Transmission Cambodia 2014

2014_transmission_edited
Description 

Staffan Hildebrand returns to Australia, where he started his project of documenting the AIDS epidemic in 1988, and to Cambodia, where he first arrived in 1998. He interviews some of the scientists and activists who he met back then and displays some footage from the archive.

Background material

"Dr. John Dwyer is a pioneer in the Australian response to HIV/AIDS. He was clinical director of Prince of Wales Hospital and also member of the National Australian AIDS Council (NACAIDS). John Dwyer also has been involved in numerous committes and boards during his thirty years in the AIDS movement. He was early on very active in fighting for the rights of prisoners living with HIV/AIDS in the Australian prisons." - Staffan Hildebrand

Interview with Staffan Hildebrand in August 2015. Duration 10:53 min

Transcription 


Hello, happy Mardi Gras guys-

As a filmmaker it's always very exciting
to visit the Sydney Gay and Lesbian Mardi Gras
festival which has evolved into one of the largest annual pride
festivals in the world-
It started in 1978, and it's a strong symbol
for gay and LGBTI rights, as well as
a celebration of sexuality-
Mardi Gras has also been an important driving force
in the fight against HIV and AIDS in Australia-
These images at the 2014 Mardi Gras
are some of the latest sequences shot for my Face of AIDS
film documentation project-

[MUSIC PLAYING]
My name is Staffan Hildebrand and I'm a Swedish documentary
filmmaker-
This is my home, where I've lived for the past 30 years-

I started my career in the '70s as a 23-year-old TV news
reporter for the Swedish Broadcasting Corporation,
covering the last years of the Vietnam War-
I later made feature films about social issues
impacting on youth-
But the one enduring project that
has captured my heart from 1988 is the Face of AIDS
film documentation project-
Today I'm on my way to the Face of AIDS studio,
just three minutes from my home-

From the start I have collaborated
with the Karolinska Institutet, the prestigious Swedish Medical
University which also awards the Nobel Prize in medicine-
Karolinska inspired me to start documenting the human story
of HIV and AIDS on film-
Three decades on and I continue to chronicle
this important story-
I became very close to many of the people I film,
and some became real friends-
Those who survived, still are-
The epidemic changed many people's lives,
including my own-
This is their story and my own journey-
When I started to film, long before digital video
and internet, we shot on 60 mm film, a format I still love-

This 60 mm reel contains a start on my long journey
to Australia, in March, 1988-
I was about to meet and film a dying AIDS patient
for the first time in my life-
I was nervous, it was confronting and very emotional-
I was never forget it-
[MUSIC PLAYING]
Please tell me your name-
My name is Lyle Taylor-

You are dying of AIDS right now-
Can you tell me about your situation?
Yes-
I discovered that I was antibody positive four years ago-
Today, through circumstances yesterday and today,
and through physical symptoms, I thought I was dying-
But, I can't find the switch to switch life off-
Good afternoon-
Good to see you-
Good to see you, Professor Dwyer
Have you had a good morning?
I've had an interesting morning-
Well that's very good-
This patient is close to dying-
He's very close to dying, he knows that, we know that-
I just don't die-
But he just is hanging in there, and as far as we're concerned,
we're very fond of him and every hour he hangs in
with us the better-
But he is as is the case with so many of these young people
dying of this horrible disease, he's
a source of inspiration to us-
In his bravery he's renewing our determination
to come to grips with this thing and to see
if we can't find answers, so in future people will not
have to go through this suffering,
because there is an enormous amount of suffering involved
that he's being very brave about-
When you see life of you patients,
now 25 years after I interviewed you, what do you think?
Sitting on that bed I was feeling
more like a psychologist and a friend
than an immunologist, a scientist who
was bringing the latest and greatest things to our patients
that would definitely help them-
That experience repeated time and time again-
It was extremely difficult-
AIDS spreads very rapidly in homosexual community-
It is not a homosexual disease and it will be slower
in the heterosexual community But if they don't do something
about it, that's the problem-
Just 10 hours after this interview Dr- Dwyer
called me in my hotel room to tell me Lyle Taylor had died-
I had captured his final thoughts,
his very last moments of life-
I was shaking and put the phone down,
and suddenly, my filming became very personal-
It was impossible to remain detached and be
just an observer-
Meeting Lyle was the reason I became an AIDS activist myself-
If any single member of humanity is infected or affected,
then it concerns us all-
And that I think, is the message of AIDS-
We are all involved-
We are all concerned-
It's a challenge to humanity and must be seen as that-
Ones indicated here that are blue are positive-
Those patients that have positive AIDS antibodies
in their serum-
What is your reaction when you see all this blue-
When I see all these positives it really
does make me wonder why people in the community
just aren't taking the precautions that they
should be-
And I think if people must start to realize
that this is a disease which affects
every single person in the community, not just some-
And as soon as people start to realize this
I think then the large part of the battle is going to be won-
The rapid spread of HIV in Australia
saw the gay liberation movement transformed
into AIDS activists-
The activists pushed AIDS high up on the political agenda,
and had a huge impact on society-
Australia quickly developed a strong response-
I found this fascinating to document-

Not only was losing my friends and things like that, dozens
and dozens and dozens of friends and people
I knew, acquaintances, but the fact that the gay community
would just be wiped out-
That was the sort of scenario that was not an unreasonable
thing to say back then because we didn't have the knowledge-
And I was going to do everything I could
to make sure the Mardi Gras was protected,
and gay rights were advanced, and my community was protected-

Albian Street AIDS hot line, can I help you?
We, throughout interest in our information unit,
and publicity and media, we're trying
to get across to the public just how serious the problem of AIDS
is-
How did you get AIDS?
I borrowed the wrong syringe off the wrong person
and I gave myself a dose of AIDS-
This bus is called an outreach bus
which was started at 1985 from the Albian Street Clinic-
It's a bus that goes out onto the streets every night
of the week from 9-00 o'clock until 4-00
o'clock in the morning-
It gives out needles to intravenous drug users,
and it offers testing and counseling
for young male prostitutes-
Harm reduction was absolutely critical to Australia's success
in keeping HIV rates low, particularly
among people who inject drugs-
But also it became a guiding principle
for dealing with all the other ramifications of HIV-
I'm terrified by it-
I think it's a threat to the community
and that we should be more aware of it-
It wasn't just gay men at risk-
Julie Bates organized the Australian sex workers
and the Australian Prostitutes Collective,
the first organization of its kind in the world-
She was also a devoted AIDS activist-
Was this like the really start of what you were
doing with the sex workers-
It was probably a couple of years in, a couple of years in-
But it was that brothel in Nevada
that really championed the cause of condoms
not being a negotiable thing in brothels in Sydney-
And now what are you doing now?
Now for me to go into to see the women,
which is what we wanted to do always,
get past the front desk, to get to the workers in the premises-
People's lives were now on the line Staffan, you know?
We needed to-- we were learning every day, as gay men were,
as people representing injecting drug users-
Every day we knew that this virus was killing people-
These were incredibly difficult issues-
It wasn't quite so much about talking about the HIV virus,
but the questions about how it was spread
became very difficult- Because it required
the federal government to talk about homosexual and
heterosexual sex-
To talk about injecting drug use-
Perhaps the provision of clean needles and syringes-
To talk about sex work-
All of this in a way that had never
been done before in Australia-
How important was the bipartisanship
to fight HIV and AIDS in Australia
I think it was an essential feature of the fight-
If we had been torn apart by the kinds of arguments that
took place in the United States, it
would be much more difficult- To pursue the policy which we did,
which had a lot of critics out in the public,
and it was a lot of homophobia about some of the things
we were doing-
And if we had been constantly sniped at by the opposition,
it would have been very difficult-
We agreed really, to tackle HIV/AIDS as a community-
And that's what we did-
We tackled it by being united-
And we never really wavered in that approach-
How important was the AIDS activists
to push the scientists to do more?
I think that was very, very important-
If it wasn't for the AIDS activists movement
I don't think we would have had the advances in treatments
that we've had today-
For you what did it mean, then, the antiretroviral came?
Oh, it was really thrilling when we,
in the middle of the '90s, when it
was shown that combining drugs was
more effective than taking one-
That really saved a lot of people's lives-
Tragically, a few numbers of people, including my friends,
missed that boat, that was just six months or nine months too
early-
They got sick and died-
So that was a very important watershed
but we also need to remember the drugs then
were very difficult to take-
There were toxicities and things like that-
So that was the beginning of modern therapy-
But I would say truly, modern therapy has,
we've been with that for about 10 years now
and the proof of that is that so many people are living
healthy lives all around the world
in developed and developing countries-
Well of course, talking to young people in 2014
about the situation in 1985, you might
as we'll be talking about what happened in the First World
War-
It's a long time ago in a land far,
far away from the preoccupations and concerns of young people
today-
And it is so, that if a young person today becomes
a positive, by and large they have access
to effective treatments-
That are not going to progress to becoming ill
or to an early death as they were 30 years ago-
[MUSIC PLAYING
Sebastian Robinson is a 27-year-old, openly gay actor
living in Melbourne-
The same day he graduated from Victoria College of the Arts
in 2013, he was cast in the lead role in a theater play,
The Death Of Kings -
I wouldn't say it was abandoned freedom-
It was the freedom that came about
by being part of a very subterranean culture-
There was no internet, there was no Google News,
there was no YouTube, there was no 24 hour news channel-
There was very, very restricted ways of communicating anything,
I must have first read about something that subsequently
turned out to be HIV in the Daily Press
or the weekly news magazines in 1982-
The Death Of Kings is a verbatim piece of theater
that chronicles eight people's stories over the AIDS epidemic
in Sydney in the 1980s-
And they talk about their experiences with the virus,
and dealing with people around them dying,
and the sort of lifestyle that was
going on both kind of professionally and socially-
And it's based on real interviews
with people that were there-
Yes-
Word for word-
There's no textbook that says how you deal with someone
you know dying every week-
When he died it was like Hiroshima-
I was shocked that this general question of HIV
should affect me so personally, and that the great love
of my life should then die-
I played two characters-
I play William Botell, who was a public servant at the time-
And another character called David,
who was a nurse in St- Vincent's Hospital in Sydney-
Very pleased that Sebastian was playing me, or giving voice
to my words in this really excellent production-
It's not just my words being spoken by an actor,
Sebastian's bringing a great deal of himself
and his understanding, and his thoughts,
and views, and attitudes to HIV and to what happened, into it
as well-
I feel that I have learned-
I feel that I've deepened just my understanding, I think,
of the period, and the time, and what was going on in Australia-
Stepping into a couple of characters, and their stories,
and getting a kind of insight into them and their thinking-
It's broadened my understanding and respect especially
for older generations-
You're, have personally also in your life,
encountered HIV and AIDS-
Your boyfriend died of AIDS when you were young,
How did this affect you?
At the same time I was dealing with as best I could
with assisting in the political response to AIDS in Australia,
in the mid '80s-
My partner at the time had acquired HIV,
and we had split up for a while-
But without telling me this progressed to AIDS, and then
towards the end of his life then,
it became apparent in '86/87 that he was going to die-
Which he did in mid-1987-
This brought home to me, in the most personal way
possible, the consequences of HIV infection-
And in another sense, the importance
of making sure as best we could, that as few people as possible
acquired HIV or died from AIDS-
[MUSIC PLAYING]
Sebastian put a lot of energy and personal commitment
into rehearsing the play and preparing for the opening
season in Sydney-
But during this period his life would dramatically change-
[MUSIC PLAYING]
During the season when you play this in Sydney
you were suddenly diagnosed with HIV-
That's correct-
But you always practice safe sex, so how could it happen?
It- happened-

I was romantically involved with a gentleman in December
and January in Melbourne-
And he was 21, and I think I just thought
it's safe to not use a condom-
Because he was young-
Because he was young-
Because he was young-
[MUSIC PLAYING]
I tried to be open with my diagnosis,
because when I was diagnosed, my immediate thought was there
was not enough visibility-
And they're not, there's not enough
visibility within the younger community-
This was serious-
Something was going on-
It was reported as attacking gay men
and it couldn't be identified and didn't look very good-
There's a lot of stigma, still, within the community-
And the stigma just comes from a lack of education-
I think everyone's heart is in the right place,
but there's a lot of fear around HIV still being a killer-
And there are many people that I've
had to educate over the last couple of months, telling them
that I'm not going to die and that there's
nothing to be afraid of-

When I left Australia more than 25 years ago,
I knew I had witnessed something extraordinary-
It was a courageous approach to dealing with the epidemic that
struck me and resulted in Australia becoming recognized
around the globe as a real success story-

In the developing countries the situation was very different-
The gap between the rich and the poor countries
became evident to me when I came to Cambodia in 1998-
HIV had then spread the out of control in the country-
This was at the peak of the Cambodian epidemic-
The country had just come out of civil war and genocide
when AIDS hit-
I think the woman's having education session
in the market, this is very important
because people start aware about HIV/AIDS-
And right on Cambodia HIV/AIDS is very fast epidemy
and although, especially among the youth-
And people around 18-35, it's a high risk group-
So now the figures is right now are
40% of the commercial sex workers are infected-
7% of military and police are infected-
3% of the pregnant women are infected-
Cambodia right now, as we see, is
one of the-- has one of the highest rates of HIV/AIDS
in Southeast Asia-
And this year we have started to see children
infected with HIV/AIDS-
And we haven't start talking what to do
for children and in Cambodia-

In 1998, people living with HIV/AIDS
could not access antiretroviral medication in Cambodia-
The gap between the rich and the poor countries
was clearly reflected by the AIDS epidemic-
A second wave of AIDS activists started
to emerge 10 years after the first wave focusing on
how to fight AIDS in the developing countries,
and how they should access medication-
She says when she was sick they took her to hospital-
She says that she was working in brothel so the friends took her
to the hospital-
[MUSIC PLAYING]
If Cambodian people didn't have any scheme for prevention
on HIV/AIDS epidemy right now, we
will have another second killing field to our people-

[MUSIC PLAYING]
When I first met the social worker Oum Sopheap
he was a passionate young aids activist-
He worked at the World Vision Project in Phnom Penh,
but on the earliest organizations
to address the growing AIDS epidemic in Cambodia-
[NON-ENGLISH SPEECH]
Through working with AIDS patients here in Phnom Penh,
especially in the poor community make us change a lot the way
we think-
It changed a lot because we feel a real need
of community people which a lot of thing
that we have to do for them-
When we think about the inequality
between the rich and the poor world, I feel very angry-
Because in the rich country, they
spend $25,000 per year for one AIDS patient,
and here in Phnom Penh we have only $10, even less than $10,
for an AIDS patient per year-
So it's not-- it's not fair to people here in Phnom Penh-
Today Oum Sopheap is executive director
of KHANA, Cambodia's largest NGO on HIV and AIDS-
It is instrumental in developing the country's response to HIV-

For today, 60 years later, what do you say today?
Today I think people are very happy-
If you look at the face of people with HIV
they're smiling, they're talking,
they are actually just like everyone else
in the communities-
They continue doing their life, doing everything in their life
just like many other community members-
But if you compare to 16 years ago it was horrible-
A lot of stigma, discrimination, and perhaps
being HIV positive almost like a death sentence-
Because as I mention, 16 years ago, ARV were just our dream
you know, there was no hope-
When I did this interview in 1998,
you were angry because Cambodia had
no antiretroviral medication, only the rich countries-
How did they-- how did this change?
I think it took us sometimes from '98 to 2002
before we could get more people on treatment for ARV-
So since then we keep scaling up and up again-
So every year we put more and more people on ARV,
and now I think we've become one of the successful country
in the region to put people with HIV on treatment-
I happened the largest number, almost 80%-

Cambodia's success story on treatment
was made possible through and action and HIV strategy-
Free access to treatment was funded
by the developed countries such as the United States
and Australia, and by international organizations
such as the Global Fund-
[MUSIC PLAYING]
Angkor Hospital for Children has a special clinic for children
who were born with HIV-

10 years ago these children died, but today they
get free access to treatment-
So far, we have 564 children in the program, and in this amount
we have-- there are of 521 on ARV medication-
[MUSIC PLAYING]
Srey is 13 years old and makes his visit
to the clinic every month-
We have chosen not to show his face because he's a minor-
[MUSIC PLAYING]

[MUSIC PLAYING]
[VEHICLES RUNNING]
KHANA is the largest NGO organization
working in the area for HIV and health overall-
The focus of the organization is to provide
HIV prevention and treatment care
and support to people with HIV in Cambodia-
[MUSIC PLAYING]
Dalish Prum 28 years old, has been
an HIV activist for five years-
She was diagnosed at the age of 18-
She now focuses her energy to empower women living with HIV-
I'm Dalish, and I am an activist for HIV-
Why am I here for HIV activist, because I am also HIV positive-
So I think that it is very important
to be involved and have people living HIV, specifically
for a woman living HIV, in order to improve their health
condition-
And especially I really want them to speak up
and to bring their voice-
Did you disclose your status and become open,
or did you keep it secret?
No, I kept it secret-
Yes-
Why?
Because I fear a threat of disclosure the HIV status-
As in, when I was 18 years old, discrimination and stigma
is very high among people with HIV,
that I do not want to live anymore-
Yes, because HIV status, because I was young,
because I think maybe I cannot marry or I cannot continue
my life-
[MUSIC PLAYING]
Today I'm very healthy, and I'm married,
and I also work for people living with HIV-
[MUSIC PLAYING]
Dalish often makes outreach visits in her work-
Here she visits a group of sex workers living with HIV
outside the capital of Phnom Penh-

[NON-ENGLISH SPEECH]
I'm now visiting sex worker group
and they asked, explaining me about all the difficulties
nowadays-
I teach them about HIV infection,
and how to use condom, and sexual- and reproductive
health, and also leadership as well-
It is difficult to be a sex worker in Cambodia
because it is illegal-
I am very happy to meet them, because they
are very popular with me-
And we are like one family when we meet-
Yes-
Together-
Yes, we are very close-
Yes-
[NON-ENGLISH SPEECH]
OK-
We don't disclose our HIV status to the client,
but we have to ask the client that you
has to use condom in order to prevent HIV or STIs
transmission-
If they don't use, we will denies to sleep with them-
[NON-ENGLISH SPEECH]
[MUSIC PLAYING]
I become HIV activist because I love, I really love this work
and I believe that I can help other people living
with HIV, especially for the women living with HIV-
And I believe that I am a role model for them,
even when I am young, but I believe that I can help them-
[MUSIC PLAYING]
You are a co-founder of an organization called
the Institute Over Many, Tim-
What is that?
Tim?
Well, the Institute of Many, the group I run,
has a private Facebook group for positive people
that has grown much faster than we could have anticipated-
And in that space the men and women in that group
share information, and they develop a stronger sense
of purpose through chatting with each other,
through engaging with each other-
Nic Holas represents a new generation
of Australian HIV activists-
Meeting the challenges of today, social media
is at the forefront of their activism-
Their main communication tool is Facebook-
[MUSIC PLAYING]
When I got my diagnosis I absolutely went into shock-
It was a shock though that didn't last that long-
I was, remained kind of on edge for a couple of days,
but I was very fortunate-
I had a great doctor and I had fantastic friends
who were very supportive right away-
And that early experience of telling people straight away,
that I was positive and not keeping it a secret, I think
is what has given me the strength
to disclose to as many people as I have-
I am a young person who very easily can access medications
with no side effects-
And as a person living with HIV my journey
is about living long term which is unlike the experience
of the previous generation-
Treatment as prevention is the future of HIV medications-
It's a process in which positive people and negative people
access the antiretroviral to either create
an undetectable viral load, or for a negative person,
to protect themselves from acquiring HIV-
It's a really important part of our war against AIDS and HIV
because it creates a level playing field-
It gives responsibility to the negative person as well as
the positive person-
[MUSIC PLAYING]
My name is Gavin-
I work for ACON Health-
It's a organization the AIDS council of New South Wales
used to be known as-
What are you doing here?
We're doing rapid HIV testing-
That's a first for Sydney-
It's a pop-up caravan that we have
for World AIDS Day, the week of World AIDS Day-
Is it easier to get people to test today than 20 years ago?
It is-
It is-
There's a lot of barriers that have been removed-
And we're hoping that these rapid HIV testing
experience will be that last hurdle that gets taken away-
I'm more encouraged more guys to get tested more often-
[MUSIC PLAYING]
You were in funding your campaign ending AIDS-
What do you think about that?
Well, I'm very passionate about the new HIV
strategy we put out-
It's got a very bold ambition, which is that by the year 2020,
we virtually eliminate the transmission of HIV-
What is your key message?
My key message is maintain all efforts in prevention-
Safe sex and behaviors that are not risky-
Know your HIV status, particularly if you're
a high risk group, get tested-
And then get on to early treatment,
because that then means you have treatment as prevention-
[MUSIC PLAYING]
You're a young politician-
How is it to try to influence the political establishment
in Australia today?
Well, on one hand we're lucky in Australia
because we had a strong bipartisan response to HIV,
where we sought to work with affected communities
in order to have a good response-
You know, and that meant we got on top
of managing issues like stigma and discrimination
in a criminal law-
But we still have problems in those areas
and it's really important that there's
a new generation of politicians that takes that bipartisanship,
and we keep strong awareness and positive positiveness
around it-
This for me, a great moment to be in Melbourne-
And it is important for us to say
to the world that is not over-
Even if we are being able to reach 10 million people
with a treatment, we still have 18 million people
who are waiting for a life saving treatment-
[MUSIC PLAYING]
Stigma today is the same thing that stigma has always been-
It's fear of the unknown, and I think in many cases,
especially with HIV, it's a projection of fear-
People are in the mirror looking back at themselves-

I think the question of why HIV notifications are on the rise
again, is a very complex question-
I think that we want to be able to say
it's because young people, or gay men acting irresponsibly,
that we stopped caring about HIV-
We're not worried about AIDS because we
have great treatments-
But ultimately I think that HIV notifications are on the rise
because we are emerging out of a period of invisibility for HIV-
I believe that the change in treatments
that occurred from 1996, onwards,
have allowed HIV positive people to go
on living their lives under the radar, which is an absolutely
fantastic thing and a crucial thing to have happened
in the war on HIV-
But at the same time I believe that has created
an invisibility around what it is to be HIV
and I think that people are less compelled to live openly
with their status-
And in doing so we lose the information and the knowledge
that we need to pass on to people-
[MUSIC PLAYING]
The message for TIM is that you don't
have to be ashamed of how you became HIV positive-
That you can be proud of how you live with it-
And why did you go?
I helped co-found the Institute of Many
because they wanted to meet other HIV positive people,
but it started in Sydney and now it's
expanded to the rest of the world-
So I'm getting an opportunity to meet-
You think that there's actually really good education
out there, but I think it's from being scared
to ask the questions, you don't really
get to know the real facts-
You're always hearing about it from someone
who was a friend of someone who got it through to them-
It's never primary source of information-
The message I want to convey to young people
is that we are all at risk-
HIV is a human condition and you're not
precluded from coming into contact with or contracting,
as a result of being female, or straight, or anything else-
As a woman with HIV I feel like I'm
able to have the same support as these guys do,
because the gay community are very welcoming,
I found, to women-
And there are specific groups for us as well,
and I found that to be a huge source of support-

Throughout the entire Australian response to HIV and AIDS
Mardi Gras has been an important driving force-
Another important driving force has been ACON in Sydney,
the AIDS Council of New South Wales,
and the Victorian AIDS Council in Melbourne-
Philanthropy is also a key in mobilizing the HIV response
and creating new resources-
[MUSIC PLAYING]
MSM, men who have sex with men, is a key group
to reach in the Cambodian HIV response-

Here is a newly opened social club for young Cambodian MSM
in the city of Siem Reap-
It is a meeting place providing counseling, testing,
and support-

[MUSIC PLAYING]
Lotia is a 23-year-old MSM who works in a bar nighttime-
At the club he takes his HIV test once a month-
So far, he has succeeded in remaining negative-

[MUSIC PLAYING]
At the AB Bar in Siam Reap Lotia and his young friends
dress up as lady-boys for the night-

[MUSIC PLAYING]

[MUSIC PLAYING]
[VEHICLES RUNNING]
[MUSIC PLAYING]
Another key group to reach the HIV response,
are the intravenous drug users-
This KHANA-supported project visits drug users
outside Phnom Penh every day-

The slum area ----- district-
So--
In Phnom Penh-
In Phnom Penh-
Yeah-
Yeah-
A lot of drug addicts gathering here in especially
for the community in here-
We will meet him at the house their resident
[MUSIC PLAYING]
Your result is good?
Yea, I think very good-
The result is to make him or her on methadone-
We are so happy to work with him or her,
especially when we found him or her to change their behavior
as they shoot-
They-- they reduce their drug use,
and they start to access the health service-
[MUSIC PLAYING]
[NON-ENGLISH SPEECH]
This group is a methadone person-
I will probably check, pick up them every morning
to methadone clinic-
They call, they call and they are still
poor they live in slum area-
They don't have any place for support for daily basic,
to access the methadone-
So we need to pick up them in order
to maintain them at methadone-
[CROWD CHATTER]
[VEHICLES RUNNING]
This is the clinic methadone, NGO are working with drug user-
All they bring or pick up the methadone patient
to methadone clinic every day-
They can improve their life, they can support their family,
they can go to earn the money to as usual-
It mean that can improve the status
the health status then before-
[CHATTER]

[CHATTER]
The methadone clinic in community
we started in July, 2010-
And until now we enrolled about 260 clients ordinarily-
And every day we got about 140 client
come to get the methadone dose daily-
And based on our record we can see that most of them,
they can reduce injecting drug use in society-
[MUSIC PLAYING]
Back in Australia the drug scene is different and evolving-

Dean is a 30-year-old HIV positive gay man
and a former user of methamphetamine and other
drugs-
At the moment methamphetamine is a big problem
in Australia amongst not just the gay community,
but youth in Australia-
I entered the drug scene when I was about 14,
at high school, just smoking marijuana with my friends-
And then it progressed on later on at dance clubs
taking ecstasy, speed, and then eventually ended up
injecting methamphetamine-
[MUSIC PLAYING]
When my life got out of control drugs
became something that I was doing recreationally
and turned into something that I have to do every day just
to get through a day at work-
When I was diagnosed with HIV-
I was using a lot of Meth-
And when I was using Meth I was generally
having sex as well and not taking care of myself-
I would never use condoms or protection
so using methamphetamine had a lot
to do with me becoming HIV positive-
The most concerning element is the rapid increase
in the number of infections among men
who have sex with men-
That's not fully understood, but it's clear
that men who have sex with men are much less fearful than they
used to be about HIV infection, because
of the improvements in treatment-
But there are other things going on as well-
Yes, it's true the drug scene is volatile,
but it's always been volatile-
And while we continue to try in futility to repress
and eradicate the drug scene it's
always going to be volatile-
When I meet young people that ask me about drugs,
I try my best not to tell them don't do drugs,
because that was the same thing that people told
me and it didn't really work-
So I try and share my experiences with them
so they have a better understanding of exactly
the dangers of methamphetamine-
[MUSIC PLAYING]
Sebastian, who was diagnosed in February, 2014,
is reflecting about when to start treatment-
[MUSIC PLAYING]
Hi Sebastian-
Hi, come in-
How are you?
Good thank you-
Have a seat-
I have a note from your doctor who
referred you saying that you were just
looking to have another--
Second opinion-
--second opinion and talk about, I understand,
you've been recently diagnosed with HIV-
I just like to be informed in all aspects of the virus,
and I've had lots of different opinions coming from all angles
and I'm open to every opinion-
You're in the room with me, so I'm your advocate right now-
I'm here to advocate for you and that I'm not
going to say you need to be on treatment so that you don't
infect other people, right?
Because for one to start treatment
at this point in time at least, it's
actually a commitment that's essentially
until the science tells us otherwise,
and that may well happen, but for now it's lifelong-
So it's a case Sebastian, if you're ready to start,
we start-
Obviously, because it's a pill-a-day,
and it's anti-viral medications what
needs to be taken every day, I want the rest
of my life to support that-
And that's good because it's more of an excuse
to have a better well being-
Going to the gym, eating right, getting a good night's sleep-
It sounds like I can imagine you could fit treatment well
into your life-
That's my sense of it-
Yeah, I hope so-
And I think you're right in a sense,
being in Australia is a remarkable country, because we
have subsidized medication, we have public health, hopefully
for a while longer-
It is a good-- if one has to be diagnosed
it is a very good country to be diagnosed in,
and treatment is available-
I can see you doing very well-
And I guess the other thing I haven't said to you,
which is incumbent upon me to say,
is that there's very good evidence
that people your age starting treatment now,
is that you have the life span of another guy exactly
identical to you but who's not HIV positive, living
in Melbourne, Victoria-
And also, as yes, you're a gay man,
but you still might want to have children
and those opportunities are still very much there for you
as well-
Yeah-
Lots of HIV positive men have children-
Fantastic-
Yeah, so there's a lot of doors, you
should see a lot coming through all the doors
that you might think are closed, there's actually light-
Yeah-
Yes, so good luck with that-
Thank you-
Lovely to meet you-
You too-
Take care-
[MUSIC PLAYING]
Burnet has a fantastic role in the development
of looking at different aspects of HIV
prevention, our treatment, toxicities, cure work-
It covers the whole panoply of issues
that are within HIV medicine-
So you are set for another experiment?
Oh, yeah?
So what are the big challenges that we
face now scientifically?
Well, I think the next big issue that we
have to tackle as a global community, together
with government and private sector,
is finding a cure and a vaccine-
And the payoff there will be huge-
If we find a cure that would allow
us to not keep people in antiretroviral therapy
lifelong, which may, which would say billions
and billions of dollars, as well as deliver incredible results
for people that thought there would
be living with HIV and on treatment forever-
And similarly for a vaccine, although we
have lots of ways now to prevent HIV,
beyond just behavioral modifications
on the vaccine which traditionally has really
been the best way to limit spread
of an infectious disease-
A vaccine that's cheap and easy, and deliverable
to a large number of people-
So I think investments paid off big time in the past and these
are the areas that need significant investment going
forward-
I think that we have made tremendous strides
in the last 10 and 20 years particularly in HIV science
and I have every confidence that properly funded and supported,
this effort will payoff-
But what do we do between now and then?
Well of course, what we do, is put all the money
and support and effort we can into keeping
the rate of new infections as low as possible
for as long as possible-

I want to see the virtual elimination of HIV
and I believe we can do that in Australia-
I'm absolutely passionate about this-
And I think we can do it and that's
why probably, the main reason I'm involved-
Without these new scientific advances
I may not have been involved very much-

I think in Cambodia we can end HIV-
We already have a clear strategy and road
map to end HIV by 2020-
We will continue working together
based on all the experience and goodness
we learned from the past 15 years, and be in a way more
to reach out to most of the population
to get them come forward for testing-
And if they tested positive we try to make sure
they get the treatment as soon as possible
and continue staying under treatment-
I will continue to work as an HIV activist in Cambodia
until HIV will be finished in the world-
I believe that the most important challenge
for HIV activism in the future is education-- education
and stigma-
We can't sit waiting for the scientific community
to come up with the cure-
I do think we need to remind people,
and gay men in particular, of the dangers of HIV-
You've got to remember the still is no cure-
[MUSIC PLAYING]
I think Australia has a global responsibility-
I think every country has a global responsibility-
And Australia has a strong economy
and a fantastic relationship with HIV and AIDS
medication, and our initial response in the '80s-
And I think we are world leaders within the virus
and I think with that comes global responsibility-
Do you think you can end HIV?
Yes-
We can end HIV-

I started to document the human story of HIV and AIDS in 1988-
The result is 900 hours unedited film material
now stored and archived at the Karolinska Institute
in Stockholm-

It has been fascinating and humbling to follow the journey
from AIDS to HIV-
Still there is much work to be done in order
to end HIV around the world-
I'm committed to continuing the documentation-
This is my personal contribution as an HIV activist-
[MUSIC PLAYING]

Film Details

Location 
Shot by 
Christer Strandell, Andreas Alfredson
Interviewer 
Staffan Hildebrand
Year 
2014
Production company 
Face of AIDS
Technical Information
Digitized aspect ratio 
16:9
Digitized audio codec 
ACC
Digitized frame rate 
25 fps
Digitized video codec 
AVC
Duration 
Video file format (container) 
MPEG-4