Many people have been able to work from home during the COVID-19 pandemic and continue to be paid, but low-income workers often haven’t had that opportunity.

In Indonesia, the latest labour force survey results show that 29 million workers have been affected by the pandemic, with 24 million workers suffering from cuts in hours of work and income. Average wages were depressed by 5.2% between 2019 and 2020. Surveys conducted by the Indonesia AIDS Coalition show that the situation is similar for people living with HIV and key populations—more than 80% of 529 respondents had experienced a reduction or loss of income due to the pandemic.

To address the rising income inequality, the United Nations allocated a US$ 1.7 million funding package to bolster the economic empowerment of women and vulnerable populations in Indonesia and to help protect their livelihoods from the devastating socioeconomic fallout of the COVID-19 pandemic. In 2020, the UNAIDS Country Office for Indonesia worked with the International Labour Organization, the United Nations Development Programme and the Office of the United Nations High Commissioner for Refugees to mobilize the funding.

A joint project launched earlier this month will directly benefit and empower vulnerable groups, including women, people living with HIV, key populations, refugees, migrant workers and people in disadvantaged regions.

The one-year project offers support through training on entrepreneurship and business development and facilitates access to skills development and jobs. UNAIDS will work closely with civil society organizations to identify the beneficiaries and ensure that people living with HIV and transgender people and other key populations are among the approximately 3650 people to be supported by the project.

The Indonesia Positive Network is among the organizations that will be involved in the project. Meirinda Sebayang, the National Coordinator of the Indonesia Positive Network, appreciates the support of the project. “COVID-19 has amplified existing disparities, especially for the livelihoods of people living with HIV and key populations in Indonesia. In this difficult time, we learned that it is important to build trust and strong collaboration between communities, government, health services and United Nations partners, not only to ensure that essential services remain available but to ensure that our community is not left behind in the response and recovery from the socioeconomic impact of COVID-19,” she said.

The project also includes advocacy for policies that promote inclusion and respond to discrimination in the government, the private sector and trade unions. Through this sensitization and advocacy work, these sectors will be required to protect vulnerable groups from discrimination and exclusion from the job market, even beyond the COVID-19 recovery.

One year into the pandemic, it is crucial that United Nations agencies join forces to support vulnerable groups, which have been disproportionately impacted by COVID-19, in the recovery process.

“Many key populations affected by HIV work in informal settings and were seriously hit by the pandemic. While we may not be able to respond to every single need of the community, we aim to provide an example of how to support vulnerable communities in these stressful and critical times. We believe that through this project many people will receive the direct support and opportunities that are vital for the recovery of their livelihoods,” said Krittayawan Boonto, the UNAIDS Country Director for Indonesia.

GENEVA, 17 March 2021—As the situation in Myanmar continues to deteriorate and fatalities rise, UNAIDS is warning that the violence also threatens access to life-saving essential services, including services for people living with and affected by HIV.

Ensuring the safety and protection of health-care workers and outreach and community volunteers across the country is critical, as is ensuring continuity in the procurement and delivery of essential life-saving services. Of priority concern across the country is maintaining access to HIV services, including the supply and delivery of antiretroviral medicines and harm reduction services for people who inject drugs.

“I express solidarity with the people of Myanmar and recognize the exceptional leadership of young people, women and social activists in trying to uphold human rights,” said UNAIDS Executive Director, Winnie Byanyima. “I also salute community networks of people living with and affected by HIV, civil society and activists who have mobilized to support and protect the most vulnerable people.”

UNAIDS further adds its voice to the urgent calls made by the United Nations Secretary-General, António Guterres, for all violence against civilians in Myanmar to cease.

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.

Wang Tang (not his real name) had never been to Nepal before, but at the end of March 2020 it was one of the few countries that had not closed its borders with China. Since he was desperate to get away from Beijing after having had to stay at home for months after the coronavirus outbreak spread throughout China, he bought a ticket.

But days after he arrived, while he was staying in Pokhara, the fourth stop on his trip, the local government announced that the city would be shut down. He heard that the lockdown would not last longer than a month.

As someone who is living with HIV, he had brought along enough HIV treatment to last for a month. However, he soon learned that the re-opening of the city was to be postponed, which meant that he was at risk of running out of the medicine he needed to take regularly in order to suppress his HIV viral load and stay healthy.

Mr Wang swallowed hard while counting the remaining tablets. He had no idea how to get more.

As the lockdown dragged on, it seemed that no end was in sight. Mr Wang started to take his medicine every other day so that his supply would last a little bit longer.

He contacted his friends back at home, hoping that they could send medicine to Nepal, but they couldn’t. The country was under lockdown—nothing could be imported.

Then, Mr Wang contacted his friend Mu-Mu, the head of Beijing Red Pomegranate, a nongovernmental organization providing volunteer services for people living with HIV. It was with Mu-Mu’s help that Mr Wang learned how to obtain HIV treatment after he was diagnosed as living with HIV. Having known each other for many years, Mu-Mu had the trust of his friend. Mu-Mu contacted the UNAIDS Country Office for China to see if it was possible to deliver medicines to Mr Wang. A UNAIDS staff member quickly got in touch with the UNAIDS Country Office for Nepal.

Everything happened so quickly that Mr Wang was shocked when he received a message from Priti Acharya, who works for AHF Nepal and had been contacted by the UNAIDS Nepal office, saying that she would bring the medicine to him.

The next day, Ms Acharya rode her motorbike for 15 km on a dusty road before reaching the place where she would meet Mr Wang. When he came down from the mountains to meet her, Ms Acharya, drenched in sweat, was waiting under the midday sun.

“I was so happy and thankful for her hard work. She gave me a sunny Nepalese smile in return, as well as detailed instructions on the medicine’s dosage,” said Mr Wang.

They took a photograph together, then Mr Wang watched Ms Acharya as she left on her motorbike. Her image, disappearing in the distance, is carved into his memory. To attend the five-minute meeting, Ms Acharya had to ride a round trip of more than 30 km.

“For half a month or so, I had been suffering from pain and anxiety almost every day due to the lack of medication and the loneliness of being in a foreign country on my own. I could not believe that I got the HIV medicine in such a short time,” said Mr Wang. After the trip, he wrote to thank Ms Acharya, explaining how important the medicine he now had in his hand was: “it’s life-saving.”

At the end of his stay in Nepal, Mr Wang wanted to do something for UNAIDS. As he is an experienced photographer, he volunteered to carry out a photo shoot for UNAIDS’ Nepal office.

The subject he chose was former soccer player Gopal Shrestha, the face of an HIV charity in Nepal and the first person living with HIV to reach the summit of Mount Everest. After his HIV diagnosis in 1994, Mr Shrestha launched the Step-Up Campaign and spent many years climbing mountains worldwide, hoping to give strength and hope to people living with HIV.

In 2019, Mr Shrestha reached the peak of the world’s highest mountain, Mount Everest, recording a historic breakthrough for people living with HIV. “If 28 000 people have already climbed Mount Everest, why can’t I?" he said. “By climbing the highest mountain in the world, I want to prove that we are no different from anyone else and that we can all make a difference.”

“The moment I saw him, I could tell he was a sophisticated man,” said Mr Wang. Without instructions, Mr Shrestha posed naturally in front of the camera. He displayed confidence and charm. His eyes, content and clear, reflected nature’s beauty. “The eyes surely are the window to the soul,” Mr Wang said.

Mr Wang is looking forward to his next trip to Nepal. After the pandemic, Pokhara’s lakeside will be flooded with tourists, and he looks forward to seeing the mountain town bustling with people like it used to.

“It was hard for us before COVID-19, but it has become even harder now,” said Ayu Oktariani, the National Coordinator of the Indonesia Positive Network of Women Living with HIV (IPPI). For more than 10 years, she has been working with women and adolescents living with HIV who have been subjected to domestic violence in Indonesia, providing them with psychosocial support and counselling. Since the first COVID-19 outbreak, she has seen increased requests for help, as violence has escalated alarmingly.

Even before the COVID-19 pandemic, domestic violence was already one of the most significant human rights violations, but the pandemic has made a challenging situation even worse. Confinement is increasing the stress caused by security, health and money worries and is increasing the isolation of women with violent partners, separating them from the people and resources that can best help them.

According to a survey conducted by the International Community of Women Living with HIV in Asia and the Pacific (ICWAP) with support from the UNAIDS Regional Support Team for Asia and the Pacific, in June 2020 almost 30% of the respondents experienced some form of gender-based violence, including stigma and discrimination. In addition, more than 80% reported a lack of access to sexual and reproductive health services, including contraception.

In Indonesia, a report released by the National Commission on Violence against Women shows that the number of reported cases of violence against women living with HIV has significantly increased during the pandemic. “A few months ago, I was contacted by a woman living in a rural area, who was forced by her husband to have regular unprotected sex. She was unable to negotiate the use of condoms because of fear of violence,” said Ms Oktariani.

With other organizations in Indonesia, IPPI is developing a referral system that will guide women living with HIV who have been subjected to violence to women-led organization for legal advice and support. IPPI is also part of a national coalition that connects women and girls, including women living with HIV, to emergency services, including the police and justice and social services.

In Nepal, women living with HIV are faced with similar ordeals as a result of the COVID-19 pandemic. Sara Thapa Magar, the President of the National Federation of Women Living with HIV and AIDS (NFWLHA), Nepal, reflects on Lily’s (not her real name) story, a woman living with HIV who was beaten by her husband after she went to the local hospital to get refills of her antiretroviral therapy. The current circumstances, including limitations on access to helplines and disrupted public services, have made reporting of abuse and violence even harder.

NFWLHA has played a critical role in addressing these challenges by offering legal support to women like Lily subjected to domestic violence and providing relief packages to women and children living with HIV. “Despite these efforts, we are struggling to cope with the knock-on effects of the pandemic, and one of the main reasons is the lack of funds,” said Ms Magar. “Women-led organizations need to be continuously supported in our frontline role.”

Kousalya Periasamy, the founder of the Positive Women Network (PWN+), explains the multiple impacts of COVID-19 on the life of women living with HIV in India. “Many women and girls were afraid of going to the hospital to get their antiretroviral therapy refill and access general health services out of fear of COVID-19,” said Ms Periasamy. “Women living with HIV who had COVID-19 were not able to provide for and look after children if they had to be admitted into the hospital.” Given the need to communicate with local network partners and members, PWN+ established a WhatsApp group to ensure that women living with HIV had access to reliable information on HIV and COVID-19. PWN+ also mobilized support from different local organizations to donate food and supplies and handed out pamphlets containing HIV and COVID-19 information.

Sarah Feagan, a Board Member of ICWAP, works for a local agency in Australia, Living Positive Victoria (LPV). During the lockdown in Melbourne, “I worked to ensure women living with HIV remained connected and supported during COVID-19. Since I could not meet anyone in person, I kept in touch on the phone, linking them together via online workshops and other women living in similar areas to meet up without breaking the 5 km rule,” she said. She was able to offer financial support, food parcels and legal and emotional support thanks to LPV and other HIV organizations.

“On International Women’s Day, we commend all our sisters across Asia and the Pacific, who, like Ayu, Sara Thapa, Sarah and Kousalya, are establishing supportive mechanisms for women and girls living with HIV, even in the face of adversities,” said Sita Shahi, ICWAP Regional Coordinator.

During the COVID-19 pandemic, the UNAIDS Regional Support Team for Asia and the Pacific has joined hands with ICWAP to raise awareness about the needs and challenges of women living with HIV and to support the implementation of small local relief projects in Nepal, Malaysia and India. “COVID-19 is already testing us in ways most of us have never previously experienced. We must emerge renewed, with women living with HIV as a powerful force at the centre of the recovery,” said Eamonn Murphy, Director of the UNAIDS Regional Support Team for Asia and the Pacific.

When the COVID-19 pandemic broke out in Phnom Penh, Em Ra, pictured above, was worried.

She lives with HIV and she only had supplies of medicine to last a month.

“First, I was afraid that the medicine could not be shipped to Cambodia, the second is that when we don’t have medicine for a few months we have to come to the clinic often,” she said. “This increases my expenses but also raises my chances of getting COVID-19.”

During a recent visit to the National Center for HIV/AIDS, Dermatology and STDs (NCHADS) clinic, her doctor, Prak Narom, informed her that she would qualify for multimonth dispensing of HIV treatment. “Because of COVID-19, a patient in good health who takes their treatment daily can be prescribed HIV medicine for more than three months, and for some patients we can give them up to six months,” he explained.

Ms Ra is one of thousands in Cambodia who can now pick up a stock of medicine in one visit. There are an estimated 73 000 people living with HIV in Cambodia and now nearly 50% of people on treatment have access to multimonth dispensing of HIV treatment. Before the pandemic, that number stood at 34%.

The multimonth dispensing of HIV treatment programme in Cambodia began in 2019, long before the COVID-19 pandemic, but it has proven to be a godsend.

“When we started multimonth dispensing, there were some challenges because we had a shortage of drugs, but today we have overcome that so we can give medicine to people for up to six months,” said Ly Penh Sun, Director of NCHADS, pictured above.

The UNAIDS Country Director for Cambodia, Vladanka Andreeva, had feared the worse when COVID-19 shut down the country. “The biggest and oldest HIV treatment site in the capital was repurposed to serve as a COVID-19 centre and our outreach activities had to cease with public venues closed to the public.”

But UNAIDS, with the national AIDS programme and communities, worked together and helped with moving people to another treatment site, while providing face coverings and hand sanitizer to people living with HIV. UNAIDS also advocated that people living with HIV be integrated in the emergency cash transfer programme. As a result, more than 2500 households benefitted.

And more importantly, UNAIDS and partners pushed to introduce the home delivery of treatment and the rollout of multimonth dispensing of HIV medicine at the national level.

“We have used COVID-19 as an accelerator to further scale up and promote the multimonth dispensing of medicine,” Ms Andreeva said, pictured above.

It has been so successful that Mr Narom can’t believe it.

“In the past we used to see 30 patients in the morning, but now with multimonth dispensing we can reduce that by half or more than half,” he said. “I can now spend more time with my patients and carry out more in-depth check-ups.”

When a person is unable to take antiretroviral therapy regularly, their viral load increases, impacting the person’s health, which can ultimately lead to death. Even relatively short-term interruptions to HIV treatment can have a significant negative impact on a person’s health and potential to transmit HIV.

UNAIDS is advocating that all countries, ministries of health and national AIDS programmes grant access to three months or more of antiretroviral therapy for all people living with HIV, including refugees and migrants.

As for Ms Ra, she has joined a Telegram group started by the clinic for people living with HIV in case they have questions about their health or their medicine.

Watch: COVID-19 spurs on multimonth dispensing of HIV treatment in Cambodia

Photo credit: UNAIDS/S.Dara

The transgender community has been severely affected by the COVID-19 pandemic in Asia and the Pacific. “My main worry is about survival and being able to support and cover the essential needs of the transgender community when job security is less and businesses are closing,” said Khartini Slamah, a transgender woman and activist from Sarawak, Malaysia, who is also known as Mama Tini in her community. “Many transgender people are unable to pay rent and utility bills, unable to do sex work, conduct their usual businesses. Some even lost their jobs,” she said.

Mama Tini’s testimony is featured in the COVID-19 Effect Series, a regular newsletter that profiles issues, challenges and solutions from the lesbian, gay, bisexual, transgender and intersex (LGBTI) communities, key populations and people living with HIV across Asia and the Pacific, created by APCOM, a regional network for LGBTI people based in Bangkok, Thailand. Since April 2020, with more than 19 issues, the newsletter has provided a platform to leverage the voices of people living with HIV and LGBTI people and to share stories, highlight challenges, showcase innovation and build strength within these communities.

The articles included in the newsletter show how civil society organizations are playing a critical role in providing essential safety nets for vulnerable communities during the pandemic. Since the first COVID-19 outbreak in Malaysia, Mama Tini has been working closely to provide support to transgender women, gay men and other men who have sex with men and female sex workers to encourage sexual health screening and testing and to raise awareness of HIV and other sexually transmitted infections.

The newsletter is also a testament to how community-led organizations have used the structure and networks from the HIV response to ensure timely access to information about COVID-19 while preventing disruption to HIV services. Examples of these initiatives include how community-led HIV services provide antiretroviral therapy, HIV testing and pre-exposure prophylaxis (PrEP) to key populations and fundraising efforts for food packages.

CARMAH, a partner in Viet Nam, has been implementing the TestSGN initiative to encourage HIV testing in Ho Chi Minh City for several years. Since the beginning of the pandemic, CARMAH has provided PrEP to 450 gay men and other men who have sex with men and transgender people in Ho Chi Minh City. During the COVID-19 outbreak, the organization implemented more flexible working schedules to ensure that PrEP and HIV testing services were not disrupted.

“The COVID-19 Effect Series documents the important work carried by our community partners and individuals in the response to COVID-19. The series captures inspiring stories from the grass-roots level on overcoming challenges, sharing best practices and how we are all working tirelessly to ensure access to HIV prevention and treatment services and the protection of LGBTI rights,” said Midnight Poonkasetwattana, the Executive Director of APCOM

The COVID-19 Effect Series also captures the unique voices of outreach workers. One of them is Deepak Tripathi, a Senior Programme Officer at the Committed Communities Development Trust (CCDT), an organization based in Mumbai, India. He has a background in and passion for documentary movies, story-telling and news anchoring, but now works full time at CCDT. Throughout the pandemic, Mr Tripathi has been committed to helping the communities hit hard by the economic fall-out from COVID-19.

“Most nongovernment organizations in India, including CCDT, play a crucial role in continuing improving the health and well-being of their target population or beneficiaries, especially during natural crises or disasters, including the COVID-19 crisis,” said Mr Tripathi. CCDT held fundraising events to support migrant workers and daily-wage communities, donated medical equipment and 3000 personal protective equipment kits to hospitals in Mumbai and supplied nutrition kits or bags to 500 individuals and the families of people living with and affected by HIV.

APCOM has also used the COVID-19 Effect Series to promote fundraising initiatives, such as #CoronaAPCOMpassion, an emergency fund started by APCOM staff donating their salaries. APCOM collaborated with SWING, the Thai Sex Workers Organization, based in Bangkok and Pattaya, and mobilized 20 000 baht (US$ 650) to purchase basic food and supplies for sex workers. Also, APCOM donated 9000 baht (US$ 300) to the Bangkok Rainbow Organization to support the health and well-being of LGBTI people in Thailand. You can watch a video here and read about other communities that have benefited from this emergency funding, and how you can support it.

“The human-interest stories included in the COVID-19 Effect Series raise the visibility of human rights violations and the challenges faced by LGBTI people and people living with HIV in accessing health services. The series amplifies community voices that have often been unheard in COVID-19 narratives,” said Eamonn Murphy, Director of the UNAIDS Regional Support Team for Asia and the Pacific, which has provided financial support to make the newsletter a reality.

To mark Zero Discrimination Day by making the voices of the communities heard, APCOM is launching a short report that compiles stories and articles published in the COVID-19 Effect Series.

Ralph Ivan Samson, the President of Y-PEER Pilipinas, and his team of young volunteers have been working tirelessly throughout the COVID-19 pandemic to supply antiretroviral therapy to young people struggling to get refills. “How could I sleep at night knowing that community members were depressed and anxious about their refills. I had young people texting me they were down to their last couple of pills,” said Mr Samson, remembering the initial COVID-19 outbreak in the Philippines in March 2020. It was at this moment that he knew he had to do something.

Throughout the region, civil society organizations like Y-PEER Pilipinas began looking into ways of overcoming the barriers and challenges that prevent young people from accessing HIV services due to COVID-19 restrictions. For example, Y-PEER gained support from local governments with special travel passes to enable the delivery of antiretroviral therapy from the hospital straight to the doorsteps of young people living with HIV.

Y-PEER Pilipinas was one of several beneficiaries of the COVID-19 Emergency Relief Fund, a regional small-grants programme established by Youth LEAD to support initiatives led by young people across Asia and the Pacific during the COVID-19 pandemic. The COVID-19 relief fund supported 12 organizations led by young people in nine countries with various projects, including the delivery of antiretroviral therapy, hygiene products, opioid substitution therapy, emergency supplies and food, cash transfer programmes for businesses run by transgender people and housing for key populations.

Youth LEAD’s efforts to mobilize resources during the early days of the pandemic are a testament to young people rising up to the occasion and working in coordination with regional partners of the HIV response in Asia and the Pacific. In their efforts to raise funds, Youth LEAD relied on the findings of a regional assessment on the needs of young key populations and young people living with HIV during the COVID-19 pandemic conducted by the Inter-Agency Task Team on Young Key Populations Asia Pacific (IATT on YKP), a regional coordinating platform comprised of United Nations agencies and young key populations regional networks. The results of this assessment helped to inform the IATT on YKP and its regional and national partners on ways to support organizations led by young key populations during the COVID-19 response. The evidence gathered through the survey was used to inform preparedness response plans and local strategies on providing timely information on COVID-19 prevention, supporting the delivery of antiretroviral therapy and tackling stigma and discrimination. 

With the support received from Youth LEAD, Mr Samson and his team of volunteers provided condoms and lubricant and emergency supplies to young key populations and young people living with HIV across several provinces in the Philippines. The programme is known online as #GetCondomsPH, and a similar initiative led by young people from the COVID-19 Emergency Relief Fund supported the delivery of antiretroviral therapy to people’s doorsteps in Goa, India.

Aadi Baig, Programme Manager, and his team at Wasaib Sanwaro, an organization that works with gay men and other men who have sex with men and male sex workers in Pakistan, have also benefited from the COVID-19 Emergency Relief Fund. Mr Baig revealed a troubling picture of how the COVID-19 pandemic has made things worse for key populations. “The pandemic has created a greater divide among people, socially and economically, and has uncovered the lack of social security and protection programmes for key populations.”

With the support received, Wasaib Sanwaro donated food and supplies to key populations and provided basic HIV and COVID-19 training. Although there are limited funding schemes for organizations of young people across the region to access grants, regional networks of young people, such as Youth LEAD, Y-PEER and YVC, and the coordinated response by the IATT on YKP, which in 2020 was co-chaired by the UNAIDS Regional Support Team for Asia and the Pacific, the APCASO nongovernmental organization and the United Nations Development Programme, have stepped in to provide support.

As part of the work of the IATT on YKPs, a website that pools together COVID-19 resources for young key populations and showcases how young people have stepped up to respond to the COVID-19 pandemic was developed. The website also focuses on resources on the mental health of young key populations and the well-being of adolescents and young people at higher risk of HIV.

The most crucial aspect of all these activities was visibility, the visibility of young people, to ensure that young key populations and young people living with HIV had a voice during the pandemic. To keep the issues and needs of young key populations on the top of the advocacy agenda in the region, the IATT on YKP, with support from the UNAIDS Regional Support Team for Asia and the Pacific and Youth LEAD, held the first Spill the T with YKPs webinar—an online panel with young people from across the region that offered a platform for young people to talk about their initiatives and their roles in the COVID-19 response. The series continued through the collaboration of the IATT on YKP with partners and explored issues of young people’s leadership, mental health and sexual and reproductive health and rights. 

Warm smiles greet Lily as she approaches her first stop of the day—one of the 11 brothels scattered across the country that Lily, the President of the Bangladesh Sex Worker Network, visits quarterly to check in with the women and see what assistance they need. Though her visits have been limited in recent months due to movement restrictions to curb the spread of COVID-19, Lily knows well enough that those smiles are a brave front for the troubling times that her peers have experienced.

“I see the sex workers as my sisters—I feel their happiness and pain and I try my best to solve any issue they face,” Lily said. During the COVID-19 pandemic, Lily and the 29 community-based organizations serving sex workers in the country have struggled to respond to the increased calls for support. In March, government countrywide movement restrictions meant that sex workers could no longer have clients, leaving most of them without a source of income and unable to provide for themselves or their families.

“Sex workers’ children faced challenges during the COVID situation because their mothers couldn’t arrange to provide them with food. When we [the Bangladesh Sex Worker Network] learned about this issue, we reached out to many organizations and the private sector for assistance,” explained Lily. Responding to the call to action, the network mobilized funds to support 2100 sex workers across the country. Community-led support in Bangladesh has also garnered global recognition. Most recently, a former sex worker, Rina Akter, was recognized by the BBC for her efforts, and those of her team of helpers, to serve 400 meals a week to sex workers in need.

“While a few sex workers had savings, most could not provide for themselves,” said Rahat Ara Nur, Technical Officer for the United Nations Population Fund in Bangladesh. “Through the United Nations Population Fund, we provided sex workers with COVID-19 prevention commodities, such as masks and handwashing materials, and we also developed public service announcements which were aired on community radio to ensure we raised awareness about COVID-19 precautionary measures among the community."

With the closure of entertainment venues, a classification that includes brothels, some sex workers have resorted to street-based sex work, which increases the risk of violence, condom-less sex and no pay or low pay.

Sex workers are also experiencing increasing vulnerability to gender-based violence. Without a source of income, conflicts about finances arise, and sex worker networks report that their members have experienced abuse at the hands of their spouses, partners and brothel owners.

Some sex workers report that they have become homeless because the brothels have been closed, or in some cases the residents were evicted because rent could not be paid. Many sex workers cite stigma and discrimination as a barrier for other forms of employment. Health outreach services that once provided brothels with sexual and reproductive health services, including HIV testing and prevention, have been suspended due to travel restrictions.

Bangladesh, October 2019. Credit: UNFPA Bangladesh/Naymuzzaman Prince

These developments are not unique to Bangladesh, however. Throughout the Asia–Pacific region, national and regional networks of sex workers are reporting that the COVID-19 outbreak has exacerbated the inequalities faced by sex workers, and many are either not eligible or excluded from social protection services.

“There is no government support specifically targeting sex workers. There is support for the general public, particularly those that are low income, but sex workers are not eligible for these social protections because they work in the informal economy,” said Hnin Hnin Yu, the Chairperson of Sex Workers in Myanmar (SWiM), a nongovernmental advocacy group for sex workers’ rights.

Additionally, many sex workers are migrants (international or internal) and lack the necessary papers or registration with local authorities to access the government’s support. Eligibility criteria for social support, such as documentation of income, proof of residence, national identification, contribution to existing social protection schemes and filing taxes, are all reasons given for excluding sex workers from government support. An online consultation of female sex workers from across the country, organized by UNAIDS and SWiM, revealed that apart from limited funds from humanitarian actors, none of the sex workers had received social support.

“When Global Fund to Fight AIDS, Tuberculosis and Malaria assistance for COVID-19 was allocated, funds for people living with HIV included the most vulnerable sex workers to receive food provisions,” said Mr Myo, Community Support Adviser for UNAIDS in Myanmar. “However, we recognized that this was an ad hoc solution that reached a small portion of the vulnerable population and there is a need for more sustainable support, such as social protection, for sex workers.”

It has become clear that focused support for sex workers must be prioritized. Recognizing that more needs to be known about the gaps in social protection for sex workers, UNAIDS in collaboration with the United Nations Population Fund and the World Food Programme are exploring the possibility of conducting a needs assessment and vulnerability mapping initiative of female sex workers during the COVID-19 pandemic. Data from the community-led mapping initiative will be used to inform programming for livelihood support, food security, improved access to antiretroviral therapy, sexual and reproductive health services and gender-based violence prevention and response services.

Commenting on the prospects of the United Nations agencies joining forces to coordinate a vulnerability mapping exercise with sex worker networks, Ms Nur expressed excitement about how this advocacy tool will not only help to identify the challenges that sex workers face during the COVID-19 outbreak, but it would also catalyse further work to mobilize resources for programmes and address injustices that pre-date the COVID-19 pandemic.

Hnin Hnin Yu cites discrimination and harassment from police as a long-standing challenge facing sex workers’ rights. During the COVID-19 outbreak, communities have reported increased police surveillance, harassment, including physical violence, and demands to pay fees to conduct sex work. In response, SWiM provides community-led, peer-to-peer legal aid for sex workers who have been arrested, educating them about their rights.

For those working closely with community-led organizations it has been inspiring to see that although sex worker networks and the sex workers they represent have seen challenges all around them, they have done their best to support their peers. There is hope that the data gathered in a vulnerability mapping exercise would not only generate the evidence needed to advocate for expanding the reach of social protection and humanitarian response services to be inclusive of sex workers, but could also inform the scale-up of community-led programming. 

GENEVA, 14 December 2020—UNAIDS congratulates Bhutan’s parliament on voting to repeal Sections 213 and 214 of the country’s Penal Code. Those provisions criminalized certain private sexual acts and led to discrimination against and the marginalization of lesbian, gay, bisexual and transgender (LGBT) people. The country’s parliament voted for the repeal on Human Rights Day, 10 December.

“I commend Bhutan’s parliamentarians for voting to create a more compassionate, tolerant and inclusive society and for recognizing that the country’s LGBT people deserve privacy, respect and dignity,” said Winnie Byanyima, UNAIDS Executive Director. “This step taken on Human Rights Day will also help to ensure that LGBT people in Bhutan receive the essential services they need, including HIV treatment, prevention and care services.”    

Bhutan becomes the latest country to decriminalize consensual same-sex sexual relations. Since 2014, Angola, Botswana, Gabon, India, Mozambique, Nauru, Palau, the Seychelles and Trinidad and Tobago have all taken the same measure. However, consensual same-sex sexual relations remain criminalized in at least 68 countries and territories worldwide.    

Criminalization of consensual same-sex sexual relations prevents people from accessing and using HIV prevention, testing and treatment services and increases their risk of acquiring HIV. It legitimizes stigma, discrimination and violence against LGBT people and is a human rights violation.  

Globally, the risk of acquiring HIV is 26 times higher among gay men and other men who have sex with men than among the general population and 13 times higher for transgender people. Prohibitive legal and policy environments and a lack of tailored services for key populations increase their vulnerability to HIV. UNAIDS urges countries to ensure the full respect of the human rights of all people, regardless of their sexual orientation, through repealing laws that prohibit sex between consenting adults in private, enforcing laws to protect people from violence and discrimination, addressing homophobia and transphobia and ensuring that crucial health services are made available.

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.