On the International Day to End Homophobia, Biphobia, and Transphobia, IDAHOBIT (commemorated worldwide on 17 May) and ahead of Pride Month in June, UNAIDS is calling on governments everywhere to protect the human rights of lesbian, gay, bisexual, transgender and queer (LGBTQ+) people.
For UNAIDS, “assuring the rights of every person is essential for public health because it enables equitable access to health services.”
“Stigma, discrimination and criminalization can be lethal,” said Winnie Byanyima, Executive Director of UNAIDS. “We have learned that a human rights-based approach is critical in responding to a health crisis. Removing discriminatory criminal laws and introducing legislation which protects rights are key steps 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. 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.
As a recent IAS – Lancet report demonstrated, human rights violations have multiple damaging public health impacts. Treating people as criminals drives them 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. People who perceive high levels of stigma and discrimination are more than twice as likely to delay enrolment in care until they are very ill.
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.
For UNAIDS, decriminalization and stigma reduction are key to addressing the growing HIV epidemic among MSM in some Asia Pacific countries.
In 2022 men who have sex with men (MSM) and transgender people accounted for 45% of new HIV infections in Asia and the Pacific. Yet, less than one-third of MSM and around half of transgender people in reporting countries have access to targeted prevention services. Seventeen countries in the region have laws that either fully or partially criminalize consensual sex between adult men.
“Criminal laws legitimize prejudice and violence against LGBT people, increasing their risk of contracting HIV while reducing access to healthcare,” said Eamonn Murphy, UNAIDS Regional Director for Asia Pacific and Eastern Europe Central Asia. “We need more community-led and LGBT-friendly HIV and sexually transmitted infection (STI) services. But we also need law reform and efforts to foster greater social inclusion and acceptance. This will make people feel safe to not only access the services and support they need, but to live full lives free from fear.”
There are recent positive examples from the region. In 2022 in Singapore and last year in the Cook Islands, parliaments decriminalized consensual same sex relations.
In Australia community organizations led by men who have sex with men (MSM) have taken the lead in delivering prevention services, including PrEP (pre-exposure prophlyaxis), a drug that prevents HIV-negative people from contracting the virus. Over the last ten years new infections among MSM have declined by 57% in Australia. This is in contrast to many countries in the region where new HIV infections among MSM are rising rapidly or in very slow decline.
The Bangkok Metropolitan Administration (BMA) in Thailand has a comprehensive strategy to promote inclusion. It includes education to develop students into global citizens; promoting the Pride Month festival; piloting the BKK Pride Clinic which now has over two dozen sites; and promoting understanding of equality at BMA agencies to foster discrimination-free work environments.
India’s Transgender Persons (Protection of Rights) Act prohibits employment discrimination against trans people in either the public or private sectors. The National Institute of Social Defence and Ministry of Social Justice and Empowerment have teamed with communities and development partners to sensitize mainstream corporations and provide a platform to connect trans people with jobs in inclusive organizations.
