GENEVA, 16 May 2018—On the International Day against Homophobia, Transphobia and Biphobia (IDAHOT), UNAIDS is calling for strengthened partnerships to support lesbian, gay, bisexual, transgender and intersex (LGBTI) people and their families living with or affected by HIV or facing discrimination.

“Stigma, discrimination and social and physical violence against sexual and gender minorities prevent them from accessing health services,” said Michel Sidibé, Executive Director of UNAIDS. “Everyone has the right to health, no matter their gender or sexual orientation. For that, we need zero discrimination for everyone, everywhere.”

Gay men and other men who have sex with men and transgender women are among the populations most affected by HIV worldwide.

More than 40% of the 100 countries responding to UNAIDS criminalize same-sex relationships. Criminalizing people because of their gender or sexual orientation drives people underground and out of reach of essential health and social services, making them vulnerable to poor health and homelessness.

To end AIDS, it is essential to ensure that people can access HIV prevention technologies, including condoms and PrEP, and quality HIV treatment and care free from discrimination. UN Women, the United Nations Development Programme and UNAIDS are working with the Global Network of People Living with HIV to end all forms of HIV-related stigma and discrimination. The initiative will require rapid multisectoral support and civil society leadership and will contribute to achieving the time-bound commitments of United Nations Member States to end AIDS as a public health threat by 2030.

Increasing political commitment and investments for the health and well-being of some of the most vulnerable people in society will help to ensure that no one is left behind.

IDAHOT, a worldwide celebration of sexual and gender diversity, is commemorated annually on 17 May. This year’s theme is alliances for solidarity to bring respect for LGBTI people and their families.

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.

UNAIDS has relaunched its Key Populations Atlas. The online tool that provides a range of information about members of key populations worldwide—sex workers, gay men and other men who have sex with men, people who inject drugs, transgender people and prisoners—now includes new and updated information in a number of areas. And in addition to data on the five key populations, there are now data on people living with HIV.

Chief among the new data is information on punitive laws, such as denial of the registration of nongovernmental organizations, and on laws that recognize the rights of transgender people. The overhaul of the site was undertaken in consultation with representatives of civil society organizations, including the International Lesbian, Gay, Bisexual, Trans and Intersex Association, which supplied some of the new data on punitive laws.

Data on the number of users of Hornet—a gay social network—in various countries has been made available for the atlas by the developers of Hornet, while Harm Reduction International supplied information on the availability of harm reduction programmes in prisons.

“Having data on the people who are the most affected by HIV is vital to getting the right HIV services available at the right locations” said Michel Sidibé, the Executive Director of UNAIDS. “The Key Populations Atlas allows UNAIDS to share the information we have for the most impact.”

The Key Populations Atlas is a visualization tool that allows users to navigate country-specific subnational data on populations particularly vulnerable to HIV. Data are presented on, for example, HIV prevalence among people who inject drugs in 11 sites in Myanmar, key populations sizes, antiretroviral therapy coverage among gay men and other men who have sex with men in 13 sites in India and specific prevention services and preventive behaviours. Updated data on many indicators that were obtained through the Global AIDS Monitoring exercise undertaken in 2017 is now available on the website.

Over the coming weeks, information on people living with HIV will be expanded, with new indicators being added, and data from the 2018 Global AIDS Monitoring will be added when available later in the year.

Singing “akouaba” (welcome), a group of young women crowded around Josiane Téty, the director of Bléty, a Côte d’Ivoire organization led by sex workers, as she arrived.

Located in Yopougon, a suburb of Abidjan, Ms Téty explained that in the centre one of the first things they do is give each other nicknames. Names such as Joy, Hope or Chance, because women, she said, often need a confidence boost and a sense of a new beginning.

“We take the time here to work on self-esteem, so that all the girls believe in themselves,” she said.

Most of the women at Bléty are current or former sex workers who carry out peer outreach, ranging from HIV awareness-raising and education about HIV prevention to promoting sex workers’ rights and continuing education.

“We seek to give young women opportunities and alternatives so that they are less vulnerable,” Ms Téty said. Pointing towards a young woman, she said that Happiness had started beginner accounting classes. 

Ms Téty and other sex workers founded Bléty in 2007 because they realized that they had little information regarding their health or their rights and hated feeling stigmatized.

“Getting an HIV test doesn’t mean that you are living with HIV, but that is how we were perceived when we were seen leaving a clinic,” she said.

They set out to correct that and have implanted themselves in the community. 

Marie-Louise Sery came to Abidjan to work following her parents’ death. She didn’t have much schooling and finding a job was difficult, so she started sex work. The 30-year-old, wearing braided pigtails, admitted being completely clueless about the risks she took.

“Bléty got me out of that situation,” Ms Sery said. This past year she became one of Bléty's peer educators.

Most of the time, she said, peer educators target bustling street corners to talk to sex workers, of which there are estimated to be more than 9000 in the country. Aside from handing out condoms, they also conduct rapid HIV tests and hand out cards with the contact details of Bléty’s various focal points, who can be reached day and night in the event of an emergency.

“My work involves giving a lot of support and hand-holding,” Ms Sery said.

Sex work is not illegal in Côte d’Ivoire, but the laws on it are vague. As a result, there is abuse and sex workers are vulnerable to violence. “We really stress to our friends out there that because they’re sex workers, it doesn’t mean people can take advantage of them,” Ms Téty said. If they have been abused they can call a Bléty peer educator and are accompanied to the police station or to the hospital.

Ms Téty said a recent victory had been to negotiate with doctors and health-care providers to provide a medical certificate free of charge, instead of for a US$ 35 fee. The law in the country requires a medical certificate in order to pursue a criminal case.

In its 10-year existence, Bléty has fended off pressure from the police and residents to change their attitudes towards sex work. Bléty has educated the police as well as sex workers in order to break the climate of mistrust between them.

“We have established good relationships with uniformed police, but there is a high turnover, so it can get frustrating to start all over again,” Ms Téty said.

Overall, she remains optimistic. Testing for HIV and sexually transmitted infections among sex workers is up, lawyers have stepped in to give legal advice and she sees her centre growing further.

On 11 and 12 December, representatives of four populations at higher risk of HIV infection—people who inject drugs, sex workers, lesbian, gay, bisexual, transgender and intersex people and former prisoners—gathered in Kyiv, Ukraine, for the legal formalization of the National Platform for Key Communities and to agree on key priorities for advocacy and on how the platform will be managed and operated.

The platform’s priorities will include influencing policies and decision-making processes, the development of a package of HIV prevention services that respond to the needs of key populations and responding to discrimination.

The participants decided on the positioning, role and contributions of the platform in the national AIDS response, the implementation of a Fast-Track strategy and the form of an HIV prevention 100 days of action campaign. They also enthusiastically welcomed continued Dutch, UNAIDS and civil society collaboration and agreed on a unified strategic vision for the participation of civil society and the platform in key events, including the International AIDS Conference, to be held in Amsterdam, Netherlands, in 2018.

The three key advocacy areas for the platform will be:

• The participation of communities in decision-making on health, an effective response to HIV and tuberculosis and the protection of human rights.
• The provision of access to services for key groups focused on the needs of communities that are implemented by the communities and funded by national and local budgets.
• The protection of rights and the prevention of discrimination.

Quotes

Young sex workers, transgender people, lesbian women, gay men and other men who have sex with men, people who inject drugs and people living with HIV from across Africa came together on 2 and 3 December for a preconference meeting ahead of the 19th International Conference on AIDS and STIs in Africa (ICASA), being held in Abidjan, Côte d’Ivoire, from 4 to 9 December.

The meeting, entitled Onto the African Map: Youth Key Populations and HIV, was a way for young people to express the challenges that they face, from a lack of opportunities to discrimination and social and legal injustices.

Those barriers make young members of key populations particularly vulnerable to HIV, violence, harassment and a lack of hope. Despite these challenges, attention to the protection of human rights and to the health needs of key populations remains limited in national HIV responses.

The meeting reviewed those challenges and identified key areas of action and recommendations that were compiled in the joint declaration adopted at the meeting. The declaration calls, among other things, for urgent action to stop violence, harassment and other human rights violations towards young people and key populations. It further calls for the participation of young key populations in health, policy and other decision that affect them and stresses the need to increase programmes and investments for services that address the needs of young key populations.

Quotes

Sex workers continue to face criminalization, violence, discrimination and other forms of human rights violations which increase their risk of acquiring HIV.

Sex workers—female, male and transgender adults who have consensual sex in exchange for money or goods, either regularly or occasionally—are among the populations that are being left behind in the HIV response. HIV prevalence among sex workers is 10 times higher than among the general population, and sex workers are poorly served by HIV services.

Many of the human rights challenges, vulnerabilities and barriers sex workers face in accessing HIV services are due to criminalisation and the restrictive laws, regulations and practices they face.  Selling and/or buying sex is partially or fully criminalized in at least 39 countries. In many more countries some aspect of sex work is criminalized, and in other countries general criminal law is applied to criminalize sex work (for example, laws against loitering and vagrancy).

The threat of detention, as well as laws that allow for the use of condoms as evidence of sex work, are serious barriers to the availability and uptake of HIV prevention programmes and services. When possession of condoms is used by the police as evidence of sex work, this greatly increases the risk of HIV among this key population. Even where sex work is not criminalized, sex workers are rarely protected under the law

Furthermore, studies have shown that female sex workers are subjected to high levels of violence—in Haiti, for example, 36.6% of female sex workers report physical violence and 27.1% report sexual violence.

However, sex worker organizations are leading efforts to advance their human rights and access to HIV services in many countries. In South Africa, sex worker-led organizations worked closely with the Ministry of Health to develop the South African National Sex Worker HIV Plan 2016–2019, which calls for an enabling environment for the protection of, and access to HIV services for, sex workers. The nationwide programme enlisted peer motivators to assist in the distribution of condoms and lubricant, information on sexually transmitted infections and HIV prevention, paralegal services and health service referrals. Community empowerment services that aim to reduce violence, stigma and discrimination included sensitization training and a helpline for sex workers.

In India, sex worker organizations are working with the police and the community to reduce violence against sex workers, and to establish health and social services for themselves and their families.

There is growing evidence of the importance of addressing the structural and legal barriers that affect sex workers. Ending the AIDS epidemic as a public health threat would require translating this evidence into practice, including by ensuring that governments and all stakeholders prioritize and intensify efforts to protect the human rights of sex workers and to increase their access to HIV prevention and treatment services. 

GENEVA, 17 May 2017—UNAIDS’ vision of zero discrimination and ending AIDS by 2030 will only become a reality if the response to HIV reaches everyone, including lesbian, gay, bisexual, transgender and intersex (LGBTI) people.

The International Day against Homophobia, Transphobia and Biphobia (IDAHOT), a worldwide celebration of sexual and gender diversity, is commemorated annually on 17 May. This year’s theme is families, focusing on the role of families in the well-being of LGBTI people and respect of the rights of LGBTI families.

“Many young gay and transgender people are rejected by their families, living on the streets, facing all types of discrimination and violence,” said the Executive Director of UNAIDS, Michel Sidibé. “This is not the path to healthy and productive societies. We must encourage inclusion and compassion and ensure that networks of support are in place, including access to essential health and social services.”

Gay men and other men who have sex with men are 24 times more likely to acquire HIV than other men and transgender people are 49 times more likely. However, in many health-care settings, LGBTI people find it difficult to access quality health services free from discrimination, making them more vulnerable to HIV and less likely to access treatment and care.

Under international human rights law, countries have a legal obligation to address discrimination in health and in the workplace. In 2016, UNAIDS launched an Agenda for Zero Discrimination in Health-Care Settings, which brings together all stakeholders for joint efforts towards a world where everyone, everywhere, is able to receive the health care they need with no discrimination.

UNAIDS is calling for respect for diversity and zero discrimination. To end AIDS it is essential to end the stigma and discrimination faced by LGBTI people.

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.

The Prince Mahidol Award Conference brought together international leaders in public health to discuss high-priority health issues in Bangkok, Thailand. The 10th annual gathering was held under the theme “Addressing the health of vulnerable populations for an inclusive society” and took place from 29 January to 3 February.

Her Royal Highness Princess Maha Chakri Sirindhorn attended the opening session, which included a keynote address from Nobel Laureate Amartya Sen, of Harvard University, who spoke about how living in a sharply unequal society affects health.

UNAIDS and the Global Fund to Fight AIDS, Tuberculosis and Malaria organized a session called From Exclusion to Leadership: Learning from the AIDS Response. The session explored how knowledge from the response to HIV could be used in addressing vulnerability, marginalization and social exclusion at the global, regional and national levels. It looked at lessons and approaches that are transferable to the broader health agenda.

Another session co-organized by UNAIDS and the World Health Organization was entitled Discrimination in Health Care—Determinants and Consequences. It examined how discrimination leads to poor health outcomes, leaving people who are stigmatized even more vulnerable to ill-health and its consequences.

Quotes