Guyana

Marcia John (not her real name), a Guyanese transgender woman, readied to leave a transgender support group meeting. She slipped off her black wig, replacing it with a bandana and hat. Her employer only allows her to perform her duties if she presents as a man.

“I have no choice,” she said. “I have to work.”

In 2018, the Caribbean Court of Justice ruled that an 1893 Guyana law that prohibited cross-dressing was unconstitutional. Last August, lawmakers formally removed that section from the law books. But for Ms John and other transgender women, this has not been enough to transform the way they navigate social spaces. Intolerant attitudes remain, with sometimes dire implications for transgender people’s welfare and livelihoods.

Led by the University of the West Indies Rights Advocacy Project, the cross-dressing law challenge started with a constitutional action filed in the Guyana High Court in 2010. Eight years and two appeals later, the litigants earned a historic win.

“At the heart of the right to equality and non-discrimination lies a recognition that a fundamental goal of any constitutional democracy is to develop a society in which all citizens are respected and regarded as equal,” the Caribbean’s final appellate court ruled in 2018.

Reflecting on the impact of the landmark law reform effort, Alessandra Hereman, Guyana Trans United (GTU) Project Coordinator, said that the main benefit has been more visibility.

“The community’s increased media presence in the lead-up to the case brought transgender issues into the public space. People realized that transgender Guyanese exist and are part of our society. Some thought we should be treated equally and others held on to their religious beliefs. But transgender issues were brought to the fore and were part of public discourse,” she said from GTU’s Georgetown office.

Formed in 2012, GTU has worked over the past decade to facilitate the dialogue and sensitization that are needed alongside key law and policy reforms to create a safe and empowering social context for transgender people. They contribute to the ongoing effort to shift the attitudes and perceptions of health-care providers around sexual orientation and gender identity. This work strengthens the community’s access to health services, including HIV prevention, testing and treatment. With support from UNAIDS, GTU also trained journalists on covering transgender people and issues ethically and accurately.

“Law reform is essential, but it is not a stand-alone,” said James Guwani, the Director of the UNAIDS Caribbean Sub-Regional Office. “Alongside strategies like judicial review and political advocacy, there must be ongoing community dialogue and targeted efforts to increase social inclusion.”

At present, GTU has two high law and policy reform priorities. First, Guyana’s Prevention of Discrimination Act of 1997 makes no mention of sexual orientation or gender identity.

“Employers use the lack of this protected status to discriminate against lesbian, gay, bisexual and transgender (LGBT) persons. Amending that legislation would mean that if you violate the rights of an LGBT person there would be some mechanism for redress. Having that in place will tell people you can’t discriminate because there will be consequences,” Ms Hereman explained.

The CARICOM Secretariat, through the Pan Caribbean Partnership against HIV and AIDS (PANCAP), has developed a model anti-discrimination bill to guide Caribbean countries in creating anti-discrimination laws. PANCAP continues to advocate with regional stakeholders, including policymakers, for countries to adopt the model as it provides for the protection of persons against discrimination, including discrimination involving harassment, victimisation and vilification on the grounds of HIV status, sexual orientation, etc. It is hoped that the model will lead to more access to health care for key populations with the overarching goal of a Caribbean free of AIDS and new HIV infections, in which all people are happier, healthier, productive, safe and respected. Next on GTU’s list is the revision of the Teachers’ Code of Conduct to be inclusive of the needs of LGBT students.

“They must know that they have a duty to create an enabling environment for all students so that LGBT pupils have an opportunity to learn without bullying,” Ms Hereman said.

Lack of gender recognition legislation and the criminalization of sex between people of the same sex remain challenges in the Guyana and wider Caribbean contexts. The United Caribbean Trans Network has mounted a campaign around gender identity recognition, while the Society against Sexual Orientation Discrimination is working to remove Sections 351 to 353 of the Criminal Law (Offences) Act, which make sex between men punishable with life imprisonment. However, GTU is first prioritizing issues that it says go to the heart of transgender’s people’s ability to get an education and access employment. Exclusion from these spaces compounds their vulnerability to poverty, violence and disease.

“We occupy the lowest socioeconomic level in society. Guyana is now an oil-producing nation. LGBT people should have opportunities as well,” Ms Hereman insisted.

This year, Guyana will roll out a comprehensive plan for pre-exposure prophylaxis (PrEP). The Guyana Minister of Health, Frank Anthony, announced that the national strategy will be implemented in collaboration with clinics across the country and nongovernmental organizations.

“We want to expand to ensure anyone who is at risk for HIV would have access,” Mr Anthony said. “We believe that with a comprehensive programme for PrEP we can prevent many infections.”

This move marks the culmination of years of advocacy and partial PrEP implementation. The existing PrEP policy is a programme for serodiscordant partners only, so couples in which just one person is living with HIV have been able to access PrEP through the public health-care system to avoid transmission to the HIV-negative partner.  

Since 2015, the World Health Organization has recommended that “people at substantial risk of HIV infection” should be offered PrEP. Several countries have prioritized key populations, including gay men and other men who have sex with men, sex workers and transgender people, for PrEP programming. In Guyana, those groups also have higher HIV prevalence: 8% for transgender women, 6% for sex workers and 5% for gay men and other men who have sex with men.

Last year, Guyana’s Society against Sexual Orientation Discrimination (SASOD Guyana) moved from calling for a more inclusive PrEP programme to offering the service itself. The group teamed with the Midway Specialty Care Centre to fill this gap in the country’s HIV prevention response.

“We want combination prevention to take the front burner,” said Joel Simpson, the SASOD Guyana Managing Director. Through this private sector/civil society partnership, for the first time people in Guyana from any population group were able to elect to initiate PrEP. The medicine was sold to clients at cost price and those accessing the service through the nongovernmental organizations paid no consultation fees.  

A 2018 SASOD Guyana assessment of gay men and other men who have sex with men and transgender people supported by the International HIV and AIDS Alliance (now called Frontline AIDS) found that, when sensitized, there was a high level of interest in taking PrEP. However, just around 60% of focus group participants were willing to pay to do so.

“We need politicians and technical people to base decisions on science and research. At times we have encountered a moralistic approach to setting public policy,” Mr Simpson reflected. “It’s not about whether you belong to a particular population group. It’s about responding to reality and lowering risk.”

Guyana’s HIV programme results are among the Caribbean’s best. The country surpassed the 2020 testing target, with 94% of people living with HIV diagnosed in 2019. Seventy-three per cent of people who knew their status were on treatment. Of those, 87% were virally suppressed. Over the past 20 years, new HIV infections have been reduced by half in the South American nation.

“HIV treatment has come a long way, and not just for people living with HIV. To close the gaps and ensure that no one is left behind it is critical that best practices for prevention and treatment are implemented fully,” said Michel de Groulard, UNAIDS Country Director, a.i., for Guyana and Suriname. “This is why we are pleased about the direction the Health Ministry is taking this year to ensure that PrEP is made available to all who need it. We have the tools to end AIDS. Now we must use them.”

For many Guyanese families, COVID-19 has meant far more than mask-use and movement restrictions.

“The disruptive effect on economic activity means that for some there simply is not enough food,” said Michel de Groulard, UNAIDS Country Director, a.i., for Guyana and Suriname.

But for people living with HIV in Guyana, there’s been no need for a hastily improvised nutrition support solution. For almost 14 years the National AIDS Programme secretariat has invested in the development of a food bank specifically for people living with HIV, including those coinfected with tuberculosis.

The programme started with support from the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) and continues to receive Global Fund contributions. From the start there were consistent, major donations from the National Milling Company of Guyana. Since 2017, the Government of Guyana and the Food for the Poor charitable organization have been the primary donors. Importantly, throughout the years the food bank has attracted significant inputs from the private sector. In 2019, there were more than 20 corporate contributors.

Referrals come from the clinical teams attending to people living with HIV. Food support is granted for an initial six-month period, after which the situation is reassessed. In the interim there is a collaborative effort with the Ministry of Social Protection and the Recruitment and Manpower Agency around job placement and other types of social support.

Rhonda Moore worked as an HIV doctor for six years and in three regions before assuming leadership of the National AIDS Programme. She’s seen the difference nutrition assistance makes for people and families on the brink. When people are worried about whether they will eat, they don’t take their treatment properly.

“Food insecurity creates a vicious cycle,” she said. “For people living with HIV it is important to have a healthy, balanced diet along with treatment to control the disease. But when someone doesn’t have food it affects them both mentally and physically. Adherence becomes an issue and the mental health impact also undermines the immune system.”

In the context of COVID-19, the food bank has expanded its reach to HIV-negative members of key populations. The National AIDS Programme is collaborating with community organizations to pair dissemination with the provision of information on COVID-19 and HIV as well as HIV prevention and testing services.

So far, more than 2700 food and personal hygiene packages have been distributed. Rather than have people journey to the food bank, the supplies are now being distributed through the treatment sites in their districts. An open invitation was issued to diagnosed people who hadn’t started or continued antiretroviral therapy to go to their nearest treatment centres for HIV medicines and food—two essentials for surviving COVID-19.

In 2019, Guyana became the first Caribbean country to introduce national nutrition and HIV guidelines. The strategy supports health-care providers, policymakers, social workers and other HIV response stakeholders in responding to the nutrition care and support needs of people living with HIV in diverse conditions. In an epidemic response often dominated by concerns around treatment, Guyana has been proactive about addressing the food insecurity challenge some people living with HIV face either consistently or—as is the case with COVID-19—in exceptional circumstances.

“HIV treatment will fail if people don’t have food—healthy food. The fact that Guyana has been able to respond immediately to alleviate food security challenges and thus protect the well-being of people living with HIV right from the outset of the humanitarian crisis demonstrates the value of making psychosocial support investments integral to our regular treatment programme,” Mr de Groulard said. “It makes countries and communities more resilient, more agile and better prepared to respond to crises.”

Twinkle Paule, a transgender activist, migrated from Guyana to the United States of America two years ago. As the COVID-19 crisis deepened, she thought of her “sisters” back home and in neighbouring Suriname. For many of them, sex work is the only option for survival.  She knew that the curfew would starve them of an income. And she was worried that some might wind up in trouble with the law if they felt forced to work at night.

After making contact with people on the ground, her concerns were confirmed. She made a personal donation, but knew it was not nearly enough.

“Being somebody who came from those same streets, I knew we had to mobilize to take care of our community. I know about lying down at home and owing a landlord … about getting kicked out because you can’t afford to pay rent,” Ms Paule said.

She collaborated with New York activists Cora Colt and Ceyenne Doroshow, founder of Gays and Lesbians in a Transgender Society (GLITS Inc), to start a GoFundMe campaign. After launching on 12 May they’ve already raised enough money to cover rent subsidies for one month for six transgender sex workers. The money has been forwarded to Guyana Trans United (GTU), the organization for which she worked as a peer educator when in 2015 she left sex work behind.

That she can now use her position of influence to mobilize emergency relief is itself a stunning success. When she migrated, she’d felt herself tottering on the brink of suicide. The emotional weight of exclusion and injustice was bearing down.

One successful asylum claim later, she’s now a full-time communications student at the Borough of Manhattan Community College. She completed her high-school education last year—something she hadn’t been able to do in Guyana. While studying she worked as an outreach officer for GMHC (Gay Men’s Health Crisis).

She seamlessly slipped into advocacy mode, addressing the city council last year about repealing New York State Penal Law § 240.37, a loitering law that is used to target transgender women. She immediately recognized that this was from the same tradition as the vagrancy laws she’d first been victimized by, and later fought against, in Guyana.

Ms Paule is acutely aware of how much her life prospects have changed due to migration.

“It just shows the difference it makes if somebody is given opportunities and the right tools to make other decisions in life. It showed me what I was lacking was adequate resources and the ability to go into an environment without having to worry about discrimination and violence. I am not saying everything is perfect here, but I don’t face the same level of injustice on a daily basis. I was able to access hormone therapy. And to me the most important thing,” she reflected, “is that I was able to go back to school.”

Her mother died when she was a child. Her father moved on with a new family. She was left in the care of his relatives. There wasn’t always enough money for her education. Some weekends she cleaned a church to earn some cash.

But poverty wasn’t the only challenge. Since she was very small she remembered feeling different. She did not have a label for what she felt, but instinctively knew it would not be accepted. At school she strained to stay under the radar. One day her heart skipped when a classmate said she sounded like an “antiman”—a Guyanese derogatory term for a gay person.

Over the years she repeatedly overheard adults in the household agreeing that she should be put out if she turned out to be gay. At 16 years old it happened. A relative spotted her “dancing like a girl” at a party. Now she was homeless.

Ms Paule sought refuge with other transgender women and, like them, used sex work to survive. The burgeoning regional movement to address the needs of vulnerable and marginalized communities had an impact on her life. From the newly formed Guyana Sex Work Coalition she learned about safer sex and accessed safer sex commodities. When some of her peers started going to conferences they found out for the first time that there was a word for their experience. They weren’t “antimen”. They were transgender.

But life on the street was brutal. If someone was robbed or raped they could not report the crime.

“The police tell you plain, “Why are you coming here when you know prostitution and buggery are against the law?”,” she remembered.

She said sometimes rogue police officers threatened to charge them and extort money from them.

Once the police locked up her and other transgender women together with men at the police station and threw condoms into the cell—a green light to the other detainees. She was a teenager at the time.

She accompanied a friend to the police station to make a domestic violence report one day. Instead a policeman told her, “You are involved in buggery. I am locking you up.”

In 2014, a group of them were arrested for sex work in Suriname. Among other indignities, a prison guard forced them to disrobe and squat outside their cell, in the presence of other detainees.

Seven years ago, one of her friends was killed, her body was thrown behind a church. There was no investigation.

Trauma after trauma. It takes its toll.

Even when nothing happens, there is lingering fear. Will I be put out the taxi? Will people insult me on the street? Will I be mistreated because of what I’m wearing?

“The girls take it like it’s their fault,” Ms Paule reflected. “Even in my personal experience I felt people had a right to do me things because I was not behaving in accordance with societal norms.”

Even as she stepped into advocacy, she didn’t feel whole. She attempted suicide once and began having a drink or smoke before turning up to work. Two years ago she was unravelling. Now she’s rallying forces in the service of her community.

Ms Paule credits the work of organizations like the Society against Sexual Orientation Discrimination and GTU for advancing the dialogue around inclusion in Guyana.

“What is still missing is safety and equity for the community,” she insisted. “We need a state response to say, “These people should be taken care of”. The trans community has no jobs, we are bullied out of school, we suffer police brutality. These things are wrong. We need more robust action from our elected officials.”

Kay Forde discusses HIV prevention with loggers
Credit: ILO

Kay Forde has been a sex worker in Guyana for more than 20 years. She is an AIDS activist too. As secretary of the One Love Organization, a non-governmental organization addressing the HIV needs of sex workers, Ms Forde is committed to making a difference in the Kwakwani region, Guyana.

This commitment involves not only advocating for the rights of sex workers to live free of stigma and discrimination, with access to good information about HIV, it also extends to working with their clients. Many of the clients earn their living in the wood logging industry.

There are some 13,000 loggers in Guyana and they are a significant segment of the migrant worker population. With forests generally found in isolated areas, there can be a lack of regular access to both condoms and correct knowledge of how HIV is transmitted, which increases vulnerability to infection. Sex workers themselves are disproportionally affected by the virus with an HIV prevalence of around 16%, compared to an adult HIV prevalence in Guyana of 1.2%.

With this in mind, in 2009 One Love joined forces with the International Labour Organization (ILO), the Government of Guyana, the US Department of Labour and the PEPFAR HIV/AIDS Workplace Education Programme. One of the principle aims is to encourage HIV prevention among loggers with a core package of services. This includes condom promotion, voluntary HIV counselling and testing, and referrals for sexually transmitted infections, which together aim to increase risk recognition and promote safer sex.

The work with loggers intensified in April 2010 when the ILO entered into a partnership with the Upper Berbice Forest and Agriculture Producers Association (UBFAPA) to educate its members. Fifteen of the One Love team and affiliate trainers travelled from camp to camp conducting interactive group discussions.  

Ms Forde believes that the loggers of Kwakwani have become more aware of HIV and are more willing to discuss intimate sexual issues. “They come and ask questions. They’re attentive and interactive and it’s very fulfilling to have them listen and get full explanations on health and sexual matters,” she said.

Charles Swaving, a logging camp supervisor working near Kwakwani, who attended a One Love discussion in July last year, agrees. He says he was grateful for the opportunity to find out correct information about HIV as well as the need to treat those living with the virus with dignity and respect. He vows to remain HIV-free.

According to Sean Wilson, ILO National Project Coordinator, this successful partnership demonstrates that sex workers can be powerful advocates for HIV prevention. “The strategy to use the One Love Organization is working well, since awareness is now being created among both the organization’s members and the loggers on the importance of adopting safer sexual practices.”

The project is ongoing and there are plans to re-engage loggers already reached and examine the impact of substance use on HIV transmission as well as how transmission risks can be reduced overall. There will also be greater efforts made to ensure a regular and reliable supply of condoms to loggers. There is also an issue of how loggers can access condoms in remote locations where transportation costs are high.

During the coming years, the project will continue working with the UBFAPA to engage more of its membership in what is seen as a vital education process. The ILO also intends to replicate this partnership with other sex workers’ organizations to reach different groups of workers across the country.

Hon. Dr. Leslie Ramsammy, Minister of Health of Guyana launching the national HIV prevention, principles, standards and guidelines. 24 March 2010.

On Wednesday 24th March 2010, Guyana unveiled the country’s new national principles, standards and guidelines for the prevention of HIV as part of its efforts to achieving universal access to HIV prevention, treatment, care and support.

“By 2020 Guyana must be well on the road towards elimination of HIV as a major public health problem,” said Dr Leslie Ramsammy, Guyana’s Minister of Health.

The principles, standards and guidelines are the result of two years of work under the leadership of the Ministry of Health’s National AIDS Programme, in close collaboration with UNAIDS. Guyana’s HIV prevention quality standards are fully in line with the UNAIDS Executive Director’s call for a global “prevention revolution” to reduce the number of new HIV infections.

“Prevention is a key priority. We need to construct a compelling prevention narrative. One built upon equality and human rights. One that recognizes the importance of responses that are strategically tailored to local epidemics, that include biomedical, behavioural and structural approaches, and that meaningfully involves beneficiaries,” said UNAIDS Executive Director Michel Sidibé.

According to UNAIDS, the national HIV prevention principles, standards and guidelines represent an important step forward for intensifying HIV prevention activities in Guyana, and should serve as a model for other countries in the region. The guidelines feature a scorecard for rating the quality of prevention programmes being implemented.

The Miller School of Medicine of the University of Miami and the Fogarty International Training Programme on AIDS and TB organized in collaboration with UNAIDS the ‘Health Research in the Americas V’ Conference on 7 and 8 May 2009, in Miami, Florida.

The aim of the conference was to highlight current evidence on HIV prevention, discuss the sustainability of comprehensive HIV prevention efforts as well as to debate how HIV prevention is situated within the broader discussion of ‘health in the Americas’ and other international development strategies.

Sir George Alleyne, Special Envoy of the United Nations Secretary General for HIV/AIDS in the Caribbean, was invited as a keynote speaker on the second day of the conference.

Numerous local and national achievements in curbing the epidemic have created a body of evidence about what works, but these successful approaches have not yet been fully applied.

At the conference, scientists, HIV prevention practitioners and policy makers explored scientific and programme experiences for prioritizing comprehensive, evidence-informed HIV prevention approaches and discussed effective solutions that could bridge the interface between HIV and other health and development issues.

The conference was open to behavioral scientists and researchers who work in the area of HIV prevention in the Americas, with a special focus on Guyana, the Dominican Republic, Jamaica, Brazil, Colombia and Peru.

This story was first published on UNFPA.org

Clients at Kevin's Reflextions have an opportunity to talk about HIV.
Credit: Carina Wint

Barber shops across Georgetown, Guyana, are buzzing with chatter about the latest trends, community happenings, neighbourhood gossip and now, ways to protect young people from AIDS. The United Nations Population Fund (UNFPA), in collaboration with UNAIDS Secretariat, has identified barber shops and beauty salons as information hubs, and is using them to spread the word about HIV prevention.

The project involves the training of shop staff to answer simple HIV-related questions, pass out informational material, dispense both male and female condoms to clients – and even provide on-site counselling and testing. As a result, young people in Guyana are given access to information and resources not readily available elsewhere in their communities. And this is important because their small country (population 751, 223) has one of the highest HIV prevalence levels in the region: about 1.6 per cent for pregnant women, according to UNAIDS. Among sex workers, prevalence rises up to 26.6 per cent.

Male and female condoms are available at selected hair salons.
Credit: Carina Wint

Juanita Huburn, a customer at DJ’s Magic Fingers, a hair salon that participates in the programme, described Guyanese society as “closed” when it comes to issues regarding sexuality. “You do not talk about sex, they just say you should not have sex, but this is not realistic,” she said.

Shops and salons were chosen based on their location in malls, parks, popular attractions, or low-income communities. Owners who opened their doors to the project got added marketing exposure for their small businesses and were provided with incentives, such as access to promotional materials. “Shops were informed how their companies would be promoted through the project, and the economic value of participating,” said UNFPA Guyana Liaison Officer, Patrice La Fleur “They would most importantly provide safe places to discuss sexuality and the prevention of HIV.”

Once the locations were identified, two employees from each shop were sent for training on basic HIV education and prevention means. They were also taught to properly monitor the project and introduced to safe practices within the context of their own work (for example, ensuring the sterility of hair cutting machines, razors, needles for stitching and weaving, manicure and pedicure implements, and tattooing and body piercing equipment).

In addition to training participants about sexual and reproductive health and gender issues, the project also focuses on building life skills such as communication, healthy relationships, and leadership. “Participants expressed personal gains in their quality of relationships with friends, family, and clients,” said UNFPA Programme Officer, Babsie Giddings who monitors the project.

DJ's Magic Fingers hair salon is another venue for building awareness of HIV prevention.
Credit: Carina Wint

Since the programme was put in place businesses report a steady boost in clientele and more shops have come on board. “Business has increased about 5 per cent since we joined this programme,” said Kevin John, owner of the Barber Shop Kevin’s Reflections. He believes it may be partly because people know his salon equipment is sanitized. Currently over 7000 male and 400 female condoms are distributed monthly by requests in the shops and salons.

Work on the project was initiated last year through efforts of the UN Country Theme Group and it has been fully funded by UNAIDS. Also collaborating on the project is a local NGO, Youth Challenge Guyana.

UNFPA provides continuous support with regular follow-ups and monitoring for participating barber shops and salons. The project aims to afford some 2000 young people access to information, skills, services and supplies they can use to protect their health.

Faith leaders from the Hindu, Christian, Islamic, Rastafarian and Baha’i faiths gathered at the Guyana National "faith-and-hiv" Conference in Georgetown, Guyana, on 11 December 2008.
Credit: UNAIDS

The National AIDS Programme Secretariat of the Ministry of Health in Guyana (NAPS/MOH) convened a National Conference on “faith-and-HIV,” supported by the Joint United Nations Programme on HIV/AIDS (UNAIDS) on 11 December 2008. The aim of the conference was to establish a national coalition of faith leaders of all denominations in Guyana to address HIV-related stigma and discrimination.

At the opening of the 'Guyana National faith-and-HIV Conference', faith leaders from the Hindu, Christian, Islamic, Rastafarian and Baha’i faiths agreed to move from commitment and rhetoric to action, by endorsing the ‘Guyana faith-and-HIV Declaration.’

Through the declaration, faith leaders recognize the need to incorporate appropriate HIV information into their discourses, rituals, religious education, and training of future leaders of faith. They also agreed to safeguard the rights of people living with HIV and affected by HIV, and ensure their complete inclusion in religious, social, familial and economic life.

Furthermore, they pledged to exhort women and their male partners to access formal healthcare, including HIV testing, in recognition of the fact that HIV is a treatable disease and HIV positive parents can have children free from HIV. They also committed to addressing all the vulnerabilities faced by children affected by and living with HIV, especially to ensure that their right to access education, treatment, care, and support in a loving environment is respected.

Finally, they agreed to utilize their places of worship, their educational and health facilities, and their women and youth programmes, to provide the full range of HIV prevention, treatment, care and support services.

During his opening remarks, Health Minister Dr. Leslie Ramsammy emphasized the importance of faith based organizations taking on a more active role in the response to AIDS and pointed to the results of a recent survey which revealed that only 50% of such organizations fully support people living with HIV.

Participants at the Guyana National "faith-and-hiv" Conference, Georgetown, Guyana, 11 December 2008
Credits: UNAIDS

Religious communities, mosques, temples, churches, hospitals and clinics have reached out to provide support to those living with and affected by HIV worldwide. Their leadership has great influence in the lives of many people, and leaders speaking out responsibly about HIV can make a powerful impact at both community and international level. However, the response of the religious community can also be negative. People living with HIV have been stigmatized by some religious leaders and communities of faith. Approaches to HIV prevention methods and attitudes towards people at increased risk of HIV infection such as men who have sex with men, sex workers or injecting drug users have sometimes hindered the response. Much work remains to be done to eradicate HIV-related stigma and discrimination.

Despite goodwill and a commitment to finding ways of working together, there is a gap between good intentions and effective joint action. Misunderstanding of how different faith communities are organized; tolerance and respect of what their followers believe, and how to identify and engage in joint initiatives that transcends organized religion can stand in the way.

The conference was used to guide the discussions through which the faith leadership in Guyana will address the issues of HIV-related stigma and discrimination and how, through the 'Guyana faith-and-HIV Coalition,' a major contribution will be made, in partnership with the National AIDS Programme Secretariat of the Ministry of Health and its partners, to achieve the national targets set towards achieving universal access to HIV prevention, treatment, care and support for all Guyanese, whoever they are, and wherever they are.

“The response to HIV, in any country, is heavily dependent on the broad mobilization of its leaders, institutions and movements. Faith leaders and their communities are present literally everywhere people live their lives - with enormous outreach as well as in-reach. They are important stakeholders in responding to HIV, as they have a strategic advantage in supporting, understanding and accepting people living with HIV, and in playing a crucial role in preventing new HIV infections,” said Dr. Ruben del Prado, UNAIDS Country Coordinator in Guyana.

Faith-based leadership plays an influential role in the efforts to stop the spread of HIV and, as demonstrated in Guyana, this important leadership can be strengthened in partnership with governments, civil society and the international community.