Transgender people

GENEVA, 29 May 2024—As LGBTQ+ communities and allies take to the streets to mark PRIDE month, UNAIDS is speaking out in solidarity, rejecting the criminalization, discrimination and stigmatization of LGBTQ+ people and insisting on respect for all.

“The PRIDE celebrations are a demonstration of the power of inclusivity,” said UNAIDS Executive Director, Winnie Byanyima. “PRIDE has brought the world a long way in the struggle to protect the human rights of LGBTQ+ people. So much has been won. But the progress that has been made is under threat. The world needs the spirit of PRIDE more than ever today: to protect everyone’s health, we need to protect everyone’s rights.”

There is much to celebrate. UNAIDS data shows that 123 countries do not penalize same-sex relations. This represents the highest number of countries rejecting criminalization ever.

More and more countries have been scrapping the harmful punitive anti-LGBTQ+ laws which are often leftovers of colonial rule. Since 2019 alone, Botswana, Gabon, Angola, Bhutan, Antigua and Barbuda, Barbados, Singapore, Saint Kitts and Nevis, Cook Islands, Mauritius and Dominica have all repealed laws that had criminalized LGBTQ+ people.

However, the human rights of the LGBTQ+ community are threatened by a globally coordinated and well-funded extremist anti-rights network who are spending millions promoting hate and social division and are proposing ever more draconian laws to punish LGBTQ+ people. Attacks on LGBTQ+ people violate human rights and undermine public health.

This perilous time calls for courage and solidarity from everyone. PRIDE has always been as much about protest and commemoration as celebration. The first marchers in New York more than 50 years ago knew that PRIDE was the antidote to stigma and discrimination – a rejection of the shame that others sought to impose on them.

Movements spearheaded by LGBTQ+ activists have driven much of the progress that has been made in protecting everyone’s human rights and protecting everyone’s health.

Today we are at a hinge moment: the end of AIDS as a public health threat is realisable in this decade, but progress is imperiled by the pushback on human rights.

At a time when support for human rights defenders is vital and urgent, funding support for civil society organizations is shrinking, as donor countries cut their budgets.

The evidence is crystal clear: stigma kills, solidarity saves lives.

This is a moment for solidarity. This is a moment for PRIDE.

UNAIDS

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

GENEVA, 15 May 2024—Ahead of IDAHOBIT, commemorated worldwide on 17 May, UNAIDS is calling on governments everywhere to protect the human rights of LGBTQ+ people. Protecting the human rights of every person, UNAIDS research shows, is essential for protecting public health, because it enables inclusive and equitable access to health services without discrimination.

The movement for human rights for all has made important progress. For example, whereas, at the start of the AIDS pandemic, most countries criminalized LGBTQ+ people, now two thirds of countries do not.

However, more than 60 countries still do while another 20 countries criminalize gender expression and identity.

“Stigma, discrimination and criminalization can be lethal,” said Winnie Byanyima, Executive Director of UNAIDS. “In the response to HIV, we have learned that a human rights-based approach is critical in responding to a health crisis and leaving no-one behind. Countries must remove these discriminatory criminal laws and introduce legislation which protects rights if we are to end AIDS as a public health threat for everyone.”

Discrimination, violence and criminalization force many LGBTQ+ people underground and away from health services; as a result, gay men and other men who have sex with men, and transgender people, are more affected by HIV. Globally, in 2022, men who have sex with men were 23 times more likely to acquire HIV, and transgender women 20 times more likely to acquire HIV than other adults aged 15–49.

Criminalization of LGBTQ+ people in particular causes significant harm to health. In sub-Saharan Africa, men who have sex with men in countries where they are criminalized, are five times more likely to be living with HIV than in countries that do not criminalize same-sex sexual behavior.

As a recent IAS - Lancet report demonstrated, violations of human rights have multiple damaging impacts on public health. Treating people as criminals drives people away from vital services for fear of arrest and discrimination, resulting in them not accessing HIV prevention, treatment and care.  In addition, strict anti-LGBTQ+ laws have been associated with a lack of knowledge about HIV testing and HIV status.

“For far too many people in our LGBTQ+ communities and beyond, the most basic things are still too far from reach, because of the discrimination, stigma, and violence they face every day,” said the international lesbian, gay, bisexual, trans and intersex association, ILGA World, co-Secretaries General Luz Elena Aranda and Tuisina Ymania Brown.  “This is why they are rallying behind an urgent cry: ‘No one left behind: equality, freedom and justice for all,’ reminding us of the importance of rejecting discriminatory laws, policies, and attitudes.”  

Criminal laws that discriminate on the basis of sexual orientation and gender identity are a breach of the right to privacy and non-discrimination and impede the HIV response. UNAIDS calls on all states to repeal such laws and to introduce legal protections against discrimination on the basis of sexual orientation.

UNAIDS, the World Health Organization, the United Nations Development Programme, and the Global Commission on HIV and the Law have made the same recommendations, as have the Office of the United Nations High Commissioner for Human Rights and several other United Nations agencies.

UNAIDS stands with LGBTQ+ people everywhere who are facing hate, discrimination and marginalization, and calls for an end to their criminalization.

UNAIDS

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

GENEVA, 19 December 2023—During the 53rd meeting of UNAIDS’ Programme Coordinating Board (PCB) held in Geneva, Switzerland, the UNAIDS board adopted decisions on key populations with a focus to increase access to HIV prevention, testing, treatment and other social protection services for transgender people.

Member states and the Joint Programme recognized that each key population, including transgender people, is diverse, and experiences multiple and intersecting forms of stigma and discrimination, and therefore requires evidence-based, data-informed tailored programmes, services and resources that are responsive to their specific needs in the HIV response.

Exact follow-up actions they agreed upon include:

• Address gaps in population size estimates and expand disaggregated data on key populations focusing on existing gaps in transgender populations, in diverse situations and conditions, including through community-led data generation;
• Optimally resource and scale-up tailored and effective HIV prevention, testing and treatment programmes and services that address the diverse needs and circumstances of key populations, including transgender people;
• Increase the proportion of community-led services for HIV prevention, testing and treatment and for societal enablers to reach the 30-80-60 targets, as described in the Global AIDS Strategy 2021-2026, including through mechanisms to increase and facilitate funding and sustainable financing for community-led HIV organizations, including for those led by key populations;
• Address gender inequality, all forms of stigma, discrimination and marginalization, and review and reform harmful and punitive laws and policies that hinder access to HIV-related services for key populations;
• Reinforce an evidence-based public health approach to HIV, particularly in the context of gender equality and human rights;
• Integrate social protection with health and HIV responses by taking people-centered approaches, which addresses economic inequalities making education, welfare, and social protection systems more inclusive of key populations.

And finally, the board requested UNAIDS to reinforce and expand the meaningful engagement and leadership of all key populations, including transgender people, in the HIV response.

This is the first time a member state-led UN body has adopted a consensus decision (without a vote) that includes specific references and commitments to transgender people and actions to be taken by member states. Deputy Executive Director of UNAIDS Christine Stegling said, “We have broken through a barrier. UNAIDS is now fully focused on maximizing the programmatic impact of this decision in-country, for communities and with communities.”

The past two PCB meetings took place midway through the Global AIDS Strategy 2021-2026 so this decision will help UNAIDS focus on achieving the 2025 targets. The UNAIDS PCB is the premier UN and global forum on HIV, bringing together civil society, cosponsors and member states to help chart the future of the response to HIV, including the development of the next Global AIDS Strategy, the vision for 2030 and beyond. The PCB NGO delegates are comprised of people living with HIV and/or key populations including transgender people. They participate in all aspects of the board’s work and strongly advocate for people living with HIV and affected by HIV.

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.

A new report by UNAIDS demonstrates the critical role communities play, and how underfunding and harmful barriers are holding back their lifesaving work and obstructing the end of AIDS.

LONDON/GENEVA, 28 November 2023—As World AIDS Day (1 December) approaches, UNAIDS is urging governments across the world to unleash the power of grassroots communities across the world to lead the fight to end AIDS. A new report launched today by UNAIDS, Let Communities Lead, shows that AIDS can be ended as a public health threat by 2030, but only if communities on the frontlines get the full support they need from governments and donors.

“Communities across the world have shown that they are ready, willing and able to lead the way. But they need the barriers obstructing their work to be pulled down, and they need to be properly resourced,” said Winnie Byanyima, Executive Director of UNAIDS. “Too often, communities are treated by decision-makers as problems to be managed, instead of being recognised and supported as leaders. Communities are not in the way, they light the way to the end of AIDS.”

The report, launched in London during a World AIDS Day event organized by the civil society organization STOPAIDS, shows how communities have been the driving force for progress.

Community advocacy from the streets to the courtrooms to parliaments has secured groundbreaking changes in policy. Communities’ campaigning helped open up access to generic HIV medicines, leading to sharp, sustained reductions in the cost of treatment from US$ 25 000 per person per year in 1995 to less than US$ 70 in many countries most affected by HIV today.

Let Communities Lead shows that investing in community-led HIV programmes delivers transformational benefits. It sets out how programmes delivered by community-based organizations in Nigeria were associated with a 64% increase in access to HIV treatment, a doubling of the likelihood of HIV prevention service utilization, and a four-fold increase in consistent condom use among people at risk of HIV. It also notes how, among sex workers reached by a package of peer-based services in the United Republic of Tanzania, the HIV incidence rate was reduced to below half (5% vs 10.4%).

“We are the vehicle for change that can end systematic injustices that continue to fuel HIV transmission. We have seen groundbreaking developments with U=U, improved access to medicines, and have made great strides in decriminalisation," said Robbie Lawlor, Co-Founder of Access to Medicines Ireland. “Yet, we are expected to move mountains without being financially supported. We are supposed to fight for a more equitable world and are tasked with dismantling stigma yet are side-lined in crucial discussions. We are at a tipping point. Communities can no longer be relegated to the periphery. The time for leadership is now.”

The report highlights how communities are at the forefront of innovation. In Windhoek, Namibia, a self-funded project by the youth Empowerment Group is using e-bikes to deliver HIV medicines, food and adherence support to young people who often cannot attend clinics due to their schooling hours. In China, community organizations developed smartphone apps that link people to self-testing which contributed to a more than four-fold increase in HIV tests across the country from 2009 to 2020.

The report reveals how communities are also holding service providers to account. In South Africa five community networks of people living with HIV inspected 400 sites across 29 districts and conducted more than 33 000 interviews with people living with HIV. In the Free State province, these findings led provincial health officials to implement new appointment protocols to reduce clinic wait times and three- and six-month dispensing of antiretroviral medicines.

“I am extremely concerned about the exclusion from health services of key populations like the LGBT+ community,” said Andrew Mitchell, Minister of State for Development and Africa. “The UK champions the rights of such communities, and we will continue to protect them, working closely with our partners in civil society. I thank UNAIDS for keeping us focused on the inequities driving the pandemic and I look forward to working with our partners to champion the voice of people living with HIV and end AIDS as a public health threat by 2030.”

Despite the clear evidence of community-led impact, community-led responses are unrecognized, under-resourced and in some places even under attack. Crackdowns on civil society and on the human rights of marginalized communities are obstructing communities from providing HIV prevention and treatment services. Underfunding of community-led initiatives is leaving them struggling to continue operating and holding them back from expansion. If these obstacles are removed, community-led organizations can add even greater impetus to end AIDS.

In the 2021 Political Declaration on ending AIDS, United Nations member states recognized the critical role communities play in HIV service delivery, particularly to people most at risk of HIV. However, whereas in 2012, when over 31% of HIV funding was channelled through civil society organizations, ten years later, in 2021, only 20% of funding for HIV was available—an unprecedented backsliding in commitments which has cost and is continuing to cost lives.

“At this time, community-led action is the most important countermeasure in the AIDS response,” said Solange Baptiste, Executive Director of the International Treatment Preparedness Coalition. “Yet, shockingly, it isn’t a cornerstone of global plans, agendas, strategies, or financing mechanisms for improving pandemic preparedness and health for all. It is time to change that.”

Every minute, a life is lost to AIDS. Every week, 4000 girls and young women become infected with HIV, and out of the 39 million people living with HIV, 9.2 million do not have access to lifesaving treatment. There is a Path that Ends AIDS and AIDS can be ended by 2030, but only if communities lead.

UNAIDS is calling for: Communities’ leadership roles to be made core in all HIV plans and programmes; Communities’ leadership roles to be fully and reliably funded; And for barriers to communities’ leadership roles to be removed.

The report features nine guest essays from community leaders, in which they share their experience on the achievements they have secured, the barriers they face, and what the world needs to end AIDS as a public health threat.

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.