A report from Elise Rile, a UCSF associate professor of medicine in UCSF HIV/AIDS Division at San Francisco General Hospital and Trauma Center:

Debbie McMillan went to the street at age 14, began sex work soon thereafter and ultimately used drugs to avoid the reality of what it took to survive on the street.

She was incarcerated for soliciting as a sex worker and, as a transgender woman housed in a men’s prison, this is where she became HIV-infected.

Debbie represents people at the heart of the AIDS epidemic, many of whom are left out of the conversations that guide HIV programs and policies. For example, drug users and sex workers are currently barred from entering the United States, which means that research, care and policy conversations taking place during the International AIDS Conference will happen without the voice of many people who are impacted the most.

Debbie also pointed out the continued U.S. federal ban on needle exchange programs despite consistent scientific evidence showing their effectiveness to prevent HIV, a decision she sees as a failure to acknowledge science.

Drug users and sex workers want to be part of the conversations that address HIV. Specifically, they want to use scientific evidence and their experiences to be part of an informed solution.

Criminalizing behaviors that put people at risk for HIV and excluding the voices of those living with, at risk for, caring for and studying HIV do not prevent HIV, rather these decisions jeopardize public health and continue to fuel the epidemic.