Zarah Ali (not her real name) remembers how things changed for the better. “In 2014, I received a loan of 40 000 Djiboutian francs (US$ 250) that I used to develop and improve my garment business. I was also trained in business entrepreneurship, including marketing and customer satisfaction. I import clothes from Dubai and Somaliland and earn a decent income that helps me support my 25-year-old son, my 16-year-old daughter in secondary school and my three-year-old adopted son. I am able to pay for my rent, electricity and water and have decent meals.”

Ms Ali’s loan came from an income-generation programme established by the World Food Programme in collaboration with the United Nations Development Programme, UNAIDS and the national network of people living with HIV in Djibouti (RNDP+). The programme supports the long-term empowerment of, and provides regular incomes to, women living with HIV in Djibouti City. It helps them to achieve financial security and have access to food and improves their access to health-care services. Income-generating activities such as those supported by the programme have a powerful potential to help people living with HIV adhere to antiretroviral therapy and optimize health outcomes. 

The loans, ranging from US$ 141 to US$ 438 per person, are for starting or building retail businesses. The beneficiaries, who are selected from among two networks of people living with HIV affiliated to RNDP+ (ARREY and Oui à la Vie – Yes to Life), also receive training on how to run their business. Government support in the form of favourable policies and legislation has been vital to the success of the programme. 

Dekah Mohammed (not her real name) now lives a fulfilling life after receiving help from the income-generation programme. Ms Mohammed, who lost her husband to AIDS, lives with six children. After she lost her job in the hospitality sector owing to her deteriorating health and to stigma and discrimination, she started her own clothing business and received a loan of 50 000 Djiboutian francs (US$ 313) to expand her business. The loan was repaid within 10 months. Her business has since expanded into furniture and electronics and she has recruited an employee. “I am no longer a desperate woman. I make enough to take care of my family and dependants,” she said. 

The programme has improved the quality of life of many Djiboutian women, allowing them to regain dignity and ensure their financial security. It empowers women and girls to protect themselves from HIV, make decisions about their health, live free from violence and be financially independent. 

Building on the belief that empowering women living with HIV and their households to be financially independent strengthens adherence to treatment and leads to more fulfilling and dignified lives, the programme contributes to the World Food Programme’s broader strategic contribution towards ending AIDS as a public health threat by 2030.

Bangula settlement in Nsanje District, in the south of Malawi, is an arduous five kilometre walk from the border with Mozambique.

It is a walk that approximately 2 000 Mozambicans have made since they were displaced a month ago by the floods caused by Cyclone Idai. The settlement is also a temporary home to approximately 3 500 Malawians from surrounding villages who were also displaced.

Being predominately a small holder farming community, their homes, belongings and livelihoods were all washed away by the floods. They are now at Bangula, waiting for the earth to dry so they can go home and begin rebuilding their lives.

The emergency response to assist the 81 000 people in the district affected by the floods is being coordinated by the Government of Malawi, the United Nations, development partners and non-governmental organizations.

Upon arrival at the settlement, heads of households are provided with mats and blankets to sleep on and maize meal to cook.

Women and children are housed in 21 tents to the rear of the settlement, while others sleep under open industrial sheds, on concrete floors under tin rooves.

On a visit to the camp, Michel Sidibé, UNAIDS Executive Director, heard that while some amenities are being provided, there is not enough shelter for everyone and there is no lighting at night, which exacerbates vulnerabilities, especially of women and children.

It is well known that sexual and gender-based violence against women and children is heightened in emergency settings such as the one at Bangula. People also spoke of a lack of adequate nutrition, access to clean water and sanitation as well as their experiences of stigma and discrimination.

The small clinic at the settlement mostly focuses on primary health care and offers antenatal and postnatal services, HIV counselling and testing, refills of HIV treatment and psycho-social support.

While at the settlement Mr Sidibé spoke to a group of people living with HIV who had come to the settlement for shelter. They spoke of how, when the floods came, they tried to keep their HIV treatment safe from the water.

“When the floods came, my house was destroyed. But I managed to reach for my plastic bag where I keep my ARVs, because it is one of my most precious possessions,” said Sophia Naphazi, who resides in Jambo village in the district.

Elizabeth Kutenti, another women living with HIV, spoke of how her pills were safe because she keeps them in the roof. “They are my life,” she said.

The support people at the settlement need to return home is modest. “We need three things: a plastic sheet to cover what is left of our homes; maize seeds to plant and a hoe. Then we can go home,” said Miliam Moses.

“The level of resilience I have seen today is just amazing,” said Mr Sidibé. “The most important message I have heard today is one of hope.”

Mr Sidibé was accompanied by Atupele Austin Muluzi, Minister of Health and Population in Malawi. He thanked the UN agencies and the government departments supporting coordinating in the emergency response.

“We need continued support so that all the people in this settlement get the help they need so they can return home and live in dignity,” he said.

Rise clubs are helping adolescent girls and young women start conversations about HIV and sexual and reproductive health and rights.

Khayelitsha is one of South Africa’s largest townships, situated in the Cape Flats in Cape Town, South Africa.

As is the case in many other communities in South Africa, women and girls in the semi-informal settlement deal with gender inequality on a daily basis, which puts them at higher risk of HIV infection.

Gender inequality is a barrier for adolescent girls and young women to access HIV and sexual and reproductive health services and comprehensive sexuality education. It also places girls at higher risk of gender-based violence.

“There is a lot of crime. The community is not on the girls’ side. The community believes that women must submit to men. Sometimes it is hard for us to speak out,” said a young woman who is a member of the Rise club in Khayelitsha.

“We belittle ourselves to fit in the box that the community puts us in. Girls get raped, kidnapped … there is a lot of violence. “You can do this, you can’t do that”, you are told what to do,” she says.

For most girls, it is difficult to talk to parents, teachers or family members about sex, sexuality and sexual and reproductive health and rights. Young women and adolescent girls face stigma and discrimination, such as being shamed for being sexually active, from nurses in health-care settings when they seek sexual and reproductive health services. While many countries in eastern and southern Africa have signed the Ministerial Commitment on Comprehensive Sexuality Education and Sexual and Reproductive Health Services for Adolescents and Young People in Eastern and Southern Africa and have some sort of policy on comprehensive sexuality education, implementation is still uneven. 

Young women are at higher risk of HIV and other sexually transmitted infections than their male peers or older women.

In eastern and southern Africa, a quarter of the 800 000 new HIV infections in 2017 were among adolescent girls and young women between the ages of 15 and 24 years. Of the 2.17 million adolescents and young people aged 15–24 years in eastern and southern Africa living with HIV, 1.5 million are adolescent girls and young women.

Of the 277 000 new HIV infections in South Africa in 2017, 77 000 were among adolescent girls and young women between the ages of 15 and 24 years, more than double that of their male counterparts (32 000).

Knowledge of HIV prevention ranges from a high of 64.5% in Rwanda to low of 20.37% in Comoros, with South Africa mid-range at 45.8%.

In some countries in the region, adolescent girls and young women are permitted by law to marry at a young age. Early marriages are associated with loss of bodily autonomy, lack of education owing to school drop-out, lack of economic independence and gender-based violence.

Transactional sex contributes to the gender disparity in HIV infection among young people in sub-Sahara Africa.

Evidence shows that transactional sex among adolescent girls and young women is associated with a number of sources of HIV risk, including abuse and violence, alcohol use, having multiple partners, lack of condom use and age-disparate sex.

Rise clubs

Rise is a club for adolescent girls and young women that seeks to build social cohesion, self-efficacy and resilience through allowing adolescent girls and young women (aged 15‒24 years) a space to support each other and undertake projects in the community that help prevent HIV, mitigate its impact and enable safer choices.

Rise helps meet the needs of adolescent girls and young women in terms of building self-confidence and encouraging them to speak out against social ills and helps them to make decisions about their lives.

The clubs were started in 2014 for young people in 15 high-burden districts in South Africa by the Soul City Institute for Social Justice.

“African parents do not talk to us about sex and we are embarrassed to talk to them. I couldn’t speak to my sister so I joined Rise and now I can sit with my girls. Some are older than me and they can give me advice.” —Cinga 

“My parents taught me that the only way to be knowledgeable is to ask questions. When I joined Rise, we’d ask questions for girls who can’t ask for themselves, making life easier for the girls.” —Okuhle

“I could not speak to anyone at home. And then I became the most talkative person. Rise has helped me deal with low self-esteem.” —Lisa

Adolescent girls and young women in eastern and southern Africa need laws, policies and programmes that meet their needs. These include tailored and focused programmes for sexual and reproductive health services and comprehensive sexuality education and on the prevention of unintended pregnancies, gender-based violence and HIV infection.

They must be informed by the principles of gender equality and human rights and should address other socioeconomic issues, such poverty and unemployment.

Having such policies and programmes will not only result in positive health outcomes but will give adolescent girls and young women the opportunity to live their lives with freedom and dignity.

Towering over a throng of young people, Christine Kafando peppers the crowd with questions.

“Do you feel pressure from other boys and girls?” “Do you feel abandoned because of poverty?” “Do you have all the information you need regarding your health and HIV? If not, ask me, ask your partners, ask! Okay!”

The 40 boys and girls nod and shrug. They have come for a workshop run by the Association Espoir pour Demain (AED) in Bobo-Dioulasso, Burkina Faso, which aims to create a space for young people to learn about sexual health and to train some to become peer educators.

“After having seen a number of young students come to us pregnant, we felt a need to start these workshops,” Ms Kafando, the founder of AED, said.

Issa Diarra said the workshop enabled a dialogue. “In our society, we really don’t talk that much about sex and, I would add, health issues, but here we really had the chance to discuss all that,” he said. Another attendee of the workshop, Roland Sanou, agreed, “Sex today remains taboo for young people, but I don’t want it to stay that way.”

Many of them say times have changed and that the way they think is different from the way their parents thought. “Currently, we young people are aware and we know what we want and we know that being sick can keep us from realizing our dreams, so that’s why we are rallying,” said Baba Coulibaly.

At the beginning, AED helped women living with HIV to access treatment. It then grew to help mothers and their babies born with HIV. Fifteen years later, many of those children are now teenagers and still drop by. Reflecting on her two decades as an HIV advocate, Ms Kafando said, “For so many years, women have been the face of HIV, but it’s key to include men and boys to raise their awareness.”

Jacinta Kienou, a nurse who has been at the association since it was founded, said that there were two big challenges: a number of young people living with HIV no longer take their treatment regularly and many young people are unsure about how to deal with relationships.

“Because they live with HIV, and they are young, lots of problems bubble up concerning affection and acceptance by others with regard to their HIV status,” she said. “Often relationships end because of someone’s HIV status. We council them and their parents at that time,” she added.

In Burkina Faso, young people make up more than 60% of the population and data show that many of them do not know their HIV status. UNAIDS Strategic Information Officer André Kaboré describes two gaps concerning young people. “Despite high-quality treatment being readily available, there are children out there who don’t know they’re living with HIV. Worse, many of those who do know that they are living with HIV aren’t accessing treatment,” he said.

In the country, 94 000 people are living with HIV, 9400 of whom are children under the age of 15 years. While 65% of adults living with HIV are on life-saving antiretroviral therapy, only 28% of children living with HIV whose status is known, about 3500, are on treatment. Ms Kafando calls them the forgotten generation. “They fell through the cracks because until now they had never been sick or needed attention and thus were never tested for HIV,” she said.

The head of the National AIDS Council for Bobo-Dioulasso and the surrounding region, Suzanne Sidibé, said, “We lost sight of children born with HIV. Our aim, with the help of the Association Espoir pour Demain, is to fan out to families through health mediators.”

Hoho Kambiré, who is living with HIV, has four children, two of whom are living with HIV. As an AED health mediator, she speaks about the benefits of knowing one’s status to all who will listen. She visits families, accompanies women to clinics and provides support.

“It is necessary to test all the children to know who is sick and who is not sick and follow up to keep them healthy,” she said. AED has now more than 50 health mediators, mostly women like Ms Kambiré, who originally came to the association seeking health services herself. 

The United Nations Children’s Fund (UNICEF) and UNAIDS both support AED financially. Mireille Cissé, a UNICEF HIV specialist, said that the United Nations in Burkina Faso had identified the top priorities for the AIDS response in the country, including working with civil society.

“We agreed that a community link needed to be established, because they are our entry into families,” she said. UNICEF formalized the health mediators’ contribution by providing a stipend for their work and works hand in hand with the regional office of the Ministry of Health.

“A real victory for us was to have the health mediators integrated into the health teams of the districts,” Ms Cissé said. “That buy-in really facilitated the role of the health mediators and has raised their profile.”

UNAIDS has reinforced the capacity of the health mediators to widen their scope of work, which ranges from psychosocial counselling to training on treatment adherence. “To maintain our progress in the HIV response and end AIDS depends a lot on civil society like the Association Espoir pour Demain,” Job Sagbohan, UNAIDS Country Director, said. “We really hope for maximum impact.”

SEATTLE/GENEVA, 6 March 2019—UNAIDS welcomes the results from the HPTN 071 (PopART) trial.  The results showed a 30% decline in new HIV infections where HIV prevention, including home-based HIV counselling and testing, was provided, as well as referral to HIV care and treatment for people testing positive for HIV according to country guidelines. The study took place between 2013 and 2018 and included 21 urban communities in Zambia and South Africa, covering a total population of 1 million people, the largest study of its kind.

“UNAIDS congratulates the PopART team on this important study, which clearly demonstrates the critical impact of community-based HIV prevention, testing and linkage to treatment,” said Michel Sidibé, Executive Director of UNAIDS. “It reinforces UNAIDS’ call for more community health-care workers across Africa, the need for increased investment in HIV prevention and treatment, including new and better tools and systems to deliver them. It also shows the urgent need to reach men and young people.”

There were three arms in the study. Arms A and B delivered the PopART package of HIV prevention, which includes annual household-based HIV counselling and testing, linkage to care at the local health centre for people living with HIV, follow-up visits to people living with HIV to ensure that they were linked to care and to support adherence to treatment, promotion of voluntary medical male circumcision for men who tested HIV-negative, services to prevent mother-to-child transmission of HIV, referral for treatment of sexually transmitted infections, provisions of condoms in the community and screening and referral for tuberculosis.

Arm A offered immediate initiation of antiretroviral therapy to people testing positive for HIV irrespective of CD4 count. Arm B offered antiretroviral therapy only to people who were eligible in accordance with the country guidelines—this was a CD4 count of 350 at the beginning of the trial, which moved to 500 and in 2016 treatment was offered to all people living with HIV, as in arm A. Arm C had no household intervention, but people did have access to HIV testing and treatment services in accordance with the country guidelines.

Both arms A and B reached the 90–90–90* targets overall. In arm B, HIV incidence declined by 30% compared to the basic standard of care offered by the countries involved in the study. In arm A incidence declined by just 7%, which, although not statistically significant, is surprising; ongoing transmission was also at a considerable rate (1.5%) in arm A. Further analysis is under way to help explain why the decline in incidence was not higher in arm A despite high viral suppression (viral suppression was 72% in arm A, 68% in arm B and 60% in arm C).

Subgroup analysis also showed that in both arm A and arm B antiretroviral therapy coverage was high in women older than 25 years and in men older than 40 years, but men and younger people had a much lower coverage. It also showed that men and younger people were much less likely to be virally suppressed. This emphasizes the importance of ensuring that 90–90–90 is reached at the country level but also that each population group reaches 90–90–90.

The impact of community-based access to testing, treatment and primary prevention in the trial is evident and supports UNAIDS’ focus on strengthening community platforms. UNAIDS promotes this work through the 90–90–90 initiative, the Fast-Track cities initiative and the Global HIV Prevention Coalition, a coalition convened by UNAIDS and the United Nations Population Fund to accelerate access to combination HIV prevention in settings with high HIV incidence. The work of the coalition includes a particular focus on young women and their male partners—groups that were found to require better access to services in the PopART trial.

UNAIDS underscores that there is still no single HIV prevention method that is fully protective against HIV. To end the AIDS epidemic, UNAIDS strongly recommends a combination of HIV prevention options. These include ensuring that all people living with HIV have immediate access to antiretroviral therapy, the correct and consistent use of male or female condoms, starting having sex at an older age, having fewer partners, voluntary medical male circumcision, and the use of pre-exposure prophylaxis for people at higher risk of HIV infection.

The results of the PopART trial were presented at the Conference on Retroviruses and Opportunistic Infections, taking place in Seattle, United States of America from 4-7 March 2019.

* By 2020, 90% of people living with HIV know their HIV status, 90% of people who know their HIV-positive status are accessing treatment and 90% of people on treatment have suppressed viral loads.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

In a landmark ruling in April 2014, India’s Supreme Court introduced recognition of a third gender and directed that transgender people must have access to the same rights to social welfare schemes as other minority groups in the country.

Now, the State of Gujarat has established a Transgender Welfare Board to increase access to essential services for transgender people, including to health care, housing, education and employment. The Ministry of Social Justice and Empowerment created the board following consultations with the transgender community and community groups, including the Lakshya Trust and Vikalp. UNAIDS and the United Nations Development Programme provided technical support and guidance throughout the process.

The new board aims to improve cross-departmental coordination to improve the delivery and provision of services for the transgender community. The 16-member board will include 8 civil society representatives, including representatives from the third gender community and will be chaired by the Minister for Social Justice and Empowerment.

"The new welfare board is a great effort to help in day-to-day issues faced by transgender people. We hope that issues of livelihood, employment, social security and the protection of human rights will be addressed by the board," said Aakriti Patel of the Lakshya Trust.

Part of the board’s work will be to work on the development of an agreed legal definition of who can be designated as transgender.

“UNAIDS looks forward to working with the new Transgender Welfare Board in Gujarat. I applaud the ministry and all partners for the work they have done in helping to create the board, which will greatly improve the lives of the transgender community,” said UNAIDS Country Director for India, Bilali Camara.

UNAIDS will continue to provide support to the board with the development of a policy road map and the roll-out of social protection programmes for transgender people. UNAIDS is also working with the private sector in Gujarat to provide skills training for around 3000 transgender people.

In India, HIV prevalence among transgender people is 3.1%, compared to the national HIV prevalence among all adults of just 0.2%.

Leaving the meeting of the REVS PLUS nongovernmental organization, the women bid each other farewell, saying, “A demain soir (See you tomorrow night).” They had gathered at a health drop-in centre that also acts as a network hub for various HIV networks in Bobo-Dioulasso, Burkina Faso, to discuss the following evening’s plan: HIV testing among their peers at selected sites.

“We share our experiences and act as confidantes,” said Camille Traoré (not her real name), a sex worker and peer educator. Her colleague, Julienne Diabré (not her real name), wearing a long flowing dress, chimed in, “In our line of work, it’s hard to confide in someone, so confidentiality is key.”

REVS PLUS/Coalition PLUS advocacy manager, Charles Somé, described the group of women as an essential link in the chain to reach out to sex workers.

“Because of stigma and discrimination, many sex workers hide and move around so they miss out on health services and are much more likely to be infected with HIV,” he said. HIV prevalence among sex workers is 5.4% in Burkina Faso, while it’s 0.8% among all adults in the country.

By recruiting peer educators who know the realities of the job and can relate to other women, Mr Somé said that HIV awareness has increased in the community.

“We also innovated and started HIV testing in the evenings in places where sex workers gather,” he said. Prostitution in Burkina Faso is not illegal, but the penal code forbids soliciting. 

The following evening, along a darkened street, REVS PLUS set up foldable tables with two stools at each table. A solar lamp allowed the peer educators to see in the pitch dark and jot down information. Donning plastic gloves, the trained peer educators sat with women, who had their finger pricked and within five minutes were given their HIV test result. No doctors, no nurses were needed. The testing was done by peers because sex workers are afraid to be identified as sex workers. 

Mr Somé explained that over the years REVS PLUS outreach has gained the trust of sex workers.

Peer educators, he said, regularly called him to complain about police violence. “It went from arbitrary arrests, to stealing their money, to rape,” Mr Somé said.

Ms Diabré described her dealings with the police. “During the day they point a finger at you and discriminate, while at night they become all nice to get favours and if we don’t deliver then it gets ugly,” she said.

After documenting police abuse for a year with the help of bar owners and feedback from sex workers, REVS PLUS met with government officials and then the police.

“Our approach got their attention and we started awareness training with police officers based on law basics and sex work,” Mr Somé said.

Slowly, REVS PLUS identified allies in each police station, facilitating dialogue whenever an issue occurred. In addition, all sex workers now need to carry a health card showing that they have had regular health check-ups.

A Nigerian woman wearing purple lipstick, Charlotte Francis (not her real name), said, “We still have issues and stay out of their way, but it’s gotten better.” She waved her blue health card, which she says bar owners regularly demand.

Showing off his bar and a series of individual rooms around an outdoor courtyard, Lamine Diallo said that the police no longer raid his establishment. “Before, police would haul away all the women and even my customers,” he said.

UNAIDS, with funds from Luxembourg, is currently partnering with REVS PLUS to scale up the police awareness training across the country. Trainings have taken place in the capital city, Ouagadougou, and in Bobo-Dioulasso.

UNAIDS Burkina Faso Community Mobilization Officer Aboubakar Barbari sees the programme as two-fold. “We supported the awareness sessions for police and security forces because it not only reduces stigma, it also puts a spotlight on basic human rights.” 

“I am lucky,” Charles Somé said. The hyperactive human rights advocacy worker from Burkina Faso recalls going to a training event and chiding some of the men there about their sexual orientation. “I had pre-conceived ideas and asked them “Don’t you want to get married?”, “Don’t you want to have kids?”” he said. One young man opened up to him and, after days of honest conversations, Mr Somé had a sea change in his views.

“It dawned on me that if I am not judged, why should I judge others,” Mr Somé said. From then on, when lobbying on behalf of gay men and other men who have sex with men, he has used the word “we”.

“I defend them and respect them,” Mr Somé, who works for the REVS PLUS/Coalition PLUS nongovernmental organization, said. 

Homosexuality is not illegal in Burkina Faso, but stigma and discrimination remains high. Many men marry and hide their double life. Support groups for lesbian, gay, bisexual and transgender people have popped up, but discretion is key.

“I am forced to hide because I am not accepted,” Rachid Hilaire (not his real name) said. He joined an informal conversation group in his home town, Bobo-Dioulasso, where young men talked about relationships, sex, HIV and other issues. “I had many doubts about myself, but once I had more confidence in myself, I felt I could help others,” he explained. Standing outside the REVS PLUS meeting room, he joked with Mr Somé about keeping an eye on him. Mr Hilaire is one of 50 REVS PLUS peer educators who facilitate informal talks like the one he had attended tailored to gay men and other men who have sex with men. After being trained, he and another peer educator led frank talks with men.

Mr Hilaire’s biggest challenge, he said, remains educating the general public, along with political and religious leaders. “I blame the older generation for their lack of awareness,” he said. “Everyone deserves to be free and I long to feel that freedom,” he said. 

Yacuba Kientega (not his real name) fled his home in Bobo-Dioulasso and moved to Ouagadougou when his family found out he had relationships with men. “I eventually came back to pursue my studies in Bobo-Dioulasso, but am living in a different neighborhood,” he said. For him, he felt things had become better for gay men, but he would not give up the fight.

As a lobbyist for an HIV umbrella network, Mr Somé’s battle for people’s rights never ends.

“I really try to have underrepresented communities heard by the government and parliamentarians,” he said. He believes support groups and peer education have helped to reach key populations, such as people who inject drugs, gay men and other men who have sex with men and sex workers. “We have seen an uptick in health-care services by focusing on certain communities and I hope it will stay that way,” Mr Somé said. “Ending AIDS will necessitate really tackling stigma and putting the onus on prevention,” he added.

The UNAIDS Country Director for Burkina Faso, Job Sagbohan, couldn’t agree more. “The HIV response must follow the evolution of the epidemic,” he said. At one time, we had to save lives and we succeeded by concentrating on treatment for all, he explained. “To end the HIV as a public health threat, we need to zero in on prevention and awareness,” he added. “It’s the only way to maintain our progress and end AIDS.”

The PK5 neighbourhood of Bangui, Central African Republic, is home to much of the city’s Muslim community. Once a bustling commercial area and the centre of Bangui’s nightlife, PK5 has become a no-go zone for many.

Like much of the country, the PK5 area and its population were greatly affected by the violence that engulfed the country in 2012 and 2013. The non-Muslim inhabitants of PK5 left; rival armed groups continue to exert control. Across the country, the consequences of the violence have led to a huge displacement of people and a humanitarian crisis. At the end of 2018, it was estimated that 2.9 million people—more than half of the country’s population—were in need of humanitarian assistance and protection.

However, the people of PK5 remain resilient. Recognizing the need for a greater awareness of HIV in the community, Muslim youth leaders and the Catholic University Center, with the support of UNAIDS, organized an HIV testing and awareness-raising campaign from 23 January to 13 February at the Henri Dunant Health Centre in PK5.

The campaign was the first of its kind to take place in PK5 since the 2012–2013 violence. In the two weeks of the campaign, 1500 people accessed voluntary HIV testing and counselling services. People who tested positive for HIV were referred for treatment.

The campaign was opened by Pierre Somse, the Minister of Health, during an event attended by religious leaders, women and young people. Mr Somse took an HIV test and stressed the importance of all people knowing their HIV status. Knowledge of HIV status in the country remains low, with only 53% of people living with HIV knowing their HIV status.

“The government is committed to intensifying its efforts to deliver health and social services to all Central Africans. PK5 is not forgotten and its population will not be left behind in our efforts to increase access to HIV testing, treatment, care and support,” said Mr Somse.

Pamela Ganabrodji, Head of Information and Counselling at the Henri Dunant Health Centre, added, “We are very proud of what we have achieved through this HIV campaign, but challenges remain. We call on the government and international partners to continue supporting the HIV and sexual and reproductive health activities of the Henri Dunant Health Centre, which are critical in a community where cultural and social taboos represent a key barrier.”

On the last day of the campaign, a community dialogue was held to discuss the HIV and sexual and reproductive health challenges faced by the people of PK5. The needs are urgent and range from basic health and social services to a lack of economic opportunities. Low access to modern contraceptives, incomplete knowledge about HIV and poverty contribute to making young people and women vulnerable to HIV.

“With this campaign, we, the young people of PK5, are showing that we are not helpless and that we are part of the solution for HIV and other social issues,” said Aroufay Abdel Aziz, President of the Muslim Youth of the Central African Republic.

A second phase of the HIV testing and sensitization campaign will continue until the end of March and will include focused HIV prevention messages with sensitization by peer educators and focus group discussions on HIV and sexual and reproductive health issues.

“UNAIDS will continue to engage the government and other United Nations agencies and partners to reinforce the involvement of young people in the HIV response,” said Patrick Eba, UNAIDS Country Director for the Central African Republic.