AIDS conferees grapple with describing sex

NEW YORK (CNN) -- At the United Nations, where diplomats argue over abstract terms like "modalities" and "transparency," the battle lines have been drawn over a more commonly used word: "sex."

The three-day U.N. Special Session on HIV/AIDS, beginning Monday, aims to spur the global response to a disease that has already killed nearly 22 million people, according to UNAIDS. But while most of the 189 member nations agree that radical measures must be taken to fight the disease, negotiations over the session's final "declaration of commitment" are stalled because of deep cultural and religious differences over sex.

At issue is how to define those who are most vulnerable and at greatest risk of HIV infection, and thus deserve to be given priority in treatment.

The phrase that has alarmed many Muslim and Catholic nations defines "those most vulnerable" as "men who have sex with men, sex workers and their clients, injecting drug users and their sexual partners," along with children, refugees and displaced persons.

"Some elements want to use the opportunity ... to legitimize behaviors which are totally inconsistent with the values of others," one Muslim diplomat told CNN.

Iranian Ambassador Nejad Hosseinian said the conference declaration should not be used "as a way for the Western world to push the envelope on areas where there is cultural sensitivity, ideological, ethical sensitivity."

Those who consider good health to be a basic human right disagree. "Moral squeamishness shouldn't stand in the way of finding solutions to this terrible crisis," said Kenneth Roth, executive director of Human Rights Watch.

"HIV/AIDS is born in large part of discrimination against women, gay men, drug users, sex workers, and others whose status has impeded their access to services, information and social support," said Joanne Csete, a public health expert on AIDS at Human Rights Watch.

UNAIDS presents a more clinical argument. "We deal with the facts," said UNAIDS Executive Director Peter Piot. "And if you exclude any group from the process in response to AIDS, you can never build an effective response. That's the fact. "

AIDS activists say the wording of any final document is crucial to providing the HIV-infected -- whatever their social standing -- with the treatment they need.

"We have to push in order to change the vision many governments have about AIDS and fight against discrimination (and) prejudice that still surrounds AIDS," said Edgar Carrasco, of Caracas-based Citizen Action Against AIDS.

The United States proposed compromise language that skirted around the objectionable wording, but it was rejected by both sides.

"We're trying to bridge the gap between both sides," a U.S. official told CNN. "Why don't we look for language that doesn't offend either side? If you have a consensus document, you have to find language that enables people from all cultures to accept."

Diplomats said Friday they were hopeful that a compromise on the most contentious language in the document could be reached over the weekend.