The global epidemic of HIV infection is causing
unprecedented destruction. It eclipses most other health issues and
casts a long shadow over our future. On this first World AIDS Day of
the new millennium we must look afresh at the epidemic. We must find a
better and more effective response.
Today, tens of millions women, men and children are
vulnerable to HIV. Many, particularly women and children, cannot
easily protect themselves. In most societies men have more power than
women. When women are dependent on the men who have sex with them,
they face particular risks. The short term consequences of refusing
sex can be more threatening than the long-term health risks associated
Men Make a Difference is the theme of this
year’s World AIDS Campaign. As fathers, grandfathers, brothers,
sons, friends, husbands and partners, men determine the shape of the
epidemic. The campaign recognizes that men could have the greatest
impact on the speed with which the epidemic subsides. Men are also
well positioned to address the consequences of HIV infection and to
ensure adequate care for those who are affected.
Some 20 years ago, when AIDS was recognized, the
response was triggered by men who have sex with men. These men
initiated action to reduce the risk of HIV by promoting healthy sex,
caring for those affected by AIDS and advocating for more attention to
HIV throughout society. Men must continue to make a difference through
the strengthening of effective prevention of HIV spread.
Men have a key role to play in controlling HIV
epidemics among injecting drug users. The overwhelming majority of
injecting drug users in all regions are men, particularly young men.
Men usually control drug injecting situations. In drug sharing
occasions usually the men inject first, passing the potentially
contaminated injecting equipment onto their female injecting partners,
increasing the partner’s exposure to HIV and other blood-borne
There is evidence from Brazil and the USA that,
given the opportunity, male drug injectors will also change their
behaviour to protect both themselves and their sexual and drug-using
More - and urgent - action is needed. We must reach
men through networks of peers, providing information on ways to reduce
risks of HIV infection, encouraging healthy behaviours and ensuring
that they can access condoms and - if they are injectors - sterile
WHO is scaling up efforts for the better
reproductive and sexual health of men and women. More effort is needed
- prevent and treat infections acquired through sex;
- increase the number of people who know their HIV status;
- promote condom use;
- prevent transmission of HIV from mother to newborn;
- promote needle exchanges and other interventions for injecting
- ensure blood safety;
- develop effective vaccines and microbicides;
- provide care for people living with HIV/AIDS.
WHO contributes to the global effort to track the
epidemic and to monitor the effectiveness with which it is tackled.
WHO encourages attention to the gender implications
of each of these strategies: this may mean different approaches for
men and women.
However, until men take responsibility for
preventing HIV, the epidemic will continue to grow. This means that
men must face up to realities of sexual experiences, gender
stereotypes and the coercion of women – often through violence –
to act against their will.
To achieve sustainable change, we must focus on
boys; the values they learn and the way they develop – starting
before they are sexually active and drawing on their openness, their
creativity and their willingness to take responsibility for themselves
Men – whatever their age and wherever they live
– can make a difference. It is the least we can expect of them.