GENEVA, 7 July 2020—UNAIDS welcomes the decision by Gabon to decriminalize same-sex sexual relations. Following a vote by the Gabon Senate on 29 June 2020, the signing off of the decision by the President means that Gabon has joined a growing list of countries in Africa and beyond that have removed criminal laws that target and discriminate against lesbian, gay, bisexual, transgender and intersex (LGBTI) people.

“I applaud the collective decision by Gabon’s parliament, government and President to decriminalize same-sex sexual relations,” said Winnie Byanyima, UNAIDS Executive Director. “By doing so, Gabon is righting a grave injustice inflicted on the LGBTI community in the country.”

Paragraph 5 of Article 402, which criminalized same-sex sexual relations—with a maximum penalty of six months in prison and a 5 million central African CFA franc fine—was inserted into the new Gabonese Penal Code in July 2019. That paragraph has now been withdrawn. UNAIDS is encouraged that such a step back in terms of human rights can be overturned quickly when communities, civil society, politicians and other allies come together to campaign to right wrongs.

Through legitimizing stigma and discrimination and violence against LGBTI people, the criminalization of same-sex sexual relations stops people from accessing and using HIV prevention, testing and treatment services and increases their risk of acquiring HIV. It is also a profound violation of a basic human right.

Gay men and other men who have sex with men had a 26 times higher risk worldwide in 2019 of HIV acquisition than all adult men. Prohibitive legal and policy environments created by stigma and discrimination are key barriers to dramatically reducing new HIV infections. While UNAIDS calls for the removal of such discriminatory laws, a critical immediate step would be to stop enforcing them.

“This is a very welcome step towards equality for LGBTI people in Gabon,” added Ms Byanyima. “I call on the at least 69 other countries and territories around the world that still criminalize same-sex sexual relations to do the decent thing: stop criminalizing people because of who they love.”

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.

Yves Yomb, a human rights activist from Cameroon, died on 15 June 2020.

His journey to becoming an activist began in his home country, in 2006. At the height of a media campaign targeting gay men and other men who have sex with men, Mr Yomb was a founding member of Alternative Cameroun, one of the first human rights organizations in western and central Africa to advocate for tolerance and social inclusion. “We told ourselves that if we didn’t act, no one would,” he once said.

For more than a decade, Mr Yomb was at the forefront of the fight for the rights of sexual minorities and human rights in Africa, and wherever else the struggle took him. Ahead of the 2018 International AIDS Conference, he spoke at the launch of UNAIDS’ global report in Paris, France, calmly and with determination, recalling that the response to HIV is an uncompromising struggle for human rights and international solidarity.

Mr Yomb was the spokesperson of Africagay against AIDS, the first network dedicated to promoting access to rights and support for lesbian, gay, bisexual and transgender people in francophone Africa, which in 2019 became the Global Alliance of Communities for Health and Rights (GACS PLUS), a member of Coalition Plus. Always at the forefront of the fight, he called on UNAIDS to renew its support for civil society, an initiative that led to the birth of the Civil Society Institute for West and Central Africa. 

“Without rights, the people most affected by the AIDS epidemic cannot have access to health services. This is what feeds the hidden epidemic we are fighting against. This is what fuels the hidden epidemic we are fighting,” he said.

"Yves Yomb was a great voice and argued in a way that left no one indifferent. I remember him speaking in 2018 in the Kofi A. Annan Conference Room at UNAIDS headquarters in Geneva, Switzerland, surrounded by senior management, representatives of UNAIDS Cosponsors and others. With the same tenacity he displayed at home in Cameroon, he advocated for the respect of human rights. He argued tirelessly for increased support for civil society in all its diversity. Rest in peace, brother. We will continue the common fight,” said Helene Badini, UNAIDS Senior Regional Community Support Adviser.

The COVID-19 pandemic has affected everyone, including key populations at higher risk of HIV. And the gains made against other infectious diseases, including HIV, are at risk of being reversed as a result of disruptions caused by COVID-19. This is the background to a new report published by FHI 360, in collaboration with UNAIDS and the World Health Organization (WHO), which gives advice on how to minimize the impacts of COVID-19 on key populations.

“With a focus on key populations, this guidance complements ongoing efforts to sustain access to HIV prevention services and commodities, sexual health and family planning services, prevention of gender-based violence and HIV counselling, testing and treatment during the COVID-19 pandemic,” said Paula Munderi, Coordinator of the Global HIV Prevention Coalition at UNAIDS. “Preserving essential HIV services for key populations and promoting the safety and well-being of staff and community members during the COVID-19 pandemic is vital to maintaining the hard-fought gains of the AIDS response.”

With practical guidance on how to support the continuation of HIV services for people living with HIV and key populations, the report is aimed at helping the implementers of programmes to carry on their work.

“Key populations are particularly vulnerable to HIV service interruptions and additional harm during the COVID-19 pandemic. We urgently require rights-based solutions that maintain or increase key populations’ access to HIV services while minimizing potential exposure to COVID-19 and promoting individuals’ safety. These must support physical distancing and decongestion of health facilities, but in ways that respond to the current realities of key populations,” said Rose Wilcher, from FHI 360.

The report gives practical suggestions in three main areas.

The first is on protecting providers and community members from COVID-19. HIV services can only continue to be provided during the COVID-19 pandemic if steps are taken to prevent coronavirus infection among programme staff, providers and beneficiaries. Links to COVID-19-related screening and care, and services to support the mental well-being of providers and beneficiaries, can also be given as part of HIV services.

The second area is supporting safe and sustained access to HIV services and commodities. HIV programmes can integrate physical distancing measures, offer virtual consultations and give multimonth dispensing of HIV medicines. Physical peer outreach should be continued where possible.

Monitoring service continuity and improving outcomes is the third area covered by the report. Since there are likely to be service disruptions, HIV programmes will need to adjust their monitoring and evaluation systems in order to allow for regular assessments of continued HIV service delivery and of the impact of COVID-19 on HIV programmes and their beneficiaries. This may require setting up strategic information systems that use physical distancing measures such as virtual data collection and reporting tools.

“The COVID-19 pandemic shouldn’t be used as an excuse to slow momentum in the global response to HIV among key populations. Instead, the pandemic is a time to draw lessons from our work to end AIDS. It is also an opportunity to provide relief to health systems overstretched by COVID-19 by fully funding community-based organizations led by gay and bisexual men, people who use drugs, sex workers and transgender people to ensure improved access to HIV services for key populations,” said George Ayala, Executive Officer of MPact.

“It remains critical to ensure access to HIV prevention, testing and treatment services during COVID-19 and sustain access to life-saving services. This document provides practical guidance and know-how on maintaining essential health services for key populations in these challenging times,” said Annette Verster, the technical lead on key populations at the WHO Department of HIV, Hepatitis and STIs.

The report was developed by FHI 360 as part of the Meeting Targets and Maintaining Epidemic Control (EpiC) project, which is supported by USAID and the United States President’s Emergency Plan for AIDS Relief. UNAIDS, WHO, the Global Fund to Fight AIDS, Tuberculosis and Malaria and partners gave inputs and advice.

Ground-breaking new study shows the efficacy of a long-acting injectable to prevent HIV

GENEVA, 19 May 2020—UNAIDS warmly welcomes the announcement that the long-acting injectable cabotegravir is safe and effective in preventing HIV among gay men and other men who have sex with men and transgender women. The HIV Prevention Trials Network (HPTN) 083 study enrolled almost 4600 HIV-negative people from across more than 40 sites in North and South America, Asia and Africa.

“This is a breakthrough that will have a significant impact on the lives of gay men and other men who have sex with men and transgender women when they are at higher risk of HIV infection.” said Shannon Hader, UNAIDS Deputy Executive Director, Programme. “We are particularly pleased that the study met its targets to recruit substantial numbers of younger black men who have sex with men and transgender women, the very people for whom accessing effective HIV prevention still remains a huge challenge.”

In 2018, UNAIDS estimates that there were 1.7 million new HIV infections, 54% of which were among key populations and their partners, including gay men and other men who have sex with men, transgender women, sex workers, people who inject drugs, people in prison, clients of sex workers and sex partners of other key populations.

Pre-exposure prophylaxis (PrEP)—HIV-negative people using antiretroviral medicine to prevent HIV infection—is an important element in the HIV combination prevention toolkit. PrEP allows people to reduce their risk of becoming infected with HIV, particularly during periods of increased risk in their lives. It may also provide reassurance and reduce anxieties when the risks are uncertain.

Once it has passed regulatory approval, and when production of affordable cabotegravir can be scaled up, gay men and other men who have sex with men will have the choice of three highly effective ways to use PrEP to prevent HIV infection: daily pills, pills taken before and after sexual activity (event-driven PrEP) or an injection every two months. Transgender women will be able to choose between injections or daily pills, since the World Health Organization does not recommend event-driven PrEP because of possible drug interactions with some hormones. Injections of cabotegravir every two months are an important option for people who find it hard to take a pill every day, yet remain vulnerable to HIV infection.

The trial was scheduled to continue for at least another year, but the first interim analysis of the data was brought forward a few weeks because of the potential disruption that the COVID-19 pandemic might cause to high-quality clinical trial procedures. The Data and Safety Monitoring Board (DSMB) in the United States of America reviewed the data up to March 2020 and found that there was already clear evidence that cabotegravir was highly effective and not inferior to the currently recommended oral PrEP regimen.

Half of the study group were given oral PrEP and were injected with a placebo; the other half were given a cabotegravir injection and took a placebo pill. The study found a total of 12 HIV infections in the group using the injectable compared to 38 in the group taking the daily pill. The side-effects of both treatments were relatively mild, with only 2.2% of people in the injection group choosing to stop having the injections because of painful reactions. The DSMB therefore recommended that the study be halted and that all participants be notified of the result. The participants will be able to choose which regimen they wish to continue on.

Despite good adherence in the oral group and very few discontinuations in the injection group, the overall incidence of HIV infection in the study was 0.79 per 100 person-years. Planned analyses will explore why those 50 infections occurred among the 4565 trial participants.

An additional study (HPTN 084) is ongoing to establish the efficacy of the long-lasting injectable in non-transgender women. To date, more than 3000 sexually active women in seven African countries have enrolled in the study. Those results are expected in November.

“We are eagerly awaiting the results of the ongoing HPTN 084 study among African women,” said Dr Hader. “We hope that by the end of this year there will be equally good news for women around the world.”

HTPN 083 was conducted by the HPTN and funded by ViiV Healthcare and the United States National Institute of Allergy and Infectious Diseases. Cabotegravir has not yet been approved for the treatment or prevention of HIV as a single agent by regulatory authorities anywhere in the world. ViiV Healthcare plans to use the data from HPTN 083 for future regulatory submissions.

UNAIDS congratulates the research teams and urges continued investment in research and development for HIV vaccines, diagnostics, preventative medicines, treatment and a cure. 

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, 15 May 2020— Ahead of the International Day against Homophobia, Transphobia and Biphobia (IDAHOT), on 17 May, UNAIDS is calling on governments to immediately stop arbitrary and discriminatory arrests of lesbian, gay, bisexual, transgender and intersex (LGBTI) people based on their sexual orientation or gender identity and to enact laws to protect their human rights.

Since the start of the COVID-19 pandemic, there have been news reports of murders of transgender people in Puerto Rico, arrests of LGBTI people in Egypt, the United Republic of Tanzania and Uganda and increasing violence and abuse in Cameroon and the Republic of Korea.

“Arbitrary and discriminatory arrests and harassment of LGBTI people must stop,” said Winnie Byanyima, UNAIDS Executive Director. “The COVID-19 crisis has exposed and exacerbated the inequality, violence and abuse that LGBTI people face every day. We need to break the silence against these draconian laws, which only serve to further marginalize people,” she added.

As of December 2019, more than 70 countries criminalize same-sex sexual behaviour. Under the Universal Declaration of Human Rights and the 2030 Agenda for Sustainable Development, governments have a moral and legal obligation to remove those laws and to enact laws that protect people from discrimination.

A few weeks ago, UNAIDS and MPact released a 12-point plan to uphold the human rights of LGBTI people and ensure their inclusion in COVID-19 response strategies.

Globally, gay men and other men who have sex with men are 27 times more likely to be living with HIV than the general population. It is estimated that gay men and other men who have sex with men accounted for 18% of new HIV infections worldwide in 2017. Meanwhile, transgender women are 12 times more likely to acquire HIV than all adults of reproductive age. It is estimated that 0.1–1.1% of the global population is transgender and that 16.5% of transgender women are living with HIV.

IDAHOT, a worldwide celebration of sexual and gender diversity, has chosen the theme “Breaking the silence” for 2020 to commemorate the World Health Organization’s decision in 1990 to declassify homosexuality as a mental disorder.

The day represents a major global annual landmark to draw the attention of decision-makers, the media, the public, corporations, opinion leaders and local authorities to the alarming situation faced by people with diverse sexual orientations, gender identities or expressions and sexual characteristics.

“We need solidarity to save lives and we need to help build healthy communities and societies so they can respond to HIV, COVID-19 and the next pandemic,” Ms Byanyima added.

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.

Two new videos released ahead of the International Day against Homophobia, Transphobia and Biphobia, celebrated on 17 May, highlight different aspects of what it means to be part of the lesbian, gay, bisexual, transgender and intersex (LGBTI) community in Brazil.

‘What is the impact of diversity at the workplace? created by the Free & Equal Campaign, in partnership with the UNAIDS, seeks to inspire people by sharing examples of companies committed to tackling discrimination against transgender people in the workplace, in the formal labour market and in the community.

The second video features Brazilian LGBTI people and members of the electronic music scene raising awareness on COVID-19 and its impact on the LGBTI community. In just four days, the video reached more than 100 000 people with a message on the importance of staying at home.

UNAIDS and MPact call on governments and partners to protect, support and respect the human rights of LGBTI people during the response to COVID-19

GENEVA, 27 April 2020—UNAIDS and MPact Global Action for Gay Men’s Health and Rights are extremely concerned that lesbian, gay, bisexual, transgender and intersex (LGBTI) people are being singled out, blamed, abused, incarcerated and stigmatized as vectors of disease during the COVID-19 pandemic. UNAIDS and MPact are also deeply troubled that this discriminatory action is compounding the challenges that LGBTI people already face in accessing their rights, including safe and quality health services.

“HIV has taught us that violence, bullying and discrimination only serve to further marginalize the people most in need,” said Winnie Byanyima, Executive Director of UNAIDS. “All people, regardless of their sexual orientation, gender identity or gender expression, are entitled to the right to health, safety and security, without exception. Respect and dignity are needed now more than ever before.”

In Belize, reports have detailed abuse by the police of a gay man who was arrested, humiliated and beaten for breaking a curfew imposed to curb the spread of the coronavirus. The 25-year-old was living with HIV and is believed to have died as a result of complications sustained from injuries inflicted by the police.

“We are receiving reports that government and religious leaders in some countries are making false claims and releasing misinformation about COVID-19 that has incited violence and discrimination against LGBTI people,” said George Ayala, Executive Director of MPact. “Organizations and homes are being raided, LGBTI people are being beaten, and there has been an increase in arrests and threatened deportation of LGBTI asylum seekers.”

In Uganda, 20 LGBTI people were recently arrested in a raid on a shelter, which police authorities claimed was due to their disobeying social distancing procedures. In the Philippines, three LGBTI people were among a group who were publicly humiliated as punishment for breaking the curfew. After segments of the incident went viral online, the police captain was forced to apologize for singling out the LGBTI group members and asking them to dance and kiss each other.

“There is also growing concern over privacy and confidentiality in the way governments are using Internet-based technologies and smartphones to monitor people’s movements during lockdowns or curfews,” Mr Ayala added. “Gay men and gender non-conforming people are often the first targets and among the most impacted by increased policing and surveillance efforts.” 

For some LGBTI people, self-isolation and physical distancing can be particularly challenging, even dangerous. Many LGBTI people face violence and/or ill-treatment while sheltering in homes with unaccepting family members. LGBTI people may also suffer from intimate partner violence while staying at home, without the ability to report cases of abuse to the police owing to fear of repercussions. Isolation can also exacerbate pre-existing mental health challenges, common among LGBTI people, including loneliness, depression, anxiety and suicidal ideation.

The COVID-19 pandemic leaves many gay men and transgender women without adequate tools for taking control of their sexual health and rights. Gay men account for nearly 20% of all new HIV infections and are 22 times more likely to become infected with HIV than other men. Transgender women shoulder a risk of acquiring HIV that is 12 times higher than the general population.

Stay at home orders, especially when implemented without flexibilities, compound the difficulties these groups already experience in accessing antiretroviral therapy and HIV prevention and gender-affirming services, including hormone therapies. This is especially true for LGBTI people who are poor, unemployed, homeless or marginally housed.

UNAIDS and MPact are urging countries to:

• Denounce misinformation that scapegoats, slanders or otherwise blames LGBTI people for the spread of COVID-19.
• Stop raids on LGBTI-led organizations, shelters and spaces and desist from arresting people based on their sexual orientation, gender identity or gender expression.
• Ensure that all measures to protect public health are proportionate, evidence-informed and respect human rights.
• Prevent the use of state surveillance on LGBTI people’s personal communication technologies.
• Invest in the COVID-19 response, while safeguarding funds and HIV/sexual health programmes that are inclusive and sensitive to the needs of LGBTI people.
• Safeguard continued access to life-saving medical support, including harm reduction, condoms and lubricant, preexposure prophylaxis, antiretroviral therapy, hormone replacement therapies and mental health services for LGBTI people.
• Provide flexible service delivery options, from multimonth dispensing to community delivery and virtual consultation and support options.
• Consider designating community-led service organizations as essential service providers so that they can provide flexible, safe delivery of key services.
• Include LGBTI people in national social protection schemes, including income support.
• Increase access to appropriate emergency and safe housing for homeless and recently evicted LGBTI people.
• Engage LGBTI people in public health planning and messaging around COVID-19.
• Implement safety monitoring and hacking mitigation during virtual meetings.

Now more than ever, we must stand together to protect and promote the health and human rights of LGBTI people worldwide.

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.

MPact

MPact Global Action for Gay Men’s Health and Rights was founded in 2006 by a group of activists concerned about HIV-related disparities as well as stigma discrimination, violence, and criminalization experienced by gay men and other men who have sex with men in all parts of the world. MPact is now an established international advocacy network dedicated to ensuring equitable access to HIV services to all gay men, while promoting health and human rights. Directly linked with nearly 150 community-led organizations across 62 countries and thousands of other advocates through its various social media platforms. MPact accomplishes its mission by: watchdogging governments, funders, and other decision makers; strengthening capacities of community-led organizations and healthcare providers; supporting the proliferation of networks led by gay men; conducting and commissioning research; and facilitating inter-regional information exchange.