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Can this innovation change the way people think about HIV?

16 October 2024

In 2020, a gay Thai man living with HIV sparked controversy with a Facebook post. He was on antiretroviral therapy and had gotten lab tests to check the level of virus in his blood. Since his viral load was undetectable, he wrote, he was going to stop using condoms.

The public responded with a mix of contempt and disbelief. How could he? So selfish! So reckless! The resulting debate spilled from social media onto national radio and TV.

“There was a huge backlash,” remembered Dr Nittaya Phanuphak, the Executive Director of the Institute of HIV Research and Innovation (IHRI). She was telling the story from IHRI’s sunlit offices to teams from Botswana, Ghana, Ivory Coast, Jamaica, Mozambique, South Africa and Zambia. They’d come to Bangkok as part of a learning exchange coordinated by the Global Partnership for Action to Eliminate all Forms of HIV-related Stigma and Discrimination.

Dr Nittaya said that she and her father, Professor Praphan Phanuphak, thought it was their duty to contribute to the public discourse. While the man’s approach might have been unconventional, the science behind his statement was sound.

They would know. Professor Praphan diagnosed Thailand’s first HIV case in 1985 and dedicated his life to HIV research, service delivery and advocacy. He co-founded the Thai Red Cross AIDS Research Centre which in 2014 conducted cutting-edge research as part of the Opposites Attract Study. Done in Australia, Brazil and Thailand, that study tracked couples in which one person was HIV-negative and the other was living with HIV but had achieved an undetectable viral load through successful HIV treatment.  It confirmed that after two years of unprotected sex, there were no cases of HIV transmission between more than 300 couples. 

“It’s a scientific fact,” Dr Nittaya said. “For me, I felt like we really needed to do something. We cannot just wait 50 years for this knowledge to gradually seep into Thai society.”

The “knowledge” to which she refers is the concept of undetectable = untransmittable, or U=U for short. Last year the World Health Organization further endorsed the principle, stressing that when a person’s viral load is undetectable there is zero chance of sexual transmission.

“Before, HIV treatment just meant longevity,” said Pan (not his real name), a person living with HIV. “But with U=U, now it is love without fear.”

Within three to six months a person who takes their HIV treatment as prescribed and receives viral load monitoring can confirm that they have achieved an undetectable viral load. This removes the self-stigma associated with having an “infectious” disease. For Thai HIV response stakeholders, this concept can also transform the public’s attitudes about people living with HIV, making it easier for them to live full, happy lives.

“If social perceptions can be brought in line with the reality of HIV treatment, we can remove the stigma around getting an HIV test or diagnosis,” said Eamonn Murphy, Regional Director of UNAIDS Asia Pacific and Eastern Europe Central Asia. “The more supportive the society, the more people we successfully treat and the fewer new infections.”

But for the U=U strategy to be fully utilized, work must be done to dispel myths and bolster confidence in science.

According to UNAIDS Country Director for Thailand, Dr Patchara Benjarattanaporn, a key step in the national process was bringing decision-makers together with relevant stakeholders, including voices from communities.

“They considered both global and local evidence,” she explained. “Now there is consensus about the science. U=U also conveys the message ‘you=you’, affirming that all individuals are equal and that people are more than their HIV status. It emphasizes the importance of ensuring people are fully informed about their options and respecting their right to make choices about their sexual health depending on their realities.”

At the opening ceremony of the eight-country learning exchange, Dr Niti Haetanurak, Department of Disease Control Deputy Director, noted that the U=U concept is a key element of Thailand’s “all of society” strategy to address the prejudice and rights violations people living with HIV face. Thailand has a National Costed Action Plan to Eliminate all forms of HIV-related Stigma and Discrimination. The Ministry of Public Health and Sub-National Committee on AIDS Rights Promotion and Protection under National AIDS Committee coordinate the effort. Community organizations play a leading role.

During the exchange the country teams visited the Service Workers in Group (SWING) Foundation which serves sex workers and IHRI’s Tangerine Clinic which primarily serves transgender people. Both have come up with innovative approaches to ensure groups that usually find it challenging to receive healthcare at state-run facilities can get HIV and sexually transmitted infection (STI) testing and treatment in a friendly environment.

A key strategy is training members of those very communities to provide certain services themselves. They can even start clients on treatment for HIV and some other conditions the same day they are diagnosed. This approach makes it less likely for people to disappear into the shadows after diagnosis, with a high chance of infecting others and eventually becoming ill.

“This community-led health model can be applied to any health condition or population. But this does not really address stigma and discrimination. It just bypasses it by opening up alternative service delivery outlets for people who want to avoid negative experiences elsewhere,” Dr. Nittaya said.  “We need to address the heart of the stigma as well. That is why we are working on using U=U as a tool to explore how we can shift attitudes.”

The Bangkok Metropolitan Administration (BMA) is integrating this concept into its work in healthcare settings and the workplace. A masterplan is in the works. One branch of the strategy will tackle employers requiring HIV testing in the pre-employment phase or targeting employees they find out are living with HIV. Another aspect of the approach is the integration U=U into all levels of HIV service delivery and ongoing healthcare worker sensitization. All staff in clinics and hospitals are trained, not just nurses and doctors.

The work doesn’t stop there, though. Describing the Bangkok society as “open”, Dr Tavida Kamolvej, Deputy Governor of Bangkok, said that the whole of society was ready for deeper conversations about inclusion and HIV. But how could these approaches be applied in other countries and cities that are not quite as tolerant or accepting, she was asked.

“If you are confronted with beliefs that might not allow open conversations about HIV, sexuality and sex, you can strategically make it about health literacy, dignity and care for all people. I think this is soft enough to make people aware about health and wellbeing,” Dr Tavida advised.

Click here to learn more about the recent eight-country learning exchange to eliminate all forms of HIV-related stigma and discrimination.  

A transformative journey: Parisa's decades-long battle against HIV stigma and discrimination

18 July 2024

Every pain yields a lesson, and every lesson transforms a person

Parisa's life was forever altered by HIV 25 years ago. The virus struck her family, snatching her husband's job and halting her child's education. Tragically, her husband passed away two years later, leaving Parisa to navigate the daunting landscape of loss and discrimination.

“I did not have a clue about this illness. It was, in fact, the first time I had even heard the word 'AIDS'”.

Parisa

Undeterred by adversity, Parisa embarked on a relentless mission for human rights, determined to combat the pervasive stigma and discrimination surrounding HIV. Initially, she immersed herself in seminars and conferences, volunteering tirelessly at counselling centres, where she shared her own experiences to chip away at the stigma and discrimination.

“My activities in the Positive Club allowed me to broaden my knowledge and take more effective steps toward raising public awareness, reducing HIV stigma and discrimination, and helping my peers… IRCHA and UNAIDS supported me to expand my knowledge and gave me the chance to exchange my experiences with the members of Positive Clubs in and out of the country.”

Parisa

Her unwavering dedication caught the attention of Dr Minoo Mohraz, the former director of the Iranian Research Centre for HIV/AIDS (IRCHA), who offered her a pivotal role in a Positive Club—a sanctuary for those grappling with similar challenges. Thus began Parisa's transformative journey, marked by a series of initiatives aimed at raising awareness, eradicating stigma and discrimination, and supporting her peers.
 

WHAT IS THE POSITIVE CLUB INITIATIVE? The Positive Club is a meeting place for people living with HIV, who run the club themselves, with supervision from Parisa and colleagues. At the club, people receive training in arts, and sports, and as peer educators.  The Positive Club initiative was one of the successful programmes aimed at promoting positive health, dignity, and HIV prevention; it has been running for over 12 years with support from UNAIDS in collaboration with national partners and civil society organizations. Through this initiative, over 10,000 people living with HIV have been supported across 25 Positive Clubs, empowering them through training classes, workshops on HIV prevention, care and treatment, counselling sessions, and psychosocial support.


Over the years, Parisa's efforts have been nothing short of extraordinary. From managing a Positive Club in Tehran to representing people living with HIV in various influential platforms, including Iran's Country Coordinating Mechanism, its Oversight Committee, and Global Fund, she has been a relentless advocate for change. 

Her initiatives have spanned diverse arenas, from radio shows and collaborations with filmmakers to training workshops for religious leaders and healthcare providers. Parisa's impact reverberates across borders, as she leverages regional platforms like MENA Rosa --the first regional network dedicated to women living with HIV in the Middle East and North Africa-- to exchange experiences and champion global efforts against HIV stigma and discrimination with a particular focus on Women living with and affected by HIV.

Amid the COVID-19 pandemic, Parisa's compassion for people living with and affected by HIV was once again evident. She mobilized support networks to provide essential supplies for Positive Club members and vulnerable families, ensuring that the crisis does not exacerbate the challenges faced by PLHIV.

Reflecting on the progress made over the last 25 years, Parisa acknowledged the remarkable strides in combating HIV-related stigma and discrimination. Efforts to eliminate HIV-related stigma and discrimination have been led by the UNAIDS Country Office for Iran, alongside national partners of the AIDS Control Programme. Notably, the first PLHIV Stigma Index study, conducted in 2010, laid the foundation for understanding the landscape of stigma in Iran. Subsequently, a second PLHIV Stigma Index study, was carried out by the network of PLHIV in collaboration with UNAIDS, Global Network of PLHIV (GNP+), International Community of Women Living with HIV (ICW), Johns Hopkins Medical University (JHMU), National AIDS Programme (NAP), and with financial support from Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) /UNDP. Parisa played an important role in implementing the Stigma Index 2.0 which provided updated insights.
 

COMPARING OF BOTH OF IRAN’S STIGMA INDEX STUDIES A comparison between the two Stigma Index studies conducted ten years apart, using updated methodologies, revealed promising changes. The prevalence of self-stigma among PLHIV decreased significantly from 80% to 40%. Similarly, the percentage of PLHIV refraining from seeking medical help has decreased from 80% to 19%, underscoring improved accessibility to healthcare services and increased health-seeking behaviour among affected individuals. Overall, reports of stigma and discrimination have decreased from 71% to 47%, reflecting tangible improvements in societal attitudes to HIV.


Parisa reflects on these notable shifts in HIV-related Stigma observed between the two studies. In the initial Stigma Index conducted a decade ago, internal stigma was predominant among PLHIV, followed by societal and healthcare provider stigma. However, in the subsequent study, internal stigma was significantly reduced, while stigma and discrimination from healthcare providers emerged as the most prevalent issue. The improvement observed in internal stigma among PLHIV could be partly attributed to the work of the empowering Positive Clubs. Additionally, this improvement highlights the importance of ongoing efforts to address stigma and discrimination comprehensively, with a particular focus on healthcare settings. By acknowledging these shifts and persisting in their efforts, UNAIDS Iran, Parisa and her colleagues remain committed to building a future free from the burdens of HIV-related stigma and discrimination.

Through her nearly two decades of hotline counselling experience, Parisa has witnessed a shift in attitudes, with increased awareness and openness surrounding HIV discourse. 

She credits grassroots campaigns and community-led initiatives for driving this transformation, paving the way for a more inclusive society.

“Positive Clubs have been played a very effective role in empowerment and phycological support to the members and reducing stigma and discrimination.”

Parisa

In 2019, Iran joined the Global Partnership to Eliminate all forms of HIV-related stigma and discrimination, prioritizing a strong emphasis on interventions within communities, emergency/humanitarian settings, and healthcare facilities. With support from UNAIDS, protocols and training packages were developed to address stigma and discrimination in these critical areas. These efforts were carried out in close collaboration with national partners and civil society organizations, with training workshops being a key component of the initiative.
 

OVERVIEW OF GLOBAL PARTNERSHIP The Global Partnership for action to eliminate all forms of HIV-related stigma and discrimination is a critical vehicle for action to mobilise all countries to reach the political declaration and Global AIDS Strategy targets. It leverages partnerships to enhance coordination of interventions and funding; it provides knowledge and evidence-guided technical support; and increases accountability mechanisms and community leadership.


Parisa was actively involved in the implementation phase of these projects. Her contributions have been instrumental in advancing the work to eradicate HIV-related stigma and discrimination across humanitarian, healthcare, and community settings.

However, Parisa acknowledges the persistent challenges faced by PLHIV, from sporadic bouts of self-doubt to occasional rejections and the lingering shadows of depression and fear. Despite these hurdles, she remains steadfast in her belief that we can achieve a future free from stigma and discrimination.

As Parisa continues her tireless advocacy, her journey stands as a testament to the resilience of the human spirit and the power of collective action in fostering a world where every individual, regardless of their HIV status, is embraced with dignity and compassion. 

“Of course, people living with HIV still experience stigma and discrimination at different stages of their lives but have a hope for a day free of stigma and discrimination.”

Parisa

UNAIDS has played a pivotal role in the establishment and sustained operation of Positive Clubs for over a decade, catalyzing transformative changes in the lives of people living with HIV such as Parisa and in the fight against stigma and discrimination. Nonetheless, the journey towards eliminating stigma and discrimination remains unfinished, albeit considerably smoother and more steadfast with the collaborative efforts and political commitment of initiatives such as the Global Partnership.

“Together, we continue to pave the way towards a future free from the burdens of stigma and discrimination for all individuals living with and affected by HIV.”

Parisa

Girls’ education for HIV prevention at 1st Pan-African Conference on Girls’ and Women’s Education in Africa

08 July 2024

Girls’ education as a tool to prevent HIV infection has been centered at the 1st African Union Pan-African Conference on Girls’ and Women’s Education in Africa. This followed African leaders designating education as the 2024 African Union theme of the year.

At a high-level side event hosted by the Education Plus Initiative on the first day of conference held at the African Union Commission in Addis Ababa, Ethiopia, leaders, girls’ and women’s networks and advocates called for greater investments in girls’ education.

“Some people claim that providing girls with secondary education is too expensive. Such claims fail to consider the exponentially higher cost of not educating them,” said UNAIDS Executive Director, Winnie Byanyima. “We can get all our girls and boys to complete secondary education; that should be our legacy."

UNICEF calculates that 34 million girls in sub-Saharan Africa are out of secondary school. According to the Global Education Monitoring (GEM) Report 2023, in all regions in Africa, there are more girls out of school at the secondary level than boys, with gender disparities worsening as children move up to higher levels of education in favour of boys over girls. In sub-Saharan Africa, less than half of adolescent girls complete secondary education, their percentage standing at 42% and there has been no progress at all in closing this gap in the past 20 years.  Sub-Saharan Africa is the region furthest from parity at the expense of girls, with no progress since 2011 at the lower secondary level and since 2014 in upper secondary.

Gender is a key factor linked to disparities in enrolment, retention, completion, and learning outcomes through social conditioning, gender-based differences in parental expectations and education-related investments, child marriages and early childbearing, female genital mutilation, child labour, gender-based violence, period poverty and discrimination.

More than forty years into the HIV response, Africa remains an epicenter of the AIDS epidemic with adolescent girls and young women being disproportionately affected. Every week 3100 adolescent girls and young women acquired HIV in sub-Saharan Africa. Every three minutes, an adolescent girl or young woman aged 15-24 years acquired HIV in 2022 in sub-Saharan Africa.  Adolescent girls and young women aged 15-24 years in the region were more than three times as likely to acquire HIV than their male peers in 2022.

UN agencies, African Union representatives, government ministers, and young women leaders called for accelerated actions to translate commitments to action through leveraging girls' education for gender equality and preventing HIV, child marriage, teenage pregnancies, violence, gender-related stigma and discrimination in Africa.

Speakers emphasized the connection between health and education. Ministers spoke about key policy reforms and best practices aimed at promoting girls' education, including creating safe and inclusive school environments, strategies to get girls into secondary school, and the readmission policy that addresses high dropout rates due to pregnancy.  UN co-leads emphasised the need for improved collection of data disaggregated by sex and other relevant population characteristics to better understand educational participation, progression, and learning, and using gender-sensitive data for policymaking and planning. 

Other issues highlighted included the integration of digital literacy programs into the secondary education and vocational training curriculum to facilitate smooth transitions from school to employment; integrate gender equality into all aspects of the education system, including curriculum-based comprehensive sexuality education  and life skills, address gender-based violence  within schools and discriminatory laws and practices, and access to information, non-discriminatory HIV and sexual and reproductive health services access.

Young women leaders spoke on the role of partnerships and young women's leadership. Participants highlighted the upcoming 30th anniversary of the Beijing Declaration as an opportunity moment to accelerate accountability and commitments, as well as the CSW Resolution 60/2, Women, the Girl Child and HIV and AIDS as significant mechanisms to address political and resource gaps so no woman or girl is behind in the HIV response.

Education Plus is a rights-based, gender-responsive action agenda to ensure adolescent girls and young women have equal access to quality secondary education, alongside key education and health services and support for their economic autonomy and empowerment.  Co-led by five UN agencies, the initiative builds on existing frameworks like the Transforming Education Summit, the Continental Education Strategy for Africa (CESA) and the Dakar Education for All (EFA) Declaration to push for access and completion of education for women and girls in Africa.

Quotes

" Some people claim that providing girls with secondary education is too expensive. Such claims fail to consider the exponentially higher cost of not educating them. We know the consequences when girls can’t finish secondary school: higher risks of sexual violence, early marriage, unwanted pregnancy, complications in pregnancy and childbirth, and HIV infection. But when a girl completes secondary school, it helps her to be safe and strong. If all girls complete secondary education, adolescent pregnancy could be cut by 75% and early marriage could be virtually eliminated. An extra year of secondary school can increase women’s eventual wages by 15-25%. We can get all our girls and boys to complete secondary education; that should be our legacy."

Ms.Winnie Byanyima UNAIDS Executive Director

We must recognize the intersecting challenges girls face, including HIV. They face extraordinarily high levels of HIV infections. Women and girls represented 63% of all new HIV infections in Africa in 2022. Empowering girls with knowledge is key to ending AIDS as a public health threat. Education is the best HIV prevention tool available.”

Dr. Sihaka Tsemo Director of the UNAIDS Liaison Office to the African Union

“African nations should ensure that young people not only gain vital knowledge but also acquire life skills, values, attitudes, and make decisions in order to live healthy and fulfilled lives. Through the AU strategy, we will see increased awareness about the importance of investing in education and the health of children and adolescents.”

Dr. Caseley Olabode Stephens African Union Commission

“Girls’ education is not only a right, but will also result in broad socio-economic development for countries. We are creating a safe and conducive environment for adolescent girls and young through the criminalization of child marriage, FGM, school-related gender-based violence, and sexual harassment, particularly sexual exploitation perpetrated by teachers. We provide life skills and comprehensive sexuality education in schools and ensure an inclusive school environment for children with disabilities, with specific attention to girls. We have enhanced social protection strategies, including cash transfers to poor households to ensure that girls go to school and are not engaged in care work and child labour.”

Hon. Médessè Véronique Tognifode Mewanou Minister of Social Affairs and Microfinance, Benin

“Girls who dropped out due to early pregnancies or early unwanted pregnancies are readmitted. We have a national girls’ education strategy aimed at facilitating the pace at which Malawi may achieve sustainable development goals. We emphasize universal primary education, the promotion of gender equality and empowering women.”

Hon. Nancy Chaola Mdooko Deputy Minister, Ministry of Education, Malawi

“We are trying to remove the cultural norm barriers and negative gender stereotypes that contribute to gender-based violence and discrimination against adolescent girls and young women with a male engagement strategy. Inclusive education provides special provisions for the less privileged and disadvantaged children and youth; user-friendly infrastructure, teaching and learning materials and provision of expert teachers.”

Hon. Nancy Chaola Mdooko Deputy Minister, Ministry of Education, Malawi

“Education is a human right. The Education Plus Initiative is driving policy changes in Africa. Education Plus seeks to keep adolescent girls and young women in school by simply unequivocally saying no to child marriage, no to violence, no to HIV infections, no to gender-related stigma, and of course, no to harmful practices. We want to keep girls in secondary education and make sure they stay there and complete their education. We do that by supporting sexual and reproductive health and rights, comprehensive sexuality education and work for integration HIV awareness, preventing and managing learners pregnancies and addressing school-related gender-based violence.”

Mr. Saturnin EPIE Chief, UNFPA Representation Office to the African Union and UNECA

“We need to scale up effective interventions to increase HIV knowledge and transform gender norms, and hence girls’ access to services. We should explore the potential of innovative solutions offered by digital technologies to mobilize and provide young women and adolescent girls with comprehensive HIV information. Let's do more, particularly for those girls living with HIV to be meaningfully engaged in the HIV response. Young women must have a formal seat and a safe space to raise their needs. let's move from rhetoric to action.”

Ms. Letty Chiwara, UN Women Representative, Malawi

“The numbers are unfortunately very clear: highest adolescent pregnancy rates of the world are in sub-Saharan Africa, highest percentages of women first married or in union before 18, young women more than 3 times as likely of HIV infection, or unacceptably high rates of justification of wife beating among adolescents. Fortunately, we benefit from a strong set of political commitments and strategies to face these issues. There is the Education Plus Initiative, the WCA Commitment for Educated, Healthy and Thriving Adolescents and Young People, the ESA Commitment, and the AU Continental Strategy on Education for Health and Wellbeing of Young People in Africa. It is high time to convert the commitments and strategies in concrete results for adolescent girls and young women.”

Mr. Xavier Hospital Regional Health Education Adviser, UNESCO

“Girls need an affirming environment. Where there's ignorance, there's a lot of resistance to education and sexuality education in the curriculum. We need to engage to change the environment, talking with parents, men and boys, community members and leaders for them to have access to information because they have a great influence on the lives of these young people. We need inclusive advocacy, especially the rural grassroots and true localization of information and interventions.”

Ms. Chidinma Adibeli Young Woman Leader, West and Central Africa

Invest in women and girls’ education and health rights to end AIDS in Africa

11 March 2024

Despite substantial declines in new HIV infections globally, the HIV/AIDS epidemic continues to disproportionately impact adolescent girls and young women in many countries, particularly in sub-Saharan Africa. In 2022, there were 3,100 new weekly infections among adolescent girls and young women aged 15-24 years.  In sub-Saharan Africa, adolescent girls and young women accounted for more than 77% of new infections among people aged 15-24 years in 2022.

That’s why Education Plus Initiative co-hosted with the Grand Duchy of Luxembourg a high-level side event on the margins of the 68th Commission on the Status of Women (CSW68) to bring attention to the cost of inaction, calling for more consistent investment in education, health and economic rights of adolescent girls and young women in Africa. The CSW, which runs from 11- 22 March 2024, is the United Nations largest annual gathering on gender equality and women’s empowerment, with this year’s priority theme, Accelerating the achievement of gender equality and the empowerment of all women and girls by addressing poverty and strengthening institutions and financing with a gender perspective.

Speakers included four ministers from Luxembourg, Benin, Sierra Leone, and Uganda, senior government officials from Cameroon and South Africa, and heads of UN agencies who co-lead Education Plus, ATHENA network. Hannah Dolly Kargbo, a young activist from Freetown, Sierra Leone, and founder of the Girls Advocacy Development Network (GADNET), pre-recorded a video that showed her work with young people to advance rights.

The event, Education Plus investment cases for transformative results: leveraging girls completion of secondary education for gender equality and HIV prevention mobilized government, partners and key stakeholders towards accelerated actions and translate commitments to action for gender equality and HIV prevention in Africa.

The costs of inaction on the rates of HIV in adolescent girls and young women remain significant, not only counted in terms of the harmful impacts on girls’ lives but in how they undermine prospects for poverty eradication and the well-being and resilience of families, communities, societies and national economies.  For instance, the lack of educational and economic opportunities that result in women’s diminished labour force participation is estimated to cost the African region US$60 billion in economic losses every year. And yet Africa could gain US$500 billion per year through multi-sectoral investments in adolescents and youth, especially girls, by capitalizing on demographic windows of opportunity.

Education Plus calls for investment in the education and empowerment of adolescent girls and young women, and 15 champion countries are already committed to using education as a means to reduce high HIV rates.  Investments that guarantee education for all young people, violence-free school environments, provision of stigma-free health services, comprehensive sexuality education, access to sexual reproductive health and rights services and economic autonomy and empowerment are key to ending AIDS as a public health threat by 2030. When adolescent girls and young women complete secondary school, their risk of getting HIV is reduced significantly.

Quotes

“We must take immediate action to change this situation, get girls back to school and ensure they complete secondary education. This requires commitments made by African member states to address gender inequalities, stigma and discrimination that fuels these infections fulfilled. There is progress in Africa, but it simply isn't fast enough. That's why we have this initiative - Education Plus”

Winnie Byanyima UN Under-Secretary General and UNAIDS Executive Director

“What I find extremely worrying is the surge in extreme conservative policies on sexual and reproductive health and rights. This is across the world but also in sub-Saharan Africa. We must avoid going back in time. We need to empower girls because it's the only way that we will have women empowered.”

Yuriko Backes Minister of Gender Equality and Diversity, Luxembourg

“We can make HIV a disease of the past, but we can't do it without listening to understanding and supporting young girls and women to take the lead. Now is the time to ensure that every girl lives a life free from violence with unhindered access to quality education, to sexual and reproductive health rights and services and with meaningful opportunities to lead a productive life.”

Catherine Russell UN Under-Secretary General and UNICEF Executive Director

"We know that investing in girls' education and health is an important lever. We can't build our country's development by leaving out 53% of our population"

Véronique Tognifodé Minister of Social Affairs and Microfinance, Republic of Benin

“Under the radical inclusion policy, we are bringing pregnant girls back to school, retain girls when they become pregnant. So, education and HIV go a long way! When they are educated and have an awareness of HIV, their well-being, and reproductive and sexual rights, they are more assertive when negotiating safer sex.”

Isata Mahoi Minister of Gender and Children’s Affairs, Sierra Leone

“Adolescent girls and young women's organizations are the least funded. Only less than 5% funding of gender equality goes to women's rights organizations, even less goes to young feminist-led organizations. We need to keep the ones who are most affected, most impacted leading the response. We're not here to ask for leadership but to offer leadership to co-lead alongside you.”

Catherine Nyambura Programs Director, ATHENA Network

"It is now a policy that when constructing a school, you must have sanitary facilities separate for both girls and boys, and girls changing rooms and space. We also have intensified education, communication and advocacy on HIV/AIDS and opened schools to give information on sexual and reproductive health. We are working with girls who have dropped out of school to skill them."

Amongi Betty Ongom Minister for Gender, Labour and Social Development, Uganda

“Girls are unable to live up to their full potential because of barriers, but those barriers are dismantlable. Africa is not poor, but African women and girls are licking a spoon, a spoon they do not even own, so let's shift the discourse so that the resources also available in the countries are prioritized for investing in education, HIV prevention and investing in girls.”

Nyaradzayi Gumbonzvanda UN Assistant Secretary-General and UN Women Deputy Executive Director for Normative Support, UN System Coordination and Programme Results

Related: At the 68th Commission on Status of Women UNAIDS calls for action to achieve gender equality and end AIDS

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On the 10th anniversary of Zero Discrimination Day UNAIDS calls for the protection of human rights as a path to protecting health for all

27 February 2024

GENEVA, 27 February 2024—Zero Discrimination Day was established by UNAIDS ten years ago to advance equality and fairness for everyone regardless of gender, age, sexuality, ethnicity or HIV status. However, progress is in peril.

Attacks on the rights of women and girls, of LGBTQ+ people, and of other marginalized communities are on the rise. And when laws, policies, practices or norms enshrine punishment, discrimination or stigma for people because they are women, or are LGBTQ+, or are migrants, or sex workers, or use drugs, the results lead to failing public health as these communities are pushed away from vital health and social services.

“The attacks on rights are a threat to freedom and democracy and are harmful to health. Stigma and discrimination obstruct HIV prevention, testing, treatment and care, and hold back progress towards ending AIDS by 2030,” said Winnie Byanyima, Executive Director of UNAIDS. “It is only by protecting everyone’s rights that we can protect everyone’s health.”

There has been progress. At the start of the AIDS pandemic 40 years ago, two thirds of countries in the world criminalized LGBTQ+ people, today two-thirds of countries do not.

38 countries around the world have pledged to end HIV-related stigma and discrimination and today 50 million more girls are in school than in 2015.

To continue this progress UNAIDS urges support for women’s movements and movements for the rights of LGBTQ+ people, for racial justice, for economic justice, for climate justice, and for peace. As communities across the world stand up for rights, the United Nations is not only on their side but by their side.

On this Zero Discrimination Day (1 March), and across the whole month of March, events and activities will remind the world of this vital lesson and call to action: by protecting everyone’s rights, we can protect everyone’s health.

“Through upholding rights for all, we will be able to achieve the Sustainable Development Goals, and to secure a safer, fairer, kinder, and happier world – for everyone,” added Ms Byanyima.

 

 

 

 

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.

Contact

UNAIDS Geneva
Charlotte Sector
tel. +41 79 500 8617
sectorc@unaids.org

Watch: By protecting everyone’s rights, we can protect everyone’s health

Winnie Byanyima on Zero Discrimination Day

Watch: Rights for All means Health for All

Zero Discrimination Day 2024

Two years on: UNAIDS supports Ukraine’s commitment to the HIV response

23 February 2024

Two years of war in Ukraine have resulted in significant humanitarian consequences. Forty percent of the current population of Ukraine,14.6 million people, are in need of humanitarian assistance, 6.4 million refugees have fled the country, and more than 3 million people are internally displaced. People living with and affected by HIV continue to be vulnerable to the effects of the war, even as HIV services have been restored and are functional in most parts of the country.

Russian strikes have continued to wreak havoc on Ukrainian cities, causing death and destruction, impacting access to water, electricity, heating, and health services for millions of civilians.

In addition, there have been 1,570 attacks on health facilities and 630 health facilities damaged.

According to the latest data from The Ukrainian Public Health Center, prior to the war, Ukraine had made significant progress in reducing HIV incidence (-47%) and AIDS-related mortality (-81%) since 2010. Despite the initial disruption to the national AIDS response at the onset of the war, the national AIDS program has gradually resumed routine operations.

As of the end of 2023, the number of patients on antiretroviral therapy (ART) was only slightly below the pre-war figure, standing at 118,348 (130,724 as of February 2022). Additionally, approximately seven thousand patients are known to receive ART abroad. In the last two years, the number of patients on opioid agonist therapy (OAT) increased by 38%, reaching 27,511 people. Pre-exposure prophylaxis (PrEP) more than doubled, reaching 12,354 people.

However, in eastern and southern occupied territories data is incomplete or not available. This is true of Donetsk, Luhansk, Zaporizhzhia, Kherson regions, AR Crimea, and the city of Sevastopol. The same occurred in 2023.  Despite these challenges, the surveillance system in the government-controlled areas remains operational, ensuring the completeness and quality of data on HIV prevention, testing and treatment services.

In addition, 9.6 million people in Ukraine are estimated to be at risk of or living with a mental health condition, and 3.9 million people are estimated to suffer from moderate to severe symptoms. And there has been an increase in gender-based violence.

Ukraine remains committed to the HIV response through a strong coalition of government, civil society, international organizations, and donors, first and foremost The United States President's Emergency Plan for AIDS Relief (PEPFAR) and The Global Fund to Fight AIDS, Tuberculosis, and Malaria. This collaboration has secured vital supplies of antiretroviral therapy (ARV), tuberculosis medicines, and opioid agonist therapy (OAT), ensuring uninterrupted HIV treatment and services.

UNAIDS Secretariat, Co-sponsors and UN agencies have joined forces to provide a unified response, ensuring that vulnerable populations, including those on the frontline and in the most severely affected areas, receive comprehensive support. This collaborative effort aims to bridge gaps and address the unique challenges faced by women, people living with HIV and key populations, including the delivery of crucial humanitarian aid and HIV services.

The past two years have been very challenging. Even though the country has managed to maintain HIV services, the unpredictability of what lies ahead has many fearing the worst. Support is needed to ensure sustainability of the AIDS response and to protect key populations affected by the enduring hardships of war.

For more information and more in-depth analysis, read the Situation Report (February 2024)

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Countries take practical steps forward towards eliminating discrimination

09 February 2024

Countries from across the world who have taken practical steps forward towards eliminating discrimination are showing what is possible, UNAIDS has said.

The countries are members of the Global Partnership for Action to Eliminate all Forms of HIV-Related Stigma and Discrimination, which have prioritized and pledged to accelerate the removal of stigmatizing and discriminatory practices, policies and laws across six settings: community, health, justice, education, workplace, and emergency/humanitarian. Recent progress that was made by members of the Global Partnership included:

  • In the Central African Republic, the law on the rights of people living with HIV/AIDS was revised with a focus on social protection, opening new opportunities for people living with HIV to access enhanced support.
  • In Argentina, the National Law for Comprehensive Response to HIV, STIs and Tuberculosis committed that care and treatment be provided without discrimination. 
  • In Kazakhstan, the government increased domestic funding to sustain a successful community-led programme for shelter and support for women living with HIV who had been subjected to violence.
  • In Ghana, a strong partnership between the government and the community enabled mothers living with HIV and caregivers of HIV-exposed infants and children to  benefit from targeted interventions that foster their and their children’s well-being, leading to improved adherence to treatment and linkage to care.
  • In Thailand, a national Code of Conduct on HIV prevention and management in the workplace was adopted, and both government and the private sector committed to review HIV policies in line with the new Code of Conduct.
  • In Iran, the Ministry of Health issued a bylaw to tackle the stigma and discrimination faced by people living with and affected by HIV. As a result, a protocol on elimination of stigma and discrimination in health care settings was developed to advance access to HIV services without discrimination, including strengthening the referral system.

“The practical steps forward which have been taken by members of the Global Partnership provide hope through action,” said UNAIDS Executive Director Winnie Byanyima. “They show what is possible. They show how it is through protecting the rights of every person that we can protect the health of every person. Progress on rights can power progress towards the end of AIDS.”

38 countries have joined the Global Partnership for Action to Eliminate all Forms of HIV-Related Stigma and Discrimination, and more have expressed interest in joining.  More information on the Global Partnership can be found here: https://www.unaids.org/en/topic/global-partnership-discrimination

On March 1st the world will mark the tenth anniversary of Zero Discrimination Day. More information on Zero Discrimination Day can be found here: https://www.unaids.org/en/2024-zero-discrimination-day

 

On World AIDS Day, UNAIDS, the European Union and partners call for an end to HIV-related stigma and discrimination

01 December 2023

BRUSSELS, 1 December 2023—On World AIDS Day, UNAIDS, Spain, as President of the Council of the European Union, and other partners called for the elimination of all HIV-related stigma and discrimination as a necessary step towards ending the AIDS pandemic as a global public health threat by 2030.

Speaking at the event held at the European Parliament in Brussels, Spain’s Minister of Health, Mónica García, re-affirmed Spain’s commitment to achieve zero HIV-related stigma and discrimination.

“We hope that this leadership of Spain for the elimination of all forms of stigma and discrimination associated with HIV will be maintained over the next 7 years to meet our goals by 2030,” said Ms Garcia.

The elimination of HIV-related stigma and discrimination has been a political priority of the Spanish Presidency of the Council of the European Union since July 2023. This was reflected in a high-level meeting on "HIV and Human Rights: Political Action to Achieve Zero Stigma" hosted by the Spanish Ministry of Health in September 2023 in Seville. At the event, Spain took the important step to officially join the Global Partnership for action to eliminate all forms of HIV-related stigma and discrimination, becoming the second EU country to join after Luxembourg.

At the event in Brussels, UNAIDS Deputy Executive Director, Christine Stegling, thanked Spain for its leadership globally and in the European Union and said the world needed to act urgently to eliminate HIV-related stigma and discrimination.

“We’ve made impressive progress against HIV, but we have much work left to do,” said Ms Stegling, “Unless we succeed in ending AIDS-related stigma and discrimination, we will not be able to reach everyone in need. Stigma and discrimination against people most affected by HIV are the biggest barriers to accessing lifesaving HIV prevention and care. We look forward to working with European Union Member States, the European Parliament and the Council of the European Union, to take this agenda forward." 

As Spain steps down from its Presidency of the Council of the European Union at the end of December 2023 and as Belgium assumes the role, Ms. Stegling also expressed hope that Belgium will follow in Spain’s footsteps and continue to lead on this critical issue. She called on the whole of the European Union to join in global efforts to abolish AIDS-related stigma and discrimination to reach people who are currently being left behind in the response.

Around the world, some 9.2 million people living with HIV still do not have access to life-saving medicines. Every minute, a life is lost to AIDS. In 2022, 1.3 million people became newly infected with HIV. Many people most affected by HIV are being left behind, including adolescent girls and young women, gay men and men who have sex with men, people who inject drugs, sex workers and migrants. These are the people who must be reached for AIDS to be ended as a public health threat by 2030.

Removing AIDS-related stigma, discrimination and criminalization will make it more possible to reach those currently being left behind. Political leadership in the European Union is key to achieving that goal.

Also critical for removing AIDS-related stigma and discrimination is community leadership. Ms. Stegling highlighted UNAIDS’ 2023 World AIDS Day report “Let Communities Lead” citing the need for governments and donors to fully empower and fund community leadership in the response to HIV.

Other speakers at the event included: Andrea Ammon, Director of the European Centre for Disease Prevention and Control; Peter Sands, the Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria; Hans Kluge, the World Health Organization's Regional Director for Europe and Kathleen van Brempt, MEP of the Progressive Alliance of Socialists and Democrats in the European Parliament.  

The World AIDS Day event was co-hosted and moderated by Marc Angel, MEP from Luxembourg and vice-president of the European Parliament.  He said, “Representing my country, I extend my deepest appreciation to Spain for joining the Global Partnership for action to eliminate all forms of HIV-related stigma and discrimination. As a UNAIDS Red Ribbon Leader for the “10-10-10" targets on societal enablers, I look forward to working closely with Spain, my own country, Luxembourg and, ideally, other EU Member States to end all forms of HIV-related stigma and discrimination in the EU, across Europe and beyond.”

The 10-10-10 targets are:

  • Less than 10% of countries have punitive legal and policy environments that deny access to justice
  • Less than 10% of people living with HIV and key populations experience stigma and discrimination
  • Less than 10% of women, girls, people living with HIV and key populations experience gender inequality and violence.

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.

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UNAIDS appoints the First Lady of Sierra Leone as a champion for adolescent girls and young women

19 September 2023

NEW YORK/GENEVA, 19 September 2023—UNAIDS has named the First Lady of Sierra Leone, Fatima Maada Bio, as a UNAIDS champion for the empowerment and engagement of adolescent girls and young women in Sierra Leone. UNAIDS Executive Director, Winnie Byanyima, confirmed the appointment during a meeting with Mrs Maada Bio and her husband President Julius Maada Bio at the 78th session of the United Nations General Assembly taking place in New York.

“I am delighted to welcome Her Excellency Mrs Fatima Maada Bio to the UNAIDS family as a champion for adolescent girls and young women,” said Ms Byanyima. “The First Lady is a strong advocate for the empowerment of women and girls. I look forward to continuing to work together to end gender inequalities that drive HIV including sexual and gender-based violence, and to ensuring that our girls and young women have all the information and knowledge they need to lead healthy lives.”

Mrs Maada Bio is a leading advocate for the Hands Off Our Girls Campaign, a movement launched by President Maada Bio in December 2018 to ban early child marriage and end sexual violence against women and girls. In 2022, she spearheaded the adoption of the first ever World Day for the Prevention of, and Healing from Child Sexual Exploitation, Abuse and Violence, which is commemorated annually on 18 November.

Mrs Maada Bio is also a champion of Education Plus, an initiative launched by UNAIDS, UNESCO, UNICEF, UNFPA and UN Women to prevent HIV infections through free universal, quality secondary education for all girls and boys in Africa, reinforced through comprehensive empowerment programmes.

“My hope is for a future where all women have equal rights,” said Mrs Maada Bio. “Where women and men can sit at the same table and make decisions together, where women are given the space to lead. That is my hope because then we will know that real equality has arrived for us all.” 

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.

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Brazil announces its commitment to the global initiative against HIV-related stigma and discrimination

19 May 2023

Brazil has joined the 34 countries that are part of the Global Partnership to take action to eliminate all forms of HIV-related stigma and discrimination. The country's entry into this group of nations was announced at a celebratory event of the International Day Against Homophobia, Biphobia, and Transphobia, held in Brasilia, Brazil’s capital and organized in partnership by UNAIDS, ILO, and the Ministry of Human Rights and Citizenship.

The Global Partnership is an initiative launched through a call for action from the NGO Delegation to the UNAIDS Programme Coordinating Board (PCB) in 2018 to remove HIV related stigma in six settings: healthcare, justice, community, workplace, educationa and humanitarian.  It is co-convened by UNAIDS, UN Women, the United Nations Development Programme (UNDP), the Global Network of People Living with HIV, and the Global Fund to Fight AIDS, Tuberculosis, and Malaria. It is also supported by a technical working group composed of 10 United Nations agencies and 24 partners and civil society organizations.

With Brazil, now 35 countries have formally joined the Global Partnership, committing to act against HIV-related stigma and discrimination in the contexts of healthcare services, educational settings, workplaces, justice systems, domestic and community environments, emergency systems, and humanitarian crises.

According to Luisa Cabal, the Regional Director of UNAIDS in Latin America, Brazil's entry into the Global Partnership is a significant step in the collective response against HIV-related stigma and discrimination in Latin America and the world. "By joining this initiative, Brazil reaffirms its commitment to defending human rights, promoting social inclusion, and eliminating barriers to access prevention, diagnosis, treatment, and ongoing response to HIV," she explains.

By joining the Global Partnership, Brazil will have access to a platform that will allow the country to share experiences and best practices with the other participating countries, creating opportunities for collective learning, strengthening the joint response to HIV-related stigma and discrimination.

"It is important to highlight that by joining the Global Partnership, Brazil will also reinforce its leadership role in the region and global diplomacy for health and human rights, demonstrating its commitment to equity and social justice," emphasizes Luisa Cabal.

It is indeed a precedent for the GP that commitment to join the Global Partnership has been witnessed by two Ministers.

Minister of Human Rights and Citizenship Silvio Almeida reiterated his unrestricted support and commitment to public policies promoting and protecting the rights of LGBTQIA+ people. ”For those who suffer violence, and are killed simply for being who they are, these people will be protected in a public commitment, and I renew this commitment not only as Silvio Almeida, but as Minister of State for Human Rights of Brazil” emphasized H.E.

Representing the Ministry of Health Helvécio Miranda, Secretary of Specialized Health Care, similarly shared the Ministry's commitment to embrace the agenda of LGBTQIA+ rights and ensure comprehensive healthcare access for all people emphasizing on a gender approach, and with a special focus on those at risk, with specific needs, or experiencing different forms of violence.

Vinícius Pinheiro, Director for Brazil at ILO, embraced the significance of the Global Partnership in promoting social justice and decent work with inclusion and opportunities for all people so that no one is left behind.

The Global Partnership for Action to Eliminate all Forms of HIV-related Stigma and Discrimination

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