GENEVA, 22 August 2022—UNAIDS applauds Singapore’s announcement that it will repeal section 377a of the country’s penal code which criminalizes consensual sexual relations between men. The law, which dates back to 1938 when Singapore was under British colonial rule, punishes gay consensual sex by a prison sentence of up to two years.

In his annual policy address speech that included plans to repeal the legislation, Singapore’s Prime Minister, Lee Hsien Loong, said sex between consenting men should not be criminalized and that there was no justification to prosecute people for it, nor to make it a crime. He said that gay people were fellow Singaporeans and that they wanted to live their own lives, participate in the community and contribute fully to Singapore.

“The end of the criminalisation of gay men is wonderful news, both for the lesbian, gay, bisexual and transgender community in Singapore, and for the country as a whole,” said Taoufik Bakkali, UNAIDS Regional Director for Asia and the Pacific region. “UNAIDS welcomes this as a significant step towards respecting the human rights of LGBT people in Singapore and creating a more open, tolerant and inclusive society where people can be who they are and love who they want without fear of being imprisoned. This vital change will save lives and benefit everyone, and will inspire other countries to follow. Other countries should join the growing group of nations who have turned away from criminalisation.”

Laws which punish consensual same sex relations, as well as contravening the human rights of LGBT people, are a major barrier to improving health outcomes, including in the HIV response. Punitive legislation embeds stigma and discrimination against LGBT people, deters LGBT people from seeking healthcare for fear of being denounced to the authorities and facing punishment and detention, and prevents countries from putting policies in place that properly respond to differentiated epidemics among their populations.

Singapore joins a growing list of countries that have recently decriminalized same-sex relations, including Antigua and Barbuda, Botswana, Bhutan and Angola. The change in Singapore will at last reduce the number of countries in which consensual same-sex relations are still criminalized to below 70 countries worldwide. Decriminalisation is not the end point in tackling stigma and exclusion, but is a vital step forward.

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.

Imagine being widely blamed for tragedies that befall your country. Earthquakes. Hurricanes. Floods.

Now imagine being excluded from disaster response efforts because of this.

Lesbian, gay, bisexual and transgender (LGBT) people in Haiti face profound prejudice. Discrimination often undermines life chances. Education and employment opportunities erode. Even accessing healthcare can be difficult.

Founded in 1999, the SEROvie Foundation pairs health promotion for the LGBT community with human rights advocacy and socioeconomic empowerment. Today the organization operates projects in nine geographical departments.

UNAIDS supports SEROvie to ensure that the needs of key population communities are addressed during disaster responses. This intervention ensures people living with HIV continue to receive HIV treatment and have timely access to aid. Beyond the emergency phase, beneficiaries get support to resume generating incomes and reintegrate into their homes. They also receive psychosocial support to cope with grief and trauma.

In 2016 SEROvie founded the J.C Ménard Clinic in Port au Prince. This clinic serves LGBT people and other key populations including female sex workers and their clients. Here SEROvie has distilled more than two decades' experience in providing health and social support into a complete service package.

With the assistance of several collaborators including the U.S. Agency for International Development (USAID), J.C Ménard offers a range of free-to-user services addressing gender-based violence, stigma and discrimination, family planning and HIV prevention, including PrEP. It also provides HIV, STI and TB treatment and care. 

At the in-house laboratory, technicians manage both diagnostics and treatment monitoring. They track individual journeys from positive test to viral suppression. Over the last year the clinic provided facility-based HIV testing for 6,000 people and supported HIV treatment management for over 1,500 clients. Apart from dispensing patients' medicines, the clinic coordinates with other treatment facilities to ensure there are no stockouts and drugs do not expire.

Social workers conduct individual assessments to determine clients' needs. Psychologist, Darline Armand says the most important moment in her work is the first interaction after someone has been diagnosed.

"They need to feel safe," she says.

Peer Supervisor, Gregory Jacques, explained that the clinic employs both peer education and peer navigation as strategic approaches. Educators engage clients about relationships, risk and safety, providing accurate information. Navigators are themselves people living with HIV who walk others through the treatment and care process.

"The thing that makes a difference is that they know you are just like them," one navigator explains.

In the community room clients learn about health and relationships through fun activities. This is also where they meet for support groups and dialogues.

The Monitoring and Evaluation team measures programme performance with painstaking detail. They track everything from the number of people living with HIV identified through index testing to the number of sensitization sessions conducted with Voodoo priests. Over the past year more than 15,000 people received awareness-raising messages on HIV, GBV, stigma and discrimination from the clinic. Over 1,500 people benefit from comprehensive HIV care and treatment services while more than 1,500 are on PrEP.

Steeve Laguerre, SEROvie's co-founder, reflects on the organization’s journey with both awe and clarity.

"The services we provide are entirely determined by the needs of the people we serve," he says. "We seek funding that aligns with their demands. The work is always client-driven." 

This client-centred approach is valuable for the wider Caribbean. According to the 2022 Global AIDS Update, In Danger, last year four of five new infections in the region were linked to key population communities and their sexual partners. At the same time, most of the funding for regional combination prevention activities with key populations comes from international sources. 

“Community-led strategies for patient care help reduce late diagnosis and loss to follow-up while improving treatment outcomes,” said Dr. Christian Mouala, UNAIDS Country Director for Haiti. “These approaches must be adequately resourced and integrated into the national response.” 

GENEVA, 23 July 2022—UNAIDS today called on governments to respond urgently to the World Health Organization declaration of Monkeypox as a Public Health Emergency of International Concern. WHO has received reports over 16 thousand cases in 75 countries. The outbreak is occurring particularly, but not exclusively, among gay men and other men who have sex with men. 

“The World Health Organization has issued an urgent call today based on clear evidence that Monkeypox represents a global threat to the health of communities and requires a global response,” said Dr. Matthew Kavanagh, UNAIDS Deputy Executive Director a.i. “This outbreak can be stopped if governments, healthcare providers, communities, and pharmaceutical companies act with urgency. Drawing on the hard-learnt lessons of the response to the AIDS pandemic, effective public health actions must be guided by the principles of solidarity, equality, nondiscrimination and inclusion. The virus, spread through close contact, can affect anyone. But it is currently most impacting gay men and other men who have sex with men, who in many communities face discrimination. Stigma and discrimination undermine epidemic response, sending people with symptoms underground and failing to address the underlying barriers that people face in attempting to protect their own health and that of their community. It can also cause public health authorities to act with insufficient urgency. We urge people to demonstrate compassion to those affected, not discrimination. UNAIDS is urging countries to partner and engage affected communities in the development, implementation, and monitoring of all stages of the response. 

“We are concerned that some low- and middle-income countries are struggling to get access to vaccines being deployed now in high income countries. Repeating vaccine nationalism and inequality will prolong the outbreak and unjustly deepen suffering from this virus.  We call on governments and vaccine manufacturers to work together to ensure that all those in need can access and benefit from vaccines, including people affected in endemic countries.

“UNAIDS would like to acknowledge the leadership of organizations led by communities of gay, bisexual and other men who have sex with men that, in many countries, have been stepping forward in responding to the outbreak, raising awareness, challenging misinformation and supporting vaccination efforts.”

The Monkeypox outbreak illustrates that communities will continue to face threats from viruses, and that international coordination and solidarity is essential for public health as viruses can only be overcome globally.

UNAIDS urges all media covering Monkeypox to follow the regular updates being issued by WHO.

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 17 May, people around the world came together to celebrate the International Day against Homophobia, Transphobia and Biphobia (IDAHOBIT) to champion inclusion and build a better world for the lesbian, gay, bisexual, transgender and intersex (LGBTI) community. In many countries, lack of adequate legal protection against discrimination on grounds of sexual orientation and gender identity exposes many LGBTI people to violations of their human rights. This is even more the case within the context of war and humanitarian crisis, as currently experienced in Ukraine.

UNAIDS and ILGA-Europe co-hosted an event, moderated by Cianán B. Russell, Senior Policy Officer, ILGA-Europe, to mark IDAHOBIT. The event brought together LGBTI representatives and a wide range of thought leaders, policymakers and practitioners.

The panellists highlighted the multiple vulnerabilities and challenges facing LGBTI people in and fleeing from Ukraine during the war. These vulnerabilities and challenges were clearly articulated by two LGBTI representatives.

“Levels of discrimination, violation of rights and hate crimes have risen in Ukraine since the start of the war. Meanwhile, no regulations or specific measures have been put in place in shelters to protect key populations. LGBTI people have no safety net since the war started,” said Olena Shevchenko, from Insight. “Go to local organizations and ask them what they need if you are intent on helping Ukraine. Ensure the accountability of humanitarian missions to fulfil the needs of the local community,” she added.

Tymur Lysenko, a Ukraine crisis consultant working for Transgender Europe, spoke about the essence of leaving no one behind, saying ““Leave no one behind” should work, not just be empty words. Trans people in Ukraine should be provided with humanitarian support, safe evacuation and access to medical care, and functioning gender recognition regulation procedures. Foster direct connections that are strong and sustainable between local organizations and international humanitarian missions. Stick to organizations that have a track record in providing direct support to LGBTI people.”

Reflecting on their own work and experiences, the panellists also reviewed the actions taken to date to protect the human rights of LGBTI people in and fleeing from Ukraine and the existing gaps within the humanitarian response and concluded with recommendations and commitment to better protect the human rights of LGBTI people staying in Ukraine or who have left.

“Humanitarian agencies must ensure that civil society organizations with expertise are included in the planning and implementation of all humanitarian assistance and in recovery efforts,” said Victor Madrigal-Borloz, a United Nations Independent Expert on Sexual Orientation and Gender Identity.

This was echoed by Kate Thomson, Head of the Community, Rights and Gender Department at the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), who referred to the need for all partners to work collectively to build back resilient health and community systems. “All partners to work together to support access to HIV services in Ukraine, including those led by LGBTI communities, inside Ukraine and abroad. Let’s work collectively to help Ukraine build back better its health and community systems,” she said.

Matthew Kavanagh, UNAIDS Deputy Executive Director, a.i., spoke about the importance of maintaining and increasing the funding for the AIDS response. “We stand with the Ukrainians who are fighting so hard to make sure that their responses—the AIDS response, the community response, the rights response, the LGBTI response—are not destroyed by the moment that we are in now. There is an urgent need to move funding towards that, and an urgent need to fund the Global Fund at the same time. We cannot choose between these two things or we will end up in a less safe world—we have to do both,” he said.

Joanna Darmanin, Head of the Humanitarian Aid Thematic Policies Unit, European Union Directorate-General for European Civil Protection and Humanitarian Aid Operations, reiterated the European Union’s commitment for an inclusive humanitarian response. “Supporting Ukraine and neighbouring countries remains the priority for the European Union, and we remain committed to providing humanitarian support in an inclusive manner, taking into account the specific needs and vulnerabilities faced by the LGBTI community,” she said.

This commitment was re-echoed by Katalin Cseh, Member of the European Parliament Committee on Foreign Affairs, who pledged to fight for inclusiveness of the LGBTI community. “I pledge to fight with all my means to ensure better consultation with the LGBTI communities on the ground in Ukraine and also within the European reception area.”

Maria Arena, Chair of the European Parliament Subcommittee on Human Rights, highlighted the need to position the humanitarian response to the needs of LGBTI people, saying, “The conflict zones are putting at risk people with these vulnerabilities, so we have to be really aware of the situation and to adapt our answers for the needs of these people, including with traceability of these funds.”

Marc Angel, Co-President of the European Parliament LGBTI Intergroup, emphasized the importance of ensuring that promises made correspond with funding. “Action and money must follow words and promises,” he said.

Valeriia Rachynska, from the Global Partnership against All Forms of HIV-Related Stigma and Discrimination, spoke about the Global Partnership’s commitment to fight for and save all lives, saying, “Our main target is to save and fight for life; we will do everything in our power to save the lives of LGBTI people in Ukraine.”

Indeed, to champion and build a better world for the LGBTI community, and to end inequalities for an effective AIDS response, especially in a humanitarian crisis context, institutional actors with differing responsibilities must ensure that no one is left behind. This among others, includes directed action to: combat discrimination targeting LGBTI people and people living with HIV, rebuild or reinforce the HIV response system, meaningfully engage LGBTI civil society both in crisis planning and in crisis response systems, ensure that LGBTI-led humanitarian efforts are adequately resourced and ensure that human rights violations faced by LGBTI people are documented, investigated and result in access to justice. 

Ahead of the International Day Against Homophobia, Biphobia, Interphobia and Transphobia (IDAHoBiT) held annually on 17 May, UNAIDS talks to Evelyne Paradis, Executive Director of ILGA-Europe, the Europe-based Lesbian, Gay, Bisexual, Trans and Intersex Association about protecting the rights of LGBTI people in humanitarian crises. 

How do humanitarian crises particularly affect LGBTI people?  

Humanitarian crises affect everybody, however, some communities sometimes need a targeted response because of pre-existing vulnerabilities. These particular vulnerabilities make people feel unsafe when dealing with humanitarian organisations providing safe shelter, basic necessities food and medical aid. Not knowing if they will be treated without discrimination, simply welcomed and be taken care of, is a barrier for people in accessing humanitarian support.

ILGA-Europe is heavily involved in the Ukraine crisis.  What are the main challenges facing LGBTI people affected by the war? 

In the Ukraine crisis, what we are seeing is that LGBTI people are not de facto integrated in first aid supply chains. Transition-related and intersex-specific medication, such as hormone replacement therapy, and to a certain extent medicines for people living with HIV, are not ensured in humanitarian packages at the moment. On top of this, a significant portion of the LGBTI community cannot meet their basic needs, due to pre-existing socioeconomic inequalities.

Trans women with a male gender marker on their documents can be obliged to join the army or cannot leave the country along with other women, which puts them in a potentially very harmful situation.

Having access to safe shelter is also an issue. In Ukraine, many LGBTI people don’t feel safe to be ‘out’ in regular shelter, while some who are displaced in the country are reporting facing discrimination when trying to rent an apartment. As a result many of the LGBTI groups have set up shelters to support their communities. Some of those who are staying and are visible have been physically attacked, as LGBTIphobia was already an issue in Ukraine before the war.

This is all happening while LGBTI people face the same struggles everyone else is facing; money, food, caring for loved ones, and so much more.

What are organizations like ILGA-Europe doing to help? 

We are sending direct financial support to groups who are staying in Ukraine and are providing direct support to their communities, as well as to LGBTI groups in hosting countries. We’re also actively working to mobilise resources for all the LGBTI groups working in support of LGBTI people in Ukraine and abroad. We’re working with large humanitarian groups and organisations like UNAIDS and connecting them to the needs on the ground, while advocating with European institutions and governments to take action both in support of LGBTI communities in Ukraine and for LGBTI people who have left the country.

What can be done to better address the unique needs of LGBTIQ+ people in humanitarian crises?  

What we are seeing is that an LGBTI perspective is really not integrated into humanitarian work and the development of protection measures, such as protection from gender-based violence or access to medicines. In many ways we have had to start from zero, including having to establish contacts with actors in the humanitarian sector.

While it is still early in this particular crisis to have specific recommendations, there will be no doubt be a lot of learning to be done from the work currently happening, so that we make sure that in future LGBTI perspectives and needs are integrated in the way humanitarian actors respond from the start.

Many civil society and community organizations are supporting LGBTI people affected by the war in Ukraine.  What challenges do they face in carrying out this important work?  

Most LGBTI organisations are not set up to be doing humanitarian work, and yet they are supporting basic needs in addition to the work they continue to do for their communities. But they cannot do it all. If they become the first point of support and assistance, there’s a lot of other work, like advocating for rights, that will not be done. This is true in Ukraine as well as in hosting countries.

Inequalities, stigma, discrimination and human rights violations against are continuing to prevent LGBTI people from being able to access the HIV and health services they need. How can we achieve positive political, legal and social change?  

The work that has started with the humanitarian sector shows there’s a need, but it’s also an opportunity. If the humanitarian sector incorporates an LGBTI perspective and LGBTI people in their work from the start, this can mean a positive change for these communities, especially in times of crisis.

Evelyne Paradis will be one of the speakers at an IDAHOBIT event held on the 17 May focusing on how to better protect the rights of LGBTIQ+ people, particularly in the context of the war in Ukraine, and how to ensure equal rights for all. More information

Andrii Chernyshev heads the advocacy work of the Ukrainian national lesbian, gay, bisexual, transgender and intersex (LGBTI) organization ALLIANCE.GLOBAL, which is one of the largest among about 30 LGBTI community organizations across the country. After the start of the war in Ukraine, he moved from Kyiv to the central part of Ukraine, a safer place to continue his work. His Facebook page has been full of announcements about where LGBTI people fleeing hostilities can find shelter and help, both inside and outside the country.

Before the war, the primary focus of ALLIANCE.GLOBAL was public health, HIV prevention, monitoring of violations of human rights and national LGBTI advocacy. But the war has brought about new urgent tasks.  

“The main challenge for all people during the war, including LGBTI people, is just to survive. Many have lost their homes and relatives. Just recently, we welcomed several people from Mariupol, which is now completely destroyed. Although they managed to leave the city, they are in a very bad psychological state,” said Mr Chernyshev.

According to the Office of the United Nations High Commissioner for Refugees, there are now 7.7 million internally displaced people in Ukraine. This number includes members of key populations, including LGBTI people, and others who are especially vulnerable.

Sviatoslav Sheremet, the coordinator of policy and legislation work of the National MSM Consortium, said that there are several factors that make LGBTI people especially vulnerable. “Many LGBTI people are fleeing the areas occupied by Russian forces. People are afraid, and this fear has pushed them to actively move out to safer zones in Ukraine and outside the country.”

He noted that LGBTI people often cannot reveal their sexual orientation or gender identity, fearing violence, rejection and discrimination if they do. He underlined that all cases of homophobia are still being recorded and submitted to state bodies. “The proceedings on such cases are postponed until there is peace,” he added.

Both ALLIANCE.GLOBAL and the National MSM Consortium have significantly changed their work. Several additional shelters for LGBTI people have opened in Dnipro and Chernivtsi. Men and women, including transgender people, can stay there one night and move on, or stay longer, and can bring their relatives and friends. People also receive financial support to leave the war zones and reach shelter.

“The shelter in Chernivtsi, for example, was in a non-residential building,” said Mr Chernyshev. With a small grant from the UNAIDS Emergency Fund and other donors, we installed a shower and bought heaters. People have food, the Internet, a first aid kit, access to HIV counselling and antiretroviral therapy.”

LGBTI organizations outside the country have also provided support to people in need.

Stas Mishchenko, an LGBTI activist from Ukraine, now lives in Munich, Germany. At the beginning of the war, he joined the Contact Group of Munich Kyiv Queer, which is part of the Alliance for Assistance to Queer People of Ukraine, a group of more than 50 LGBTI organizations in Germany whose members volunteer to help people who have fled to Germany and those who remain in Ukraine.

“Sometimes there is homophobia and transphobia in refugee camps. And even if these are not systemic, there is always the human factor, combined with stress, fear and violence. That is why we accompany people on their way to us, provide psychological assistance, try to resettle them in private homes, help with humanitarian aid,” said Mr Mishchenko.

“The war exacerbated both good and bad in our society,” said Marina Novachuk, UNAIDS Community Adviser at the UNAIDS Country Office for Ukraine. It is essential for the state and all stakeholders engaged in protecting forcibly displaced people to recognize and respond to the unique needs of LGBTI and gender-diverse people.”

Over the past 20 years, Ukraine has made a real breakthrough in ensuring the rights of LGBTI people and in protecting their security. LGBTI rights are an integral part of the National Human Rights Strategy. Leaders of the LGBTI community sit on the National Council of HIV and TB, as well as on regional councils. The number of participants of the annual equality marches has risen from just a dozen to thousands of people. Ukraine plans to develop legislation on the registration of civil partnerships.

“Achieving civil equality has been the goal of my work for many years—I have seen huge improvements. The attitude towards LGBTI communities is a litmus test of civilization,” Mr Sheremet said.

In April 2022, Ukraine received a questionnaire from the European Commission on its readiness for candidate status for membership of the European Union. On 18 April, Ukraine completed and submitted the first part of the questionnaire, which includes several questions on the situation with regard to LGBTI people and legislation, specifically about the legislative and policy instruments in place to prevent and respond to discrimination and how hate crimes are addressed in the criminal code. ALLIANCE.GLOBAL and the National MSM Consortium team will follow the process closely.

“We have been working on changes in the legislation on LGBTI rights for many years now and we hope that now it will take not years but months to change. But first the war should end,” added Mr Chernyshev.

The economic impact of the COVID-19 pandemic on lesbian, gay, bisexual, transgender and intersex (LGBTI) people has been huge. A 2020 survey of more than 20 000 LGBTI people from 138 countries showed that many had lost their jobs because of the pandemic. In addition, members of the community experienced increased discrimination, hate crimes and arrests. Criminalization combined with stigma and discrimination of LGBTI people in some countries has hindered their ability to seek essential economic and health-care support.

Several of the 23 UNAIDS Solidarity Fund grantees across Brazil, Ghana, India, Madagascar and Uganda are supporting LGBTI organizations in building economic capacities and driving social impact for their respective communities through diverse social entrepreneurship projects.

Uganda is home to more than 1.5 million refugees. Same-sex sexual relations are illegal in the country, and being a refugee brings a host of other challenges, including social exclusion. Adding to this, the COVID-19 pandemic has destroyed the livelihoods of many of Uganda’s refugees who are members of key populations. Through a Solidarity Fund grant, the Simma Africa Creative Arts Foundation set up the Rainbow Drip Craft Shop Project, which markets creative and cultural goods, including fine beaded and brass jewellery, handmade leather-craft shoes and Ankara fusion clothing made by LGBTI people and adolescent girls and young women from refugee camps and host communities. “The shop has become a safe space and a creative outlet for the community to channel their skills and talents towards building self-sustaining livelihoods,” said Natasha Simma from Simma Africa.

Also working with the Ugandan LGBTI and sex worker communities, Vijana Na Children’s Foundation (VINACEF Uganda) has set up a community-run salon offering diverse beauty treatment services. About 80 community members have been connected to social services and trained in social enterprise and financial management. “The social entrepreneurship project has enhanced community involvement and strengthened the capacity of LGBTI and sex worker communities while allowing them to gain and practice new skills to earn a sustainable income,” said Benard Ssembatya, the Executive Director of VINACEF Uganda. Inspired by this initiative, VINACEF Uganda is forming a network of salons to improve access to information on HIV, sexual and reproductive rights, tuberculosis, cancer and noncommunicable diseases for community members.

Similarly in Brazil, tapping into the talents of members from the LGBTI and sex worker communities in beauty treatment, Associação Social Anglicana de Solidariedade do Cerrado (Casa A+) implemented the Empodera Mais Project. “We motivated members from vulnerable backgrounds to participate in the social entrepreneurship project through the provision of the Empodera Mais Kit, with basic equipment and supplies for entering the hairdressing and beauty treatment profession,” said Anglican Bishop Maurício Andrade, the founder of Casa A+. The technical skills provided and encouraged members to start businesses in beauty treatment and survive the hardships of the COVID-19 pandemic. Technical partnerships with professionals, a beauty studio and institutions such as Palmas’ Municipal Department of Human Development provided the participants with on-site experience before launching their own businesses and generated a professional network to exchange experiences and get new business.

In Ghana, the Hope Alliance Foundation and the OHF Initiative launched the Community Economic Empowerment Program to set up social enterprises led by people living with HIV and LGBTI people to support them economically to confront complex political and COVID-19-related challenges. The initiative provided vocational skills training for the production of food and hygiene products to 30 young people, supported the creation of social enterprises in fashion design and supported the refurbishment and revamping of 10 selected small-scale businesses adversely impacted by COVID-19.

In India, Nachbaja.com’s online artist platform was set up to overcome the challenges of discrimination, unfair remuneration and the safety of artists from the LGBTI community. Meanwhile, Gaurav Trust opened its doors for members to be a part of a community-led salon, La Beauté and Style, and mobilized additional funding for sustainability and scalability.

Stories of growth continue with Let’s Walk Uganda, whose Jump Start project was established to host small-scale enterprises in fashion, design and the production of liquid soap led by gay men and other men who have sex with men. Community members have proven their ingenuity to grow, scale up and diversify their enterprises by successfully reinvesting the revenue from the first batch of products in new entrepreneurial ventures. This led to the development and launch of the UNAIDS-supported Stall App, an online social marketing app that could help to boost the sale of products developed by several key population-led enterprises, including other Solidarity Fund grantees.

“We must recognize that while the rest of the world recovers from the economic impact of the COVID-19 pandemic, its effects will last longer for marginalized communities. Hence, it is of the utmost importance to continue to support innovative community-led social enterprises designed to support livelihoods and overcome special challenges,” said Pradeep Kakkattil, the UNAIDS Director of Innovation.

Restoring the self-reliance and dignity of LGBTI communities must be grounded in initiatives led by themselves, with a focus on addressing inequalities. A common thread that connects these diverse enterprises is the ingenuity of LGBTI people in the face of hardship. The grantees demonstrated the potential of empowerment through art, creativity and professional skills supported by the Solidarity Fund seed funding.  Acknowledging and embracing diversity in sexual orientation and gender identity in all areas is crucial to making the community visible, protecting them from stigma, discrimination and violence, and engaging them in the response to pandemics.

“Young people here don’t regularly access HIV services. I really want to invite my friends to get tested, but they are all so afraid. They don’t have enough information or support from their families and are scared about finding out their status,” said Andika Bayu Aji, a young person from West Papua, Indonesia.

The HIV epidemic among young people in Asia and the Pacific has largely been overlooked, even though about a quarter of new HIV infections in the region are among people aged 15–24 years. The vast majority of young people affected by HIV in the region are members of vulnerable populations—people living with HIV, gay men and other men who have sex with men, transgender people, sex workers and people who inject drugs.

Like many countries in the region, Indonesia’s HIV infections among young people, which make up almost half of new infections, are attributed to stigma and discrimination, poor educational awareness of HIV, lack of youth-friendly services and social taboos.

“Young people far too often experience stigma and discrimination in health-care settings. Health-care workers are first-line responders. If the services are bad, young people won’t use them and they will tell other young people not to use them. We are limited by which clinics we can access because many, if not most, are not youth-friendly,” said Sepi Maulana Ardiansyah, who is known as Davi and is the National Coordinator for Inti Muda, the national network of young key populations in Indonesia.

A recent study conducted by Inti Muda and the University of Padjajaran found that the willingness of young people to access services in provinces like West Papua was very low, mainly due to the lack of youth-friendly services and the poor understanding of key population issues by health-care workers. Young people often face difficulty accessing services because of the remoteness of clinics and hospitals and encounter barriers such as the age of consent for testing.

Stigma and discrimination, and especially discrimination from health-care providers, discourages many young key populations from accessing HIV services. Concerns about privacy and confidentiality are some of the main challenges. Additional obstacles include that the opening hours of public clinics are often ill-suited to people’s daily routines, and the assumptions and attitudes of health-care workers can be judgemental, especially on issues around sexual orientation, gender identity and mental health.

Between 14 and 18 March, Inti Muda, with technical support from Youth LEAD and UNAIDS, organized a sensitization training of health-care workers in two cities, Sentani and Jayapura, in the West Papua region. More than 50 health-care workers participated. A few days before the training, Inti Muda organized a festival for more than 80 young people, joining in an effort to engage young people in the HIV response and generate demand for access to HIV services.

“Prior to this training, I didn’t know about the different needs of key populations, which hinders our ability to reach them. We learned about important techniques for reaching young people, such as providing youth-friendly counselling, digital interventions and encouraging them to get tested,” said Kristanti, from the District Health Office of Jayapura.

“I learned that the needs of young people are diverse. The training will allow us to improve our services to become youth-friendly, which is now our main priority,” added Hilda Rumboy, a midwife in charge of the HIV Services Department at the Waibhu Primary Health Centre.

The training and festival were supported by the Australian Department of Foreign Affairs and Trade (DFAT). The recent investment of AU$ 9.65 million set aside by the Australian Government from the sixth replenishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), including DFAT funding of AU$ 2 million previously committed to UNAIDS, is aimed at reducing the annual number of new HIV infections among key populations in Cambodia, Indonesia, Papua New Guinea and the Philippines.

“Ensuring young people and vulnerable groups have access to accurate, digestible information about how to prevent HIV, and that testing facilities are cheap and accessible, is crucial to ending the AIDS epidemic. We are proud to work with local communities and UNAIDS to increase availability of information on HIV, improve the reach and quality of medical services and encourage young people and vulnerable groups to get tested,” said Simon Ernst, Acting Minister Counsellor for Governance and Human Development at the Australian Embassy in Indonesia.

The training is based on the manual developed by Youth LEAD in 2021, which was financially supported by the Global Fund’s Sustainability of HIV Services for Key Populations in Asia Programme and the UNAIDS Regional Support Team for Asia and the Pacific. Under the DFAT grant for the next two years, Youth LEAD will expand the training to two more countries, Cambodia and the Philippines, supporting networks led by young people in the respective countries to roll out the training.

“Young people still encounter many challenges that prevent them from accessing the life-saving health care they need. The UNAIDS Country Office for Indonesia is working closely with the UNAIDS regional support team and DFAT to ensure that networks led by young people have the capacity and leadership capabilities to take control of the HIV response and to have direct involvement in creating safe spaces where young people can access HIV services free from stigma and discrimination,” said Krittayawan Boonto, the UNAIDS Country Director for Indonesia.

The UNAIDS Key Populations Atlas is an online tool that provides a range of information about members of key populations—sex workers, gay men and other men who have sex with men, people who inject drugs, transgender people and prisoners—worldwide, together with information about people living with HIV.

Information about gay men and other men who have sex with men has been expanded with the inclusion of 11 new indicators from the EMIS and LAMIS projects. Under funding from the European Commission, EMIS-2017 collected data from gay men and other men who have sex with men in 50 countries between October 2017 and January 2018. LAMIS is the Latin American version of EMIS and finished data collection across 18 additional countries in May 2018.

The 11 new indicators shown in the Key Population Atlas—on syphilis, symptomatic syphilis, gonorrhoea, symptomatic gonorrhoea, chlamydia, symptomatic chlamydia, sexually transmitted infections testing, syphilis partner notification, gonorrhoea partner notification and hepatitis A and B vaccination—were chosen because of their high relevance to the communities.

Community-led and community-based infrastructure is essential for addressing the inequalities that drive pandemics such as the AIDS and COVID-19 pandemics, as well as for ensuring the continuity of health services and protecting the rights and livelihoods of the most vulnerable. The EMIS and LAMIS findings will be important for informing civil society organizations working on sexual health, HIV prevention and sexual minority rights and for policymakers, non-community prevention planners, epidemiologists and modellers.

“To leave no one behind, we need people-centred data collection that spotlights the inequalities that are hampering access to services. It is critical to understand who are the most affected and unable to access services. This will enable the European Commission, European Union Member States and civil society and community organization alike to address the specific needs of gay men and other men who have sex with men,” said Jantine Jacobi, the UNAIDS representative to the European Union.

Civil society and community-based organizations, especially those led by key populations, can complement traditional health systems’ pandemic responses, but this requires that they be treated as full partners—involved in governing, designing, planning and budgeting pandemic responses––with the technical and financial support to do so effectively.

The findings of the new indicators will help to increase the role of partnerships and communities across each country and will serve as the basis for decision-making and policy planning. For example, in Ireland, the EMIS-2017 National Report acknowledges that, “there has been an increase in HIV and STI testing compared to previous surveys and this is in some part due to the positive interventions carried out by stakeholders and the MSM [men who have sex with men] community in response to findings from previous surveys. Some of these positive interventions in relation to HIV testing can also be attributed to the increased availability of community testing.”