By all accounts, the world is terribly off track to meet global targets to curb new HIV infections. This is especially true for gay and bisexual men and other key populations who have been systematically denied rights, equity, and justice in the HIV response. 2020 is a critical year for communities to reclaim the global HIV response. This post by MPact Global Action for Gay Men’s Health and Rights shares messages that advocates for gay and bisexual men and other men having sex with men should use while participating important forums such as AIDS2020 and HIV2020.
Gay & Bisexual Men at the Center of the Response
- Gay and bisexual men are best equipped to help members of our communities to access and adhere to services.
HIV programs must meaningfully engage gay and bisexual men in every aspect of research, design, implementation, evaluation, and redesign.
- Formalized positions must be created to enable gay and bisexual men to dialogue with National AIDS Commissions, donors, and implementing partners regarding the HIV response.
- Organizations led by gay and bisexual men should be funded to conduct community-led monitoring on the acceptability, accessibility, affordability, and quality of services, and utilize data produced from this community-led monitoring to continually improve services.
- Community led services will be limited in reaching and serving gay and bisexual men in criminalized settings
The Human Rights of Gay and Bisexual Men Need to be Protected for a Successful HIV Response
- Discriminatory and punitive laws, policies, and practices reduce the efficacy of the HIV response and exacerbate risk for HIV among gay and bisexual men.
- Governments should fully decriminalize:
o Consensual same-sex relations between adults
o Gender identity and expression
o Sex work
o Drug use and possession; and
o HIV non-disclosure, exposure, and transmission.
- Poverty, racism, sexism, homophobia, transphobia, and xenophobia hurt heath; the HIV response needs to take into account these multiple and intersecting structural barriers.
- Violence perpetrated on the basis of sexual orientation and gender identity and expression particularly impacts the ability of gay and bisexual men to seek and continue services.
Gay and Bisexual Men Need Combination Approaches for HIV Testing, Prevention and Treatment as Part of Holistic Sexual Health Services
- All sexual health and HIV programming should emphasize a holistic approach to well-being that embraces pleasure and endorses harm reduction and mental health.
- All HIV services must be free from judgment, stigma, and discrimination and must be sex-affirming, honor self-determination, and respect bodily autonomy.
- Biomedical responses are only part of the solution: prevention programs must also address upstream factors and support tailored strategies for community mobilization.
- PrEP programming for gay and bisexual men must be brought to scale, inclusive of demand generation, risk reduction counseling, literacy, adherence, and support.
- Healthcare professionals should always act in the interest of their clients, even when national or sub-national laws or policies oppose human rights.
- PrEP in all forms must be made available at affordable prices.
Gay and Bisexual Men Need Earmarked International and Domestic Funding
- Political will and insufficient engagement of the community remain the primary barriers to targeted resource allocation and investment for gay and bisexual men.
- Funding allocations should be proportionally based on HIV burden and based in evidence, human rights, and community engagement.
- More investment and financial support should be directed to core funding for community- and key population-led networks, coalitions, and consortia.
- Flexible emergency response funding and funding to support longer-term social change for gay and bisexual men is necessary in all regions.
- Domestic resource mobilization should be scaled-up for gay and bisexual men, particularly in countries that are transitioning from international donor support.
- Programming for gay and bisexual men should be safeguarded as funding priorities shift amid the COVID-19 crisis.
Gay and Bisexual Men Need to be Accounted for and Reflected in Global and National Targets
- Data must be disaggregated by sexual orientation, gender identity and expression in a way that is safe, responsive and confidential.
- Community-based participatory action research should be funded and recognized as a source of rigorous and robust data that will inform the response.
- Civil society organizations led by gay and bisexual men should actively participate in parallel reporting processes, such as Global AIDS Monitoring, the Universal Periodic Review, and Voluntary National Review of Sustainable Development Goal implementation to offer a complementary analysis of progress on achieving HIV targets.
- More data should be collected and analyzed regarding funding needs and gaps.
- Governments, multilateral agencies, and bilateral development agencies should meaningfully consult gay and bisexual men to ensure that targets and indicators are inclusive and feasible to measure progress on the HIV epidemic.
The COVID-19 Response Can Not Leave Behind Gay and Bisexual Men
- To ensure that COVID-19 doesn’t further threaten progress on achieving global HIV targets, all HIV responses need to expand partnerships with community-led organizations, networks, and consortia.
- All statements and misinformation that scapegoat, slander, or otherwise blames LGBTI people for the spread of COVID-19 must be unequivocally denounced.
- Efforts to decentralize HIV services should bolster pre-existing community-led strategies during COVID-19.
Inequalities and economic precarity are amplified during COVID-19, and special measures and programs should be enacted to protect gay and bisexual men.
- Governments must acknowledge barriers to meaningful participation of gay and bisexual men in virtual meetings during the pandemic.
Two years ago, the International AIDS Society (IAS) chose the United States of America (U.S.) as the site for the 2020 International AIDS Conference (AIDS2020). Community advocates argued that the U.S. was an inappropriate choice given legal travel restrictions on sex workers, people who use drugs, and Muslims, which would have made it very difficult for members of these communities to enter the country. The Trump regime’s racist immigration, detention and family separation policies, state-sanctioned violence against Black and Brown people, and the country’s worsening human rights conditions for LGBT people, added to advocates’ grave concerns.
The IAS’ decision created a dilemma for many in the global HIV movement and revealed a willingness by mainstream HIV actors to tolerate the discrimination of immigrants, Black and Brown people, Muslims, people who use drugs, sex workers, and transgender people in the conference’s host country. The IAS’ decision also resurfaced questions about the community-relevance of large, multi-million-dollar conferences in the face of shrinking global HIV investments. Moreover, persistent barriers to HIV prevention, care, and treatment services like the costs of medicines and diagnostics as well as criminalization, stigma, discrimination, and violence, compel community advocates to ask:
- How can IAS better and more meaningfully engage community advocates?
- How does the conference directly benefit people living with and most affected by HIV (gay and bisexual men, people who use drugs, sex workers, and transgender women)?
- How can the conference be reimagined to improve its community-relevance and usefulness to the global HIV movement as a whole?
- How can future conferences model and evaluate participatory and dynamic approaches to sharing knowledge and deliberating new research findings with community advocates valued as equal partners and acknowledged as experts?
- How can the conference be better leveraged to develop and advance interlocking HIV research, program, and policy agendas?
Community advocates want to see the IAS and its conferences succeed. Central to its future success is the meaningful, respectful, and equitable engagement of community advocates as experts. The questions raised above are not new, nor are community advocates’ calls for structural and programmatic change. Better accountability to communities living with and most affected by HIV can only bolster the international AIDS conferences’ quality and IAS’ integrity.
VIDEO STATEMENTS FROM THE ORGANIZERS OF HIV2020 ONLINE
Ruth Morgan Thomas of NSWP: https://youtu.be/rn4POuvVFfc
George Ayala of MPact: https://youtu.be/Lg6UWsCA6b0
Judy Chang of INPUD: https://youtu.be/ReCYNUvkgBs
Rico Gustav of GNP+: https://youtu.be/UbXgHNYf14c
This Call to Action has been developed by Frontline AIDS, AIDS and Rights Alliance for Southern Africa (ARASA), Global Coalition of TB Activists, TB People, and Stop TB Partnership alongside community organisations on the frontline of the HIV and TB responses, and national, regional and global civil society groups committed to ending AIDS and TB.
We recognise and welcome the contributions that the Global Fund to Fight AIDS, TB and Malaria and a number of donor governments have already made towards tackling COVID-19. However, further action is needed to sustain progress on HIV and TB during the COVID-19 pandemic, to adapt HIV and TB programmes so that they can also address COVID-19 and to protect human rights.
With this Call, we ask governments, donors and UN partners to support our efforts, by committing to the following actions during the COVID-19 pandemic.
SUSTAIN PROGRESS ON HIV AND TB
Even before COVID-19, the world was failing to deliver on global HIV and TB targets, and HIV prevention continues to be in crisis. Now under lockdown, we have seen prevention services disappear overnight, with disastrous consequences. Women and girls are facing higher risks of HIV infection under lockdown, due to increased levels of violence, yet many now have no access to essential HIV or SRHR services. A severe shortage of condoms is looming, and the sudden closure of harm reduction services is depriving people who use drugs of access to opioid substitution therapy and other life-saving interventions, putting them at higher risk of HIV, TB, viral Hepatitis and fatal overdose.
In many countries, we are also seeing resources diverted from the HIV and TB responses to COVID-19. People living with HIV and TB are finding their treatment providers closed, and in some countries, supply chains are no longer functioning. The WHO has warned that if we do not overcome these interruptions, we could face more than 500,000 extra deaths from AIDS in 2020–2021. Modelling by the Stop TB Partnership has also shown that an additional 1.4 million people could die due to the impact of lockdown on TB programmes.
We ask governments to urgently recognise HIV and TB prevention and treatment as essential, and to ensure that they have enough staff, resources and supplies to continue uninterrupted HIV and TB services during the COVID-19 pandemic. We also urge donors to honour their existing commitments to sustain and increase HIV and TB funding during the COVID-19 pandemic. UNAIDS and other UN partners must continue to advocate for adequate HIV and TB funding, in order to meet global targets and avoid undoing the gains of recent years.
ADAPT COMMUNITY RESPONSES TO HIV AND TB TO TACKLE COVID-19
Communities are an integral part of health systems, and networks of people living with HIV and community organisations have been on the frontline of the HIV and TB responses for decades. Many are now also playing a critical role in tackling this new pandemic, adapting their existing programmes to include COVID-19 awareness and prevention and to address the health, social and economic consequences, from gender-based violence to loss of livelihoods and food insecurity.
We call on governments, donors and UN agencies to recognise the essential work that communities on the frontline of the HIV and TB responses are doing to tackle COVID-19, and to focus on providing community organisations with the financial resources, technical support and equipment they need to adapt to COVID-19, instead of starting brand new programmes using parallel structures. We also urge donors to grant maximum flexibility to existing partners, so that they can adapt to address HIV, TB and COVID-19 together, alongside the social and economic impacts of COVID-19 restrictions, including lockdown.
PROTECT HUMAN RIGHTS
As HIV and TB organisations, we know too well how stigma and human rights violations can rapidly erupt in the face of a health crisis. As COVID-19 responses by governments continue and human rights are limited to reduce the spread of the virus, we are seeing a rise in human rights abuses targeted at people who are already marginalised or criminalised due to sexual orientation, gender identity, drug use or sex work. The Frontline AIDS’ Rapid Response Fund, which provides grants to LGBT people in emergency situations, has received almost triple the number of applications since January, highlighting examples of LGBT people being jailed for putting others at risk for COVID-19, and underlining the acute challenges facing marginalised communities as this pandemic takes hold.
We demand that governments and all other state actors desist from human rights violations carried out in the name of the COVID-19 crisis, and urge them to uphold dignity and human rights for all people. We also urge donors and UN partners to make human rights a core component of their responses to COVID-19, by increasing their advocacy efforts in response to human rights violations and by ensuring that new vaccines and treatments for COVID-19 are available and affordable for all, in line with the right to health.
To sign your organisation on this Call to Action, please email: firstname.lastname@example.org.
More info and all signatories on: https://frontlineaids.org/sustain-adapt-protect-a-call-to-action-on-hiv-tb-and-covid-19/
The Step Up Campaign Mission to Mt. Everest was envisioned to combat the deep rooted stigma, discrimination and attitudes our society has towards people living with HIV (PLHIV) & eliminate all forms of Stigma & Discrimination. The Campaign was initially led by Mr. Gopal Shrestha himself who later formed a Committee under the Chairmanship of Mr. Padam Raj Pahari with the objective of raising funds needed to ascent Mt. Everest and make the campaign successful.
Mr. Gopal Shrestha has been living with HIV for 18 years now. Since his HIV infection, he has been working as a volunteer campaigner and activist in the sector of HIV/AIDS and drug addiction. Braving all the hopelessness, fear and stigma accompanied the disease; he was successful on reaching the summit of Mt. Everest on his 2nd attempt on 22nd May. 2019. During his 1st Attempt on 2015, he survived and avalanche which caused him a broken leg. In that avalanche he lost 5 of his foreign friends. The avalanche occurred after the disastrous earthquake that shook Everest Base Camp.
Step Up Campaign aims to create enabling environment to reduce social stigma which has led many infected to hide their status due to hopelessness, fear of social stigma & later to untimely death. The campaign has proved to be successful in stressing the importance of timely access to ARV treatment & adherence. Mr. Shrestha aims to be an inspiration for other PLHIV to follow in his footsteps. His work has also helped in conveying a message that HIV can be treated.
The campaign also aims in helping to create an environment where new HIV infections do occur, every person regardless of age, gender, race/ethnicity, sexual orientation, gender identity or socio-economic circumstance, will have unfettered access to high quality, life-extending care, free from stigma and discrimination.
See this amazing video with the glorious moment of reaching Mt. Everest’s Peak on YouTube:
For more information: Gopal Shrestha, email@example.com
Now, in 2020 – we are at a pivotal moment — 60% of Africa is 25 years old or younger – this percentage of youth provides an opportunity for us to change the landscape. Not only are we just ten years away from the SDG targets, but we are also facing another global pandemic.
COVID-19 is putting extreme pressure on health systems globally and restricting access to HIV services and support.
We need to take action at AIDS 2020!
- At AIDS2020, we need to ask world leaders to make a public statement – commit to funding for young people. We need to ask this question at all sessions, we attend.
- Say Hello to other conference attendees, introduce yourself and tell them exactly what you would like to do together!
- After the Conference, It sounds simple, but we need to work together. Find alternative ways of doing youth-HIV work in this new context
We’re all online now, so we need to be flexible, even if it requires a voice note on WhatsApp, as opposed to an email.
- Share your HIV Story. We built a website to share your personal HIV story to be part of LiveLiveLoving (http://www.LiveLifeLoving.org), an online portal for young people living with HIV.
- We live in a COVID-19 world. We need to continue being innovative and listen to each other. We created a 25+ language campaign called HeyCOVID19 (http://www.HeyCOVID19.com), to make COVID-19 information accessible to everyone.
- Be Kind. We are human beings and if we remember this through our activism, we can achieve greater good, by collaborating with each other.