In 2019, key populations (including gay men and other men who have sex with men, people who inject drugs, sex workers, transgender people and prisoners) and their partners accounted for 62% of all new HIV infections worldwide, including the largest share of new infections in every region other than eastern and southern Africa.

Globally, new HIV infections declined by 23% from 2010 to 2019. The 1.7 million new infections that occurred in 2019 are more than three times higher than the global target of less than 500 000 new infections in 2020.

However, barely a dent has been made in the number of HIV infections among female sex workers, people who inject drugs and transgender women, and HIV infections among gay men and other men who have sex with men increased by an estimated 25% between 2010 and 2019.

This story was first published by UN Women

On World AIDS Day, UN Women spoke to survivors and community changemakers in South Africa who as part of UN Women’s HeForShe community-based initiative and a joint UNAIDS programme are engaging men and women to reject violence against women and seek HIV testing and treatment. 

Until two years ago, Karabo Chabalala (28) and Sarah Baloyi (26), young women from Mamelodi — a township northeast of Pretoria in Gauteng, South Africa — were living very different lives.

“I was in a very dark place. I had multiple sexual partners and was part of a lifestyle that was not good or healthy for me,” says Baloyi. Her friend, Chabalala says, “I had many personal problems. I engaged in a transactional relationship with an abusive older man to fund my education and provide for my family.”

Their lives turned around following their involvement in UN Women’s HeforShe community-based initiative that aimed at improving attitudes and behaviours around gender-based violence (GBV) and HIV.

“Karabo introduced me to HeForShe, a community that cares for one another,” says Baloyi. “The dialogues showed me that I am not alone in my mistakes and could change my life. I have been inspired to promote safe and healthy living for young girls and to provide them with the same loving acceptance that was extended to me.”

Chabalala adds, “Many young women don’t open up at home about problems they are facing. These dialogues give us a space to express our thoughts and feelings and to ask any questions that we have about life.”

Led by UN Women’s partner, Southern Africa Catholic Bishops Conference (SACBC), and funded through the Joint United Nations Programme on HIV/AIDS (UNAIDS), the HeforShe dialogues have since 2018 engaged 115,000 men and women across seven districts (Mamelodi, Klerksdorp, Bojanela, Sedibeng, city of Johannesburg, Ehlanzeni and CapeTown) in South Africa’s five provinces.

“The dialogues are coordinated by 151 trained women and men ‘changemakers’, including young women like Baloyi and Chabalala, equipped with knowledge on HIV and violence prevention, unequal gender norms, the importance of HIV testing and adhering to treatment, responsible sexual behavior, and how socio-economic factors can drive HIV infections among men and women,” explains UN Women's South Africa Multi-Country Office Representative, Anne Githuku-Shongwe.

“Many women in Mamelodi have been victims of abuse or witnessed femicide in their homes, often at the hands of men who [are alcoholic].” says Baloyi.

“All I feel is anger,” says Chabalala. “These men don’t respect us. Women in our community are being raped and killed. Some men who perpetrate these crimes are out on bail the following day.”

“There has been a rise in GBV since the COVID-19 lockdown,” says Baloyi. “Abusive partners have been stuck at home and they are frustrated. They are no longer able to spend their time working or drinking with friends, and take it out on their partners and children. This is especially the case in informal settlements, where families live in one- or two-room shacks.”

South Africa is home to almost one-fifth of people living with HIV worldwide and has an HIV prevalence rate of 20.4 per cent among adults (15-19 years). In line with trends across Sub-Saharan Africa, in 2019, women accounted for the majority of new infections in the country. Structural gender inequalities, discrimination, violence against women and girls, and unequal gender norms continue to undermine efforts by women and girls to prevent HIV and use HIV/AIDS services.

“The stigma around HIV prevents people from seeking treatment. I have met some older patients who still fear going to the clinics because they feel judged or embarrassed,” says Chabalala.

To increase the uptake of HIV testing, the changemakers partnered with 20 local HIV counselling and testing clinics across participating districts. They also facilitated outreach for HIV testing at community and church events and developed a referral system. In two years, the HeforShe initiatives have resulted in 62 per cent of those engaged testing for HIV, and 36 per cent returning and adhering to their antiretroviral treatment. However, because of the COVID-19 pandemic, people living with HIV and people at higher risk of HIV infection are facing life-threatening disruptions to health services.

Inspired by the positive impact of UN Women initiatives in communities and empowered by the change makers, Mamelodi community members founded the national ‘Young Women for Life Movement (YWfLM)’, which has grown to 2,035 members. With support from the SACBC, the group is currently monitoring the proceeding of 30 cases of sexual and gender-based violence and 17 cases of femicide in the justice system, as well as supporting the families of survivors. They also played a crucial role in organizing food supply drives to the most vulnerable households in their communities during the COVID-19 lockdown.

“I started the Mamelodi chapter of the Young Women for Life Movement,” says Chabalala. “Being part of this community of 200 powerful young women has taught me so many things and helped me grow. It has changed my life”.

“As a YWfLM member, I work with our local clinic and visit people living with HIV in our community to confirm that they are taking their medication and to ask if they need any assistance or additional supplements,” says Baloyi. “We also have an HIV-positive support group that now mainly connects online due to the pandemic.”

Both Baloyi and Chabalala believe that men need to be more involved in initiatives to improve attitudes and behaviours to prevent GBV and HIV. “Young men need to not only be part of this conversation, they must have their own dialogues where they focus on how to change their mindset,” says Chabalala.

Baloyi adds, “Many more men need to join women in our fight. Men must join us in court and in the streets. They must fight with us.”

As COVID-19 pushes the AIDS response even further off track and the 2020 targets are missed, UNAIDS is urging countries to learn from the lessons of underinvesting in health and to step up global action to end AIDS and other pandemics

GENEVA, 26 November 2020—In a new report, Prevailing against pandemics by putting people at the centre, UNAIDS is calling on countries to make far greater investments in global pandemic responses and adopt a new set of bold, ambitious but achievable HIV targets. If those targets are met, the world will be back on track to ending AIDS as a public health threat by 2030.

The global AIDS response was off track before the COVID-19 pandemic hit, but the rapid spread of the coronavirus has created additional setbacks. Modelling of the pandemic’s long-term impact on the HIV response shows that there could be an estimated 123 000 to 293 000 additional new HIV infections and 69 000 to 148 000 additional AIDS-related deaths between 2020 and 2022.

“The collective failure to invest sufficiently in comprehensive, rights-based, people-centred HIV responses has come at a terrible price,” said Winnie Byanyima, Executive Director of UNAIDS. “Implementing just the most politically palatable programmes will not turn the tide against COVID-19 or end AIDS. To get the global response back on track will require putting people first and tackling the inequalities on which epidemics thrive.”

New targets for getting back on track

Although some countries in sub-Saharan Africa, such as Botswana and Eswatini, have done remarkably well and have achieved or even exceeded the targets set for 2020, many more countries are falling way behind. The high-performing countries have created a path for others to follow. UNAIDS has worked with its partners to distil those lessons into a set of proposed targets for 2025 that take a people-centred approach.

The targets focus on a high coverage of HIV and reproductive and sexual health services together with the removal of punitive laws and policies and on reducing stigma and discrimination. They put people at the centre, especially the people most at risk and the marginalized—young women and girls, adolescents, sex workers, transgender people, people who inject drugs and gay men and other men who have sex with men.

New HIV service delivery targets aim at achieving a 95% coverage for each sub-population of people living with and at increased risk of HIV. By taking a person-centred approach and focusing on the hotspots, countries will be better placed to control their epidemics.

The 2025 targets also require ensuring a conducive environment for an effective HIV response and include ambitious antidiscrimination targets so that less than 10% of countries have punitive laws and policies, less than 10% of people living with and affected by HIV experience stigma and discrimination and less than 10% experience gender inequality and violence.

Prevailing against pandemics

Insufficient investment and action on HIV and other pandemics left the world exposed to COVID-19. Had health systems and social safety nets been even stronger, the world would have been better positioned to slow the spread of COVID-19 and withstand its impact. COVID-19 has shown that investments in health save lives but also provide a foundation for strong economies. Health and HIV programmes must be fully funded, both in times of plenty and in times of economic crisis.

“No country can defeat these pandemics on its own,” said Ms Byanyima. “A challenge of this magnitude can only be defeated by forging global solidarity, accepting a shared responsibility and mobilizing a response that leaves no one behind. We can do this by sharing the load and working together.”

There are bright spots: the leadership, infrastructure and lessons of the HIV response are being leveraged to fight COVID-19. The HIV response has helped to ensure the continuity of services in the face of extraordinary challenges. The response by communities against COVID-19 has shown what can be achieved by working together.

In addition, the world must learn from the mistakes of the HIV response, when millions in developing countries died waiting for treatment. Even today, more than 12 million people still do not have access to HIV treatment and 1.7 million people became infected with HIV in 2019 because they did not have access to essential HIV services.

Everyone has a right to health, which is why UNAIDS has been a leading advocate for a People’s Vaccine against COVID-19. Promising COVID-19 vaccines are emerging, but we must ensure that they are not the privilege of the rich. Therefore, UNAIDS and partners are calling on pharmaceutical companies to openly share their technology and know-how and to wave their intellectual property rights so that the world can produce successful vaccines at the huge scale and speed required to protect everyone.

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 Yerevan, the capital of Armenia, all polyclinics are now providing free, anonymous, and fast testing for HIV, Syphilis, Hepatitis B and C as part of the “Do not guess, get tested” campaign launched by the Ministry of Health and the Yerevan Municipality on World Hepatitis Day.

“It is an important signal to the population that we keep providing all necessary HIV services to people and that the COVID-19 pandemic has not stopped our prevention and testing work,” said Alexander Bazarchyan, Director of the National Institute of Health.

In preparation for this initiative, the Ministry of Health together with the National Institute of Health and the Municipality of Yerevan, conducted training sessions for medical staff in 20 polyclinics in Yerevan. More than 300 health workers—family doctors, infectious disease specialists, general practitioners, laboratory specialists, etc—received theoretical and practical information on “Management skills of Tuberculosis, Hepatitis B and C” and “HIV testing and counselling services in primary healthcare facilities”. 

The activities continued during the COVID-19 epidemic through an educational website developed with support from UNAIDS. The site is a platform where specialists can post accredited online courses so that health professionals can continue their education for free.

In addition, rapid tests for HIV, Syphilis, Hepatitis B and C were purchased within the framework of the UNAIDS Regional Cooperation Programme (RCP) for Technical Assistance on HIV and other Infectious Diseases funded by the Government of the Russian Federation. The RCP aims to strengthen health systems, ensure better epidemiological surveillance of HIV, and promote the scale up of HIV prevention programmes among key populations at higher risk in Armenia, Belarus, Kyrgyzstan, Tajikistan, and Uzbekistan.

“We welcome such timely support as this initiative can facilitate access to testing for people through primary healthcare services and make another step towards achieving Armenia’s commitments to increase access to early diagnosis and treatment,” said Roza Babayan, UNAIDS Representative in Armenia.

GENEVA/BANGKOK, 13 December 2019—UNAIDS congratulates Sri Lanka for achieving the elimination of vertical transmission of HIV and congenital syphilis. “Sri Lanka’s remarkable achievement gives me hope and shows that change is possible. It is clear that when a country ensures that services are accessible and stigma-free for women, including for women living with or affected by HIV, results follow that benefit women’s health, their children’s health and society as a whole,” said Winnie Byanyima, UNAIDS Executive Director.

According to the Ministry of Public Health of Sri Lanka, in 2018 all pregnant women diagnosed with HIV started antiretroviral therapy and 97% of pregnant women diagnosed with syphilis received treatment. The country has not reported any case of mother-to-child transmission of HIV since 2017 and the rate of congenital syphilis has been reduced to less than 50 cases per 100 000 live births in 2017 and 2018.

“The elimination of mother-to-child transmission of HIV is the result of strong political commitment, a successful multisectoral integrated approach built upon the foundations of the public health system and technical expertise,” said Anil Jasinghe, Director General of Health Services in Sri Lanka.

Sri Lanka becomes the fourth country in the Asia–Pacific region after Thailand, Malaysia and the Maldives to be validated for eliminating vertical transmission of HIV and congenital syphilis.

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.

“Is it safe to do their work?” Renaè Green and Donique Givans go silent for several seconds. “I am still scared,” says Ms Green, the Associate Director for Policy and Advocacy at TransWave Jamaica. “I don’t like to go to certain spaces. If anyone wants to participate in one of our campaigns, we explain the risks. You don’t know what kind of backlash you might experience.”

Ms Givans, who is the organization’s community liaison officer, knows this all too well. She wasn’t up front about her gender identity with her father when she began becoming more visible in her advocacy work.

“He doesn’t want anything to do with me now,” she says, her voice shaking a little. “He told me to go and not to come back to his house. So, we do let people know they might have difficulties.”

TransWave was formed in 2015 following a lesbian, gay, bisexual and transgender health and gender-based violence training, conducted by WE-Change and supported by the Jamaica Forum for Lesbians, All-Sexuals and Gays and Jamaica AIDS Support for Life.

TransWave’s Executive Director, Neish McLean, is the only transgender man at the helm of a Caribbean transgender organization. Recently Mr McLean discussed his personal journey publicly, exploring issues ranging from the distinction between gender identity and sexuality to top surgery. This is largely unchartered territory in a Caribbean nation famed for its social conservatism.

“For a long time, people actually said that transgender people didn’t exist in Jamaica because people could not put a face to them or identify anyone who was transgender. Now we have so many people who identify. It has helped in terms of explaining who transgender people are,” explains Ms Green. 

In addition to increasing transgender visibility, TransWave advocates on a wide range of subjects that affect the community—the lack of access to transgender-oriented housing, education and employment, for example, as well as initiatives to reduce poverty and violence. HIV is a huge challenge. A 2018 Integrated Biological and Behavioral Surveillance Survey conducted by the University of San Francisco found that 51% of Jamaican transwomen tested were living with HIV.

TransWave advocates strongly for all members of the community to access health care.

“Many are aware that they are HIV-positive but don’t seek treatment. They are just waiting to die. People cannot stomach not being able to live their lives as their real selves and won’t put themselves through the distress of going to a clinic,” says Ms Green. “It becomes difficult because all eyes are on you and you are putting yourself at risk for people to attack or hurt you,” explains Ms Green.

In July, UNAIDS Jamaica supported TransWave’s Transgender Health and Wellness Conference. The event helped launch a toolkit on how health-care providers can provide holistic, non-discriminatory services, along with dialogue around the rights and inclusion of transgender people. The organization has also met some employers to gauge the degree of acceptance for the inclusion of transgender workers.

Ms Givens paints a mixed picture of what life is like for transgender people in Jamaica. 

“It is very difficult, but people try to align themselves with society’s gender norms. They might do a little makeup to feel comfortable, but they don’t go heavy. Some workplaces allow people to be themselves, but you don’t have transwomen wearing skirts,” she said.

Public transportation is often challenging. When TransWave books a taxi, for example, they are never sure if the driver will be tolerant. Renting an apartment can be a landmine. Lower-priced housing often means living in a less safe area. Landlords and neighbours can be judgemental.

At the extreme, homelessness remains a major problem, with some young transgender people being thrown out of their homes before they even become teenagers. This is often the starting point for a frightening array of vulnerabilities, including a lack of schooling, poor job prospects and bad health, with some turning to sex work.

Asked about their hopes for the future, Ms Givans and Ms Green list adequate funding for TransWave and being able to further their education. Ms Green adds that she would like to emigrate.

“But not everybody wants to leave Jamaica and not everybody should leave,” she says pointedly. “That’s why we are working so hard. So that we can get to a point where everybody is accepted.”

Originally published by UNESCO on 16 October 2019

On 9 October, Po Pravde Govorya, an educational show by UNESCO, UNAIDS and OK.RU, went live on air to discuss how to talk with teenagers about health and sexual relations. The Russian social network Odnoklassniki hosted Po Pravde Govorya, [Telling the Truth], a live talk show co-organized by the UNESCO Institute for Information Technologies in Education (UNESCO IITE) and the UNAIDS Regional Office for Eastern Europe and Central Asia (UNAIDS EECA). Experts and celebrity parents discussed ways of talking with kids and teens about complex issues such as puberty, sexual relationships, personal boundaries, HIV and AIDS, and much more. The two-hour show hosted by TV presenter and journalist Lika Dlugach, received some 1.3 million views and 1,320 likes from OK.RU users.

The talk show guests included film and theater actress Elena Borshcheva, journalist Tatiana Nikonova, family therapist Marina Travkova, obstetrician-gynecologist Tatiana Rumyantseva, Alfiya Maksutova, editor-in-chief of DVOR, a social media page for youth, Vinay Saldanha, UNAIDS Regional Director for Eastern Europe & Central Asia, and Tigran Yepoyan, UNESCO Regional Health Education Advisor.

They used examples from their personal life and professional practice to illustrate how to discuss sensitive issues with kids and teens in an atmosphere of trust and without embarrassment, how to help young people make sense of what happens to their minds and bodies as they reach the challenging period of puberty, and how to educate them, honestly and non-judgmentally, about the basics of health and relationships.

Should we talk with kids and teens about sex and if so, how to do it right?

Marina Travkova, family therapist

We should tell them the truth in a way that is adapted to their age. But I would like really like all parents to understand that they do not need their child to be a certain age or to pick a special time and place for this conversation. Like it or not, you have been communicating with your kids about sex all the time since the moment they were born, because understanding sexuality is not only about technical knowledge of where babies come from. There is a lot more to it, including how your children feel about themselves, their personal boundaries, whether or not they tolerate uncomfortable clothes, how they feel about being hungry, whether they can refuse to kiss a granny who loves them. All of these are integral parts of our sexuality. The hands of the father and mother who hold and caress the baby build the first layer of what will later become his or her sexuality. How they feel about themselves, their body, the world around, their personal boundaries. We’ve been having this conversation with our kids all the time by sending them messages about the way to live their lives, to make choices, to fall in love, and to treat their bodies. When your child approaches you with a concrete question, this is a moment not to be missed – a moment of trust. Parents who feel at a loss or afraid to say the wrong thing should remember that it’s always possible to say, “I don’t really know, to be honest,” and perhaps find and offer your child a good book on the topic. You also need to understand that today, teens live in an incredibly open world, and the average age they are introduced to pornography is 9 to 11. Indeed, many teens today say or write, “How can I explain to my mom that she needs to read something about sex?” This is the way teens take care of their parents.

What questions do teens want answered?

Tatiana Nikonova, journalist

Most of the time, teens seek answers to questions which have little to do with what adults want them to ask about. What are most parents concerned about? Pregnancy, bad company, sexually transmitted diseases. But teenagers are interested in relationships. What to do and say, how to tell a person you love them, how to survive rejection, how to say no, and how to deal with the fact that everyone knows something about you that you’d rather keep private. Very often, teens struggle with the issues of bullying and aggression. What happens on a date and what can happen besides being offered sex – this is also something they’d like to know.

How to be more confident talking with your children?

Marina Travkova, family therapist

I can share two lifehacks with parents of teenagers. The first is to speak honestly about yourself, e.g. about the first time you fell in love, the first time you said no to a boy who was in love with you and how it made you feel – all of this has great value for your child. The second lifehack is to be honest with them about your fears.

Tatiana Nikonova, journalist

Discuss TV serials with them – something is always happening there! Like, unplanned pregnancies, complex diseases, breakups, misunderstandings – these are the most common stories in TV shows and a virtually endless source of topics for discussion.

Is it true that sex education can encourage young people to have sex earlier in life?

Vinay Saldanha, UNAIDS Regional Director for EECA

Numerous studies in different countries have found that not only sexuality education programs do not lead to an earlier or more active onset of sexual life, but have the opposite effect: adolescents tend to have a later sexual debut, fewer partners, a lower incidence of risky behaviors, and they are more responsible about the use of condoms and contraception. Together, this reduces the risks of contracting HIV and other sexually transmitted infections. Of course, such programs must be age-appropriate, evidence-based and, most importantly, they must be timely, i.e. before children become adults, otherwise it will be too late. This is what is said in the International Technical Guidance on Sexuality Education developed by several UN organization led by UNESCO.

Why do we need to talk with children about HIV if most people who get infected are adults?

Vinay Saldanha, UNAIDS Regional Director for EECA

In EECA countries alone, dozens of thousands of children and adolescents live with HIV. Therefore, we cannot say that this disease does not concern children. But it is essential to have a high-quality sexuality education program to make sure that a discussion of these complex issues brings positive outcomes.

What can we do if a kid does not believe that HIV exists, because they have read on the internet that “HIV is a hoax”?

Tatiana Rumyantseva, obstetrician-gynecologist

Give this kid a link to the website of the World Health Organization, to other sites which discuss infections. There are many organizations of people living with HIV who work to help others. You can take the kid to such an organization and let him or her meet people there. This approach might work well with someone who responds to emotions more than to words.

How to talk about HIV and not scare people?

Tatiana Rumyantseva, obstetrician-gynecologist

This information serves as a warning. Speaking about infections, I would say that some of them cannot be cured but require lifelong treatment. It makes good sense to plant a grain of concern for their future in young people’s minds. We usually spell out the dangers which we want to protect children from, and the same should apply to sex.

What source of information would a teenager trust the most?

Elena Borshcheva, actress

Bloggers. All teens are watching bloggers. Good educational programs for teens on TV are lacking, so young people learn a lot from bloggers. It makes sense to share essential information through their idols.

Recently, I came across a book and read it before giving it to my daughter. The author is American, and some realities are different from ours, but the concept of personal boundaries in relationships not only between a boy and a girl but also between friends is very well explained. And I thought, “Where was this book when I was a child?” It explains, plain and simple, how to act in certain situations, how to check what’s right, and what to say.

We all want relationships in the first place, warm relationships in which we need and love each other, and sex is part of such relationships. But many people – especially young people — do not quite understand why sex is special and whether a girl can refuse a guy, although it is her right. They need to learn how to tell real love from being taken advantage of in a relationship.

Can websites help parents in educating their children, and how can we teach children to safely navigate the diverse resources?

Tigran Yepoyan, UNESCO Regional Health Education Advisor

Absolutely yes. There is an increasing number of such resources available for parents and for teenagers. As far as teenagers are concerned, media literacy is the key, and UNESCO has been working to help countries educate teachers about media literacy, so that they may teach their students. Here are some basic lifehacks: it is essential to help children develop an ability to critically assess and analyze information, never take it for granted but double-check and look at the source of information: who created the website, who are the authors of posted materials, whether they provide links to primary sources and refer to relevant experts and research findings; ask yourself whether the main purpose of the website is to provide objective information or to impose a particular behavior pattern or lifestyle, manipulate the reader, or sell a product or service.

About DVOR, an online community for teens

In June 2019, more than 3 million people took to the streets of São Paulo, Brazil, to celebrate lesbian, gay, bisexual, transgender and intersex (LGBTI) pride and to mark the 50th anniversary of the Stonewall riots, a turning point in the struggle for LGBTI rights. For gay entrepreneur Almir Nascimento, 2019 marked a return to involvement in the event’s organization after a 20-year break.

What prompted Mr Nascimiento’s pride comeback was a rising unease about the increasing number of new HIV infections in Brazil among young people, especially among young gay men and transgender women. For many years, he thought that the mobilization of the 1990s and the arrival of antiretroviral therapy would be enough to end the HIV epidemic.

“The epidemic was at its height when I first joined pride as one of the organizers in 1999 and 2000. Back then, it seemed to me that we had made significant achievements, and I thought it would be enough to stop HIV”, recalls Mr Nascimento. “But four to five years ago, I began to notice that a lot of young gay, bisexual and transgender people were getting infected with HIV again, and even worse they were dying of AIDS-related illnesses at a really young age. This situation motivated me to come back and support the parade organizers in promoting an open discussion about HIV and AIDS inside our community.”

In 2018, there were around 900 000 people living with HIV in Brazil, with new HIV infections up by more than 20% since 2010. While HIV prevalence in Brazil among the adult population is estimated to be 0.5%, among transgender people it stands at around 30% and among gay men and other men who have sex with men at round 18.3%.

Mr Nascimento is the owner of a gay sauna in São Paulo and says he has always made efforts to ensure that his customers have the knowledge and tools to prevent HIV and other sexually transmitted infections. He partners with the São Paulo health authorities to distribute free condoms, for example. More recently, health researchers have been welcomed to the sauna to recruit people interested in participating in pilot programmes for PrEP (pre-exposure prophylaxis), a pill that can prevent people becoming infected with HIV.

“There is no denying that gay men and transgender people are the most affected populations here in Brazil. And I realized that the lesbian, gay, bisexual and transgender parades, including the São Paulo one, no longer had effective HIV initiatives within their associations,” he says. “Because of that, we decided to call a meeting with the 27 parades representing each of Brazil’s state capitals and a dozen others from the most important cities in São Paulo State. Altogether, we estimate they reach over 18 million people every year.”

Because the numbers are so huge, Mr Nascimento believes there is not only an opportunity but also a responsibility to convey HIV prevention and zero discrimination messages to the LGBTI community.

“There is still resistance among some parade organizers to link the festivities with AIDS-related discussions because of the fear of stigma and discrimination. But everyone is together during these events and we must take advantage of that to generate candid discussions to educate people about HIV prevention, which can save lives.”

With the support of the UNAIDS office in Brazil and other key partners, Mr Nascimento and the São Paulo LGBT Pride Parade Association are now preparing for the third LGBTI Youth Health and Prevention Meeting, to be held in November.

“After our first meeting in 2017 focusing on HIV prevention among young lesbian, gay, bisexual and transgender people, over a fifth of the participating parade associations have now started the same discussions in their cities. That’s what we want: that every pride president learns how to conduct them and that they hold their own meetings during pride week and indeed throughout the year.”