Keynote Challenge for 2010

The SAHARA conference 2009 focused on sociocultural issues surrounding HIV, and in an attempt to kickstart the conference in a diverse manner, they hosted 3 keynote speakers:
a politician,
a physician,
and an openly HIV+ activist.
I was most impressed by this final speaker. Why? Because he made me uncomfortable.

He started off his speech in a fairly predictable way, discussing what it is like to be an openly HIV+ person, the difficulties he's faced in his family and neighborhood, and his optimism for a potential cure during his lifetime. Then he turned his focus to the audience:

"There is a Voluntary Counselling and Testing tent in the main auditorium," he stated. "I challenge each and every one of you: Get tested, and come out. Today."

He told us that public health campaigns can't just focus on testing, but must also promote a sense of responsibility among HIV+ patients. He emphasized the word responsibility, as opposed to guilt. By taking ownership of the disease, he stated that patients may find the strength to publicly disclose their illness. And through these disclosures, the HIV epidemic will take on a face, a name, and a meaning.

"Let 2010 be the year in which we all come out. I hope that we can do this. And I challenge us to start here today."

This speaker's challenge was more powerful than any I'd heard of before, because it was personal. He was not challenging the anonymous masses. He was challenging us as individuals in a (relatively small) group of our peers, to start the charge today.

At my 1pm seminar on female circumcision policies in eastern Africa later that day, the speaker approached the stage as her credentials were announced: MD/PhD, published widely, involved heavily in HIV/AIDS research. She began her speech with, "I'd like to tell you all here today that I have been living with HIV for the past 20 years. I think I'm the first person to disclose here at the conference, and I thank the keynote speaker for his challenge."

Applause.
Ovation.
Was this really happening?
Over the course of the next few days, I heard 4 more people diclose their HIV publicly.

This campaign made me really uncomfortable because it made me question my own strength. Would I have the courage to wave my health status above my head like a war flag? If I don't, does that make me a hypocrite?

This campaign, if nothing else, makes people talk. Some comments I heard during the course of the conference:

I don't think it's appropriate to have the VCT tents here in the main auditorium. If you had even the slightest inclination that you might be HIV+, why would you want to find that out in a giant room filled with your colleagues? The publicity is totally uncalled for.

I'd be concerned that if I found out I were HIV+, I'd feel peer pressure to disclose publicly, and might regret it later. His speech was kind of coercive in that way.

I'm totally blown away by the fact that people are brave enough to say it in front of everyone.

Unfortunately, the fact that so many of us felt uncomfortable serves as validation of the social stigma of HIV. It is very real! The keynote speaker's challenge was valiant, and it may indeed do wonders for the HIV epidemic to remember that we are working with people, not statistics. But it is not realistic to expect this from our patients if we are not yet comfortable with it ourselves.

I was profoundly moved by each and every disclosure on stage. Despite my education, I was still overwhelmed to see that HIV does not discriminate. It is not a black person's disease, or a poor person's disease, or a women's disease, or an uneducated person's disease. I (again) applaud the people who are strong enough to come out. I thank the keynote speaker for pushing me outside my comfort zone. And I hope some of you can join me in considering his ideas for 2010....