Sexual transmission of HIV

GENEVA, 17 May 2017—UNAIDS’ vision of zero discrimination and ending AIDS by 2030 will only become a reality if the response to HIV reaches everyone, including lesbian, gay, bisexual, transgender and intersex (LGBTI) people.

The International Day against Homophobia, Transphobia and Biphobia (IDAHOT), a worldwide celebration of sexual and gender diversity, is commemorated annually on 17 May. This year’s theme is families, focusing on the role of families in the well-being of LGBTI people and respect of the rights of LGBTI families.

“Many young gay and transgender people are rejected by their families, living on the streets, facing all types of discrimination and violence,” said the Executive Director of UNAIDS, Michel Sidibé. “This is not the path to healthy and productive societies. We must encourage inclusion and compassion and ensure that networks of support are in place, including access to essential health and social services.”

Gay men and other men who have sex with men are 24 times more likely to acquire HIV than other men and transgender people are 49 times more likely. However, in many health-care settings, LGBTI people find it difficult to access quality health services free from discrimination, making them more vulnerable to HIV and less likely to access treatment and care.

Under international human rights law, countries have a legal obligation to address discrimination in health and in the workplace. In 2016, UNAIDS launched an Agenda for Zero Discrimination in Health-Care Settings, which brings together all stakeholders for joint efforts towards a world where everyone, everywhere, is able to receive the health care they need with no discrimination.

UNAIDS is calling for respect for diversity and zero discrimination. To end AIDS it is essential to end the stigma and discrimination faced by LGBTI people.

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.

The National Health Service (NHS) in Scotland, United Kingdom, announced on 10 April that pre-exposure prophylaxis (PrEP) would become available in Scotland.

PrEP is taken as a daily pill to significantly reduce the chances of contracting HIV. UNAIDS recommends PrEP use by people who are HIV-negative but at higher risk of becoming infected. The people who can benefit most from PrEP include gay men and other men who have sex with men, transgender people, sex workers and serodiscordant couples before the partner living with HIV becomes virally suppressed.

Since government estimates show that a large proportion of new HIV infections in Scotland are among gay men and other men who have sex with men, the introduction of PrEP could make a significant impact on the number new HIV infections in Scotland.

PrEP has been made available in a number of countries around the world as choice for HIV prevention. It cannot currently be obtained from the NHS in the rest of the United Kingdom, but can be accessed from some private clinics.

Countries agreed in the 2016 United Nations Political Declaration on Ending AIDS to reach 3 million people with PrEP by 2020.

Ayushi Tripathi is a student at Banaras Hindu University in Varanasi, a city in India’s northern state of Uttar Pradesh.

She explains that she comes from a family where talking about sex is taboo. “We never talk about it at home. Even seeing an advertisement about condoms is uncomfortable for my parents,” she said. But nonetheless, she was intent on attending a youth health workshop.

This week, she joined 27 other students for a three-day workshop to raise young people’s awareness of their sexual and reproductive health and rights. The training was led by the Dove Foundation, a youth-led organization based in Varanasi and supported by UNAIDS. The advocacy materials used were developed by the PACT, a global coalition of 25 youth networks working on HIV and sexual and reproductive health and rights.

“When I was younger, I didn’t have knowledge on where to get information and access to HIV services,” Ms Tripathi said. “Until I took this workshop, I had no idea that young people in India face challenges in accessing HIV testing and services.”

Monique Long from the Jamaica Youth Advocacy Network led the training, which provided youth and adolescents with the skills and information necessary to tackle the different barriers affecting their health.

“Working with this diverse group of intelligent and energetic young people reminds me of why we say youth are the future. This training also reaffirms that youth right here and right now have the capacity and the will to do amazing things to change the world,” Ms Long said.

Asia and the Pacific is the region with the largest number of young people in the world. In the region, people are starting sex at an increasingly younger age and having multiple sex partners, placing young people at higher risk of HIV.

During the training, the participants stressed how many countries are not tailoring their programmes to young people. For example, India requires people under 18 years old to have parental consent for HIV and other sexual and reproductive health services. Comprehensive sexuality education is often not taught in schools. The low levels of HIV knowledge and discrimination faced in health-care settings further exacerbate the situation.

The PACT and UNAIDS have been working with governments and other partners in advocating for the revision and reform of age of consent laws. The training provided young people with the techniques and skills needed for prioritizing advocacy issues, mapping different stakeholders, crafting key advocacy messages and lobbying.

“UNAIDS knows that the future of the HIV response lies in the hands of young people,” said Aries Valeriano, Youth Officer at the UNAIDS Regional Support Team for Asia and the Pacific. “We are working hand in hand with youth organizations and community groups to break down the barriers that young people face and that keep them from staying healthy and productive.”

After completing the workshop, Ms Tripathi said she plans to start a community of advocates at her university to push for ending the age of consent laws in India. As Ms Tripathi received her completion certificate, she beamed. “The workshop helped to open my eyes on social activism,” she said. “I am so inspired and hope to really influence policies in my university and beyond.”

UNAIDS is working to ensure that the target in the 2016 United Nations Political Declaration on Ending AIDS of ensuring that 90% of young people have the skills, knowledge and capacity to protect themselves from HIV and have access to sexual and reproductive health services by 2020, in order to reduce the number of new HIV infections among adolescent girls and young women to below 100 000 per year, is met.

“Age of consent: my body, my rights”, “Rights have no age” and “#Sex happens” were some of the creative advocacy messages that young people came up with during the pilot training on an age of consent advocacy manual that took place in Harare, Zimbabwe.

As part of the All In partnership to end adolescent AIDS, UNAIDS and the PACT, a global coalition of 25 youth-led and youth-serving organizations and networks working on HIV, developed a comprehensive advocacy manual on age of consent policies that relate to the sexual and reproductive health and rights of youth and adolescents. The manual seeks to provide youth advocates with the skills and information they need to respond to legal barriers, specifically age of consent laws and policies related to sex, HIV and sexual and reproductive health services.

As stated in the UNAIDS Prevention gap report, “In many settings, parental and other third-party consent requirements for access to HIV and sexual and reproductive health services remain an important barrier to their uptake. Adolescents often are reluctant to seek services that require the consent of a parent or guardian. Similarly, laws that restrict people’s access to health services—for example, by requiring third-party authorization for accessing sexual and reproductive health services or by criminalizing certain consensual sexual behaviours—exclude people from the health information and services they need”.

The piloting of the manual in Zimbabwe was facilitated by Youth Engage, a youth-led advocacy organization that brought together 25 youth advocates from diverse backgrounds.

Young people, with support from the National AIDS Council of Zimbabwe, are now mobilizing and preparing for a dialogue with parliamentarians to discuss the age of consent laws on marriage, sex and HIV testing in Zimbabwe and young people’s access to sexual and reproductive health services.

The manual will soon be piloted in India and will become a key resource for advocates to challenge legal and policy barriers that pose obstacles for young people’s access to HIV and sexual and reproductive health services all over the world.

UNAIDS International Goodwill Ambassador Annie Lennox galvanized participants at the opening of the Women Deliver conference, which is taking place in Copenhagen, Denmark, from 16 to 19 May. Ms Lennox said that women had to break down the structures that cemented gender inequality and end all forms of gender-based violence. Her speech electrified the more than 5000 delegates taking part in the conference, which is the world’s largest global conference on the health, rights, and well-being of girls and women to take place in the past decade.

The 2016 Women Deliver conference is being held under the theme of “Implement the Sustainable Development Goals so they matter most for girls and women.” The conference has a special focus on health, and in particular maternal, sexual and reproductive health and rights. Other themes include gender equality, education, the environment and economic empowerment.

The agenda of Women Deliver is central to the UNAIDS Fast-Track approach which calls for action on women’s empowerment and the advancement of sexual and reproductive health and rights in order to end the AIDS epidemic.                 

Other speakers at the opening ceremony included Her Royal Highness Princess Mary of Denmark, Jill Sheffield, the Chief Executive Officer and President of Women Deliver, Babatunde Osotimehin, Executive Director of the United Nations Population Fund, Gro Harlem Brundtland, the former Prime Minister of Norway, Margaret Chan, Director-General of the World Health Organization, and the journalist, human rights activist and Nobel Prize laureate, Tawakkol Karman.  

GENEVA, 17 May 2016—UNAIDS stands with people and organizations around the world in commemorating the International Day against Homophobia, Transphobia and Biphobia (IDAHOT) on 17 May, the day 26 years ago when the World Health Organization declassified homosexuality as a mental disorder. The IDAHOT theme for 2016 is mental health and well-being.

Although there is still much progress to be made to achieve UNAIDS’ vision of zero discrimination, there have been encouraging steps in the right direction. In June 2015, Mozambique decriminalized homosexuality in its new penal code. In September 2015, some 12 United Nations agencies issued a powerful joint call to action on ending violence and discrimination against lesbian, gay, bisexual, transgender and intersex (LGBTI) people. In May 2016, the Government of the United States of America released guidance “to help provide educators the information they need to ensure that all students, including transgender students, can attend school in an environment free from discrimination based on sex.”

“It is unacceptable that lesbian, gay, bisexual, transgender and intersex (LGBTI) people face violence and discrimination just because of who they are and who they love,” said UNAIDS Executive Director Michel Sidibé. “They are our sons and daughters, our brothers and sisters, our friends and colleagues. LGBTI rights are human rights. We must challenge prejudice wherever we are.”

Many LGBTI people continue to face enormous daily challenges, sometimes living in fear, in isolation and out of reach of life-saving health services. Fear of abuse or discrimination by health-care workers prevents people from accessing HIV testing and treatment services. In addition, a large percentage of LGBTI people face isolation and discrimination in their immediate social environment, negatively affecting their mental health.

Reaching the Sustainable Development Goals, which include ending AIDS by 2030, requires the end of discrimination in all its forms.

UNAIDS calls for full and complete access to quality health care for LGBTI people, including access to mental health services, which are often less well supported in health systems. “Act with compassion. Embrace diversity. Leave no one behind,” added Mr Sidibé.

Ending discrimination will be one of the central themes discussed at the upcoming United Nations General Assembly High-Level Meeting on Ending AIDS, taking place at the United Nations in New York, United States of America, from 8 to 10 June 2016. For more information, go to www.hlm2016aids.unaids.org. 

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.

In collaboration with UNAIDS and other partners, the United Nations Development Programme (UNDP) and IRTG, a Global Network of Trans Women and HIV, have released a new publication today entitled Implementing comprehensive HIV and STI programmes with transgender people: practical guidance for collaborative interventions. The publication presents concrete steps that public health officials, health workers and nongovernmental organizations can adopt to implement HIV and sexually transmitted infection (STI) programmes with transgender people.

Topics covered in the publication include community empowerment and human rights, addressing violence, stigma and discrimination, and delivering transgender-competent services, especially for HIV and STI prevention, diagnosis, treatment and care. The publication also covers community-led outreach, safe spaces and the use of information and communications technology in service delivery. It describes how to manage programmes and build the capacity of organizations led by transgender people and shows how services can be designed and implemented to be acceptable and accessible to transgender women. Wherever possible, it gives particular attention to programmes run by transgender organizations.

The publication was developed in collaboration with transgender people and advocates, service providers, researchers, government officials and representatives of nongovernmental organizations from all over the world. UNDP and IRTG coordinated its production, with the support of the United Nations Population Fund, the University of California, San Francisco, Center of Excellence for Transgender Health, the Johns Hopkins Bloomberg School of Public Health, the World Health Organization, the United States Agency for International Development, the United States President’s Emergency Plan for AIDS Relief and UNAIDS.

The document is based on recommendations included in the Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations, published in 2014 by the World Health Organization.

Transgender women continue to be heavily affected by HIV, being 49 times more likely to become infected with HIV than non-transgender adults.

As part of the global effort to achieve the Millennium Development Goals (MDGs), countries around the world reported major gains in the health and wellbeing of women and children between 1990 and 2015. The global rate of maternal mortality fell by 47 per cent and child mortality declined by 49 per cent. However, any celebration of progress is tempered by the reality that millions of women, children, newborns, and adolescents continue to die every year; mostly from preventable causes. As the world transitions from the MDGs to the Sustainable Development Goals (SDGs), we must uphold our commitment to keep reproductive, maternal, newborn, child, and adolescent health (RMNCAH) at the heart of the global agenda. Fulfilling this promise is both a practical imperative and a moral obligation.

The UN Secretary-General's Global Strategy for Women's, Children's, and Adolescents' Health sets out a plan to give every woman, child, and adolescent the opportunity to not only survive, but to thrive and transform his or her community. Implementing the Global Strategy and achieving the SDG targets requires an unprecedented level of alignment and coordination amongst each and every one of us working in the field of RMNCAH.

On behalf of the six organizations responsible for promoting and implementing the global health agenda across the UN system, UNAIDS, UNFPA, UNICEF, UN Women, WHO, and the World Bank Group, we, the undersigned, stand united in our commitment to operationalize the Global Strategy.

Building on our tradition of working together to support countries in achieving the MDGs, we, as members of the H6 (previously known as the H4+), will provide coordinated technical support to country-led efforts to implement the Global Strategy and achieve the ambitious targets of the health-related SDGs. At the same time, we will continue to advocate for evidence-based RMNCAH programmes and policies at the global, regional, and national levels.

As the current H6 chair (2016-2018), UNAIDS will lead the partnership in fulfilling its mandate to leverage the strengths and capacities of each of the six member organizations in order to support high-burden countries in their efforts to improve the survival, health, and well-being of every woman, newborn, child, and adolescent.

As representatives of the H6, we renew our commitment to implement this mandate in support of the Global Strategy. We call on RMNCAH activists and advocates worldwide to join us in fulfilling this shared pledge to women, children, and adolescents everywhere.

Michel Sidibé, Executive Director, UNAIDS

Babatunde Osotimehin, Executive Director, UNFPA

Anthony Lake, Executive Director, UNICEF

Phumzile Mlambo-Ngcuka, Executive Director, UN Women

Margaret Chan, Director General, WHO

Tim Evans, Senior Director, Health, Nutrition and Population Global Practice, The World Bank Group

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.