Global AIDS update 2019 — Communities at the centre

The HIV epidemic has put a spotlight on the many fault lines in society. Where there are inequalities, power imbalances, violence, marginalization, taboos, and stigma and discrimination, HIV takes hold.

The epidemic is changing: in 2018, more than half of all new HIV infections were among key populations—sex workers, people who use drugs, gay men and other men who have sex with men, transgender people and prisoners—and their partners.

Globally, new HIV infections among young women (aged 15–24 years) were reduced by 25% between 2010 and 2018. This is good news, but of course, it remains unacceptable that 6000 adolescent girls and young women become infected with HIV every week. The sexual and reproductive health and rights of women and young people are still too often denied.

Despite the scale of the challenges and the miles we must still travel together in the AIDS response, I am hopeful. The AIDS response has demonstrated what is possible when people organize and assert their rights. Around the world, people living with HIV and civil society have raised their voices and exerted leadership. As Mariana Iacono says in this report, “I decided to tell the world about how it is to live with HIV—to join the struggle, so that the world can be a little fairer towards us, the people living with HIV.”

When communities organize and people empower each other, oppression can be replaced by rights and access to HIV services can be accelerated. Peer-to-peer counsellors, community health workers, door-to-door service providers, grass-roots activists and networks of people living with or affected by HIV all have key roles to play in the response to HIV. As this report shows, community leadership in the AIDS response helps to ensure that HIV services are relevant to, and reach, the people who need them the most.

The world has committed to achieving the 2030 Agenda for Sustainable Development. As part of that, governments must protect and uphold the human rights of everyone. As the eyes and ears of the AIDS response, communities play a critical role in holding decision-makers to account and demanding political leadership.