This story first appeared in the UNAIDS Global AIDS Update 2025 report.

In seven countries in western and central Africa surveyed in 2023, more than 12% of people living with HIV aged 18–24 years reported avoiding health centres for care because of their HIV status. 

Whether it is a refusal of care, humiliating comments or disclosure of their status, many people described feeling alienated. Last year, with funds from Expertise France and the help of UNAIDS and partners, a pilot was launched to raise awareness of stigma in Cameroon, Côte d’Ivoire, Senegal and Togo.

Training in the Looking In, Looking Out (LILO)* approach raised awareness among 150 health professionals in Senegal and 97 in Togo about sexual diversity, gender-based violence and respect for human rights. In Kara, northern Togo, a visual digital tool (named “image boxes”) has been designed with communities to raise awareness of health and HIV.

When individuals and communities know their rights, they are empowered to take control of their own health and to hold service providers accountable. This is one of the key messages of this tool used by the Network of People Living with HIV (RAS+ Togo). A total of 300 young people attended educational health sessions in the Central African Republic. In Benin and the Central African Republic, the project focused on legal reform, with the involvement of parliamentarians, including members of the women’s caucus in both countries. Legal texts, a draft decree and a decree have been drafted in the Central African Republic. In Benin, the work also focused on advocacy for the adoption of the new HIV bill.

“We must make the link between HIV and gender-based violence. The law must protect women in all spheres, especially including health,” said Huguette Bokpe Gnacadja, President of the National Institute for Women in Benin.

The year-long partnership has enabled action to be taken at the individual level (rights literacy), organizational level (paralegals in community organizations, training for community actors), interorganizational level and national level (legal reform).

In the next year, UNAIDS wants to further improve access to inclusive human rights-based HIV services for people from key populations, adolescents, girls and young women in the region.

“The fight against HIV will not be won in laboratories, but in the power relations between caregivers and those receiving care, between the state and its citizens,” said Fatou Sy, a UNAIDS focal point in the region who oversaw the projects in the six countries. “We have more work to do.”

*Looking In, Looking Out (LILO) refers to a process of internal and external reflection aimed at improving understanding of key populations and their access to health services. The approach seeks to strengthen the knowledge of intermediaries in the response to stigma surrounding key populations, with a view to encouraging their involvement in creating a supportive environment.