, to access the type of sexual and reproductive health services they need, including a range of contraceptive options. If pregnant, every woman should be able to decide if they will carry to term their pregnancy—and have access to safe abortion or maternal health care and social support services.

Second, governments and stakeholders need to scale up their commitments to protect women’s agency. Women have to be empowered to make choices regarding their own health, and those choices need to be respected. Women living with HIV have shared their painful experiences of being subjected to coercive sterilization or abortion and of having their right to reproductive autonomy erased. Advocates and policymakers need to reinforce the rights and dignity of women and show that respect for their decisions is at the center of any policy and health intervention. As we learned from the AIDS response, this work of fighting a global health crisis must start with the concerns of those most vulnerable and marginalized, and their voices must be heard at all times.

Lastly, in a world where leaders look for magic bullets and advance biomedical approaches as one-size-fits-all solutions to health challenges, governments and different stakeholders need to bolster all efforts aimed at eliminating discrimination and violence against women and girls. These efforts should include removing obstacles to reproductive health services, investing in the empowerment of adolescents, and training health providers to protect and promote women’s sexual and reproductive decision making. These interventions will ensure that when a crisis hits, all persons—whether women or those from other marginalized groups—are enjoying the legal, policy, and cultural conditions that recognize them as full citizens and agents of their health and lives.

The views and opinions expressed in this article are those of the authors and do not necessarily reflect the official policy or position of UNAIDS.