The United Nations General Assembly will hold its first high-level meeting on HIV since 2016 on 8–10 June 2021.  

In the run-up to the meeting, before the end of April 2021, an interactive multistakeholder hearing will be held with the participation of communities and other stakeholders, who will also participate in other activities before and during the high-level meeting itself.

To ensure the involvement of civil society and ensure an open, transparent and participatory process, UNAIDS is forming, by the end of March, a multistakeholder task force comprised of representatives of civil society and the private sector. The task force will advise UNAIDS on the format, theme and programme of the multistakeholder hearing and will help to identify speakers for the hearing and high-level meeting plenary and panel discussions.

Different constituency networks are asked to use their own networks and selection processes to nominate people to be considered for the task force. UNAIDS and the Programme Coordinating Board nongovernmental organization delegation will select individuals for each of the categories of members:

• One representative openly living with HIV of networks of people living with HIV.
• One representative openly living with HIV of networks of women living with HIV.
• One representative openly living with HIV of networks of young people.
• One representative of each of the key populations (people who use drugs, sex workers, transgender people, gay men and other men who have sex with men, people in prison settings).
• One member of the UNAIDS Programme Coordinating Board nongovernmental organization delegation.
• A representative of a women’s organization, particularly working on sexual and reproductive health and rights.
• A representative of a young’s people organization, particularly working on sexual and reproductive health and rights.
• A representative of the private sector.
• A representative of a faith-based organization.
• A representative of networks or organizations of indigenous people.
• A representative of networks or organizations of people with disabilities.
• A representative of an organization working with tuberculosis and HIV. 

“The engagement of people living with HIV, key populations and other priority communities is fundamental for the success of the high-level meeting. Communities have led the way in the HIV response since the beginning and know what is needed to make sure that all people everywhere have what they need to prevent new HIV infections and to ensure that people living with HIV can survive and thrive. The task force represents an important platform for participation in the preparatory phase for the meeting. As the task force is necessarily limited in size, we are particularly interested in nominations of people from networks, who are closely linked across their communities and across regions, to be able to bring a deep and broad perspective. Additional opportunities for people living with HIV, key populations and other affected groups to engage with be made available throughout the lead-up to the high-level meeting,” said Laurel Sprague, UNAIDS Chief/Special Advisor, Community Engagement.

Civil society networks and relevant stakeholders are asked to submit nominations here by 16 March 2021 at 18.00 CET. The call for nominations with detailed information can be accessed here.

The Democratic Republic of the Congo has been plagued by political instability since the 1990s and has seen widespread attacks against civilians, violence between ethnic factions, rape and other forms of sexual violence, and murder. Sexual violence against adolescent girls and young women is common.

Violence against women and girls continues to be a global pandemic that affects one in three women in their life. Violence against women is a major factor for contracting HIV—in areas with a high HIV burden, such as sub-Saharan Africa, women subjected to intimate partner violence are 50% more likely to be living with HIV. And men who are perpetrators of violence against women tend to be at a higher risk of HIV themselves and to use condoms less frequently, thus increasing the risk of HIV transmission.

According to the latest Demographic and Health Survey of the Democratic Republic of the Congo, HIV prevalence is three times higher among women aged 15–49 years (1.1%) than among men of the same age (0.4%) and twice as high among young women aged 15–24 years (0.46%) than among young men of the same age (0.22%).

RENADEF (Réseau National des ONG pour le Développement de la Femme), a platform of approximately 350 non-state groups working for women, is tackling this issue front and centre. As a subrecipient of a grant from the Global Fund to Fight AIDS, Tuberculosis and Malaria, RENADEF is running a project to strengthen awareness around sexual and reproductive health and rights, including HIV, to facilitate access to support services and to encourage behaviour change among adolescent girls and young women in 16 HIV high-burden provincial divisions.

In collaboration with health-care providers, almost 200 peer educators and mentors have been trained on sexual and reproductive health and more than 600 educational talks in different settings, including schools and communities, have been facilitated, reaching more than 6500 people, including 2500 girls.

“I was not informed about sexually transmitted infections and their consequences on my life, but I had the chance to participate in an awareness session organized by the peer educators and mentors in my neighbourhood; at the end of the session, I approached one of the sensitizers to explain my problem to her. She gave me advice and referred me to a health training, where I was taken care of for free and I feel good now,” said Nathalie Nyembwe (not her real name), who attended one of the educational talks.

The project also supports clinics giving psychosocial, legal and judicial support to survivors of sexual violence. Since 2018, clinics have been held that have provided psychological support to almost 5500 people and legal/judicial support to more than 3500 survivors of sexual violence.

The community sensitization, capacity-building of legal clinics and support for survivors of sexual violence have contributed to an increase in the reporting of rape.

“It’s particularly important, particularly as we reflect on our experience with COVID-19, that we acknowledge the important role that women have played to protect others from violence, to ensure continued support to vulnerable families and to ensure access to food and medicine. Women have provided invaluable support to keep people connected to neighbours, services and information, all the while ensuring that homes remain a safe space for children and families to continue to learn and grow socially,” said Susan Kasedde, the UNAIDS Country Director for the Democratic Republic of the Congo.

As a champion country of the Global Partnership for Action to Eliminate all Forms of HIV-Related Discrimination, the Democratic Republic of the Congo has a unique opportunity to strengthen its implementation of coordinated, comprehensive and scaled-up action involving a range of stakeholders and to build synergies on action on gender equality across sectors. 

GENEVA, 23 February 2021—UNAIDS warmly welcomes the appointment of Andrew Spieldenner as the Executive Director of MPact Global Action for Gay Men’s Health and Rights. MPact has been working since 2006 at the intersection of sexual health and human rights for gay and bisexual men and is linked to more than 120 community-based organizations in 62 countries. MPact has long been a key partner of UNAIDS—its work is critical for the promotion of the health and rights of gay and bisexual men and their communities and to ending AIDS.

“Andrew Spieldenner is a long-time respected HIV activist and scholar. In recent years, he has provided invaluable service to UNAIDS and the global AIDS response through his role as a delegate to the UNAIDS Programme Coordinating Board,” said Winnie Byanyima, UNAIDS Executive Director. “We look forward to continue working closely with him in this new position and to strengthen our relationship with MPact to address the challenges and inequalities faced by lesbian, gay, bisexual, transgender and intersex communities in accessing health and fully enjoying their human rights around the globe.”

Mr Spieldenner’s commitment to people living with HIV, lesbian, gay, bisexual, transgender and intersex communities, feminist principles and racial justice has been evident throughout his 30 years of activism. A skilled organizer, communicator and mentor, he brings to his new position at MPact a long history of engagement with networks of people living with HIV. Working within local organizations, national networks of people living with HIV, health departments and academia, he has been at the centre of movements for social justice, leading from within, in partnership with the communities of which he is a part.

Mr Spieldenner will take up his new role on 1 March 2021.

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.

Irina Kutsenko, a deputy of the Odesa City Council in Ukraine responsible for social issues, is an active advocate of community rights who campaigned for medical and social services for HIV to be brought closer to the most disadvantaged. She is the first and so far the only government official nominated by civil society for the #inYourPower award. The award, which is given by civil society to leaders, government officials and eastern European and central Asian politicians, is given to people who have contributed to improving the financial sustainability and effectiveness of HIV programmes for key populations and to removing legal barriers to HIV services and protecting human rights.

However, the route to the award was not straightforward. “As a deputy, I closed the opioid substitution therapy site in my district. I collected signatures from people against the gay movement in our city,” she said. But after completing a course run by the International Academy of Harm Reduction, she began to research the topic in more detail. “I started reading about the issue on the Internet, listening to interviews of people, listening to life stories, until I understood that I was wrong!”

Ms Kutsenko started to cooperate with community organizations to make Odesa a safer city for key populations.

“When representatives of community organizations came to me with a harm reduction project in the city, I already understood what they were talking about. At that moment, I realized that nongovernmental organizations today know more than officials. At the beginning, I was only listening,” she said.

The first task for Ms Kutsenko and the community organizations was to find a common language and common platform. “We needed everyone: doctors, the authorities and public organizations to unite and work towards one common goal,” she said. “It didn't work out when everyone was separate.”

But, as Gennadiy Trukhanov, the Mayor of Odesa, said, it was not easy for the city. The city authorities, in addition to responding to local everyday problems also need to address global challenges, in particular helping health-care workers to fight the COVID-19 pandemic. “Mayors are assessed by the state of the city: roads, public spaces, etc. We can have clean cities, but with the spread of infectious diseases around the world, the time may come when there will be no one to walk along these roads,” he said.

Over the past few years, Odesa has been implementing steps within the framework of the Paris Declaration to end the AIDS epidemic in cities and was the first city in Ukraine to commit to the Zero TB Cities initiative. The city has initiated outpatient treatment of tuberculosis, instead of in hospital, and has begun widescale testing programmes for HIV, increasing the detection rate of HIV and ensuring that people who test positive access treatment.

“Of course, there are still many problems, but, step by step, we are changing the situation in the city,” said Ms Kutsenko.

Ms Kutsenko’s story can be viewed on YouTube.

Kenyan AIDS activist Inviolata Mbwavi died on 29 July 2020 in Kakamega, Kenya, at the age of 48 years. 

Ms Mbwavi was the first Chief Executive Officer of the National Empowerment Network of People Living with HIV in Kenya. At the time of her death she was the National Coordinator of the International Community of Women Living with HIV, Kenya Chapter (ICW-Kenya). ICW-Kenya exists to support an enabling human rights environment, promote gender equality and address the HIV-related vulnerabilities and needs of women and girls. ICW-Kenya also works to respond to HIV among gay men and other men who have sex with men and transgender people, supports legal frameworks enabling trade and intellectual property legislation for improved access to affordable essential medicines and commodities and campaigns against violence and discrimination against key populations.

For Ms Mbwavi, the responses to HIV and to other underlying social, economic and legal factors were equally important. She was uncomfortable with an HIV response that does not question why more girls than boys and more women than men are living with HIV in Kenya and the wider African continent decades after the advent of the epidemic.

Ms Mbwavi was an active member of a civil society coordination group on HIV and tuberculosis and collaborated with UNAIDS in pushing for an HIV response that values and recognizes the contribution of civil society and affected communities.

“Inviolata Mbwavi was a fierce advocate for gender equity, safety and dignity. She was a passionate activist and leader who broke barriers for women and for civil society and was one of the first women living with HIV to serve in a Country Coordinating Mechanism. Her leadership qualities and desire to serve were further demonstrated when she twice ran to be a member of parliament,” said Medhin Tsehaiu, UNAIDS Country Director for Kenya. “We give our condolences to her family and all who loved her.”

Emihle Dlamini (not her real name) lost both her parents to AIDS-related illnesses when she was young, so she was raised by her grandmother. For years, Ms Dlamini didn’t know that she was born with HIV. She was given medicine, but was told it was for tuberculosis. South Africa had approximately 260 000 children living with HIV in 2018. Around one third lived in the KwaZulu-Natal province that Ms Dlamini lives in.

One day, Ms Dlamini attended a lesson at school run by the Community Care Project, where she learned about HIV and was offered an HIV test. The result came as a shock, “I was in total disbelief. I knew that I was not sexually active, but my family had never told me that I was HIV-positive,” she said.

Ms Dlamini experienced feelings of anger, confusion and sadness. “Why did my family not tell me? On many occasions, I stopped taking my “tuberculosis” treatment because I wondered why I was taking it for so many years,” she said.

Many people do not disclose their HIV status out of fear of the stigma and discrimination that, despite improvement, remains a real barrier to people seeking access to health services. Particularly affected are young women seeking protection from sexually transmitted infections, as well as HIV diagnosis and treatment. Every day in South Africa, 200 adolescent girls and young women aged 15–24 years are newly infected with HIV.

The Community Care Project has shown the importance of equal and free access to primary and secondary education as a gateway to other social and health services. Almost 163 000 children (0–14 years) living with HIV in South Africa were receiving antiretroviral therapy in 2018, but many are still missing out: an estimated 66 000 children did not even know their HIV-positive status.

The project is accustomed to breaking the silence surrounding HIV as well as managing and reducing its effects. Founded in 1999, it is a faith-based organization from KwaZulu-Natal that helps communities and families manage HIV and respond to stigma and discrimination. Since 2007, it has partnered with secondary schools to run awareness programmes and provide services that help schools and pupils understand and demystify HIV. It also provides care for orphans and other vulnerable children and their families.

The Community Care Project provided Ms Dlamini and her grandmother with counselling by an auxiliary social worker, to help them come to terms with the HIV diagnosis and to ensure that Ms Dlamini follows a sustained treatment programme. Ms Dlamini says she is now coping much better with her situation emotionally and mentally. She has a better understanding of HIV and sexual and reproductive health and is adhering to her medication. She feels that she can have a bright future.

“The Community Care Project taught me positive life skills. I learned how to cope with my HIV status, deal with stigma and help others to do the same,” she says. “One day I would like to be a motivational speaker and empower my peers at school with HIV information and how to live without judgement.”

Ronie Zuze believes in the power of information. Not only did it save them (Ronie uses the pronouns them/they/their), they are convinced that it can change lives and mindsets.

As the first born, their father was ecstatic when he was told he had a son, they recounted. “I was born with ambiguous genitalia, so doctors assigned the male gender,” Ronie said.

Ronie grew up as a boy until the age of 16 years.

“That’s when my body started developing some female features, despite the fact that I associated myself with being a boy,” the Zimbabwean said.

Ronie’s father panicked and sent Ronie to live in another town with his former wife.

“My father became very confused and fearful of the stigma and discrimination,” Ronie said, “so he sent me away.”

Ronie’s mother cautioned them—she immediately told they must now be a girl—to be careful around other people. “Sleepovers and contact sports were forbidden,” Ronie recalled.

Ronie believes the shame around who they were propelled them into a tailspin of denial and self-hate. “I attempted to kill myself two to three times and consumed excessive amounts of alcohol and drugs,” Ronie said.

They started seeking out help on the Internet, convinced there were others in the same situation, which led to a slew of information about what it meant to be an intersex person.

Intersex people are born with any of several variations in sex characteristics, including chromosomes, gonads or genitals that do not fit the typical definitions of male or female.

“The flood of information empowered me to understand who I was,” Ronie said. “I stopped being shameful of myself.”

Most of the people they engaged with were in Europe or North America. “If 1.7–2% of the global population is intersex, then I knew there must be more than just me in Africa,” Ronie said, brushing aside a dreadlock.

Ronie joined a local group for lesbian, gay, bisexual, transgender and intersex people and initially self-identified as a lesbian, but it did not feel right. Even the community didn’t understand intersex people, Ronie said. That’s when they decided to become a voice for people like them and started an organization, the Intersex Community of Zimbabwe, in 2018. Ronie now identifies as non-binary.

“As an activist, it means I empower other intersex people, I speak for those who cannot speak out, I encourage them to be proud and I provide information to them as well as support them,” Ronie said.

Ronie spends a lot of time with other intersex people and their immediate families. They pound the pavement telling parents to let nature take its course and not rush into assigning one gender to their intersex children. They believe an intersex person should decide for themselves when they are old enough to make that decision.

“I know there is a lot of stigma and misconceptions about intersex bodies, but parents need not panic,” Ronie said. “I want intersex people to know there is nothing to be ashamed of, so be proud.”

A new film about HIV in the Russian Federation by YouTuber and journalist Yuri Dud is stirring people’s interest about the epidemic in the country.

Since its release on 11 February, the video has been viewed by more than 14 million people, and the number of online searches about HIV and HIV testing has skyrocketed. According to Google Trends, the number of searches on where to buy an HIV test has increased by 4000% since the launch of the video—the highest level of interest in HIV and HIV testing in the past five years.

In the film, published on his YouTube channel, Mr Dud talks to people living with HIV, activists, experts and journalists. Through his interviews, the film voices some of the taboos surrounding HIV in Russian society, including condom use, and looks into the drug use epidemic in the country, the services available for people who use drugs and the lack of sex education, among other things.

It is clear in the film that younger people still lack basic information about HIV—things like the difference between HIV and AIDS, the effectiveness of treatment or even how the virus is transmitted are still mysteries for many in the country. “You can touch people living with HIV, exchange clothes, swim in the same pool, drink from the same mug, cuddle, kiss. It's stupid to be squeamish about people living with HIV. It is much better to be squeamish about unprotected sex and drugs. These are still the two main modes of HIV transmission,” said Mr Dud.

The popularity of the film has prompted government officials to take a closer look at the HIV epidemic and response.

“Yuri Dud’s film about HIV is undoubtedly useful. It provides a lot of important information and motivates people to get tested for HIV,” said Oleg Salagai, Deputy Health Minister, in his Telegram channel. Mr Salagai emphasized how the film draws attention to the issue of the stigma endured by people living with HIV. “HIV is not a death sentence anymore. It is very important that people living with HIV have access to HIV treatment to live a healthy and fulfilling life,” he wrote.

Mr Salagai was not the only government official reacting to the video.

Alexei Kudrin, the Head of the Accounts Chamber of the Russian Federation, promised to carry out a review of the effectiveness of HIV prevention and care programmes in the country. “This year, the Accounts Chamber will analyse the effectiveness of government resources allocated to people living with HIV in the Russian Federation,” he said.

And the first Deputy Head of the State Duma Health Committee, Fedot Tumusov, invited members of parliament to watch the film and discuss to the HIV situation in the Russian Federation. He is also planning a round-table meeting in the State Duma to explore ways to improve access to HIV prevention and treatment.

“The public response to Mr Dud’s film is incredible. However, even such a successful action is not enough. We need consistent and long-term activities to raise HIV awareness coupled with programmatic actions to ensure access to HIV testing and treatment for all,” said Alexander Goliusov, Director, a.i., of the UNAIDS Regional Support Team for Eastern Europe and Central Asia.

Eastern Europe and central Asia, of which the Russian Federation is a part, has the fastest growing HIV epidemic in the world. Most new HIV infections in the Russian Federation are among key populations, including people who inject drugs, despite the well-documented power of harm reduction programmes, where available, to reduce new HIV infections—insufficient access to sterile injecting equipment and the unavailability of opioid substitution therapy are stymying efforts in the country to prevent HIV infections among people who inject drugs.