Stigma and discrimination

Despite decades of advances in prevention and treatment, stigma and discrimination towards people living with HIV and key populations are a persistent barrier to addressing the epidemic. To encourage innovative approaches to address HIV-related stigma and discrimination in the region, UNAIDS has launched a new tool: the HIV-Related Stigma and Discrimination Community of Practice: Asia and Pacific Region.

HIV-related stigma and discrimination significantly impacts the health, lives and well-being of people living with or at risk of HIV, especially key populations. The Global AIDS Strategy 2021-2026 has prioritized the realization of human rights and elimination of stigma and discrimination by including new global targets that UN Member States have committed to as part of the 2021 Political Declaration. Yet, people living with HIV and key populations continue to face unfair treatment, rejection, abuse and even violence in various settings, including in their communities, healthcare, workplace, justice and education systems.

In Asia and the Pacific, which is the world’s most populous region, there were 6 million people living with HIV in 2021 and 86% of people living with HIV knew their status. Furthermore, amongst young people almost all new HIV infections are among key populations (gay men and other men who have sex with men, transgender people, sex workers, people who use drugs) and their sex partners who face many barriers in accessing HIV prevention and treatment services.

The online community of practice platform will capture and disseminate knowledge, experiences and innovative ideas and approaches to inform programming to reduce stigma and discrimination across the region.

“Relevant stakeholders working in the HIV response in Asia and the Pacific region are welcome to join the interactive platform and engage on the issues,” said Taoufik Bakkali, UNAIDS Regional Director for Asia and the Pacific. “Academics and researchers, communities of people living with or affected by HIV and of key populations, representatives of government ministries and other relevant government agencies, and civil society groups working on the HIV response are all encouraged to join and shape the conversation.”

The initiative is expected to foster south-south stakeholder dialogue and collaboration on interdisciplinary initiatives on programme design and implementation, the development and knowledge management of HIV-related stigma and discrimination and the creation of opportunities for peer learning and exchange of good practices and lessons learned.

“This platform provides an opportunity for all stakeholders to engage and shape responses to HIV-related stigma and discrimination while engaging communities in the process,” noted Harry Prabowo, the APN+ Program Manager. “This is an opportunity to link the science and evidence to innovative programming.”

Imagine being widely blamed for tragedies that befall your country. Earthquakes. Hurricanes. Floods.

Now imagine being excluded from disaster response efforts because of this.

Lesbian, gay, bisexual and transgender (LGBT) people in Haiti face profound prejudice. Discrimination often undermines life chances. Education and employment opportunities erode. Even accessing healthcare can be difficult.

Founded in 1999, the SEROvie Foundation pairs health promotion for the LGBT community with human rights advocacy and socioeconomic empowerment. Today the organization operates projects in nine geographical departments.

UNAIDS supports SEROvie to ensure that the needs of key population communities are addressed during disaster responses. This intervention ensures people living with HIV continue to receive HIV treatment and have timely access to aid. Beyond the emergency phase, beneficiaries get support to resume generating incomes and reintegrate into their homes. They also receive psychosocial support to cope with grief and trauma.

In 2016 SEROvie founded the J.C Ménard Clinic in Port au Prince. This clinic serves LGBT people and other key populations including female sex workers and their clients. Here SEROvie has distilled more than two decades' experience in providing health and social support into a complete service package.

With the assistance of several collaborators including the U.S. Agency for International Development (USAID), J.C Ménard offers a range of free-to-user services addressing gender-based violence, stigma and discrimination, family planning and HIV prevention, including PrEP. It also provides HIV, STI and TB treatment and care. 

At the in-house laboratory, technicians manage both diagnostics and treatment monitoring. They track individual journeys from positive test to viral suppression. Over the last year the clinic provided facility-based HIV testing for 6,000 people and supported HIV treatment management for over 1,500 clients. Apart from dispensing patients' medicines, the clinic coordinates with other treatment facilities to ensure there are no stockouts and drugs do not expire.

Social workers conduct individual assessments to determine clients' needs. Psychologist, Darline Armand says the most important moment in her work is the first interaction after someone has been diagnosed.

"They need to feel safe," she says.

Peer Supervisor, Gregory Jacques, explained that the clinic employs both peer education and peer navigation as strategic approaches. Educators engage clients about relationships, risk and safety, providing accurate information. Navigators are themselves people living with HIV who walk others through the treatment and care process.

"The thing that makes a difference is that they know you are just like them," one navigator explains.

In the community room clients learn about health and relationships through fun activities. This is also where they meet for support groups and dialogues.

The Monitoring and Evaluation team measures programme performance with painstaking detail. They track everything from the number of people living with HIV identified through index testing to the number of sensitization sessions conducted with Voodoo priests. Over the past year more than 15,000 people received awareness-raising messages on HIV, GBV, stigma and discrimination from the clinic. Over 1,500 people benefit from comprehensive HIV care and treatment services while more than 1,500 are on PrEP.

Steeve Laguerre, SEROvie's co-founder, reflects on the organization’s journey with both awe and clarity.

"The services we provide are entirely determined by the needs of the people we serve," he says. "We seek funding that aligns with their demands. The work is always client-driven." 

This client-centred approach is valuable for the wider Caribbean. According to the 2022 Global AIDS Update, In Danger, last year four of five new infections in the region were linked to key population communities and their sexual partners. At the same time, most of the funding for regional combination prevention activities with key populations comes from international sources. 

“Community-led strategies for patient care help reduce late diagnosis and loss to follow-up while improving treatment outcomes,” said Dr. Christian Mouala, UNAIDS Country Director for Haiti. “These approaches must be adequately resourced and integrated into the national response.” 

"We are here, we are not giving up". These are the encouraging words of Thérèse Omari, an activist who has been involved in the fight against AIDS for more than 20 years within the Femme Plus organisation, of which she is the co-founder and National Director in the Democratic Republic of Congo.

Femme Plus, true to its motto "Positive Life", works to improve the quality of life of people living with HIV. "The objective is for our beneficiaries to live in harmony with themselves, with their environment and with their beliefs," explains Ms Omari. 

To this end, the organisation provides psychosocial support to people living with or affected by HIV through counselling, care and support services. Femme Plus also carries out numerous activities in communities to free people living with HIV from the burden of stigma. "There is still a lot to be done to change behaviours towards people living with HIV," says Ms Omari. In the Democratic Republic of Congo, HIV-related stigma is still very present, especially in community settings. "Many people living with HIV say they no longer participate in family gatherings and other events fearing discrimination. It is therefore essential that people who come to Femme Plus feel that they are considered normal people with rights and obligations," she explains. In order to raise awareness, the organisation runs workshops to provide communities with the knowledge to better support people living with HIV, without isolating them or treating them differently.

Ms Omari also deplores the persistence of stigma and discrimination in health care settings despite the numerous HIV-related trainings for health care workers. In particular, she receives testimonies from pregnant women who have tested positive for HIV in one facility and wish to give birth in another, fearing of being stigmatised and treated differently. This is problematic as it can be detrimental to the provision of appropriate care for the mother and baby.

Ending discrimination and ensuring that the rights of people living with HIV are protected is therefore one of Femmes Plus' priorities to help them assert themselves and make the right choices about their health. "We encourage people living with HIV to empower themselves, to speak up about their condition, for their own well-being," says Ms Omari. 

Ms Omari also raises other obstacles to the AIDS response. The lack of access to prevention and treatment, and the low rate of people with an undetectable viral load, are among the shortcomings of the fight against HIV in the Democratic Republic of Congo. "Not everyone has access to testing. There are still people with HIV who live in anonymity," warns Ms Omari.

To overcome this gap, Femme Plus works with community leaders to teach them how to stay healthy with HIV. Among other activities, it also engages with pregnant and breastfeeding women, providing them with the knowledge to protect their babies and thereby stop vertical transmission.

"As long as there are people who do not know their HIV status, who do not have access to treatment and who have not reached an undetectable viral load, the fight of Femme Plus will remain meaningful," insists Ms Omari.

She concludes by pointing out that the fight against AIDS in the Democratic Republic of Congo is taking place in a context where resources are limited. "The local population must be involved in psychosocial care and prevention activities to make HIV an electoral issue," she explains. While waiting for more substantial funding from the State and better traceability of funds, community-led services have a crucial role to play with people living with HIV. They are at the heart of the fight against AIDS, advocating for access to prevention and life-saving care, calling for respect for human rights and addressing the specific needs of their beneficiaries. Their support is therefore pivotal in meeting the challenges of the HIV response and ending AIDS by 2030.

4 July 2022—UNAIDS congratulates the Argentinian Congress on the approval of a new law on a comprehensive response to HIV, viral hepatitis, tuberculosis and sexually transmitted infections (STIs). The bill, which has had input from a number of civil society organizations, replaces 30-year-old legislation and changes the country’s health approach from a biomedical approach to an approach more focused on gender and human rights. The new law calls for an end to stigma and discrimination against people living with HIV or STIs and aims to stop criminalization of HIV exposure or transmission.

By prohibiting mandatory testing for HIV and other STIs as part of pre-employment exams, the new law also seeks to protect against discrimination in all areas (with emphasis on the workplace) and ensures the privacy of the diagnosis.

“We join the civil society and community movements in this important celebration. The new law is evidence-based and written from the perspective of human rights,” celebrates Alberto Stella, UNAIDS Country Director for Argentina, Chile, Paraguay and Uruguay. “The HIV response in the country now counts on a broad framework of social protection, very much in line with the Global AIDS Strategy (2021-2026), which focuses on ending inequalities to end the AIDS epidemic.”

Besides eradicating discriminatory practices, the new legislation also includes the possibility of early retirement at 50 years old for people who have been living with the virus for ten years and who have paid at least 20 years of pension contributions. It also allows access to a non-contributory pension for life in cases of social vulnerability.

The new bill pays a historical debt for dozens of activists who occupied the balconies of Congress in recent voting sessions and the thousands of people living with HIV they represent. “We are one step closer to eliminating barriers to the implementation of self-testing and promoting prevention strategies such as Pre-Exposure Prophylaxis (PrEP)”, celebrated Fundación Huesped, an Argentinian organization with a regional reach that has advocated for the right to health since 1989.

The new law also recognizes specific rights of women, guarantees the right to health of their children and ensures compliance with the rights recognized in the law for the Integral Protection of Women.

“This is the result of the articulated work conducted by civil society who not only led its elaboration but who also did excellent and hard work on advocacy,” says Stella. “Along with the National HIV, TB, Hepatitis and STI department of the Ministry of Health, UNAIDS was able to contribute with advocacy efforts and the facilitation of dialogues, providing evidence and the informing on international guidelines.”

The new bill also proposes the national production of medication and supplies.

The latest estimates from the UNAIDS 2021 Global AIDS Update report show that 140 000 people are living with HIV in Argentina and 65% of whom are on antiretroviral treatment. Every year 5600 people are newly infected with HIV, and 1400 people die from AIDS-related illnesses.

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, 22 May 2022—UNAIDS has expressed concern that some public reporting and commentary on Monkeypox has used language and imagery, particularly portrayals of LGBTI and African people, that reinforce homophobic and racist stereotypes and exacerbate stigma. Lessons from the AIDS response show that stigma and blame directed at certain groups of people can rapidly undermine outbreak response.

Since May 13, 2022, an outbreak of Monkeypox has been reported in multiple UN member states where cases are not usually reported. As of May 21, the World Health Organization received reports of 92 laboratory-confirmed cases and 28 suspected cases from 12 Member States not endemic for the disease. A significant portion of the cases have been identified among gay, bisexual, and other men who have sex with men, with some cases identified through sexual health clinics. Investigations are ongoing.  WHO notes that available evidence suggests that those who are most at risk are those who have had close physical contact with someone with monkeypox, and that risk is not limited to men who have sex with men.

UNAIDS urges media, governments, and communities to respond with a rights-based, evidence-based approach that avoids stigma.

“Stigma and blame undermine trust and capacity to respond effectively during outbreaks like this one,” said Matthew Kavanagh, UNAIDS Deputy Executive Director a.i. “Experience shows that stigmatizing rhetoric can quickly disable evidence-based response by stoking cycles of fear, driving people away from health services, impeding efforts to identify cases, and encouraging ineffective, punitive measures. We appreciate the LGBTI community for having led the way on raising awareness – and we reiterate that this disease can affect anyone.”

The Monkeypox outbreak illustrates that communities will continue to face threats from viruses, and that international coordination and solidarity is essential for public health as viruses can only be overcome globally.

“This outbreak highlights the urgent need for leaders to strengthen pandemic prevention, including building stronger community-led capacity and human rights infrastructure to support effective and non-stigmatizing responses to outbreaks,” noted Dr. Kavanagh. “Stigma hurts everyone. Shared science and social solidarity help everyone.”

UNAIDS urges all media covering Monkeypox to follow the regular updates being issued by WHO.

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 prevalence of discriminatory attitudes towards people living with HIV varies widely. Across nearly all regions, there are countries where large proportions of adults continue to hold discriminatory attitudes towards people living with HIV.

In 52 of 58 countries with recent population-based survey data, more than 25% of people aged 15 to 49 years reported holding discriminatory attitudes towards people living with HIV, and more than 50% held discriminatory attitudes in 36 of 58 countries.

On 1 March, Marc Angel, a Member of the European Parliament and former champion for the 90–90–90 HIV targets, hosted a virtual Zero Discrimination Day parliamentary event. The event, co-organized by the Global Partnership for Action to Eliminate all Forms of HIV-Related Stigma and Discrimination (Global Partnership), brought together high-level speakers who are passionate about ending discrimination in the European Union (EU) and beyond.

The speakers addressed HIV-related rights violations, societal barriers, including laws and policies, and the underlying stigma and discrimination that fuels the AIDS pandemic. Reflecting on their own work and experiences, they discussed how the EU and its member states could advance the work of the Global Partnership in ending discriminatory laws, policies and practices within the EU region and partner countries.

“Stigma and discrimination hurt the fight against HIV/AIDS, as they constitute a major obstacle to seeking testing and accessing or staying on treatment,” said Helena Dalli, the EU Commissioner for Equality. “We can, and must, combat HIV stigma and discrimination, speak up, collect evidence and share facts and knowledge.”

Evidence gathered by community networks and civil society organizations reveals significant levels of stigma and discrimination and other human rights violations that impact people living with and affected by HIV in the EU, which has been exacerbated by the COVID-19 pandemic.

“When it comes to the EU, there are still growing inequalities, which are major barriers in the HIV response,” said Ferenc Bagyinszky, the Executive Coordinator of AIDS Action Europe. “The global AIDS strategy gives an excellent opportunity for the EU and its member states, together with the communities, to work towards ending these inequalities in the EU, especially in relation to the 10–10–10 targets.”

“The EU can make a critical contribution to address HIV-related stigma and discrimination by establishing linkages with its various human rights and gender equality projects,” said Mandeep Dhaliwal, Director of the HIV, Health and Development Group of the United Nations Development Programme.

“By leveraging its expertise, resources and political leadership to support communities and partner countries in ending HIV-related stigma and discrimination wherever it exists, the EU can make a huge contribution to getting the HIV response back on track,” said Matthew Kavanagh, UNAIDS Deputy Executive Director, a.i., Policy, Advocacy and Knowledge.

To date, 29 countries, none of which are EU member states, have joined the Global Partnership.

Luxembourg’s Minister for Development and Humanitarian Affairs, Franz Fayot, announced Luxembourg’s support for the Global Partnership, the first EU member state to do so. “We support the work of the Global Partnership and can only applaud its role in assisting countries in achieving the 10–10–10 targets by removing laws that harm and creating laws that empower. The Global Partnership’s strategic approach and inclusive platform to manage the diverse human rights violations faced by people living with HIV and marginalized populations will be key to addressing counterproductive discriminatory practices,” Mr Fayot said.

“The Global Partnership is a unique opportunity for the EU and its member states to end intersecting inequalities and injustices for a pandemic-resilient Europe and the world,” said Mr Angel.

Catharina Rinzema, a Member of the European Parliament, spoke about the importance of talking about HIV openly, to correct misconceptions and help the public to educate themselves. She also alluded to the stigma and discrimination that lesbian, gay, bisexual, transgender and intersex people face in the EU. “We should have a blood donation policy where it doesn’t matter with whom you have sex, but whether the sex was safe,” she said.

Maria Walsh, a Member of the European Parliament, referred to the effects that stigma and discrimination has on the mental health and well-being of people living with HIV and called for an inclusive and comprehensive EU mental health strategy. “In order to break the stigma and empower HIV-positive people, it is essential that we speak openly and honestly about their lived experience,” she said.

Mr Angel concluded by encouraging EU member states to join the Global Partnership and highlighted the need for global and concerted action to meaningfully advance towards ending HIV-related stigma, discrimination, inequalities and AIDS by 2030. 

Michael James (not his real name) was shell-shocked when he was fired. He scanned the dismissal letter. It cited his performance and tardiness as reasons for the job loss. But years of performance appraisals told a different story. He’d consistently received positive evaluations and there were no memos about late-coming or substandard work on his file. The only reason he could discern was that colleagues recently learned that he was living with HIV.

HIV-related prejudice remains rife in Jamaica. One third of people living with HIV responding to the 2020 Jamaica People Living with HIV Stigma Index reported experiencing stigma and discrimination. Verbal harassment, gossip and discriminatory remarks were the most common violations. But one in 10 said they were refused employment or lost a source of income because of their HIV status. No legislation prohibits a Jamaican employer from discriminating on the basis of HIV status.

This has marked implications for the HIV response. Twenty-one per cent of respondents were worried about mistreatment or confidentiality breaches by health-care workers. Thirty-eight per cent delayed testing and 29% delayed starting treatment because of concerns about how they would be treated.

Shelly John (not her real name) recounts hopping from one treatment site to another before landing at Jamaica AIDS Support for Life. At other facilities she overheard nurses gossiping about patients’ medical histories.

“I felt uncomfortable. If I am hearing about other clients, other clients can come inside and hear about me as well,” she reasoned.

“The fear of stigma drives some persons underground and away from much needed health services. Owing to stigma and discrimination, some persons delay accessing needed services and, as a result, some are diagnosed with HIV at an advanced stage,” acknowledged State Minister in the Health and Wellness Ministry and Chair of the Jamaica Partnership to Eliminate HIV-Related Stigma and Discrimination, Juliet Cuthbert Flynn.

Jamaica’s testing and treatment outcomes bear this out. While an estimated 86% of people living with HIV were aware of their status in 2020, just 40% of people living with HIV were on HIV treatment.

While the Jamaica Charter of Fundamental Rights and Freedom guarantees protection against discrimination, it is limited in scope. The protected grounds are race, sex, place of origin, social class, colour, religion and political opinions. There are piecemeal anti-discrimination provisions in different pieces of legislation, such as the 2014 Disabilities Act and the 1975 Employment Act. But neither the constitution nor ordinary legislation make discrimination on other grounds unlawful.

Since 2020, UNAIDS and the United Nations Development Programme have been providing technical and financial support to local nongovernmental organizations, including Jamaica AIDS Support for Life, to support the rollout of a national survey on the public’s perspectives and experiences with stigma and discrimination in Jamaica and on the need to have more adequate protections in the law. The results of the survey will be used to advocate for legislation to adequately deal with discrimination experienced by vulnerable and marginalized groups.

The proposed legislation should provide protection across areas including discrimination based on health status, pregnancy or childbirth, hiring or termination decisions and the denial of services to minority groups. It should also address discriminatory conduct based on assumptions about a person’s competence, capabilities, age, self-expression, income level, the neighbourhood in which they live or their educational background.

“Comprehensive anti-discrimination legislation will strengthen the legal framework for the protection of human rights towards achieving equality for all,” Manoela Manova, the UNAIDS Country Director for Jamaica, explained.

In real terms, this means that duty-bearers will have to consider how their policies, programmes and services will affect people with the protected characteristics. Critically, the focus on markers related to poverty would mean that for the first time public bodies will have a duty to consider socioeconomic disadvantage when making strategic decisions about how to exercise their functions and when proposing to use public funds.

“Our overarching finding has been that regardless of health status, sex, age or sexual orientation, the factor that fuels discrimination and makes people more vulnerable is poverty. Moving forward, it is critical that we don’t treat HIV as a stand-alone concern but address the full picture of what makes people marginalized and vulnerable in Jamaica,” said UNAIDS Community Support Adviser for Jamaica, Ruben Pages Ramos.

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.