GENEVA, 8 October 2020—Drawing on 40 years of experience from the AIDS response, UNAIDS is issuing new guidance on how to reduce stigma and discrimination in the context of COVID-19. The guidance is based on the latest evidence on what works to reduce HIV-related stigma and discrimination and applies it to COVID-19.

Since the start of the COVID-19 pandemic, numerous forms of stigma and discrimination have been reported, including xenophobia directed at people thought to be responsible for bringing COVID-19 into countries, attacks on health-care workers and verbal and physical abuse towards people who have recovered from COVID-19. Attacks on populations facing pre-existing stigma and discrimination, including people living with HIV, people from gender and sexual minorities, sex workers and migrants, have also been reported.

“In the wake of the fear and uncertainty that emerge during a pandemic, stigma and discrimination quickly follows,” said Winnie Byanyima, Executive Director of UNAIDS. “Stigma and discrimination is counterproductive. It exposes people to violence, harassment and isolation, stops people from accessing health services and prevents public health measures from effectively controlling pandemics.”

Addressing stigma and discrimination in the COVID-19 response provides countries with rights-based guidance through education, support, referrals and other interventions. It offers solutions across six specific areas: community, workplace, education, health care, justice and emergency/humanitarian settings.

As with the HIV epidemic, stigma and discrimination can significantly undermine responses to COVID-19. People who have internalized stigma or anticipate stigmatizing attitudes are more likely to avoid health-care services and are less likely to get tested or admit to symptoms, ultimately sending the pandemic underground. 

“We know what works and what doesn’t, we know how to change beliefs and behaviour. For the last 30 years we have been successfully leading the HIV response, building valuable experience, knowledge and wisdom along the way,” said Alexandra Volgina, Programme Coordinator, Global Network of People Living with HIV. “We want to share these to change people’s lives for the better, and to make our distinctive contribution to overcoming the COVID-19 pandemic.”

Some countries have used existing criminal laws or new, COVID-19-specific laws, to criminalize alleged exposure or transmission of COVID-19, putting more people in overcrowded prisons, detention centres and other closed settings where COVID-19 is easily transmitted.

“There is no greater manifestation of stigma than when it is enshrined in law. The use of the criminal law or other unjustified and disproportionate repressive measures in relation to COVID-19 is having a devastating impact on the most vulnerable in society, including many people living with HIV, exacerbating inequalities and perpetuating stigma,” said Edwin J. Bernard, Executive Director of the HIV Justice Network. “Measures that are respectful of human rights and empowering of communities will be infinitely more effective than punishment and imprisonment. We hope that these evidence-based recommendations on reducing COVID-related stigma and discrimination will make a difference to those who need it most.”

Reports in the early days of COVID-19 include discrimination related to gender and gender-based violence, targeting of key populations, including sex workers, and arrests and beatings of lesbian, gay, bisexual, transgender and intersex people. In April 2020, following a number of reports of violence and stigma and discrimination arising from the implementation of COVID-19 measures, UNAIDS began to identify the actions needed to respond, and in August UNAIDS issued a report, Rights in a pandemic, that highlights many of the human rights abuses that took place early in the response to COVID-19.

The new guidance, Addressing stigma and discrimination in the COVID-19 response: applying the evidence of what works from HIV-related stigma and discrimination in six settings to the COVID-19 response, is part of efforts by UNAIDS and the Global Partnership to Eliminate All Forms of HIV-Related Stigma and Discrimination to accelerate progress on the goal of zero discrimination, in line with the political commitments that United Nations Member States made in the 2016 Political Declaration on Ending AIDS and in Sustainable Development Goal 3, ending AIDS as a public health threat by 2030.

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.

WASHINGTON, D.C./GENEVA, 29 September 2020—Despite decades of scientific advance in the HIV response, progress remains uneven, with some countries rapidly reducing AIDS-related deaths and new HIV infections and others seeing increasing epidemics. Laws and policies are driving a significant part of that divergence. 

Launched today, the HIV Policy Lab is a unique initiative to gather and monitor HIV-related laws and policies around the world. 

“Laws and policies are life or death issues when it comes to HIV. They can ensure access to the best that science has to offer and help people to realize their rights and live well, or they can be barriers to people’s well-being. Like anything that matters, we need to measure the policy environment and work to transform it as a key part of the AIDS response,” said Winnie Byanyima, UNAIDS Executive Director.

The HIV Policy Lab is a data visualization and comparison tool that tracks national policy across 33 different indicators in 194 countries around the world, giving a measure of the policy environment. The goal is to improve transparency, the ability to understand and use the information easily and the ability to compare countries, supporting governments to learn from their neighbours, civil society to increase accountability and researchers to study the impact of laws and policies on the HIV pandemic. 

According to Matthew Kavanagh, Director of the Global Health Policy & Politics Initiative at Georgetown University’s O’Neill Institute, “Policy is how governments take science to scale. If we want to improve how policy is used to improve health outcomes, it is essential to monitor and evaluate the policies that comprise it.”

“Reducing stigma and making care easier to access are fundamental for improving the lives of people living with HIV—and those are all consequences of policy choices. Tracking these choices is a key tool for improving them, and ensuring justice and equity for people living with HIV,” said Rico Gustav, Executive Director of the Global Network of People Living with HIV.

The HIV Policy Lab draws information from the National Commitments and Policy Instrument, legal documents, government reports and independent analyses to create data sets that can be compared across countries and across issues. The goal of the HIV Policy Lab is to help identify and address the gaps between evidence and policy and to build accountability for a more inclusive, effective, rights-based and science-based HIV policy response.

The HIV Policy Lab is a collaboration between Georgetown University and the O’Neill Institute for National and Global Health Law, UNAIDS, the Global Network of People Living with HIV and Talus Analytics.

About the Georgetown University O’Neill Institute for National and Global Health Law

The O’Neill Institute, housed at Georgetown University, was established to create innovative solutions to the most pressing national and international health concerns, with the essential vision that the law has been, and will remain, a fundamental tool for solving critical health problems. The Georgetown University Department of International Health is home to scholarship in public health, economics, political science, and medicine. Georgetown’s Global Health Initiative serves as a university-wide platform for developing concrete solutions to the health challenges facing families and communities throughout the world. Read more at oneillinstitute.org and connect with us on Twitter and Facebook.

About 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.

About GNP+

GNP+ is the global network for and by people living with HIV. GNP+ works to improve the quality of life of all people living with HIV. GNP+ advocates for, and supports fair and equal access to treatment, care and support services for people living with HIV around the world. Learn more at gnpplus.net and connect with GNP+ on Facebook, Twitter and Instagram. 

GENEVA, 14 August 2020—UNAIDS is deeply concerned by reports of the targeting and arrest of lesbian, gay, bisexual, transgender and intersex (LGBTI) rights activists as they peacefully exercise their rights to freedom of expression and association, as well as reports of discrimination, repression, and scapegoating of LGBTI people.

UNAIDS has been made aware that on August 7 a protest against the detention of LGBTI activist, Margot Szutowicz, currently being held for two months of pre-trial detention, resulted in reports of police violence and over 50 arrests. This followed recent arrests of activists for placing rainbow flags on public monuments, ostensibly carried out under Article 196 of Poland’s criminal code, which calls for up to two years in prison for anyone who “offends the religious feelings of others by publicly insulting a religious object or place of worship.”

International and European human rights bodies have affirmed the rights to freedom of expression, association and peaceful assembly. They have also affirmed the fundamental right to be free from discrimination on the basis of sex, sexual orientation or gender identity.

The 2016 United Nations General Assembly High-Level Political Declaration on Ending AIDS recognizes that discrimination, particularly discriminatory and abusive use of law enforcement powers, create significant barriers to people’s health and well-being, including their access to HIV prevention, treatment and care services, barriers that governments have committed to removing. Stigma and discrimination have been shown to increase violence, abuse and harassment against LGBTI people and to cause significant harm to their physical and mental health and well-being, their inclusion in society and their ability to access work, education and essential services.

The actions in Poland limit freedom of speech and, when combined with discriminatory application that targets human rights defenders, undermine equality, the rule of law and people’s access to essential services. In the context of closing civic space for advocacy to end discrimination in areas such as LGBTI rights, sexual and reproductive health and gender equality, freedom of speech protections are more vital than ever.

UNAIDS is concerned by the ongoing and intensifying persecution of LGBTI people in Poland, including the encouragement of so-called “LGBT ideology-free zones” throughout the country over the last year and up to recent mounting crackdowns on human rights defenders exercising their fundamental human rights to advocate for an end to discrimination.

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.

GENEVA, 7 July 2020—UNAIDS welcomes the decision by Gabon to decriminalize same-sex sexual relations. Following a vote by the Gabon Senate on 29 June 2020, the signing off of the decision by the President means that Gabon has joined a growing list of countries in Africa and beyond that have removed criminal laws that target and discriminate against lesbian, gay, bisexual, transgender and intersex (LGBTI) people.

“I applaud the collective decision by Gabon’s parliament, government and President to decriminalize same-sex sexual relations,” said Winnie Byanyima, UNAIDS Executive Director. “By doing so, Gabon is righting a grave injustice inflicted on the LGBTI community in the country.”

Paragraph 5 of Article 402, which criminalized same-sex sexual relations—with a maximum penalty of six months in prison and a 5 million central African CFA franc fine—was inserted into the new Gabonese Penal Code in July 2019. That paragraph has now been withdrawn. UNAIDS is encouraged that such a step back in terms of human rights can be overturned quickly when communities, civil society, politicians and other allies come together to campaign to right wrongs.

Through legitimizing stigma and discrimination and violence against LGBTI people, the criminalization of same-sex sexual relations stops people from accessing and using HIV prevention, testing and treatment services and increases their risk of acquiring HIV. It is also a profound violation of a basic human right.

Gay men and other men who have sex with men had a 26 times higher risk worldwide in 2019 of HIV acquisition than all adult men. Prohibitive legal and policy environments created by stigma and discrimination are key barriers to dramatically reducing new HIV infections. While UNAIDS calls for the removal of such discriminatory laws, a critical immediate step would be to stop enforcing them.

“This is a very welcome step towards equality for LGBTI people in Gabon,” added Ms Byanyima. “I call on the at least 69 other countries and territories around the world that still criminalize same-sex sexual relations to do the decent thing: stop criminalizing people because of who they love.”

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 UNAIDS Country Office for the Islamic Republic of Iran and the country’s branch of the International Federation of Medical Students’ Associations have been collaborating on new ways of making an impact on the national AIDS response since 2013.

In the past, the collaborations have included public awareness campaigns, educational workshops, field visits and week-long summer schools open to health-care students.

“The summer schools were more than inspiring, they made us confident about our next area of focus: acting against HIV-related stigma and discrimination,” said Aidin Parnia, one of the founders of the summer schools and of the Avecene Consultancy.

Started by people who had attended the summer schools, the Avecene Consultancy was formed to mobilize the accumulated knowledge and experience of the summer schools and to combine them with modern and up-to-date educational developments. The result is the REDXIR educational online platform, which uses games to change the attitude and behaviour of health-care students in order to bring about a future generation of discrimination-free health-care professionals.

Set in an imaginary world where the players are a young group that battles a mysterious enemy that symbolizes HIV-related stigma and discrimination, the goal of REDXIR is to fight back and defeat stigma and discrimination.

The 10 levels of the game are designed to challenge the students’ knowledge of HIV and their attitude and behaviour towards people living with the virus. For example, in the Blood Pressure level of the game, the students have to take the blood pressure of a person living with HIV to show that he or she can do so without discrimination. At higher levels, they should be able to take a blood sugar test and a blood sample for a routine laboratory test.

While some of the levels are performed virtually, others need action to be taken in the real world. For example, in the Do Not Be Silent level, the students must recognize discriminatory posts on social media, post #Zerodiscrimination below at least one of the social media feeds they see and comment on the reason why the content is discriminatory. In the Campaign level, the students participate as trainers in an HIV awareness campaign.

“New generations need new platforms. REDXIR, through its user-friendly approach where students are in direct contact with the target populations, has proved to be an effective way to help eliminate HIV-related stigma and discrimination in health-care settings,” said Parvin Kazerouni, the Head of the HIV Control Department of the Center for Communicable Disease Control of the Iranian Ministry of Health and Medical Education and the National AIDS Manager.

“REDXIR shows how creative and innovative approaches can embrace and support the novel ideas of young people to address issues such as stigma and discrimination,” said Fardad Doroudi, the UNAIDS Country Director for the Islamic Republic of Iran.

The UNAIDS country office provided technical and financial support for REDXIR. 

Some Jamaicans have responded to the COVID-19 outbreak in extreme ways. Family members of one of the first confirmed cases received death threats, and nurses have reported being barred from public transport. Some people have given the health authorities wrong addresses to avoid the stigma that a home visit would attract.

UNAIDS Jamaica and civil society organizations serving people living with HIV have joined the national discourse to share a key lesson learned from HIV: that stigma and discrimination are barriers to an effective response.

Two-thirds of Jamaicans would not purchase vegetables from someone they knew to be living with HIV, according to the 2017 Knowledge Attitude and Behaviour Study. The effect of such widespread prejudice is seen in the island’s treatment outcomes. According to government estimates, while an estimated 84% of people living with HIV were aware of their status in 2018, less than half (47%) were on treatment

For Jumoke Patrick, Executive Director of the Jamaica Network of Seropositives, there are clear parallels between people’s reactions to the novel coronavirus and HIV.

“People living with HIV feel they need to stay away from people and from accessing services. They feel they need to reduce and limit their lives because of how people treat them. We have some of the same treatment meted out to people positive with, or suspected of having, coronavirus. When there’s fear we respond in a defensive way,” Mr Patrick explained in a webinar hosted by UNAIDS Jamaica.

Community organizations have reported that some COVID-19 stigma has even been directed to people living with HIV. UNAIDS Jamaica has been working to raise awareness among policymakers and through the news media about the importance of building trust with affected people while combatting stigma and discrimination among the wider population.

“Just as with HIV, success in combatting COVID-19 absolutely depends on people’s willingness to get tested and access care. Verbal abuse, violence and intimidation will only chase people away from services,” said Manoela Manova, UNAIDS Country Director for Jamaica.

The Jamaica Ministry of Health has launched an antidiscrimination campaign that includes stories of harassed COVID-19 patients in virtual press conferences.

“None of us are immune to the virus,” Christopher Tufton, the Jamaican Minister of Health, said at a recent press conference. “None of us must claim or think that we will exclusively escape and it is somebody else’s fault. We must treat each other in a way that almost assumes that tomorrow we are going to need the support from those who are so infected and impacted today. We really need to cut the hate and work together as a country and as communities, to overcome.”

Discriminatory attitudes towards people living with HIV remain extremely high in far too many countries. Across 26 countries with recent population-based survey data for a composite indicator developed by UNAIDS, more than half of respondents expressed discriminatory attitudes.

In 29 of 68 countries with available data on one of the two questions within the composite indicator between 2013 and 2018, more than half of people aged 15–49 years said they would not buy fresh vegetables from a shopkeeper living with HIV; in three of these countries, more than three quarters said they would not do so.

UNAIDS and MPact call on governments and partners to protect, support and respect the human rights of LGBTI people during the response to COVID-19

GENEVA, 27 April 2020—UNAIDS and MPact Global Action for Gay Men’s Health and Rights are extremely concerned that lesbian, gay, bisexual, transgender and intersex (LGBTI) people are being singled out, blamed, abused, incarcerated and stigmatized as vectors of disease during the COVID-19 pandemic. UNAIDS and MPact are also deeply troubled that this discriminatory action is compounding the challenges that LGBTI people already face in accessing their rights, including safe and quality health services.

“HIV has taught us that violence, bullying and discrimination only serve to further marginalize the people most in need,” said Winnie Byanyima, Executive Director of UNAIDS. “All people, regardless of their sexual orientation, gender identity or gender expression, are entitled to the right to health, safety and security, without exception. Respect and dignity are needed now more than ever before.”

In Belize, reports have detailed abuse by the police of a gay man who was arrested, humiliated and beaten for breaking a curfew imposed to curb the spread of the coronavirus. The 25-year-old was living with HIV and is believed to have died as a result of complications sustained from injuries inflicted by the police.

“We are receiving reports that government and religious leaders in some countries are making false claims and releasing misinformation about COVID-19 that has incited violence and discrimination against LGBTI people,” said George Ayala, Executive Director of MPact. “Organizations and homes are being raided, LGBTI people are being beaten, and there has been an increase in arrests and threatened deportation of LGBTI asylum seekers.”

In Uganda, 20 LGBTI people were recently arrested in a raid on a shelter, which police authorities claimed was due to their disobeying social distancing procedures. In the Philippines, three LGBTI people were among a group who were publicly humiliated as punishment for breaking the curfew. After segments of the incident went viral online, the police captain was forced to apologize for singling out the LGBTI group members and asking them to dance and kiss each other.

“There is also growing concern over privacy and confidentiality in the way governments are using Internet-based technologies and smartphones to monitor people’s movements during lockdowns or curfews,” Mr Ayala added. “Gay men and gender non-conforming people are often the first targets and among the most impacted by increased policing and surveillance efforts.” 

For some LGBTI people, self-isolation and physical distancing can be particularly challenging, even dangerous. Many LGBTI people face violence and/or ill-treatment while sheltering in homes with unaccepting family members. LGBTI people may also suffer from intimate partner violence while staying at home, without the ability to report cases of abuse to the police owing to fear of repercussions. Isolation can also exacerbate pre-existing mental health challenges, common among LGBTI people, including loneliness, depression, anxiety and suicidal ideation.

The COVID-19 pandemic leaves many gay men and transgender women without adequate tools for taking control of their sexual health and rights. Gay men account for nearly 20% of all new HIV infections and are 22 times more likely to become infected with HIV than other men. Transgender women shoulder a risk of acquiring HIV that is 12 times higher than the general population.

Stay at home orders, especially when implemented without flexibilities, compound the difficulties these groups already experience in accessing antiretroviral therapy and HIV prevention and gender-affirming services, including hormone therapies. This is especially true for LGBTI people who are poor, unemployed, homeless or marginally housed.

UNAIDS and MPact are urging countries to:

• Denounce misinformation that scapegoats, slanders or otherwise blames LGBTI people for the spread of COVID-19.
• Stop raids on LGBTI-led organizations, shelters and spaces and desist from arresting people based on their sexual orientation, gender identity or gender expression.
• Ensure that all measures to protect public health are proportionate, evidence-informed and respect human rights.
• Prevent the use of state surveillance on LGBTI people’s personal communication technologies.
• Invest in the COVID-19 response, while safeguarding funds and HIV/sexual health programmes that are inclusive and sensitive to the needs of LGBTI people.
• Safeguard continued access to life-saving medical support, including harm reduction, condoms and lubricant, preexposure prophylaxis, antiretroviral therapy, hormone replacement therapies and mental health services for LGBTI people.
• Provide flexible service delivery options, from multimonth dispensing to community delivery and virtual consultation and support options.
• Consider designating community-led service organizations as essential service providers so that they can provide flexible, safe delivery of key services.
• Include LGBTI people in national social protection schemes, including income support.
• Increase access to appropriate emergency and safe housing for homeless and recently evicted LGBTI people.
• Engage LGBTI people in public health planning and messaging around COVID-19.
• Implement safety monitoring and hacking mitigation during virtual meetings.

Now more than ever, we must stand together to protect and promote the health and human rights of LGBTI people worldwide.

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.

MPact

MPact Global Action for Gay Men’s Health and Rights was founded in 2006 by a group of activists concerned about HIV-related disparities as well as stigma discrimination, violence, and criminalization experienced by gay men and other men who have sex with men in all parts of the world. MPact is now an established international advocacy network dedicated to ensuring equitable access to HIV services to all gay men, while promoting health and human rights. Directly linked with nearly 150 community-led organizations across 62 countries and thousands of other advocates through its various social media platforms. MPact accomplishes its mission by: watchdogging governments, funders, and other decision makers; strengthening capacities of community-led organizations and healthcare providers; supporting the proliferation of networks led by gay men; conducting and commissioning research; and facilitating inter-regional information exchange.