Absence of evidence does not mean evidence of absence

At the close of the AIDS Conference in Vienna, Alice Welbourn reports that the question of whether a human rights agenda to public health will really start to find its way into the science tracks of these conferences still hangs above us all

Alice Welbourn
23 July 2010

It feels like the end of yet another school year – celebratory that we have all survived the week, let alone the months of planning, utterly exhausted faces, last minute meetings to squeeze out every precious moment together before we return to our far-flung global corners, the prospect of the great clear-up this afternoon – this time, thank goodness without the need for screwdrivers – and yet more exhaustion as we all wonder whether it was really worth it.

Well with the end of term comes the school report. I always dreaded mine: lazy, could work harder, she has much potential but it would be nice if she used it occasionally…my poor mother used to call it “the annual telling-off” -  those old taunts come back to haunt me here as I wonder what else we could have done, how can we do things differently next time, what, if anything have we achieved. 

There have been some terrific moments in the main conference. This morning’s plenary, for the first time, had papers by Manfred Nowak and Dmytro Shermebey on the shocking state of the world’s prisons in relation to HIV. The results of the CAPRISA trial which, at last, gives good news for women regarding microbicides protection is a landmark moment for feminism and good science.

Two other highly important moments were the great plenary presentation on violence against women by Everjoice Win (“Violence against women and girls”) – another first for the conference; and the presentation in a formal science track by Charlotte Watts of their ground-breaking multi country study. Drawing on data from 96 countries globally, and entitled “Preventing HIV by preventing violence: global prevalence of intimate partner violence and childhood sexual abuse”, the study shows conclusively that intimate partner violence doubles women’s risk of contracting HIV. This study vindicates much work that has been conducted on these links over the years and is highly welcome. In fact I must confess to a personal high after this session, because I was involved in putting this whole session together and three women told me separately afterwards that this session had made their conference. For a few moments the waves of utter exhaustion receded and it felt good. Yet this study didn’t receive much press across the conference in general.

We activists know that HIV and gender based violence (GBV) are closely and reciprocally linked. I have written elsewhere about how much HIV increases a women’s vulnerability to discrimination and, in many cases, violence. Yet it came as a shock to me yet again, in this session,  that some audience members were raising this as an issue they were wondering - and concerned - about. Once more it highlights the gulf between the “grey” literature – which we activists write and share amongst ourselves – and the “academic” literature, where the HIV-causes-gender-violence link is still undocumented – and therefore doesn’t yet (quite) exist. As Dr Shirin Heidari, Editor of the International AIDS Society Journal said in one session we ran in the Women’s Networking Zone “absence of evidence does not mean evidence of absence”. I wish every single peer-reviewed journal had that on its masthead and then perhaps the world might shift its axis just slightly

There were other great moments in this conference also – the “We hear the thunder but we see no rain” satellite of the Global Coalition on Women and AIDS, about funding for women’s rights – which is so very scarce, as opposed to funding for women’s reproductive functions, which abounds. There was the plenary by Meena Seshu on sex workers’ rights, there were other inspiring talks. For the most part, however, I still come away with the impression that the scientific track abstracts,  whilst they may be becoming more sex-disaggregated in their approaches to data collection and analysis, still have a long way to go in becoming more aware of a gendered perspective to research.

There are glimmers of hope – in the plenaries and the satellites – but whether a human rights agenda to public health will really start to find its way into the science tracks of these conferences is still a big question mark hanging above us all. One woman involved in the organising of the conference confided in me that she thought the programme of the Women’s Networking Zone was “ten times better” than what was available inside the conference proper. Well maybe that was a slight exaggeration, and time will of course tell, but considering that what we were offering in our Zone was free, compared with the several hundred dollars cost of the conference proper, perhaps we might have just managed to push that door on women’s rights a wee bit more ajar. 



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