HIV in NSW in 2010: sustaining success in an evolving epidemic

Collaboration between key populations in a global partnership for health and human rights: Lessons learned from 'Bridging the Gaps'

Because HIV and AIDS key populations share common social-cultural factors challenging their sexual health and rights (e.g. stigma, criminalisation), there is an assumed benefit of collaborative programmes where various key populations work in solidarity. In this paper, we reflect on how partners collaborated in a complex alliance of over 100 different NGOs, representing and supporting three key populations - lesbian, gay, bisexual and transgender (LGBT) people, sex workers and people who use drugs - working across 16 countries. We used a multiple-method approach of participant observation, qualitative interviews, and a survey to explore the benefits, facilitators and challenges of collaboration. Results show that motivators for collaboration included being part of the larger funding structure with applied impacts, a repressive human rights context, and intersectionality. Barriers for collaboration included identity politics, stigma, and constraints regarding the appropriate timing of new collaborations. Finally, facilitators include practical support for engagement, the framing of human rights in a medical agenda, and recognition of implicit differences. We conclude that for building the capacity for collaboration among socially marginalised groups it is important to develop trust and the ability to recognise strength in difference beyond the initial identification of shared norms and common goals.

Resetting the agenda: the makings of ?A New Era

The New South Wales Government's NSW HIV Strategy 2012-2015: A New Era represented a punctuated shift of policy direction, and was remarkable for its ground-breaking declaration that HIV transmission could be virtually ended by 2020. This significant policy shift occurred after a long period of stability and only incremental change, some of it represented by policy decline as political and public interest in HIV waned. This article uses punctuated equilibrium theory to explore the conditions that allowed for change, and the roles played by new and long-standing actors in the HIV policy subsystem. It explains the importance of challenges to the policy image and the policy venue as key mechanisms that allowed new possibilities, created by advances in the scientific understanding of HIV, to be incorporated rapidly into government policy.