Sexual transmission of HIV

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.  

Four weeks before the African Cup of Nations football tournament kicked off it was down to the wire. José Fardon, a Côte d’Ivoire web designer and digital developer, had his whole team frantically working on a special edition of an interactive health and HIV game app, called "A l'Assaut du Sida", ‘Tackling AIDS’ (AADS) to coincide with the tournament.

The UNAIDS team had secured funds for the latest rendition of the online game and had rallied UNICEF and the Global Fund to chip in.

“We had launched various versions of the game in the past, but this required a different look and feel to gel with the sporting event,” said Mr Fardon, founder of SYL.

They also needed a final approval from the National AIDS Programme (PNLS).

"Out of the many initiatives put forward ahead of the CAN, the online app really appealed to us because we knew it would not only reach the target audience, it would also make an impact,” said Eboi Ehui, PNLS Coordinating Director. “This is a generation that has never seen the ravages of AIDS so they have felt like it isn’t a problem but it is.”

The success was beyond anyone’s expectations.

The 20,000 tournament volunteers recruited by the Ministry of Youth not only played the online game themselves but they fanned out around the stadiums promoting the game by sharing the QR code with the hundreds of thousands of supporters. And with various prize giveaways during the tournament and afterwards, more and more people downloaded the app to play. Since mid-January 2024, AADS has reached nearly 200,000 adolescents and young people with the latest version reaching a lot of young boys and men (cumulatively, the three versions have reached almost 300 000 people.)

“When I think back, this idea germinated in 2016 as a tool for schools then was launched at the Francophonie Games a year later but now, we really brought it to the general public,” Mr Fardon said. “I am so proud we never gave up.”

His determination impressed more than one person.

In eight years, he convinced UNAIDS staff, the country’s Ministry of Health in close collaboration with PNLS, the Ministry of Education, the Ministry of Youth and countless partners on the ground.

UNAIDS Country Director Henk Van Renterghem, like his predecessors before him, saw the value and potential of using digital technology to reach adolescents and young people. “General knowledge about HIV and overall comprehensive sexual education has decreased and young people are struggling with so many choices that this easy to download game is without a doubt relevant,” he said.

In July 2023, he explained, the National AIDS Council was alerted by the results of a survey and beseeched HIV partners to step up communication and education efforts.

“Despite the fact that young people have more access to information through the internet and social media than ever before, many young people are struggling to make informed decisions about their sexual relations,” said Mr Van Renterghem. For example, the survey revealed that only 40% knew that medicine (anti-retroviral treatment) existed for HIV and 39% of girls (29% of boys) did not know that condoms prevented HIV transmission. Last year, 20% of new HIV infections in the country were among 15–24-year-olds, according to government data.

As a result, UNAIDS staff along with SYL, vetted and increased the number of questions expanding prevention info.

He and his staff were particularly happy because they also succeeded in expanding the scope of the content.

In went the fact that people with HIV on effective treatment can achieve an undetectable viral load and cannot transmit the virus (U=U) plus stuff about stigma & discrimination, human rights, gender equality and gender-based violence – all structural drivers of HIV.

The full game of 400 questions is like a quiz with additional information popping up. Players score points by advancing through 40 sets of ten questions. At least seven correct answers are needed to advance to the next level. It can take up to an hour to get to the last round and when the updated pilot was tested in October and November of 2023, young people responded well.

Two of the young players who scored in the best percentile agreed.

“The game really taught me a lot. There are a lot of facts about HIV and sexually transmitted diseases,” said Marie Koffi. For Wilfried Touré he said, “I learned a lot of things that I had no idea about from tuberculosis to HIV and even on a personal level I picked things up.”

Going forward national partners now want to distribute a scholastic version of the game to all Côte d’Ivoire schools.

During the final awards ceremony at the end of March, Côte d’Ivoire’s Minister of Health, Pierre Dimba, was clear.  “This fun and educational online game is a response to young people's need for true and accurate information via social media,” he said.  “The popularity of this game among teenagers is a real testimony that adapting our communication strategies to the habits and needs of young people pays off.”

In Mr Van Renterghem’s mind, Côte d’Ivoire should be proud.

“This home-grown low-cost tool will help us sustain our HIV prevention efforts as international funding will inevitably dwindle.”

That is in part why Mr Fardon and UN partners are dreaming even bigger.

“We would like to launch the app-based game in neighboring countries and eventually roll this out throughout western and central Africa,” he said.

“The sky is the limit.”

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, 29 October 2022—Responding to the statement by the Russian government that it intends to extend the so-called “LGBTQ propaganda” law, UNAIDS Executive Director Winnie Byanyima has joined with UN High Commissioner for Human Rights in expressing deep concern.

“Extension of this law,” said Ms Byanyima, “is a further violation of the rights of people to autonomy, dignity and equality. Not only will it harm the security and general wellbeing of LGBTQ individuals, it will have a serious negative impact on people’s health outcomes. The evidence is clear that punitive and restrictive laws, including those restricting free speech, increase the risk of acquiring HIV and decrease access to services. Such laws reduce the ability of service providers, including peer networks, to provide critical sexual and reproductive health information and services, and increase stigma related to sexual orientation, making it harder for people to protect their health and that of their communities. This will undermine Russia’s efforts to end AIDS by 2030. Our call to the Parliament and Government of Russia is to withdraw these harmful proposals and indeed to repeal the existing law. Stigmatising approaches damage public health, perpetuate pandemics and hurt everyone. Social solidarity, inclusion and protecting every person’s human rights are key to ending AIDS and ensuring health for 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.

Like any other regular day in Bangkok, Thailand, Pete went to work and was living a pretty normal life. He had a business that imported and exported fresh vegetables from neighbouring countries in South-East Asia, a family business that he shared with his sister. He was happy and in a serious long-term relationship with his boyfriend, and everything seemed perfect. That day, he and his partner went to get tested for HIV, and that’s when his life suddenly began to change.

“I found out about my HIV status in 2016 and soon after left my business because I didn’t know if I was going to live much longer. Without guidance and mental health support, I had many misconceptions about HIV, and I started to suffer from depression,” he said.

“I blamed myself for contracting HIV, and I couldn’t cope with this thought. I became a drug user, was engaging in chem sex, broke up with my partner and survived suicide attempts,” he continued. “But after receiving support from local organizations of people living with HIV, I decided to retake control of my life. I started to talk openly about HIV to help other young people live with a positive diagnosis. Even though this was never my plan, I knew I had to do it. That’s why I became an HIV activist,” he added.

Nowadays, Pete (famously known online as Pete Living with HIV) is a well-known HIV activist in Thailand and has come far since his diagnosis. He has spent the past few years building an online community for people living with HIV. In this safe space, people can connect and be comfortable enough to share their stories and experiences in an open environment free from stigma and discrimination. His Facebook group, which has strict membership requirements (for obvious reasons), has more than 1300 members.

“I created this space because I didn’t have a place to share my story. I wanted to create a platform where people living with HIV can be proud of themselves and be reminded they are not alone. No one deserves to be stigmatized, bullied, dehumanized or disrespected. Everyone deserves to be loved, respected and accepted,” he said.

In 2019, the country announced the Thailand Partnership for Zero Discrimination, which calls for intensified collaboration between the government and civil society to work on stigma and discrimination beyond health-care settings, including workplaces, the education system and the legal and justice system. UNAIDS has been involved since the outset of the initiative by providing technical assistance to formulate the zero discrimination strategy and the five-year action plan, develop a monitoring and evaluation plan and operationalize the strategy as a joint effort between the government and civil society.

Pete thinks this initiative is a cornerstone to ending the AIDS epidemic, as stigma and discrimination continues to be the main barrier to HIV services. “Although it has improved a lot over the years, I still experience stigma and discrimination when I go for regular sexually transmitted infection check-ups. I still receive judgement from nurses and doctors,” he said.

Pete has also become a passionate activist for, and speaks about the importance of, U = U (undetectable = untransmittable) at international forums and conferences. “U = U changed my life. I continue to fight for and promote U = U because its messages have the power to change the lives of people living with and affected by HIV. Still, more importantly, it can change social attitudes and tackle stigma and discrimination,” he said.

With U = U, HIV treatment has transformed the HIV prevention landscape. The message is clear and life-changing: by being on HIV treatment and having an undetectable viral load, people living with HIV cannot transmit HIV to their partners. The awareness that they can no longer transmit HIV sexually can provide people living with HIV with confidence and a strong sense of agency in their approach to new or existing relationships.

Pete launched a campaign in 2020 focusing on U = U and mental health advocacy. “Through my social media channels, I raise awareness about the importance of listening to people and their experiences and respecting them. U = U is key to helping people living with HIV overcome self-stigma and negative feelings like shame, which discourage them from accessing and/or remaining on treatment. U = U is encouraging; it can help remind people living with HIV to be proud of themselves,” he said.

Pete is now strengthening partnerships with national stakeholders and allies of the HIV response to ensure that messages related to U = U, HIV prevention and zero discrimination are amplified and reach different audiences. He is also a representative on a multisectoral task force to design and implement the People Living with HIV Stigma Index in Thailand, which will be conducted this year. He has supported the United Nations in Thailand on various campaigns, including the Everybody Deserves Love Valentine's Day campaign and the zero discrimination campaign, in which he is engaging young people from across Thailand. 

The Bangkok Metropolitan Administration (BMA) in Thailand has been awarded the inaugural Circle of Excellence Award at the Fast-Track cities 2021 conference, held recently in Lisbon, Portugal. The Circle of Excellence Award showcases outstanding work in fast-tracking the HIV response and advancing innovative programming to end the AIDS epidemic in cities by 2030.

“To receive the Circle of Excellence Award for Bangkok is a great honour. It demonstrates not only the past achievements but, moreover, the future commitment to accelerate the HIV response and towards ending AIDS in Bangkok. We are proud that innovations have produced remarkable results, particularly same-day antiretroviral therapy and key population-led health services, such as specialized and holistic services for transgender people and the scale-up of pre-exposure prophylaxis (PrEP) programmes. These innovations are not only applied in Bangkok but have become models for the region,” said Parnrudee Manomaipiboon, the Director-General of the Department of Health, BMA, during the award ceremony.

Organized by the International Association of Providers of AIDS Care, in collaboration with UNAIDS, the Fast-Track Cities Institute and other partners, the Fast-Track cities conference highlighted successes achieved across the Fast-Track cities network, addressed cross-cutting challenges faced by local stakeholders and shared best practices in accelerating urban HIV, tuberculosis and hepatitis B and C responses.

“Bangkok has put in place a 14-year strategic plan for ending AIDS from 2017 to 2030, which is under the leadership of the Bangkok Fast-Track Committee,” said Pavinee Rungthonkij, the Deputy Director-General, Health Department, BMA. “During COVID-19, BMA and partners have introduced innovations such as multimonth antiretroviral therapy, an express delivery of antiretroviral therapy service, sexually transmitted infection self-sampling and PrEP,” she added. Among other achievements, Bangkok has expanded its PrEP services to 16 municipal public health centres and eight city hospitals and implemented citywide awareness campaigns. PrEP in the City was the first citywide PrEP campaign focusing on transgender people in Asia.

“Significant progress has been made in the HIV response since Bangkok joined the Paris Declaration to end the AIDS epidemic in cities in 2014. It shows that mutual commitments and a strengthened partnership between stakeholders at all levels are key to an effective HIV response. Bangkok will continue to leverage support, scale up innovations and Fast-Track solutions to achieve the 2025 targets and end AIDS by 2030,” said Patchara Benjarattanaporn, the UNAIDS Country Director for Thailand.

In 2019, key populations (including gay men and other men who have sex with men, people who inject drugs, sex workers, transgender people and prisoners) and their partners accounted for 62% of all new HIV infections worldwide, including the largest share of new infections in every region other than eastern and southern Africa.

Globally, new HIV infections declined by 23% from 2010 to 2019. The 1.7 million new infections that occurred in 2019 are more than three times higher than the global target of less than 500 000 new infections in 2020.

However, barely a dent has been made in the number of HIV infections among female sex workers, people who inject drugs and transgender women, and HIV infections among gay men and other men who have sex with men increased by an estimated 25% between 2010 and 2019.

This story was first published by UN Women

On World AIDS Day, UN Women spoke to survivors and community changemakers in South Africa who as part of UN Women’s HeForShe community-based initiative and a joint UNAIDS programme are engaging men and women to reject violence against women and seek HIV testing and treatment. 

Until two years ago, Karabo Chabalala (28) and Sarah Baloyi (26), young women from Mamelodi — a township northeast of Pretoria in Gauteng, South Africa — were living very different lives.

“I was in a very dark place. I had multiple sexual partners and was part of a lifestyle that was not good or healthy for me,” says Baloyi. Her friend, Chabalala says, “I had many personal problems. I engaged in a transactional relationship with an abusive older man to fund my education and provide for my family.”

Their lives turned around following their involvement in UN Women’s HeforShe community-based initiative that aimed at improving attitudes and behaviours around gender-based violence (GBV) and HIV.

“Karabo introduced me to HeForShe, a community that cares for one another,” says Baloyi. “The dialogues showed me that I am not alone in my mistakes and could change my life. I have been inspired to promote safe and healthy living for young girls and to provide them with the same loving acceptance that was extended to me.”

Chabalala adds, “Many young women don’t open up at home about problems they are facing. These dialogues give us a space to express our thoughts and feelings and to ask any questions that we have about life.”

Led by UN Women’s partner, Southern Africa Catholic Bishops Conference (SACBC), and funded through the Joint United Nations Programme on HIV/AIDS (UNAIDS), the HeforShe dialogues have since 2018 engaged 115,000 men and women across seven districts (Mamelodi, Klerksdorp, Bojanela, Sedibeng, city of Johannesburg, Ehlanzeni and CapeTown) in South Africa’s five provinces.

“The dialogues are coordinated by 151 trained women and men ‘changemakers’, including young women like Baloyi and Chabalala, equipped with knowledge on HIV and violence prevention, unequal gender norms, the importance of HIV testing and adhering to treatment, responsible sexual behavior, and how socio-economic factors can drive HIV infections among men and women,” explains UN Women's South Africa Multi-Country Office Representative, Anne Githuku-Shongwe.

“Many women in Mamelodi have been victims of abuse or witnessed femicide in their homes, often at the hands of men who [are alcoholic].” says Baloyi.

“All I feel is anger,” says Chabalala. “These men don’t respect us. Women in our community are being raped and killed. Some men who perpetrate these crimes are out on bail the following day.”

“There has been a rise in GBV since the COVID-19 lockdown,” says Baloyi. “Abusive partners have been stuck at home and they are frustrated. They are no longer able to spend their time working or drinking with friends, and take it out on their partners and children. This is especially the case in informal settlements, where families live in one- or two-room shacks.”

South Africa is home to almost one-fifth of people living with HIV worldwide and has an HIV prevalence rate of 20.4 per cent among adults (15-19 years). In line with trends across Sub-Saharan Africa, in 2019, women accounted for the majority of new infections in the country. Structural gender inequalities, discrimination, violence against women and girls, and unequal gender norms continue to undermine efforts by women and girls to prevent HIV and use HIV/AIDS services.

“The stigma around HIV prevents people from seeking treatment. I have met some older patients who still fear going to the clinics because they feel judged or embarrassed,” says Chabalala.

To increase the uptake of HIV testing, the changemakers partnered with 20 local HIV counselling and testing clinics across participating districts. They also facilitated outreach for HIV testing at community and church events and developed a referral system. In two years, the HeforShe initiatives have resulted in 62 per cent of those engaged testing for HIV, and 36 per cent returning and adhering to their antiretroviral treatment. However, because of the COVID-19 pandemic, people living with HIV and people at higher risk of HIV infection are facing life-threatening disruptions to health services.

Inspired by the positive impact of UN Women initiatives in communities and empowered by the change makers, Mamelodi community members founded the national ‘Young Women for Life Movement (YWfLM)’, which has grown to 2,035 members. With support from the SACBC, the group is currently monitoring the proceeding of 30 cases of sexual and gender-based violence and 17 cases of femicide in the justice system, as well as supporting the families of survivors. They also played a crucial role in organizing food supply drives to the most vulnerable households in their communities during the COVID-19 lockdown.

“I started the Mamelodi chapter of the Young Women for Life Movement,” says Chabalala. “Being part of this community of 200 powerful young women has taught me so many things and helped me grow. It has changed my life”.

“As a YWfLM member, I work with our local clinic and visit people living with HIV in our community to confirm that they are taking their medication and to ask if they need any assistance or additional supplements,” says Baloyi. “We also have an HIV-positive support group that now mainly connects online due to the pandemic.”

Both Baloyi and Chabalala believe that men need to be more involved in initiatives to improve attitudes and behaviours to prevent GBV and HIV. “Young men need to not only be part of this conversation, they must have their own dialogues where they focus on how to change their mindset,” says Chabalala.

Baloyi adds, “Many more men need to join women in our fight. Men must join us in court and in the streets. They must fight with us.”