Regions

Progress towards ending AIDS as a public health threat has been strongest in the countries and regions with sufficient investments in their HIV responses, especially in countries from eastern and southern Africa. However, a critical part of this success lies in understanding where resources are being allocated and ensuring that investments are directed towards the most impactful interventions.

“HIV financial data is essential for decision-making”, said Jaime Atienza, Director of Equitable Finance at UNAIDS. “This is especially important when we can see constraints, now and around the corner.”

To reflect on the current use and future potential of HIV financial data, UNAIDS and the Global Fund to Fight AIDS, TB and Malaria brought together representatives from 10 African countries to Cape Town, South Africa. During the event, countries shared how they are using HIV financial data to transform their national HIV responses.

In the case of Kenya, for example, the 2022 National AIDS Spending Assessment (NASA) revealed that approximately 84% of the funds for care and treatment programmes came from external sources. This heavy reliance on external funding prompted the development of a cabinet advisory note on local commodity manufacturing, aimed at addressing commodity security risks. In response, the Office of the Presidency issued a statement on Worlds AIDS day 2022 directing that the government would support the pharmaceutical sector to strengthen its local manufacturing capacity and review relevant regulations and tax policies to create an enabling environment.

In Mozambique another NASA study showed how the country spent 26% less on HIV treatment than the National Strategic Plan required, while surpassing the antiretroviral (ART) coverage target by 24%. ART unit costs have fallen from US$ 208 in 2017 to US$ 137 in 2022—well below most countries in the region. Economies of scale and differentiated service delivery likely contributed to this outcome. “We are using this data to inform multi-sectoral plans and state budgets” said Francisco Mbofana, Executive Secretary of Mozambique's National AIDS Council.  

HIV financial data is also seen by countries as an effective tool for mobilizing resources. Ethiopia’s NASA and National Health Accounts (NHA) informed a Domestic Resource Mobilization Strategy. The Strategy aims to boost domestic investment from US$ 27.9 million in 2020 to US$ 68.5 million by 2025 through government revenues, AIDS fund(s), targeted mainstreaming, community care coalitions, and earmarked taxes. In addition, South Africa demonstrated to the Global Fund that of the US$ 6.3 billion the government committed to invest in HIV from 2022-2025, US$ 6.2 billion (98.99%) is likely to be realized. This, in turn, unlocks the US$ 92.7 million co-financing incentive from the Global Fund grant for 2025-2028.

Financial data has also stressed the major underinvestment in HIV prevention. “The de-prioritization of HIV prevention is among the top sustainability threats,” said Thembisile Xulu, Chief Executive Officer of the South African National AIDS Council. While prevention will require a third (32.8%) of total HIV resources by 2025, NASA data shows current HIV prevention spending is at 9.4% in Kenya, 9% in Namibia, 11% in South Africa, and 13% in Uganda.

Nonetheless, several strategies to boost HIV prevention investments are being developed following evidence provided by HIV financial data. Kenya used its NASA data to develop guidelines for harnessing resources from construction projects to support HIV prevention. Zimbabwe’s resource tracking influenced a new policy to implement social contracting with a least one civil society organization per province, to channel domestic resources to community-led HIV responses. Zimbabwe has committed to invest 21% of domestic funds in HIV prevention, with a focus on key populations.

In the current environment of dwindling resources for HIV—2023 recorded the lowest amount of resources available for HIV in low-and-middle income countries in a decade—strengthening HIV resource tracking is key to ensure effective and sustainable HIV responses. “We need to plan for sustainability,” said Nertila Tavanxhi, Senior Manager for Health Financing Country Support at the Global Fund. “To do this, we really need to understand who is funding what, where and whom. This will show us the gaps, and where we must focus.”

“We are in a time of transformations towards sustainability,” said Mr Azcona. The National HIV Response Sustainability Roadmaps are an essential part of the work that the Global Fund, UNAIDS, PEFPAR and country partners are undergoing in 2024 and 2025. “This makes it even more important to have the right data to make the best possible choices on what these transformations must be.” 

Marouane Abouzid, a 25-year-old from Casablanca, grew up in an environment where social challenges and gender stereotypes were pervasive. However, his perspective changed the day he joined "The Ball is Your Protection" program, an initiative by Tibu Africa in partnership with UNAIDS, which uses sports to raise awareness about HIV, gender equality, and gender-based violence. 

Before joining the program, Marouane had limited knowledge about HIV and gender equality. “The training on HIV awareness led by UNAIDS and Tibu Africa was a transformative experience,” he says. “It equipped me with essential skills like effective communication and active listening.” Thanks to the program, Marouane discovered how sports can be a powerful tool to engage young people on often-overlooked topics, such as HIV prevention and breaking gender stereotypes. 

Now, trained to be a change ambassador in his community, Marouane leads sports activities and participates in educational sessions, becoming a role model for his peers. “I talk openly about what I’ve learned. I encourage my friends to get tested for HIV and respect the rights of others,” he shares. 

For Marouane, this program was more than just training. “Today, I feel ready to take action and share what I’ve learned with my community,” he says. 

During the closing ceremony of the "The Ball is Your Protection” project, Marouane facilitated workshops and sports activities with other young participants. “I saw how sports could become a tool for awareness and social mobilization,” he explains. These activities created a safe space for young people to discuss issues related to HIV and gender equality, free from societal judgment. 

In Morocco, approximately 23,000 people live with HIV, nearly 50% of whom are women. Although the prevalence rate is relatively low, vulnerable groups such as sex workers, men who have sex with men, and people who inject drugs are particularly at risk. “Before, I thought HIV didn’t have a real impact on those around me. Now, I understand that we all have a role to play,” Marouane adds. 

Marouane is not alone on this journey. Assia Ezzahraoui, 25, a participant in Tibu Africa’s Sports Vocational School program, reflects: “HIV awareness was a profoundly enriching experience. It gave me new insights into symptoms, prevention methods, and available treatments.” For Assia, taking part in the educational event deepened her understanding of HIV and reinforced the importance of protecting her health and that of those around her. 

“I want to thank everyone who contributed to this initiative. Their commitment to young athletes in Morocco is truly inspiring,” says Assia, emphasizing the value of such events in educating youth about HIV. 

Thanks to initiatives like "The Ball is Your Protection," young people like Marouane and Assia are playing an active role in addressing gender inequalities and HIV-related stigma. These young leaders are helping to build a healthier and more equitable future, proving that change can start with something as simple as a ball. 

Ethiopia faces a triple crisis of conflict, climate change, and displacement that impedes the capacity to provide essential health and other humanitarian assistance to those in need, including people living with HIV.

With support from 2Gether 4 SRHR, UNAIDS and partners recently organised a joint mission to learn about the humanitarian response and to identify the challenges that persist. The findings of the mission will help update the guidelines on Addressing HIV in Humanitarian Settings, a crucial resource for all actors working on HIV in emergency settings, providing evidence-based recommendations for integrating HIV into the different sectors of humanitarian responses.

Ethiopia hosts more than 1 million refugees, predominantly from South Sudan, Somalia, Eritrea and Sudan, the majority of whom live in 24 refugee camps established across five regional states, and 80,000 of whom reside in the capital Addis Ababa. In addition, the country has 4.4 million internally displaced persons (IDPs) and over 1.5 million IDP returnees.

The team visited two of the regions hardest hit by humanitarian crises, grappling with rising HIV rates: Tigray and Gambella. In Tigray, just 5 kilometers from the capital Mekelle, lies Seba Kare (70 Kare) IDP camp—a settlement hosting over 20,000 people displaced by the conflicts in the western and eastern parts of the region. Seba Kare represents both the resilience of its inhabitants and the dire challenges of prolonged displacement. The camp, initially intended as temporary shelter for six months, has now housed many families for over four years. Cramped conditions, insufficient food, limited access to education, and inadequate healthcare services are daily realities for residents. Despite the tireless efforts of humanitarian partners on the ground, the growing needs of the displaced population far exceed the resources available.  

Among the most pressing gaps is the lack of comprehensive healthcare, particularly for people living with HIV. In humanitarian crises, critical services for HIV and sexual and reproductive health are often sidelined, overshadowed by the urgent need for food, shelter, and disease control. Healthcare is restricted to primary services. Care for chronic conditions, such as HIV, is referred to government hospitals. This means that all patients, IDP or not, must pay for transportation as well as services and purchase vital medical supplies on their own—an impossible burden for many.

Despite the continuous advocacy efforts in support of the decentralization of services and outreach interventions at camp-level, government-owned facilities outside the camp remain the only viable option for IDPs in need of health services.

The refugee camp of Jewi—in the western province of Gambella which has the highest HIV burden across Ethiopia—is equipped with its own antiretroviral therapy center. However, like in Tigray, Gambella faces significant challenges in providing HIV testing and treatment. Limited mobility within and beyond the camps, due to the costs of transport for clients and a shortage of ambulances in medical emergencies, combined with resource constraints at health centres, often results in treatment interruptions and high rates of loss to follow-up.

Adding to the crisis, the recent reduction in donor funding has severely impacted the quality of health services in the camps. The gender-based violence (GBV) center run by International Medical Corps will soon close due to funding cuts, leaving no other GBV services available outside of health services.

The situation for women and youth in Gambella is especially concerning. Limited educational and employment opportunities, compounded by rising HIV infections, put them at higher risk of infection due to the adoption of negative coping mechanisms, including substance abuse. The high rates of new HIV infections exacerbate these existing challenges, underscoring the urgent need for sustained interventions to improve health services, livelihoods, and social inclusion for refugees and host communities in the region.  “There are many young and vulnerable people who need protection, shelter, food, income, education – and HIV prevention, testing, treatment and care. We must make sure to rebuild health and social services and fill the current resources gap,” said Tina Boonto, UNAIDS Ethiopia Country Director.
 
As international organisations step up their efforts to address HIV in humanitarian settings, there is a coordinated push in Ethiopia, at both the federal and regional levels, to ensure that the health needs of people living with HIV are met, even in the most challenging circumstances. The Ministry of Health, with support from UNAIDS, is developing an HIV Baseline Survey in Humanitarian Settings and a comprehensive National HIV/Sexual and Reproductive Health Guiding Document. This initiative is a substantial step towards safeguarding the rights and well-being of people living with HIV across the country.

"Ethiopia's progress in addressing HIV is inspiring,” said Maheswari P Murugayia, Public Health Officer and Global HIV Focal Point at UNHCR. “Tackling HIV in humanitarian settings is not just a priority— it’s a necessity for ensuring the health and well-being of displaced populations.”

ABUJA, NIGERIA, 3 December 2024 — The Joint United Nations Programme on HIV/AIDS (UNAIDS) is pleased to announce the appointment of Funke Akindele, a multiple award-winning actress, movie producer and director, as its new National Goodwill Ambassador (GWA) for Nigeria. This prestigious nomination recognizes Funke Akindele’s outstanding contributions to the fight against HIV and her unwavering commitment to advocacy, raising awareness, and driving efforts to end AIDS as a public health threat by 2030.

Funke Akindele’s career took off with her role in the United Nations Population Fund (UNFPA)-sponsored television series “I Need to Know”, which focused on adolescent reproductive health and rights, including HIV. Since then, she has captivated audiences worldwide, earning millions of fans and accolades for her unforgettable roles. Known as the “Queen of Box Office” in Nollywood, Funke holds the top three slots on the list of highest-grossing Nollywood films of all time, reflecting her prominence and influence in the industry.

Over the past two decades, Funke Akindele has consistently broken barriers and used her platform to amplify social impact issues, influence positive change, and champion causes that matter. As UNAIDS’ National Goodwill Ambassador, she will contribute to efforts aimed at eliminating vertical transmission of HIV, ending HIV-related stigma and discrimination, and promoting HIV prevention across Nigeria.

Nigeria has made significant strides in the fight against HIV over the past two decades. As of 2023, approximately 2 million people are living with HIV in the country, with an adult prevalence rate of 1.3% among individuals aged 15–49. Nigeria recorded approximately 130,000 new HIV infections in 2010. By 2023, this number had declined to about 75,000 new infections, representing a reduction of approximately 55,000 cases, or a 42.3% decrease over the 13-year period. . The country has also achieved notable progress in treatment access, with 1.6 million out of the 2 million people living with HIV in Nigeria currently on treatment.

Despite these advancements, challenges remain, including addressing stigma and discrimination, and ensuring equitable access to prevention and treatment services across all regions.

“We are thrilled to welcome Funke Akindele as our National Goodwill Ambassador for Nigeria,” said Dr Leopold Zekeng, UNAIDS Country Director for Nigeria. “Her powerful voice, vast influence, and commitment to social change make her an invaluable ally in our efforts to combat HIV and support people living with HIV in Nigeria. We look forward to working with her to drive positive impact and progress in the fight against AIDS.”

The nomination process for the National Goodwill Ambassador involved active collaboration with the National Agency for the Control of AIDS (NACA), which has expressed appreciation for UNAIDS’ role in securing such a significant partnership for Nigeria’s HIV response. Funke Akindele’s work as a National Goodwill Ambassador will be vital in mobilizing efforts for HIV prevention and ensuring that key messages reach wider audiences across the country.

The official announcement of Funke Akindele’s appointment as UNAIDS National Goodwill Ambassador was made during the World AIDS Day commemoration in Abuja on 3 December 2024, during an event led by the United Nations Resident Coordinator for Nigeria, Mr. Mohammed M. Malick Fall.

Michael Onyango rises before dawn in his Nairobi apartment and catches a train eight hours east to Kilifi, a coastal town north of Mombasa. Resorts populate Kilifi’s sandy beaches and narrow wooden boats dot the water. Onyango heads inland to meet with the Kilifi County health management team, before dashing to an assembly of peer outreach workers from across the districts of Kaloleni, Malindi and Kilifi North.

Onyango runs the Movement of Men Against HIV in Kenya (MMAHK), spearheading a community-led monitoring initiative in the region to address the high numbers of men and boys who lack access to HIV services. In Kenya, only 65 percent of the men and boys over 15 years of age who are living with HIV are on antiretroviral therapy, compared to 80 percent of women and girls. The trend is mirrored globally: in 2024, the WHO and UNAIDS released data that men lagged on progress in achieving the 95-95-95 targets. Worldwide just 83 percent of men living with HIV know their status; 72 percent are on treatment and only 67 percent are virally suppressed.

MMAHK, in collaboration with the Masculinity Institute (MAIN), the International Network of Religious Leaders (INERELA+Kenya) and the UNAIDS Kenya country office, came together to tackle these service gaps in Kilifi County, which surrounds the town of the same name. The area, home to around 1.5 million residents, extends westward from the Indian Ocean and supports livelihoods through fisheries, factories, cashew nut mills, and farming.

In Kilifi, peer data collectors have identified that health facilities need to change their opening days and hours to accommodate the work and school day.

Community organizers are also working to challenge harmful prejudices that assert that men visiting a health facility or seeking an HIV test are “weak”.

As they rapidly roll-out peer support groups to challenge these beliefs, Onyango has had flashbacks to the pandemic’s earlier phases, when in the 1990s he worked as a counselor in a Nairobi hospital. HIV treatment was not yet available. “Many men I met who found out they were positive would resign from their jobs, go to their rural homes, sell their property, and wait to die,” Onyango said.

In 2001, Onyango and others started MMAHK to create a safe space for men to talk about their health needs. MMAHK also ran community testing, workplace outreach and targeted advocacy with religious and cultural leaders. As grassroots initiatives challenged harmful gender norms, Onyango saw social stigma and self-stigma among men decrease across Kenya. But the past few years have seen a resurgence of harmful norms around masculinity.

Onyango shares that the shift in funding away from many community initiatives, which were seen as harder to measure than biomedical interventions, has hampered community engagement efforts. Both are needed, he says. For example, although HIV treatment and voluntary male circumcision are now available in Kenya, cultural factors prevent some men from accessing these services.

A regional strategy developed in 2022 by UNAIDS, WHO, UN Women and partners –“Male Engagement in HIV Testing, Treatment and Prevention in East and Southern Africa” – outlines four key approaches: Improve access to health for men and boys and decrease vulnerability; prevent HIV among men and boys; diagnose more men and boys living with HIV; and increase the proportion of men and boys accessing and adhering to antiretroviral therapy.

“Tackling harmful masculinity also has a ripple effect,” reflects Lycias Zembe, a UNAIDS advisor in Geneva. “Harmful gender norms affect everyone, and changing these norms creates a better environment for women and girls and for men and boys.”

Community initiatives like MMAHK remain key. To challenge gender norms, MMAHK positions service access as courageous, and educates men that discussing emotions is a sign of strength. At 63, Onyango shows no signs of slowing down: “We’re going to keep addressing self-stigma and figure out how to help men access the services that they need to stay healthy,” he said. “We don’t have any other option.”

The only HIV prevention that Elena Felix knew of was condoms. But condoms were not something that she was able to make use of, and she contracted HIV. Thirty years after her diagnosis, she’s helped conduct research to determine whether women in the Philippines would use a more confidential tool, and one that does not need a man to agree, to lower women’s risk of HIV infection.

“We hear from women that some partners insist on not using condoms. We hear cases too of rape. Women need protection that does not depend on men” the Association of Positive Women Advocates founder explained.

The Dapivirine Vaginal Ring or DVR was given the green light by the World Health Organization for women at high risk of contracting HIV in 2021. Unlike other types of pre-exposure prophylaxis (PrEP), this one is exclusively for women. It is a silicone vaginal ring that is inserted and worn for 28 days before being replaced. It releases an antiretroviral drug locally, reducing the risk of HIV infection through vaginal sex by half.

Since its introduction, the technology was made available in several (11) African countries. And with good reason. Around two-thirds of new HIV infections in Eastern and southern Africa and Western and central Africa are among adolescent girls and women. The combination prevention strategies implemented in these two regions have super-charged progress, driving the global 39% decline in new infections since 2010.

But the Asia Pacific picture is quite different.

“This region has an HIV prevention crisis,” Eamonn Murphy, UNAIDS Regional Director for Asia Pacific and Eastern Europe Central Asia said. “And I am not speaking only of the countries where new infections have doubled, tripled or increased six times since 2010. The average regional decline in new infections is far too slow. At 13% it has virtually flatlined.”

He was speaking to a group of community, government, research and development partners from Cambodia, Indonesia, Papua New Guinea and the Philippines who met from November 11 – 12 in Bangkok. Findings were disseminated from a DVR acceptability and feasibility study conducted by ThinkPlace, and a discussion held on next steps. UNAIDS and the World Health Organization (WHO) are providing technical support for this initiative. The Australia Department of Foreign Affairs and Trade (DFAT) funded the research as part of its ongoing support for prevention work in the region.

Seven percent of new infections in Asia Pacific are among sex workers while 12 percent occur among the intimate partners of key populations. Angeli Achrekar, UNAIDS Deputy Executive Director, called for women in Asia and the Pacific to be provided more HIV prevention options.

“Choice is the way to go!” Ms Achrekar stressed. “Providing options in prevention tools and service delivery increases overall use and results. We must ensure that people have access and that they are supported with the appropriate policies and enabling environment. The ring has great potential to be empowering as an additional choice for women, including in Asia Pacific.”

A person newly acquires HIV in the Asia Pacific region every two minutes. Despite this, the overall momentum on rolling out pre-exposure prophylaxis (PrEP) options has been sluggish. At the end of 2023 there were just 204,000 PrEP users in this region, 98% short of the 8,200,000 target by 2025. The vast majority of those on PrEP were men.

ThinkPlace Regional Director, Elliot Duffy, revealed that overall, the studies found women have high interest in this discreet, woman-controlled prevention method. Sex workers in the four countries sought the DVR given their high vulnerability to sexual violence. And in all countries the sex workers indicated that they would want to access the DVR through community-based health services or their local healthcare facilities. The research also found that healthcare providers in the four countries were enthusiastic about offering this new prevention option.

“The number one barrier is the extent to which women understand how the ring would fit. Many had questions like, “would it be lost in my body? Will I feel pain? Will I be able to have sex?’ Some women worried about a partner thinking they distrusted them,” Mr Duffy explained. “The DVR is not immune to the challenges of other HIV programs and continued effort is needed to increase awareness, generate demand and create services that are accessible.”

Already the research findings have resulted in the introduction and phased implementation of the DVR into 2024 – 2026 Global Fund grant implementation for Cambodia and Indonesia. Cambodia has begun pilot testing. At the meeting the four country teams developed plans to guide their next steps, including on further research, legal and policy reviews, regulatory approvals and community system strengthening.

DFAT Health Adviser, Joshua Metcalf-Wallach, emphasized that as stakeholders switched gears from research to rollout, they should keep communities in the driver’s seat.

“Our Indo-Pacific prevention work has shown that HIV services work best when they are key population- and community-led. As we expand prevention options for women, let us be guided by their needs and demands,” he ended.

Now 43 years old, Ariadne Ribeiro Ferreira, a trans woman working for UNAIDS in Brazil, advocates to leaders and speaks to media around the world. As she is an inspiration to colleagues, many are keen to learn more about Ariadne’s story.

From a young age, Ariadne sensed that she was different from those around her. “When my sister arrived, I understood, as a child, that I was like her,” Ariadne recalls.

Ariadne's situation, already challenging, became dangerous when her mother remarried. “My stepfather would beat me almost every day, berating me for my lifestyle,”  she recalls.

At just 13, Ariadne was forced to flee her home. "I had no choice," she remembers. Despite these difficulties, she was fortunate to have a caring grandmother who took her in and provided support. “My grandmother was different from the rest of the family. She was like a teacher to me,” Ariadne reflects. Her grandma had a transgender friend named Zeze, an activist who also inspired her.

At the age of eighteen while living with her grandmother, Ariadne’s life took a turn when she heard on the radio that a local hospital would begin offering sex change surgeries with state support. “My grandma was overjoyed at the news and danced for me,” Ariadne recalls with a smile. Shortly after Ariadne began her transition.

However, that same year she experienced a traumatic event when she contracted HIV after being raped. Despite this devastating ordeal, she refused to give up. She began treatment and continued her life with determination and resilience.

By the age of 24, she had completed all her surgeries, and she had been legally registered a woman. Ariadne officially changed her name on all her documents.

She pursued education to open up opportunities. “I had the chance to specialize at UNIFESP, the second-best university in Brazil. Since then, I have continued my education, earning a specialization, a master’s degree, and recently a Ph.D.”

Ariadne began her healthcare career in Itanhaém, where she worked in a peer education program at a health facility and contributed to a cooperation agreement with the State Government. “I focused on HIV prevention programs, gaining visibility as one of the few transgender professionals at the time,” she explains. “This recognition opened up new opportunities for me.”

Reflecting on her proudest achievements, Ariadne highlights her work with homeless individuals in São Paulo, Brazil and her role in establishing the state’s first shelter for homeless transgender people. Following these accomplishments, she joined UNAIDS in 2019, where she continues to advocate for transgender rights and supports people living with and affected by HIV, using her voice to uplift and empower others.

Ariadne's makes use of her extensive experience to champion the rights and well-being of everyone living with HIV, including UN staff. Working with UN Plus, she is pioneering innovative strategies to uphold dignity in every workplace.  Building a future free from stigma and discrimination, say Ariadne and UN Plus, is how to enable everyone to perform at their best, and to thrive.

After Evelyn Siula’s husband died, she knew she had to get tested for HIV. The result came back as positive.

"I had prepared myself mentally for either outcome, but it was still a shock."

She was jobless and with three children to care for.

The stigma and discrimination surrounding the virus meant that many people were scared to disclose their status. "I had three friends whose families rejected them because their HIV status became known,” Evelyn shares.

But Evelyn chose to break the silence early, starting by telling her young daughter. Family support played a crucial role in Evelyn’s journey. Her family stood by her, offering constant encouragement and strength, vital for getting through the many challenges.

Stigma followed Evelyn. She recalls a particularly painful moment: “At a community gathering, someone pointed at me and asked, ‘Can you believe she’s HIV-positive?’ It was one of the worst experiences being talked about like that.”

Evelyn became a strong advocate for people living with HIV, standing up to stigma everywhere, including in her church. At a gathering in a church, when a speaker criticized people living with HIV, she shared her own status as HIV-positive and as a church elder. Her openness has helped challenge stigma and gain support. Through her work she  learned that many fellow church members were struggling in silence, and so helped create the Livingstonia Synod Positive Christians group, known as LISAP+.

Despite her bold advocacy, Evelyn acknowledges how mental health challenges, particularly fear and anxiety, have affected her. “I have thoughts like: ‘What if something happens to me? What if I die?’ I worry about my children and how they would manage without me. These are the fears that raise my blood pressure.”

But over time, Evelyn’s diagnosis has become not just a challenge but also a source of strength.

Today, Evelyn works for UNAIDS and is the vice chair of the UN Plus Advisory Group. She is proud to show that people living with HIV are leading healthy and productive lives.

She has completed  Bachelor’s and Master’s degrees in business administration. “The day I graduated with my Master’s degree was extra special because I graduated alongside my eldest son. It’s rare for a mother and son to share such a moment.”

Evelyn encourages everyone to ensure they know their HIV status as the first step to taking control of their health: “Please get tested. It's just a status. If you're positive, follow the advice of your doctors. There is full life after testing HIV positive. Take your medication religiously, eat well, and live a healthy life.”

“Never stigmatize anyone,” says Eveyln, “because we are all one.”

Life became chaotic for Poon early. (Not his real name.)

As a gay teenager he was bullied at school by students and teachers. He moved in with his grandparents when his parents separated, but eventually left northern Thailand for Bangkok. There he survived through sex work.

Then Poon learned he was living with HIV. The weight of HIV prejudice merged with the stigma he already carried as a young gay man and sex worker. Some friends he made at a camp disclosed his HIV status online after an argument. He was diagnosed with major depressive disorder.

A partner introduced him to drug-use during sex. He went on to use multiple substances including methamphetamines and cocaine.

“Sex, drugs and alcohol are my escape,” he said.

This was one of the stories shared at the 6th Asia Pacific Chemsex Symposium (APCS). Held in Bangkok on November 6 and 7, the event brought together over 300 stakeholders from 27 countries. They shared their research and responses to a practice that remains largely hidden and not yet well understood. The event specifically explored pleasure as opposed to risk as an entry point for providing services.  

Chemsex—also called High Fun in several Asian countries—refers to the use of stimulant drugs during sexual activity. It lowers inhibitions and may increase risk-taking. There are several public health implications including higher rates of HIV and sexually transmitted infections (STIs), lower adherence to treatment, overdose and the fallout linked with intoxication.

In Asia Pacific four of every five new HIV infections are among people from key population communities including men who have sex with men or MSM, people who use drugs, people in prisons or other closed settings, sex workers and transgender people. Young people make up a quarter of all new HIV infections and in some countries around half of new infections are among youth ages 15 to 24.

Several countries in the region are facing an HIV prevention crisis with new infections among MSM either increasing or decreasing far too slowly. In 2023, 43% of new infections in Asia-Pacific were among MSM. At the same time, there is evidence that the practice of chemsex in this community ranges from 3% to 31% depending on the country. But although chemsex is most visible in the MSM community, it is practiced by people from all populations.   

“We are talking about sex and drugs—two topics that people call taboo,” said Brigitte Quenum, UNAIDS Regional Team Lead for Sciences, Systems and Services at the opening ceremony. “But as HIV has taught us, to reach people, we must confront the realities of their lives.”

Toolkit now available for Asia Pacific health workers

On day 2 of the symposium UNAIDS and UNODC launched the first-ever toolkit on chemsex for Asia Pacific clinical service providers. The toolkit was developed by the Australian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM). It is geared toward health workers in Asia and the Pacific working with men who have sex with men and transgender women.

"The increasing use of stimulant drugs in the region, including for ‘Chemsex’, poses significant health risks, including drug use disorders and various psychosocial challenges," said Masood Karimipour, Regional Representative of UNODC’s Office for Southeast Asia and the Pacific. "This UNAIDS-UNODC toolkit provides essential guidance for healthcare providers to address these challenges through evidence-based interventions. It emphasizes the importance of holistic, non-judgmental care that prioritizes the physical, psychological and social wellbeing of individuals, while ensuring access to harm reduction services and the prevention and treatment of drug use disorders within a comprehensive continuum of care."

The resource was created to support comprehensive clinical services in the region’s restrictive legal environments. Twenty-eight countries in Asia Pacific criminalise drug possession for personal use while 17 criminalise same-sex relations. Penalties for drug-related offences in the region are among the world’s harshest.

The toolkit was developed through consultation with clinicians, community representatives and government agencies. It covers chemsex basics as well as approaches to harm reduction, sexual health, and mental health services. It also covers different service delivery models including face-to-face, online and by communities. The toolkit offers guides and tools on topics such as initiating non-judgmental conversations and risk assessment.

“Stronger HIV prevention strategies tailored to chemsex are needed, along with expanded, inclusive services for sexual, physical and mental health,” said Suniya Taimour, UNAIDS’ Community-led Responses Advisor for Pakistan and Afghanistan.

Thia approach recognises that comprehensive health services can be lifesavers by using one point of contact to address multiple issues including physical, sexual and mental health as well as social issues. Poon is a living example. He has benefitted from a service package that has combined his HIV treatment with harm reduction interventions and psychiatric care. Today he is a 22-year-old university student with clear life goals who feels more empowered about his HIV status.

MHAMID AL GHIZLANE, 2 November 2024 — The Joint United Nations Programme on HIV/AIDS (UNAIDS) is pleased to announce the appointment of renowned Moroccan artist OUM as its National Goodwill Ambassador in Morocco. The prestigious announcement was made at the Taragalte Festival, held from November 1-3, 2024, in Mhamid El Ghizlane, where OUM proudly serves as the festival's ‘Godmother.’ OUM’s influence and commitment to social change will play a vital role in UNAIDS' efforts to combat HIV/AIDS in Morocco and beyond.

“OUM’s appointment as National Goodwill Ambassador is a powerful step forward in our efforts to fight against HIV in Morocco,” said Houssine El Rhilani, UNAIDS Country Director for Morocco. “Her artistic influence and commitment to social causes will help amplify our messages of prevention, tolerance, and support for people living with HIV.”

In her new role, OUM will work to promote awareness and education around HIV prevention. She will also focus on fighting against the stigma and discrimination faced by people living with HIV. “As an artist, I have a platform to reach many people. It is my duty to use my voice to advocate for people living with and affected by HIV who are often unheard,” said OUM. “I am honored to take on this role with UNAIDS and am committed to supporting the fight against HIV in Morocco.”

Morocco faces significant challenges in the fight against HIV, with approximately 23,000 people currently living with the virus. The National Integrated Strategic Plan for HIV, Viral Hepatitis, and STIs (2024-2030) outlines essential actions to strengthen HIV prevention efforts and improve access to care, particularly for populations most affected by HIV. OUM's role as an ambassador is vital in driving these efforts forward.

OUM is no stranger to social advocacy, having previously collaborated with various United Nations agencies. Her engagement includes speaking on international platforms and participating in initiatives promoting women's rights and education. The official ceremony for OUM’s appointment highlighted her commitment to raising awareness around HIV issues in Morocco. It featured speeches from local leaders, including representatives from the region of Zagora and the Ministry of Health and Social Protection. The festival itself serves as a cultural backdrop, emphasizing the power of music and art in promoting peace and social change.

As UNAIDS continues its mission to end AIDS as a public health threat by 2030, collaboration with influential figures like OUM is crucial. Her role as National Goodwill Ambassador will not only increase awareness but also inspire collective action to ensure that all people affected by HIV, regardless of their status, have access to the care and support they need.

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.