Maria de Bruyn is the Senior Policy Advisor for Ipas.

Prior to and throughout the International AIDS Conference, activists and experts are meeting in a series of satellite sessions that address issues that may not get the full attention of the conference. This satellite session focused on linking HIV/AIDS with sexual and reproductive health and rights (SRHR), especially with regard to men who have sex with men, sex workers and injecting drug users. There were a number of noteworthy statements and reflections:

• Sexual and reproductive health (SRH) problems and HIV/AIDS have common determinants, including poverty, gender inequality, social norms and values, and cultural influences. (It was interesting to note that no one mentioned the fact that spouses of wealthier individuals appear to be at higher risk in some places.) The groups that discussed human rights and sex workers also pointed out that younger age may increase vulnerability to SRH/HIV problems.

• While the "HIV/AIDS camp" has often failed to address broader sexual and reproductive health issues, the "SRH camp" has been reluctant to embrace diversity and expand its audience beyond the traditional group of married women.

• It is important for those working on SRHR and HIV/AIDS to find common ground to facilitate collaboration and linkages. This will require development of a shared understanding of how sexual and reproductive rights should be defined and promoted. This process for identifying shared concepts must include education of, and dialogues with, civil society organizations, community-based groups and health-care providers.

• We must ensure that the principle of the Greater Involvement of People Living with HIV/AIDS (know as the GIPA principle) is also applied to men who have sex with men, sex workers and injecting drug users; in addition, we must understand the particular needs and critical rights of sub-groups within these vulnerable populations. For example, the sexual health and rights of men who have sex with men and women or bisexual men have scarcely been addressed; these men may also face "bi-phobia" from both the heterosexual and gay communities.

• Increasing trends toward criminalization of HIV transmission must be stopped; a human rights approach may also demand decriminalization of sex work, drug use, homosexuality and abortion. To create an enabling environment for such advocacy, more education about rights is needed for civil society and community groups.

• It is not sufficient to ensure that our use of human rights – and especially sexual rights – language is explicit and specific. We must also advocate for enforcement of existing laws that protect rights and focus on demanding accountability in relation to rights.

• Nono Simelela of the International Planned Parenthood Federation (IPPF) remarked that we have a moral and ethical responsibility to stick to what we believe really works; at the same time, we must respect the rights of every individual who seeks care.

• We must emphasize that human rights and public health approaches are not mutually exclusive; indeed, ensuring respect for human rights can improve and enhance public health. To promote the linkages between human rights and public health, we must address the issue of individual rights and protecting the greater good. Joy Phumaphi of the World Health Organization (WHO) remarked that we should focus on a new kind of harm reduction, i.e., reducing harm caused by our inability to adequately ensure individuals' rights.

Finally, participants acknowledged that we must do much more to address the particular needs of youth, women and disabled people – in addition to the vulnerable groups mentioned above. It is important to note that there was no mention of older people – either HIV-positive or HIV-negative. The fact that post-menopausal women are no longer of childbearing age leads many SRH and HIV/AIDS workers to overlook their sexuality as well as their sexual and gynecological health. Linking SRHR and HIV/AIDS is of vital importance for all people affected by and living with HIV/AIDS: youth entering puberty, people of reproductive age and older adults.

It was further noted that gathering evidence of the benefits to society of observing individuals' human rights (e.g., reduction of certain health costs) may be important for donors and governments; these agencies must accordingly make resources available for such data collection. However, meeting participants pointed out that political ideologies may lead those in power to ignore certain evidence or emphasize only certain rights. Respect for, and promotion of, sexual and reproductive rights therefore cannot be made contingent on "evidence" as the dignity of all human beings requires that their rights be observed.

The organizers of the satellite meeting – Action Canada for Population and Development, the International Community for Women Living with HIV/AIDS, IPPF, CARE Canada, the government of Canada, the United Nations Population Fund and WHO – promised to produce a summary document from the meeting so that interested groups can move forward with the suggestions for action.