“My life is now in my hands,” says Erick González, a Venezuelan who has been living in Ecuador for almost a year. For a long time, he has looked for a place where he could feel part of society—he has found that place in Diálogo Diverso. 

Based in Quito, the civil society organization created in 2018 works on the protection and promotion of human rights, with an emphasis on gender and lesbian, gay, bisexual, transgender and intersex (LGBTI) people. Through the Hablemos Positivo (Let’s Talk Positively) initiative, supported by UNAIDS, Diálogo Diverso increased its capacity to respond to the needs of LGBTI migrants during the first year of the COVID-19 pandemic.

“There are very few entities working on HIV prevention as well as the other health issues to which we are exposed as part of the LGBTI and migrant community,” said Mr González.

Diálogo Diverso is among the 61 organizations that received grants from the UNAIDS Regional Support Team for Latin America and the Caribbean as part of the Soy Clave: de las Comunidades para las Comunidades (I Am Key: from Communities to Communities) initiative, a platform that aims to promote community-led social solutions to respond to HIV during the COVID-19 pandemic.

“We have received requests from different LGBTI people: Venezuelans, Cubans, Colombians, among others. And we have identified that they all face a very similar migration process,” said Danilo Manzano, the Director and co-founder of Diálogo Diverso, which counts on a team of more than 40 people working in the cities of Quito, Guayaquil, Manta and Cuenca. “But on top of the collective needs as migrants and key populations, it was important to take into account the intersectionality with human rights and the impact of the individual challenges they face in a new country.”

“HIV is one of the reasons why LGBTI people leave the Bolivarian Republic of Venezuela, given the difficulties in accessing antiretrovirals on a permanent basis, the invisibility of their rights and, on other occasions, hate crimes,” said Andrés Alarcón, an activist with Diálogo Diverso. “This project was born from our experience in serving thousands of LGBTI migrants. And during the pandemic, we identified a particular trend among those living with HIV: lack of information and access to different health services.”

Thanks to a grant provided by UNAIDS, the project delivered hundreds of sexual and reproductive health kits, organized several conversations on health promotion, HIV prevention, sexually transmitted infections and COVID-19 and disseminated a campaign on social networks focused on raising awareness and promoting the human rights of migrant LGBTI people.

“This is a great example of how international organizations, donors and governments can invest in communities so that they can bring social solutions to their own communities while tackling key intersecting issues such as LGBTI rights and migration,” said Guillermo Marquez Villamediana, Senior Community Support Adviser for the UNAIDS Regional Support Team for Latin America and the Caribbean. “Their expertise and outreach capacity have been crucial to keeping the HIV response alive for those most vulnerable during the COVID-19 pandemic.”

One of the highlights of the project was the creation of an alliance between two community-based organizations that work with migrants and refugees in Ecuador, Alianza Igualitaria and Construyendo Igualdad, which extended their reach and allowed them to work with other populations, such as sex workers and young people.

Exclusion based on sexual orientation and gender identity compounds the violations of the human rights of LGBTI migrants and refugees in the Bolivarian Republic of Venezuela. According to a study carried out by Diálogo Diverso and the International Organization for Migration in 2020, 43% of LGBTI migrants in the country had experienced exclusion, discrimination or violence. The same study pointed out that LGBTI migrants and refugees find it difficult to access the health system due to lack of information and awareness about it.

“This project gave me knowledge about the possibilities to avoid HIV infection and transmission,” said Reinaldo Mendoza, a Venezuelan migrant who received support from Hablemos Positivo.

Reina Manteña, the President of the Women’s Association of Cantón Milagro, in Ecuador, said that the partnership with Diálogo Diverso in providing technical advice to LGBTI women has been rewarding. “Many compañeras benefited from the kits and the dialogues. Let’s not forget that in the face of this pandemic, health centres were not providing care nor condoms, which are vital for sex workers,” she said. “In addition, we have provided technical support to Venezuelan sex workers so that they could regularize their situation in the country.” 

For Mr Manzano and his team in Diálogo Diverso it is gratifying to see these results. “It has never been about quantity, but the quality of the assistance we can offer and its real impact on their lives.”

“We have changed our way of thinking and our attitude towards people living with HIV. In the jungle, we don’t talk about it, and every day we see more and more people living with the virus,” said Aurora Coronado, a member of the National Federation of Peasant, Artisan, Indigenous, Native and Salaried Women of Peru.

Fenmucarinap, as it is known by its acronym in Spanish, is among the 61 organizations that have received grants from UNAIDS through an initiative called Soy Clave: de las Comunidades para las Comunidades (I Am Key: from Communities to Communities) since its launch in May 2020. The funds support community-led solutions in the response to HIV during the COVID-19 pandemic. “The project allowed us to share knowledge and learn more about HIV. Now knowledge is being passed on. Now we speak from the heart to young people living with HIV and many are taking care of themselves and taking their treatment,” Ms Coronado added.

Almost 5000 kilometres away from the project in the Peruvian jungle, in the Santa Martha Acatitla Penitentiary in Mexico, another community-led initiative was also implemented in the first year of the pandemic. “We can basically say that we saved the lives of people who are generally forgotten, especially in moments like these,” said Georgina Gutiérrez, from the Mexican Movement for Positive Citizenship, whose project was implemented in the same institution in which her husband had been imprisoned for eight years. “Through this initiative, we were able to support a population that lacks basically everything, especially dignity.”

These projects are examples of how small catalytic funds can make a difference and bring a positive impact for entire communities, especially in moments of extreme vulnerability and exacerbated inequalities. Through the Soy Clave initiative, UNAIDS and its partners focus on offering support to community-led projects around three pillars: prevention of the transmission of COVID-19, continuation of the HIV response and upholding human rights and preventing stigma, discrimination and violence towards people living with or affected by HIV and COVID-19.

The Latin America and Caribbean region experiences inequalities that are both deep and widespread and includes countries that are more unequal than those in other regions with similar levels of development, according to recent reports from the Inter-American Development Bank and the Latin American and Caribbean office of the United Nations Development Programme (UNDP).

The first phase of the US$ 300 000 initiative was launched in July 2020 in response to evidence from several regional online surveys conducted by UNAIDS since the onset of the COVID-19 pandemic. Grants were initially distributed among 31 projects, 10 of which were also funded with the support of UNAIDS Cosponsors through their regional offices—the United Nations Population Fund (UNFPA) helped fund four projects, whereas the United Nations Children’s Fund (UNICEF), the World Food Programme (WFP) and UNDP funded two projects each.

Data from the 31 initiatives of the first round of grants collected up to July 2021 by the UNAIDS Regional Support Team for Latin America and the Caribbean show that more than 700 000 people in the region had already been reached through the projects’ activities. Altogether, the community-led projects have delivered more than 270 community solutions that have had a direct impact on, for example, the strengthening of health services, the training of vulnerable communities and populations, awareness-raising of key HIV and COVID-19 issues and COVID-19 prevention and mitigation.

Recently, UNAIDS launched a second tranche of funding for 30 community-led initiatives, reaching a total 61 projects in 19 countries (Argentina, Brazil, Bolivia (Plurinational State of), Chile, Colombia, Costa Rica, Dominican Republic, Ecuador, El Salvador, Guatemala, Guyana, Honduras, Mexico, Nicaragua, Panama, Paraguay, Peru, Uruguay and Venezuela (Bolivarian Republic of).

“From 40 years of experience in the HIV response, we have learned that civil society and community-led initiatives are essential to reach the most vulnerable. We were right when we decided to invest in these organizations during the COVID-19 pandemic because they have delivered results and have proven that they are crucial to the response to both pandemics,” said Alejandra Corao, Director, a.i., of the UNAIDS Regional Support Team for Latin America and the Caribbean. “I congratulate the organizations selected in 2020 and hope that the 30 selected for the second phase of funding will also have the same success in reaching the most vulnerable people in these challenging times for our region.”

The implementing phase for these newly selected projects will run until December 2021. All the initiatives were selected by a joint committee formed by the UNAIDS Regional Support Team for Latin America and the Caribbean and the regional offices of UNICEF, WFP, UNDP, UNFPA, the United Nations Educational, Scientific and Cultural Organization and the Pan American Health Organization.

More than 200 Spanish-speaking and 70 Portuguese-speaking organizations participated in virtual workshops organized by UNAIDS to guide community-led organizations in applications for the Soy Clave initiative and in the creation of projects and the definition of objectives for a US$ 5000 grant.

Impact on communities

HIV activist Marcela Alsina, who is from Honduras and who implemented a regional project with the Asociación para una Vida Mejor (APUVIMEH) and the Latin American Movement of Positive Women (MLCM+), noted that the funds allowed the organizations to carry out an online survey in eight countries and to gather data to define their strategic lines of action.

“We learned that 35% of the women surveyed in these countries suffered some type of gender-based or institutional violence during the COVID-19 pandemic,” she said.

At least 23% of all the funding was directed towards women. Funds were also distributed among projects focused on key and vulnerable populations, including indigenous people, Afro-descendant communities and people on the move.

“Thanks to this funding, our project, Hablemos Positivo (Let's Talk Positively), delivered 450 sexual and reproductive health kits and organized talks on health promotion, HIV prevention, sexually transmitted infections and COVID-19,” said Danilo Manzano, of Diálogo Diverso in Ecuador. “We also disseminated a communication campaign on social media to raise awareness about the human rights of lesbian, gay, bisexual, transgender and intersex people on the move, as well as people living with HIV.”

“It is not easy to get funding to work with women, especially women living with HIV in Latin America”, said Kattia López, from the International Community of Women Living with HIV/AIDS in Costa Rica, who developed virtual working groups with more than 60 women living in vulnerable conditions and who suffered violence from their partners during the early stages of the pandemic. “We saw that this project gives us the light to reach women that no one else reaches, and to transform their realities. We are not going to leave any of them behind. Investing in women always pays.”

Nilsa Hernandez, 62, used to work as an informal greengrocer in Venezuela to help increase her family income and provide for her children, grandchildren and great-grandchildren. As a person living with HIV for 16 years, Nilsa had managed to reduce her viral load to undetectable until everything changed suddenly when the political-economic crisis took hold in Venezuela. Health services were severely affected and people living with HIV gradually lost access to regular care, treatment and medication.

"I went about two years without access to treatment. My body started to feel the consequences and I realized that I needed to do something urgently. It was a live or die situation, and I decided to live!", remembers Nilsa.

Nilsa crossed the border and emigrated to Brazil, where HIV treatment is available to everyone through the public health system. It took her a year to prepare for the journey. In 2018, she arrived in Roraima, the Brazilian state bordering Venezuela, with her partner, who also lived with HIV, and her 12-year-old grandson.

They ended up in the streets after suffering all kinds of discrimination and violence. Thanks to the support of people she met, she finally managed to rent a small house in the outskirts of Rio Branco, the capital of Roraima, and resume her HIV treatment. As soon as she recovered immunity, she had no doubt: it was time to become an activist and create Valientes por la Vida (Brave for Life), a voluntary initiative to support other Venezuelans living with HIV who, like her, arrived in Brazil with scarce resources and little information.

"We are brave because it takes a lot of courage to leave your country, often with only the things we had to hand, in search of treatment and in search of life."

Today, as a humanitarian activist, Nilsa has mobilized a network of other Valientes who joined her to spread the word about the arrival of new Venezuelan migrants in search of HIV treatment.

The COVID-19 pandemic has severely affected this process, especially when the borders between Brazil and Venezuela were closed in March 2020. “The closure made it very difficult for my compatriots to access HIV treatment that could save their lives. With the reopening of the border, we are now putting these services back on track."

According to the 2020 Annual Report on Epidemiology issued by the state of Roraima’s medical authority, in the years 2018 and 2019, a combined total of 1,137 cases of HIV/AIDS were reported in the state. Among the foreign population, migrants from Venezuela represent the most significant number of the combined HIV/AIDS cases for the same period: 383 people.

Just like Nilsa, many of the Venezuelan people living with HIV migrate to Brazil in search of access to HIV treatment that they are no longer able to have in many parts of the country. In this context, UNAIDS established a partnership with UNESCO in December 2020 in a joint, collaborative and intersectoral strategy to grant Venezuelan migrants access to health education, prevention, and health promotion, and to support the responses of Roraima to HIV and COVID-19.

Claudia Velasquez, UNAIDS Representative and Country Director in Brazil, explains that the proposal is to reduce prejudice, stigma and discrimination related to migrants and refugees, and more vulnerable populations, such as sex workers and LGBTQIA+ population, youth and indigenous peoples.

"We want to promote the empowerment of vulnerable populations through the dissemination of information about HIV and the rights of people living with HIV”, says Ms. Velasquez. “Nilsa Hernandez is an example of a humanitarian activist. And people like her, who are Brave for Life, show the enormous impact that civil society's mobilization has on supporting and welcoming people living with HIV and on the efforts to face stigma and discrimination, which enhance the inequalities that prevent us from ending the AIDS pandemic by 2030."

For the future, Nilsa's dream is for Valientes por la Vida to become an international organization, with volunteers dedicated to supporting people living with HIV to have access to treatment and a healthy life. "I also want people to stop seeing us as HIV positive. This creates a horrible stigma that weighs on us all. We are not HIV positive. We are brave and impatient because we are in a hurry to live like everyone else."

GENEVA, 11 August 2021—UNAIDS welcomes the announcement by Chile that it recognizes international responsibility for violating the rights of a woman living with HIV who was sterilized without her consent almost 20 years ago. The government has agreed a friendly settlement with the woman, Francisca, that includes the payment of reparations for the violation of her human rights. It has also committed to ending forced sterilization and to guaranteeing reproductive rights as human rights without discrimination.

Francisca delivered a healthy baby boy in 2002 and was then sterilized without her consent by the doctor who carried out her Caesarean section, making the decision that a woman living with HIV should not be able to have children. The friendly agreement announced this week comes after more than a decade’s litigation by the woman and her legal teams.

“This settlement is a significant moment for women around the world who have been fighting for reproductive justice for decades. Coercive sterilization of women living with HIV is a violation of women’s most fundamental human rights,” said UNAIDS Executive Director, Winnie Byanyima. “Unfortunately, this practice is still happening in many countries and efforts to stop it and bring justice to more women must be stepped up.”

This settlement comes after years of efforts before the Inter-American Commission on Human Rights (IACHR) after an earlier complaint in the Chilean justice system was unsuccessful. The case was litigated by the Chilean organization, Vivo Positivo, and the international human rights organization, Center for Reproductive Rights.

UNAIDS submitted an amicus brief to inform the IAHCR the standards that governments must uphold to address the HIV stigma and discrimination that impact women living with HIV. These include the obligation to respect, protect and fulfil women’s autonomy in decision making on matters related to their sexual and reproductive lives, their right to physical integrity and their right to be free from violence, including from violence by health personnel.

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.

Costa Rica has joined the Global Partnership for Action to Eliminate all Forms of HIV-Related Stigma and Discrimination. At a United Nations High-Level Meeting on AIDS side event on 7 June, the Vice President of Costa Rica, Epsy Campbell Barr, emphasized the country’s commitment to human rights by highlighting that a comprehensive and effective HIV response needs to include the human rights of people living with HIV.

Costa Rica is the third signatory to the global partnership in the Latin America and Caribbean region, joining Jamaica and Argentina.

The side event, Latin America and the Caribbean on the Road to Eliminating HIV-Related Stigma and Discrimination, was co-organized by the regional coordinator of the global partnership, RedTraSex (the Sex Workers Network for Latin America and the Caribbean), the Global Network of People Living with HIV and the Governments of Jamaica and Costa Rica, with the support of UNAIDS.

Five year ago, the 2016 United Nations Political Declaration on Ending AIDS recognized the HIV epidemic as a human rights challenge. Member States expressed concern about HIV-related stigma and discrimination around the world and about the regulatory and legal frameworks that discourage and prevent people from accessing HIV-related services.

The Global Partnership for Action to Eliminate all Forms of HIV-Related Stigma and Discrimination was created in 2017. The initiative has the goal of catalysing and accelerating the implementation of commitments made to end HIV-related stigma and discrimination by United Nations Member States, United Nations agencies, bilateral and international donors, nongovernmental organizations and communities.

Countries have made commitments on ending discrimination in various international conventions, and have made further promises at the regional and national levels. The global partnership supports countries in transforming those promises into reality through policies, programmes and practices that strengthen health and HIV-related rights.

Through the regional coordination of RedTraSex, the global partnership supports an open and ongoing dialogue in the regional civil society networks with the goal of strengthening national coordination platforms and representation, with a focus on people living with, at risk of or affected by HIV.

Quotes

“AIDS came to my door as a surprise. It all started in 1988, when my partner, Rafael, started to get sick. We were both 28 years old at the time,” said Georgina Gutiérrez, who has been a human rights activist for people living with HIV in Mexico for more than 30 years.

Today, she is a representative of the Mexican Movement for Positive Citizenship, which aims to promote the empowerment of people living with HIV in prison. She is also part of the Latin American and Caribbean Movement of Positive Women.

“In those years, stigma and discrimination were widespread. I knew about HIV only through television and many women who had HIV-positive partners assumed they were living with HIV without ever having been tested,” she said.

Her partner was imprisoned in Santa Martha Acatitla Penitentiary in Mexico City, where he spent eight years. This was when she got to know the reality inside prison, and it was this experience that would set the course of her life towards working with jailed people living with HIV.

“People living with HIV in prison are invisible to society. I remember many years ago, as a protest they would burn their mattresses, just to demand dignity in their access to HIV treatment,” Ms Gutiérrez recalled.

Ms Gutiérrez knew that there was a need for action to protect the physical and mental health of people living with HIV in prison. This is how she and others started a project against HIV and COVID-19 in the Santa Martha Acatitla Penitentiary.

The project is one of 30 initiatives selected from more than 190 applicants for the UNAIDS 2020 call for proposals for community-based organizations working on HIV in Latin America and the Caribbean that received funding. The project received an award of US$ 5000 to help its work.

The Santa Martha Acatitla Penitentiary houses around 2000 inmates, including 180 people living with HIV, some in the advanced stages of AIDS-related illnesses. People living with HIV are concentrated in Dormitory 10 in the prison.

“Dormitory 10 is overcrowded and physical distancing is difficult. Hygiene standards were low. In addition, most of them had not received COVID-19 personal protective equipment—the very few who were able to access such equipment did so through their families,” said Ms Gutiérrez.

In addition to the 180 people living with HIV in the prison, each of whom received personalized face coverings and other personal protective equipment and who attended a series of trainings, approximately another 1000 staff and inmates benefited from the project.

“I have been able to see them change. They have told me many times that they feel safer with the tools and knowledge they have gained,” said Ms Gutiérrez. “They feel good to know there are people concerned about them during this health crisis.”

“With our trainings and donations, the prisoners can now keep their rooms clean and can frequently wash their hands, clothes and personal belongings.” 

Working for HIV prevention is, “A commitment I have in every drop of my blood,” she said. “With these actions, we are giving life to forgotten people. I thank UNAIDS for financing this project—with it we are supporting a population that is being left behind.”

On any given day, approximately 11 million people worldwide are incarcerated. The risk of sexual violence among prisoners—and their inadequate access to condoms, lubricants, pre-exposure prophylaxis and harm reduction services—increases their chances of contracting HIV, hepatitis C and other sexually transmitted infections.

GENEVA, 29 January 2021—UNAIDS is deeply troubled and concerned about the detention by military police of the Venezuelan citizens and humanitarian workers Johán León Reyes, Yordy Bermúdez, Layners Gutiérrez Díaz, Alejandro Gómez Di Maggio and Luis Ferrebuz, who are members of the nongovernmental organization Azul Positivo. The five have been held since 12 January 2021.

“I call on the Venezuelan authorities to release from police custody the five humanitarians working for the nongovernmental organization Azul Positivo, and to return essential equipment seized at the time of their arrest,” said Winnie Byanyima, UNAIDS Executive Director. “A strong and empowered civil society plays a central role in providing much-needed services to the most vulnerable people and is critical to making progress against the HIV pandemic and other health threats in the Bolivarian Republic of Venezuela.”

Azul Positivo was established in 2004 to work on the prevention of HIV in the state of Zulia, Bolivarian Republic of Venezuela. UNAIDS has supported Azul Positivo’s work for many years and has witnessed the positive impact of their contributions to the community.

UNAIDS is strongly supportive of the full empowerment and engagement of civil society organizations in the AIDS response and in humanitarian work. It looks forward to continuing its partnership with community and civil society organizations in the Bolivarian Republic of Venezuela, as well as with government officials, in ensuring that all people affected by HIV have access to HIV prevention, treatment and social support services and that their human rights are protected.

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.

When Lima celebrated this year’s World AIDS Day, the Mayor, Jorge Muñoz, decided to go beyond the traditional lighting of buildings and participation in official events to mark the day. By signing the Paris Declaration to end the AIDS epidemic in cities, he joined the Fast-Track cities initiative, a network of more than 300 municipalities around the world, 70 of which are in Latin America and the Caribbean, and committed to ending the AIDS epidemic as a public health threat by 2030.

Lima has a population of more than 10 million people and accounts for around one third of the national population. Lima and the two other Peruvian municipalities that have already signed the Paris Declaration, Callao and La Victoria, accounted for around 50% of all new HIV infections in the country in 2019.

“Through this public commitment, the city of Lima pledges to carry out the necessary actions to accelerate the response to AIDS, including education, awareness-raising and non-discrimination campaigns,” said Mr Muñoz during the signing ceremony. “We will also implement a work plan to train health personnel and promote access to information and sex education.”

“With the signature of the Paris Declaration, the city has committed to eliminate stigma and discrimination against people living with HIV and key populations, scale up HIV prevention services and contribute to achieving national targets to end AIDS as a public health threat by 2030 as part of the Sustainable Development Goals,” said Andrea Boccardi, the UNAIDS Country Director and Representative for Peru, Ecuador and the Plurinational State of Bolivia.

This is not the first time that Mr Muñoz has taken action against discrimination. In May 2019, when he was the Mayor of the city of Miraflores, he established an ordinance that prohibited discrimination in all its forms in the public and private spheres of the district. Now, as the Mayor of Lima, he has extended that policy to the entire province.

On 1 December 2014, mayors from around the world met in Paris to launch the Fast-Track cities initiative and pledged to adopt a series of commitments to accelerate their response to HIV, with the aim of ending the AIDS epidemic by 2030. Besides committing to ending the AIDS epidemic at the municipal level and uniting as leaders, the signatories also commit to putting people at the centre, addressing the causes of risk, vulnerability and transmission of HIV, using the AIDS response for positive social transformation, building and accelerating appropriate responses reflecting local needs, and mobilizing resources for integrated public health and sustainable development. 

UNAIDS is saddened by the death of Guillermo Soberon Acevedo on 12 October at the age of 94 years. He leaves behind a long list of accomplishments in his home country, Mexico, in the education and health sectors. He was the architect of modern public health in Mexico and served as the Rector of Mexico’s National University through difficult times, from 1973 to 1981.

Under his leadership as the Minister of Health from 1982 to 1988 he secured the constitutional right to health for all Mexicans and created the National Institute of Respiratory Diseases, which has become today vital for people with the new coronavirus. He also established the National Institute of Public Health and created around 800 health centres and general hospitals.

Dr Soberon led the AIDS response in Mexico in the early 1980s from the Ministry of Health and started public debates on prevention campaigns that included the use of the word “condom”, proudly confronting fundamentalist groups in the country. He is also known for spearheading Mexico’s health response to the 1985 earthquake.

When he led the National Bioethics Commission from 2004 to 2009 his work included the right to health and the role of homophobia in limiting effective health responses.

He was a great friend of UNAIDS. His vision to host the SIDALAC initiative, funded by the World Bank, which became a UNAIDS collaborative regional project as soon as the Joint Programme started to operate, allowed the flourishing of a programme that contributed to strengthening the AIDS response throughout Latin America and the Caribbean. He was also a member of the UNAIDS Human Rights Committee at the beginning of its operation.

Once the COVID-19 lockdown in her country was put in place, Marisela Mariño (not her real name), a transgender woman living with HIV, immediately contacted her treatment provider, convincing them to supply her with antiretroviral therapy to last at least two months.

“I was saved by having the phone number of one of the health promoters at the clinic I attend,” said Ms Mariño. But now she, like seven out of 10 people who responded to a Latin American regional survey on the needs of people living with HIV during the COVID-19 pandemic, does not have enough antiretroviral medicines for a lockdown of more than 60 days.

From the online survey, which was answered by 2300 people from 28 countries in the region, it was seen that despite the communication efforts by national health authorities and the international organizations that are leading the response to COVID-19, 31% of people stated that they had not received sufficient information on preventing the transmission of the new coronavirus. More than half, 56%, expressed that they do not have sufficient personal protective equipment, while only 22% of people think that masks are a useful protection against COVID-19.

Claudia Cardenal (not her real name), another transgender woman in the region, says that the offer of services adapted to the COVID-19 pandemic is not reflected in the options for people living with HIV. Ms Cardenal only has antiretroviral treatment for one more month, despite the World Health Organization recommendation that people living with HIV have at least a three-month supply.

The survey also shows that five out of 10 people are having difficulties in obtaining their antiretroviral treatment during the pandemic and less than two out of 10 people had antiretroviral medicines delivered to their homes.

Only three out of 10 people have been offered the option of telemedicine, and four out of 10 people living with HIV in Latin America state that they need psychological support to address anxiety related to COVID-19.

Stigma and discrimination continues to be an important barrier for people living with HIV to fully access their rights. More than half of the people surveyed, 56%, believe that they could suffer physical, psychological or verbal violence due to living with HIV in the midst of the COVID-19 pandemic. Forty per cent answered that they do not know where to go or call in the event that they encounter violence or discrimination due to living with HIV and the fear of discrimination caused three out of 10 people to refrain from accessing services in the midst of lockdowns.

Confinement can increase and incentivize stigma and discrimination. For example, in countries that have rules on leaving one’s home under the lockdown based on gender, violence to people with a different gender identity or expression than that appearing on their official identification may increase.

Job loss or lack of income was a top concern in the findings of the survey. Mobility restrictions and compulsory quarantines have deprived four out of 10 people who needed to leave their homes for work of their income, which means that four out of 10 people require nutritional support and/or cash transfers.

From the results of the survey, it is clear that the response to COVID-19 should consider the realities of people’s lives and focus on removing the barriers that people face to protect themselves and their communities.

Countries, ministries of health and national AIDS programmes should ensure access to three months or more of antiretroviral therapy by all people living with HIV, including refugees and migrants. In addition, the provision of food and other social protection services, including temporary shelters for key populations, people living with HIV and other vulnerable people, must be ensured.

The provision of services and support to the populations most affected by violence, especially women and girls, also needs to be a key priority for governments.

“This evidence has been shared with Cosponsors, national AIDS programmes and civil society organizations. I urge them to push for multimonth dispensing of antiretroviral therapy, social protection measures focusing on key populations and people living with HIV and support for mental health initiatives,” said César Núñez, Director of the UNAIDS Regional Support Team for Latin America and the Caribbean.