This will speed up progress to end the AIDS pandemic and save lives.

GENEVA, 4 October 2023—The United Nations in Mauritius—which includes UNAIDS, UNFPA, OHCHR, UNDP and WHO—welcome today’s ruling by the Supreme Court of Mauritius that a discriminatory law criminalizing consensual same sex relations is unconstitutional and will be immediately struck from the legal code. Previously, under Section 250 of the Mauritian Criminal Code (which dated back to 1898) anyone convicted could have faced up to five years in prison.

“The Supreme Court today overturned an obsolete colonial law and demonstrated its commitment to non-discrimination and leaving no-one behind,” said Lisa Singh, United Nations Resident Coordinator in Mauritius. “The UN in Mauritius and internationally welcomes the decision of Mauritius to join the growing list of African countries protecting the human rights of everyone, including LGBTQI+ people.”

The ruling noted that “Section 250 was not introduced in Mauritius to reflect any indigenous Mauritian values but was inherited as part of our colonial history from Britain. Its enactment was not the expression of domestic democratic will, but was a course imposed on Mauritius and other colonies by British rule.” It also noted that a growing number of countries have decriminalized consensual same sex sexual relations, including the United Kingdom which overturned its law in 1967. 

“Mauritius' decision to decriminalize homosexuality is an important step forward for public health and a step towards equal rights, respect and dignity for the LGBTQI community,” said Anne Githuku-Shongwe, Director of UNAIDS’ Regional Support Team for Eastern and Southern Africa. “UNAIDS applauds Mauritius for today’s decision which will mean that men who have sex with men will have much easier access to the health and social services they need without fear of arrest or criminalization. Work will need to continue to break down the barriers of stigma and discrimination towards the LGBTQI community, but today’s ruling is a positive step in the right direction. It will save lives.”

Mauritius becomes the latest in a growing list of countries to declare that laws which have criminalized LGBTQI people are unconstitutional. However, UNAIDS estimates that 66 countries still have laws which criminalize consensual same sex relations. In addition to contravening the human rights of LGBTQI people, these laws impede access to health and social services, including HIV services. Such laws fuel stigma and discrimination against LGBTQI people and put them under constant fear of being punished or detained.

The case was brought forward by Abdool Ridwan Firaas Ah Seek, President of Arc-en-Ciel, the largest and longest-standing organisation in Mauritius championing the human rights of LGBTQI people, and was supported by partners including the Human Dignity Trust.

Civil society organizations, especially community-led organizations, are at the forefront of a global wave of progress that advances access to health for all. UNAIDS urges all countries to decriminalise same sex sexual relations. Decriminalization saves and changes lives.

Maneesh Gobin, Attorney General and Minister of Foreign Affairs and Regional Integration in Mauritius said, “In keeping with its internationally acclaimed respect for the rule of law, Mauritius will indeed report to United Nations Member States at the next cycle of the Universal Periodic Review.” The Universal Periodic Review is a unique mechanism of the Human Rights Council that calls for each UN Member State to undergo a peer review of its human rights records every 4.5 years.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

GENEVA, 13 July 2023—A new report released today by UNAIDS shows that there is a clear path that ends AIDS. This path will also help prepare for and tackle future pandemics and advance progress towards achieving the Sustainable Development Goals. The report, ‘The Path that Ends AIDS’, contains data and case studies which highlight that ending AIDS is a political and financial choice, and that the countries and leaders who are already following the path are achieving extraordinary results.

Botswana, Eswatini, Rwanda, the United Republic of Tanzania, and Zimbabwe have already achieved the “95-95-95” targets. That means 95% of the people who are living with HIV knowing their HIV status, 95% of the people who know that they are living with HIV being on lifesaving antiretroviral treatment, and 95% of people who are on treatment being virally suppressed. A further 16 other countries, eight of them in sub-Saharan Africa, the region which accounts for 65% of all people living with HIV, are also close to doing so.

“The end of AIDS is an opportunity for a uniquely powerful legacy for today’s leaders,” said Winnie Byanyima, Executive Director of UNAIDS. “They could be remembered by future generations as those who put a stop to the world’s deadliest pandemic. They could save millions of lives and protect the health of everyone. They could show what leadership can do.”

The report highlights that HIV responses succeed when they are anchored in strong political leadership. This means following the data, science, and evidence; tackling the inequalities holding back progress; enabling communities and civil society organizations in their vital role in the response; and ensuring sufficient and sustainable funding.

Progress has been strongest in the countries and regions that have the most financial investments, such as in eastern and southern Africa where new HIV infections have been reduced by 57% since 2010.

Thanks to support for and investment in ending AIDS among children, 82% of pregnant and breastfeeding women living with HIV globally were accessing antiretroviral treatment in 2022, up from 46% in 2010. This has led to a 58% reduction in new HIV infections among children from 2010 to 2022, the lowest number since the 1980’s.

Progress in the HIV response has been strengthened by ensuring that legal and policy frameworks do not undermine human rights, but enable and protect them. Several countries removed harmful laws in 2022 and 2023, including five (Antigua and Barbuda, the Cook Islands, Barbados, Saint Kitts and Nevis, and Singapore) that have decriminalized same-sex sexual relations.

The number of people on antiretroviral treatment worldwide rose almost fourfold, from 7.7 million in 2010 to 29.8 million in 2022.

However, the report also sets out that ending AIDS will not come automatically. AIDS claimed a life every minute in 2022. Around 9.2 million people still miss out on treatment, including 660 000 children living with HIV.

Women and girls are still disproportionately affected, particularly in sub-Saharan Africa. Globally, 4,000 young women and girls became infected with HIV every week in 2022. Only 42% of districts with HIV incidence over 0.3% in sub-Saharan Africa are currently covered with dedicated HIV prevention programmes for adolescent girls and young women.

Almost one quarter (23%) of new HIV infections were in Asia and the Pacific where new infections are rising alarmingly in some countries. Steep increases in new infections are continuing in eastern Europe and central Asia (a rise of 49% since 2010) and in the Middle East and North Africa (a rise of 61% since 2010). These trends are due primarily to a lack of HIV prevention services for marginalized and key populations and the barriers posed by punitive laws and social discrimination.

Funding for HIV also declined in 2022 from both international and domestic sources, falling back to the same level as in 2013. Funding amounted to US$ 20.8 billion in 2022, far short of the US$ 29.3 billion needed by 2025.

There is an opportunity now to end AIDS by increasing political will by investing in a sustainable response to HIV through financing what matters most: evidence-based HIV prevention and treatment, health systems integration, non- discriminatory laws, gender equality, and empowered community networks.

“We are hopeful, but it is not the relaxed optimism that might come if all was heading as it should be. It is, instead, a hope rooted in seeing the opportunity for success, an opportunity that is dependent on action,” said Ms Byanyima. “The facts and figures shared in this report do not show that as a world we are already on the path, they show that we can be. The way is clear.”

In 2022, an estimated:

• 39.0 million people globally were living with HIV
• 29.8 million people were accessing antiretroviral therapy
• 1.3 million people became newly infected with HIV
• 630 000 people died from AIDS-related illnesses

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.

As millions of people around the world march in the streets of several big cities this month of June to celebrate and honor Pride Month, in Guatemala, over 200 LGBTIQ+ people in human mobility - applicants for refugee or asylum status or nationals and foreigners in transit – and in need of protection find every year in Asociación Lambda their reason to celebrate pride and life through psychosocial care, legal support, medical follow-up and the provision of a shelter or a safe space to be who they are.

Roberto Gonzales*, a Colombian migrant, is one of them. Like hundreds of thousands of other migrants, he overcame the exhausting experience of crossing the Darien Gap,  a journey in which the dangers include natural hazards and criminal gangs known for inflicting violence, including sexual abuse and robbery. According to statistics from the Government of Panama, from January to April 2023, a record number of 127,000 people crossed the Darien.

Unlike many people who go after the American dream, Gonzales wants to stay in Guatemala because the country has a lot to offer. "LAMBDA, for me, is a unique platform of empowerment. They listen to you; they invite you for training twice a month", he says. "Through Lambda, I have formed a network of friends and support. One should not forget the importance of mental health if we want to move forward."

Asociación Lambda works to improve the livelihoods of this marginalized group by providing technical assistance to community groups in management, governance, leadership, and entrepreneurship skills. Lambda's activities strengthen community organizations through education and training and build action and peer-to-peer learning networks.

Andres Martinez*, from Nicaragua, is thankful to Lambda for their support in successfully processing his refugee claim. In his country, he was persecuted for being a journalist and suffered violence in his community because of his sexual orientation. "It is difficult to reinvent oneself in another country, but my favorite color is green, the color of hope, because I hope one day to return to my country," says Martinez. "Here, at Lambda, I felt supported by a brother. One feels very safe with the staff. The shelter is my second home."

As in many parts of the world, LGBTQI+ people in Central America face a complex reality that exposes them to different forms of violence and discrimination and puts their physical integrity at risk, limits their life options, often forces them to flee their homes, and, in some cases, to escape their own countries. The National LGBTIQ+ Human Rights Observatory, which Lambda coordinates, documented at least 29 violent deaths of LGBTIQ+ people in 2022 in the region, killed for reasons allegedly related to their sexual orientation, gender identity, and gender expression.

As part of the LGBTIQ+ Pride Month activities, Lambda opened the doors of its shelter to a United Nations delegation in Guatemala led by the Resident Coordinator Miguel Barreto for an exchange with migrants hosted and receiving care in their safe space. "I came away from the dialogue more human and supportive, and convinced of the centrality of the United Nations commitment to end discrimination and exclusion, reduce vulnerabilities, and promote the human rights of every human being," said Barreto after the visit and the dialogues.

Along with UNAIDS, several UN agencies, funds, and programmes, like the United Nations High Commissioner for Refugees (UNHCR), the International Organization for Migration (IOM), and the Office of the High Commissioner for Human Rights (OHCHR), have joined forces to support Lambda in different fronts hosting, sheltering and supporting LGBTIQ+ migrants and those in transit or in need of protection.

"Before coming to Lambda, very few of our clients had had sufficient access to information about HIV risks and prevention, many of them are victims of sexual crimes, and it is only when they arrive at Lambda that they are offered information and testing free of charge," explains Carlos Valdés, Director of Lambda. "Some people were already aware of their HIV diagnosis but did not know how to access care services."

Globally in 2021 gay men and other men who have sex with men have a 28 times higher risk of acquiring HIV than the rest of the adult (15-49) male population, and among transgender women, the risk is 14 times higher than adult women (15-49) in the general population

Among over 200 people who came to Lambda in 2022, 19% of the men and 17% of the women lived with HIV.

"The vast majority of these people were trans women and gay men, mainly from Guatemala, Honduras, Venezuela, and Nicaragua," explains Marie Engel, UNAIDS Representative for Guatemala, Nicaragua, and Honduras. "We know that these situations of stigma, discrimination, and violence create barriers to accessing health services, including HIV. We must recognize the greater vulnerability of the LGBTQI+ community to HIV and support their right to health and dignity."

*All names of Lambda beneficiaries in this report have been changed for people’s safety.

At his previous factory job, Tom Wang (not his real name) says coworkers gossiped about his sexuality and made fun of him. When he visited a public health facility for an HIV test, the nurse peppered him with questions like “Why do you need it? Have you been sleeping with many partners?”

Thailand is a country famed for its tolerance. It is among the world’s top locations for gender affirming care. Same-sex sexual activity hasn’t been criminalised since 1956. And the policy tide is turning on other key population issues. A 2021 Drug Law allows for harm reduction as opposed to automatic imprisonment, while a bill is in the pipeline to affirm the rights of sex workers. Yet stigma and discrimination persist. In homes, communities, schools, workplaces and—critically—healthcare settings, discriminatory attitudes can take their toll.

“Microaggressions—intentional or unconscious verbal or behavioural slights toward stigmatised groups—can drive people away from HIV prevention and treatment,” noted UNAIDS Regional Human Rights and Law Adviser, Quinten Lataire. “There are evidence-based approaches for measuring and lowering both overt and subtle stigma and discrimination in healthcare settings.”

It was this need for stigma-free services that led to the establishment of the Rainbow Sky Association of Thailand (RSAT). RSAT offers sexual healthcare for men who have sex with men, migrants, people who use drugs, sex workers and transgender people. It also advocates for the full rights and equity of lesbian, gay, bisexual and transgender (LGBT) communities. Tom Wang is amongst the clients who have benefited from their support.

This work is critical if HIV programmes are to reach and retain key population communities. In Thailand, as in the rest of Asia, these groups carry the heaviest HIV burden. Nationally HIV prevalence is 1% for sex workers, 8% for people who use drugs, 11% for transgender women and 12% for men who have sex with men.

A one stop shop for sexual health services

RSAT’s approach demonstrates how programmes can improve outcomes by implementing strategies to affirm and empower clients. They are jointly supported by PEPFAR, USAID, EpiC, the National Health Security Office (NHSO) and Thailand’s Institute of HIV Research and Innovation (IHRI).

There are no depressing charts or drab walls at their five key population clinics. At the Bangkok site the rainbow motif appears on the floors and walls. There are swarms of cut-out butterflies. Signs are either upbeat and multi-coloured or a soothing blue.

Most of the staff are themselves members of key population groups. All staff receive anti-stigma and discrimination training which even addresses the fine point of body language. Nothing about staff’s interactions should make a client feel judged or uncomfortable. The entire team is retrained annually. There is an internal complaint mechanism that allows clients to confidentially flag issues, as well quality assurance staff to ensure Standard Operating Procedures are followed. Every team member signs a confidentiality agreement.

RSAT’s service package includes on-site testing for HIV and other sexually transmitted infections, Hepatitis C, Tuberculosis and Covid-19. For transgender clients they offer hormone level monitoring. Mental health screenings which evaluate for depression, anxiety and stress have been integrated into the HIV service package. Where required, clients are referred for additional mental healthcare.

“Many of our clients engage in chem sex (recreational drug-use during intercourse). Some clients inject meth so we need to provide more than condoms. They also need clean syringes and needles which are part of our harm reduction package,” said Deputy Director, Kao Kierati Panpet.

Pre- and post-test counselling are critical. All counsellors are certified and accredited by the Ministry of Public Health according to Counsellor Supervisor, Sasiprapha Khamthi. Even before receiving HIV test results, clients know that treatment is available. Following a positive test, the counsellors reassure clients that with treatment they can live a normal life, explained Niphon Raina, Care and Counselling Supervisor.

“We also ask what their concerns are and give basic information about how HIV is and is not transmitted, using a picture book so they are clear on the facts,” Care and Counseling Officer, Bussarin Poonvisitkun added.

RSAT keeps a stock of antiretroviral therapy drugs onsite and can initiate new clients’ treatment on the day of diagnosis by giving them one month’s supply. Although HIV care is provided at the Ratchaphiphat Hospital, RSAT is able to dispense right away in accordance with instructions from a hospital doctor, delivered via telemedicine. Clients living with HIV receive help from the care and support team to navigate their next steps, including attending hospital visits.

RSAT also provides pre-exposure prophylaxis or PrEP services with hospital supervision. Mr. Tom Wang explains how this has protected his health: “I decided to get on PrEP because I am changing partners. To me PrEP is another means of protection in case you are intoxicated or the condom breaks. It’s a way to ensure I stay HIV-free.”

A redress mechanism for rights violations

The organisation advocates for structural changes to eliminate stigma and discrimination. For example, they are currently making recommendations for the Gender Recognition Draft Bill.

“But the reality is that policy and legal changes take a lot of time,” said RSAT Director, Tanachai Chaisalee.

While this longer-term work proceeds, a redress mechanism helps clients address current concerns. RSAT is tapped into the Crisis Response System (CRS) initiated by the Ministry of Public Health in collaboration with the Office of the Attorney General, Ministry of Justice. People with complaints about prejudice or rights violations in any sphere can scan a QR code and report their experience. Reports may also be sent via Facebook, email or LINE, Thailand’s answer to WhatsApp. A multi-disciplinary team conducts investigations and works with the client and other stakeholders to help.

The lion’s share of reports made via RSAT come from transwomen (78%) while gay men have lodged 17% of reports. The most common challenges relate to requirements for gender confirming attire, social exclusion (particularly during job application processes) and HIV status.

RSAT’s Human Rights Manger, Watcharawit Waraphattharanon, shares that they have been able to resolve some cases very quickly. For instance, if a person living with HIV is being forced to take an HIV test as a requirement for work, the Attorney General’s office does an emergency intervention.

“We can close these cases within one week,” he said.

“The work of key population-led, community-based organisations like RSAT is critical to reach those who most need HIV services,” UNAIDS Country Director, Patchara Benjarattanaporn stressed. “The Government’s progress in funding Community-led Health Services and building partnerships between these organisations and the public health system puts us on the path to end AIDS.”

A group of journalists visited the Ozone Foundation as part of the UNAIDS, UNDP, APN Plus and USAID/PEPFAR Southeast Asia Regional Workshop on HIV-related Stigma and Discrimination in Bangkok, Thailand on June 8, 2023. Learn more about this novel training

GENEVA, 1 June 2023—As the world comes together to celebrate Pride Month, UNAIDS stands in solidarity with lesbian, gay, bisexual, transgender, queer and intersex (LGBTQI) communities around the globe. Pride Month provides an opportunity to celebrate the resilience, diversity, and achievements of LGBTQI individuals, while also reflecting on the challenges they continue to face. This momentous occasion serves as a reminder of our collective commitment to human rights, equality, and the urgent need to decriminalize same-sex relationships.

Cleiton Euzebio, Senior Advisor for Communities and Key Populations, UNAIDS said, “As a gay man, and as an activist for social justice for all, I am so proud to work for the UN’s Joint Programme to end AIDS. The UN is standing with communities, supporting them in leading the HIV response, confronting stigma, and building societies where every person is valued. This month and every month, may everyone feel pride in who they are.”

Thanks in large part to efforts led by key populations, the world has seen substantial progress in the HIV response. The end of AIDS is possible. However, inequalities stand in the way. Discrimination, violence, and stigma against LGBTQI people persist in many parts of the world, limiting access to essential services, including HIV prevention, treatment, care, and support.

Criminalization of same-sex relationships remains a significant barrier to achieving social justice and equality for LGBTQI individuals, and to ensuring health for all. Laws that criminalize consensual same-sex activity perpetuate stigma, contribute to violence and discrimination, and obstruct access to vital healthcare services. UNAIDS calls on all governments to urgently repeal discriminatory laws and policies, and to work towards creating an enabling legal and social environment that respects and protects the rights of LGBTQI people.

The decriminalization of same-sex relationships is a crucial step in our collective efforts to end the AIDS pandemic. When marginalized communities are criminalized or stigmatized, their vulnerability to HIV infection increases, and their access to HIV prevention, treatment, care, and support services is obstructed.

Significant gains that have been won in advancing LGBTQI rights in many parts of the world, including the decriminalization of same-sex relationships in several countries—from Angola to Singapore to Barbados. However other countries are imposing harsher criminal laws on same sex relationships. Decriminalizing homosexuality is essential to ensuring the end of AIDS.

UNAIDS will be taking part in the Geneva Pride march on 10th June. Pride Month is a vital reminder of the need for governments, civil society organizations, and individuals to join together for the protection and promotion of human rights for all, irrespective of sexual orientation, gender identity, or expression. Together, we can build a world that upholds equality, justice, and dignity for everyone.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

GENEVA | WASHINGTON, D.C., 29 May 2023— The Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund), the Joint United Nations Programme on HIV/AIDS (UNAIDS), and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) are deeply concerned about the harmful impact of the Ugandan Anti-Homosexuality Act 2023 on the health of its citizens and its impact on the AIDS response that has been so successful up to now.

Uganda’s Leadership Towards Ending the AIDS Pandemic as a Public Health Threat

Uganda and President Yoweri Museveni have been leaders in the fight to end AIDS. Progress has been made thanks to the implementation of large-scale prevention, diagnosis, treatment and care programs, all provided on the principle of access to health care for all who need it, without stigma or discrimination. This approach has saved lives. The strong health systems built to support the AIDS response serve the entire population of Uganda. This was evident as community health workers and health systems developed for the AIDS response played a key role in tackling COVID-19 and other disease threats. Maintaining this is vital: Failures in the HIV public health response will have system-wide impacts that could negatively affect everyone.  

Success Is Possible

We know that we will be able to overcome this public health threat when we ensure that 95% of people living with HIV know their status, 95% of them are on treatment, and 95% of those on treatment have achieved viral suppression. Uganda can reach that. By 2021, 89% of people living with HIV in Uganda knew their status, more than 92% of people who knew their HIV status were receiving antiretroviral therapy, and 95% of those on treatment were virally suppressed.  Uganda is well on track to achieve the UNAIDS HIV treatment targets if progress can be maintained. 

Discrimination Threatens Progress in the AIDS Response

Uganda’s progress on its HIV response is now in grave jeopardy. The Anti-Homosexuality Act 2023 will obstruct health education and the outreach that can help end AIDS as a public health threat. The stigma and discrimination associated with the passage of the Act has already led to reduced access to prevention as well as treatment services. Trust, confidentiality, and stigma-free engagement are essential for anyone seeking health care. LGBTQI+ people in Uganda increasingly fear for their safety and security, and increasing numbers of people are being discouraged from seeking vital health services for fear of attack, punishment and further marginalization.

Uganda has repeatedly demonstrated leadership and commitment to ending AIDS – and has achieved great success – by leaving no one behind. Together as one, we call for the Act to be reconsidered so that Uganda may continue on its path to ensure equitable access to health services and end AIDS as a public health threat by 2030.  

Peter Sands, Executive Director, The Global Fund

Winnie Byanyima, Executive Director, UNAIDS, and Under-Secretary General of the United Nations

Ambassador John Nkengasong, U.S. Global AIDS Coordinator and Special Representative for Global Health Diplomacy, U.S. Department of State

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.

Released ahead of the International Day against Homophobia, Transphobia and Biphobia – 17 May 2023

GENEVA, 15 May 2023—Around the world, 67 countries still criminalise same sex relations, with 10 imposing the death penalty. 20 countries criminalise gender diversity. Such laws hurt the public health of everyone, costing lives. Public health and human rights go hand in hand.

“The importance of decriminalising homosexuality and gender diversity cannot be underestimated,” said Christine Stegling, Deputy Executive Director, Policy, Advocacy and Knowledge, UNAIDS. “Decriminalising will save lives and is a crucial step towards equality, dignity, and health for all.”

Across all cultures, sexual orientation, gender identity, and expression are diverse. LGBTQI+ people are part of every society in every country since time immemorial, yet LGBTQI+ people continue to be marginalised and excluded—be it legally, culturally, socially or a combination of all.

Criminalisation, along with pervasive discrimination and violence, obstructs LGBTQI+ people from accessing life-saving services. In a growing number of cases, health service providers are also experiencing being harassed by vigilantes or police for providing life-saving services to LGBTQI+ people.

UNAIDS reports that in countries where same sex relations are criminalised, HIV prevalence is five times higher among gay men and men who have sex with men than in countries where same sex relations are not criminalised. Where there have been recent prosecutions, this increases to 12 times higher.

Recognizing that criminal laws have a detrimental impact on the HIV response, United Nations member states at the UN General Assembly committed to ambitious targets in the 2021 Political Declaration on HIV to remove criminal laws that are undermining the HIV response and leaving key populations behind. Recognizing decriminalisation as a critical element in the HIV response, countries made a commitment that by 2025, less than 10% of countries would have punitive legal and policy environments that affect the HIV response.

There has been a positive wave of progress. In the past year Antigua & Barbuda, St Kitts & Nevis, Singapore, Barbados and the Cook Islands have repealed old colonial laws which had criminalised same-sex relations. Kuwait’s court overturned a law that had criminalised “imitating the opposite sex”.

Brazil is amongst the countries driving forward progress in advancing the human rights of LGBTQI+ people. The Minister of Health and the Minister of Human Rights will announce that the country will be joining the Global Partnership for Action to Eliminate All Forms of HIV-related Stigma and Discrimination during an event on 17 May. The event will focus on access to care and justice for trans and gender-diverse communities.

However, running counter to the wave of progress is a renewed, well-funded, well-organised international drive to sow prejudice and push discriminatory and harmful new anti-homosexuality legislation and anti-trans legislation.

If enacted into law, this legislation will have extremely damaging consequences for public health, obstructing LGBTQI + people from accessing health services, and obstructing health workers from providing, life-saving services including services to prevent and treat HIV. It is vital for public health that this harmful push be stopped.

On International Day against Homophobia, Transphobia and Biphobia, UNAIDS is calling on all countries to remove punitive laws and tackle prejudices against lesbian, gay, bisexual, transgender and intersex people. A more just, equitable and kind world is a healthier one, for everyone.

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.

On April 14^th members of the Cook Islands rainbow community assembled at parliament with colourful flags and cautious optimism. It turned out to be the day they’d been working toward for the last twelve years. Parliament removed laws prohibiting consensual sex between men, striking out sections of the Crimes Act that had been on the books since the turn of the 20^th century.

“This decision by Cook Islands is part of a wave of global progress around abolishing harmful laws,” noted UNAIDS Asia Pacific Regional Director, Eamonn Murphy.

“This was a huge historical moment,” said Valery Wichman, President of the Te Tiare Association, the nation’s oldest lesbian, gay, bisexual and transgender (LGBT) organisation. “It’s not just a win for the community, but also a shift in terms of our nation maturing and upholding the constitutional rights of all people.”

Ms Wichman, an attorney and public servant, is also an akava'ine—a Māori word meaning transgender woman. She attests that the anti-LGBT laws which made so-called “sodomy” and “indecent acts” punishable by imprisonment reinforced prejudices. This contributed to the LGBT community’s exclusion, harassment and bullying. She has herself experienced being mocked and assaulted.

“A lot of people chose not to live here. It was too hard for them to endure their family’s and society’s judgment. The idea that you are not worthy has carried down from parents to children and has affected how we have been treated by our peers. A lot of trans women have not gone to the doctor because they have been misgendered and have felt disrespected. There have been cases where they ended up dying,” she said.

The journey toward law reform started in 2011. The spark was the discriminatory response to the nation’s first HIV diagnosis. Te Tiare led the advocacy charge with support from organisations including the Cook Islands Family Welfare Association.

A Crimes Bill drafted around 2013 removed the discriminatory clauses. In 2017 parliament set up a Standing Committee to review its raft of proposed revisions. Support for civil society to prepare submissions outlining public health grounds for reforms was provided by the United Nations Development Programme (UNDP), the lead agency amongst the United Nations Joint Programme on HIV and AIDS working on effective democratic governance and issues affecting sexual and gender minorities.

But following a political change the next year, the committee’s Chair recommended retaining the ban on gay sex. What’s more, he proposed a new section criminalising sex between women. The bill remained in limbo for years. Reform efforts seemed to hit a wall.

A strategy of public dialogue and political engagement rooted in Cook Islands culture enabled a breakthrough. Pride Cook Islands (PCI) was formed as a sister organisation to Te Tiare, focusing on this public advocacy branch of work.

“Obviously we are in a unique situation as a small, conservative, religious population,” PCI President, Karla Eggelton began. “The work of advocacy becomes more delicate when you are living beside people making these decisions for you. We welcomed support from international allies, but we knew we had to do this our own way and have our own approach that is mindful of the situation and culture we live in.”

First TCI tackled messaging. There were deep deliberations around word choice. The mandate was to keep the conversation simple. Ultimately the cause was framed as an equality issue. The rallying cry became, ‘don’t make us criminals in our own country’.

The organisation stayed in communication with policymakers on both sides of aisle. They not only explained their position, but sought to understand politicians’ concerns.

The group met with traditional leaders who are grassroots decision-makers. Village communities were invited to have conversations during public meetings.

“It offered an opportunity for us to understand the misperceptions. We were able to explain that all we are asking for is to not be made criminals. People said, ‘we don’t want to send you to jail, we love our neighbours and our family’,” Ms Eggelton remembered.

The organisation’s patron is Lady Tuaine Marsters whose husband, Sir Tom Marsters, is the British King’s Representative. Lady Marsters frequently attended consultations. Other spokespersons included parents and people with standing in the church. At times supporters were invited to simply stand in solidarity. But anyone who would speak was carefully prepared.

“We spent hours articulating what we would say. We reaffirmed our pledge to not become emotional. We had to keep each other in check to make sure we did not say anything we could regret,” Ms Eggelton outlined.

Then came an effort to increase visibility. The call for equality was largely coming from the LGBT community. They needed other people to demand the same. So PCI embarked on a campaign for people to show their support either by lending their voice to the public dialogue or flying the rainbow flag.  The group distributed free flags, urging people to fly one for their daughter, son or grandchild. From restaurants to bars, t-shirts to earrings, the display of support resonated.  

A first-of-its-kind pride ad on TV, newspapers and radio challenged Cook Islanders: “We are good enough to be your teachers, nurses, choreographers, dressmakers and orators… but not good enough in the eyes of the law. We are already part of your community, we are just asking you to recognise us as equals.”

This visibility and advocacy work was supported by UNDP through the Being LGBTI in Asia and the Pacific program. PCI developed a project to strengthen the digital capacities of community organisations. A critical outcome was the Pride Pledge Cook Islands initiative with the business community which provides visible safe spaces for LGBT people.

“The UNDP support was instrumental in promoting acceptance and awareness and utilising digital tools to share our message,” Ms Eggelton said.

TCI conducted frequent polls to gauge public sentiment. At the start of the process they lagged behind reform opponents. But by the time would-be Prime Minister, Mark Brown, made an election promise to change the law last year, public sentiment had tilted.

“Once we were able to establish that it was really about equality, then we saw a changing of the tide,” Ms Eggelton reflected.

Ultimately the entire government bench voted in favour of an Amendment Bill while opposition leader, Tina Brown, and two of her Members of Parliament also supported.

Renata Ram, UNAIDS Country Director for Fiji and the Pacific, noted that seven other countries in the Pacific region retain laws criminalising same-sex relations.

“The Cook Islands example proves that along with law reform we can have national dialogues about inclusion, justice and equity,” Ms Ram said.

At a national ceremony marking the end of the South Pacific cyclone season the rainbow community gathered once more, this time to give thanks.

“We want to make sure people understand our gratitude for everything that has transpired and for everyone who worked hard to achieve this,” Ms. Eggelton said. “Our community is now recognised through the eyes of the law as being equal. Now people can feel safe, not like second class citizens.”

BANGKOK, 15 April 2023—UNAIDS applauds today’s decision by Cook Islands lawmakers to remove laws prohibiting consensual sexual acts between men from the Crimes Act. By decriminalising sex between same-sex partners, the Pacific nation joins a global movement toward affirming the human rights to non-discrimination and privacy.

“Cook Islands’ latest move is part of a wave of global progress around removing laws that harm. It will inspire countries across the Pacific, Asia and the world to follow suit. Decriminalise, save lives," said UNAIDS Asia Pacific Regional Director, Eamonn Murphy.

Criminalisation of same-sex relations undermines the human rights of lesbian, gay, bisexual and transgender (LGBT) people. Punitive laws reinforce stigma and discrimination against LGBT people, undermining their access to the rights, remedies and opportunities available to other people. Such laws also obstruct access to vital services, including sexual and reproductive healthcare.

"This decision by Cook Islands will save lives,” said Mr Murphy. “The abolition of punitive and discriminatory colonial laws across the world is essential for public health, including for ensuring the end of AIDS.”

Bi-partisan support for the Crimes (Sexual Offences) Amendment Bill demonstrates that policy-makers, civil society and communities can dialogue to develop laws that create more just and equitable societies. 

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.