It was a very different morning bus ride for UNAIDS Executive Director Winnie Byanyima as she boarded the hepatitis bus in Oslo, Norway, to hear more about the work of ProLAR, an organization that supports people who use drugs. ProLAR provides a range of services, including opioid substitution therapy and testing for HIV and hepatitis C. It is also active in calling for changes in drug policy and promotes evidence-informed policy that involves the affected communities.

“We welcome people who use drugs into a warm, safe space. Here we can talk, get to know each other then take the necessary tests,” explained Ronny Bjørnestad, Managing Director of ProLAR.

According to the European Monitoring Centre for Drugs and Drug Addiction, around 9000 people who inject drugs lived in Norway in 2019, many in the two largest cities, Oslo and Bergen. In 2015, the Norwegian Government presented a new action plan addressing substance use and addictions that prioritizes prevention, early intervention, treatment and aftercare for people who use drugs. In 2018 the European Centres for Disease Control reported that there were only six new diagnosis of HIV among people who inject drugs in Norway.

Ms Byanyima also visited Sjekkpunkt, a free and anonymous testing service in Oslo for HIV and other sexually transmitted infections that caters for gay men and other men who have sex with men. Rolf Martin Angeltvedt, Director of Helseutvalget, said that, “Checkpoint does not say “no” to anyone who wants to come in to talk and take a test. We offer free, anonymous and rapid testing.”

New HIV infections among gay men and other men who have sex with men have been declining steadily in Norway in recent years. In Norway the most commonly reported mode of HIV transmission in 2018 was heterosexual transmission.

Following the visit to Sjekkpunkt, Ms Byanyima met with representatives of civil society organizations working in Norway on issues concerning people living with and affected by HIV. The dialogues centred around sex work, chemsex, ageing, youth, lesbian, gay, bisexual, transgender and and intersex people and migration. In Norway, civil society groups play a critical role in addressing the AIDS epidemic by supporting prevention, treatment and care efforts.

“The leadership of networks and peer-led organizations working to support people living with, and affected by, HIV is instrumental. More than ever, the role of civil society is critical to removing barriers to health, dignity and the enjoyment of human rights. I encourage you to build bridges with civil society organization in other regions of the world. We must work together to reverse the disturbing trend of shrinking space and lack of funding for civil society or we will fail to reach the target of ending the AIDS epidemic by 2030,” said Ms Byanyima.

A report on the progress made over the past 12 months by organizations active in the health sector to implement policies that promote gender equality, non-discrimination and inclusion in the workplace has once again rated UNAIDS as a “very high scoring” organization.

UNAIDS is one of only 13 out of the top 200 global health bodies—funders, nongovernmental organizations, corporate organizations and others with a presence in at least three countries—to be designated as very high scoring. A further 27 organizations were “high scorers”.

“I’m proud that UNAIDS is seen as gender-responsive and inclusive,” said Winnie Byanyima, Executive Director of UNAIDS. “But we must continue to build on these results—we’ve still got a long way to go.”

Researchers assessed the gender and geography of global health leadership, and the availability of gender and diversity policies in the workplace. The report also assessed whether organizations address the crucial role of gender in their health investment programmes and the health priorities they address.

While identifying some progress towards gender equality across the 200 organizations surveyed, the report warns that the pace of change is too slow, estimating that it will take more than 50 years to reach parity at the senior levels of global health organizations.

“Many of the 200 organizations we reviewed are falling short on the equality measures that they purport to uphold. More than 70% of the chief executives and chairs of boards are men, while only 5% are women from low- and middle-income countries,” said Sarah Hawkes, co-founder of Global Health 50/50 and Professor of Global Public Health at University College London.

Power, privilege and priorities is the third Global Health 50/50 report. Previous Global Health 50/50 reports have also found UNAIDS to be a gender leader, being rated in the top nine out of 140 organizations in 2018 and in the top 14 out of almost 200 organizations in 2019.

There are around 45 000 people living with HIV in Papua New Guinea, with marginalized groups, such as sex workers and other women who exchange sex for money, goods and protection, gay men and other men who have sex with men and transgender women, most affected. However, less than half of the people who belong to those vulnerable groups have ever taken a test to know their HIV status.

In November 2018, UNAIDS, the Global Fund to Fight AIDS, Tuberculosis and Malaria and other partners implemented a new outreach programme in the capital, Port Moresby, to try to reduce the impact of HIV among those groups of people by mapping the HIV epidemic and expanding HIV treatment and prevention services. Under the project, several outreach teams were created to promote and increase the uptake of testing and prevention services and to link people to HIV prevention and care services, if necessary.

By April 2019, the outreach teams had contacted 5000 people and tested 3000 of them for HIV, offering advice and support so that each person understood their test result.

“I like that we go to new places where people have never been offered an HIV test,” said a member of one of the outreach teams. “My motivation is meeting the young girls and taking care of them—making sure they take their medication.”

The outreach workers sometimes face harassment while conducting their work and change out of their official uniforms and into their own clothes so that people feel more comfortable talking to them. But the outreach workers find the work deeply rewarding.

“I have lost friends to AIDS, so that keeps me doing this work,” said another of the outreach workers. “It makes me work extra hard not to see someone else lost to this disease.”

The outreach teams are led by members of marginalized groups, an essential part of establishing community trust and engagement. In addition, leaders offer coaching, support and advice to field workers on a daily basis in order to ensure that their activities are as effective as possible.

The outreach programme is saving lives. Another of the outreach workers recalled his work with a transgender person, who he persuaded to try medication after testing positive for HIV.  

“He told me that because he is transgender, he will only talk to a friend and that when he saw me, he knew I was a friend. Later, he brought in his companion to take a test.”

“This is a model of what can be achieved when we put our trust in community-led HIV services and programmes,” said Winnie Byanyima, UNAIDS Executive Director, in discussion with the outreach workers during her visit to Papua New Guinea with the United Nations Deputy Secretary-General, Amina Mohammed. “These outreach workers are heroes and they are saving lives.”

The outreach programme is also cost-effective and is projected to save hundreds of thousands of dollars over the next two years.

Photos: UNAIDS/P.Caton

It’s been a year since Cyclone Idai made landfall in Sofala Province, Mozambique, where one in six of the population is living with HIV. The cyclone caused devastating floods that destroyed homes and washed away savings, documentation and medicines. Thousands of people were displaced. Health centres across the province were destroyed or severely damaged.

Working with national and provincial authorities, including Mozambique’s Ministry of Health, UNAIDS responded by helping to re-establish community-based support programmes to find thousands of people who had been lost from HIV treatment in order to ensure that they received the necessary support to get back and remain on treatment.

Community volunteers and HIV activists received bicycles from UNAIDS to help them reach people affected by the flooding and to locate people lost from treatment programmes.

Community activists fanned out across areas affected by the disaster.

When the cyclone hit, 14-year-old Pedro José Henriques lost everything, including his medication and his identity card. Community activists supported by UNAIDS helped him receive a new identity card so that he could re-register at the health clinic and obtain new antiretroviral medicines.

“I was so happy to get my new medicines,” he said. “When the activists found us, we had nothing. At least now my grandmother and I have somewhere to stay. It’s not much, but it’s better than sleeping in the cold.”

Rita Manuel is disabled and living with HIV. Her husband is also HIV-positive. When they lost both their children to AIDS-related illnesses, they decided to stop taking their HIV medicines. They simply lost the will to live.  

After the cyclone, activists in the lost-to-follow-up programme visited the couple three times. Finally, Ms Manuel and her husband agreed to visit the health centre and resume their medication.

The activists belong to an association called Kupulumussana, which means “we support each other”.

Ms Manuel is now involved in some of the association’s activities herself. “I am not really happy because I wish I had known about this treatment for my children,” she said, “But I am grateful to be alive and to have people supporting me. The situation is better than before.”

Peter Joque is also in an association to help people affected by the disaster. The Kuphedzana association helped Mr Joque rebuild his home after the cyclone and helped him get back on his feet.

This motivated him to start helping to find people in need of HIV medication. He uses hospital records to search for those who were displaced.

When he finds someone, he takes time to talk to them about the importance of staying on treatment. Mr Joque’s door-to-door strategy managed to locate 40 people living with HIV and persuade them back on to antiretroviral therapy. 

“Talking to someone face to face means it is easier to persuade the person to return to the health centre,” he said. “Stigma and discrimination is still a challenge among communities.”

Medical staff like Alfredo Cunha at the Macurungo health facility treat all patients with respect and dignity. Everyone receives the best care possible.

Sowena Lomba lost her husband to an AIDS-related illness in 2014. When she started getting ill, she thought she had malaria, but when she tested for HIV the result came back positive. During the flooding she lost her identity card and was no longer able to receive treatment. Activists helped her to receive new documents and get back on to treatment.

Ms Lomba says she is grateful to be alive for the sake of her children, Evalina and Mario.

Community activists have now helped more than 20 000 people back on to treatment over the past 12 months and say they won’t stop until they have found everybody lost to treatment, including those who were in need before the catastrophic events of March 2019.

“We are still at it and we will not stop until everybody living with HIV is receiving treatment and care,” said one of the activists.

For six weeks, two teams covered 12 HIV clinics on a data checking mission in Papua New Guinea. UNAIDS joined the country’s strategic information technical working group in the National Capital District, which includes Port Moresby, to inspect the clinics’ records to see if they match the records of the National Department of Health.

“The data quality assessment is part of the country’s HIV monitoring and evaluation plan to ensure the quality of data and reporting of the AIDS response,” explained Zimmbodilion Mosende, UNAIDS Papua New Guinea Strategic Information Adviser.

Led by USAID, the two teams of 12 branched out into smaller teams to look at the number of people registered as enrolled on antiretroviral therapy, the number of people newly starting treatment, the percentage of people returning for refills and the number of people who did not return to the clinics. In addition, the groups checked information on, for example, the age and sex of each person.

The volunteers from civil society groups, international nongovernmental organizations, development partners and key government offices went through the records of nearly 5000 people.

Papua New Guinea has the highest HIV incidence and prevalence in the Pacific region. The country of 8.4 million people represents 95% of the reported HIV cases in the region. There are approximately 45 000 people living with HIV in the country, of whom 65% are on antiretroviral therapy.

The groups tried to find out if there are discrepancies in the data and the reasons behind them. Albert Arija, Monitoring and Evaluation Specialist of USAID, described the reasons for discrepancies, which range from there being an inadequate number of staff, hence not enough time to fill out all entries, to incorrect data entry or at times misinterpretation of information. For fear of stigma and discrimination, some clients don’t want to give personal information.

One key missing data point was also birthdates. “Many people in Papua New Guinea cannot recall their exact date of birth,” said Mr Arija.

The technical working group is advocating for the use of electronic forms and real-time reporting. “Since the current antiretroviral therapy forms are still paper-based, there are several potential data quality risks, including human errors, from the data entry and processing,” Mr Mosende said.

Overall, most of the clinics had good quality data and processing, according to the teams’ assessment. They hope to simplify the overall process to scale up the data check for the whole country.

The Pacific region has among the world’s highest rates of gender-based violence. National research show that 72% of Fijian women experience gender-based violence, compared to the global average of 35%. Women in the region also have a low representation in leadership positions—out of the 560 Pacific members of parliament, 48 are women, of whom 10 are Fijian women.

Adding to these sociocultural impacts is the climate emergency. In response, Pacific women are demanding more involvement in climate-related decision-making and to be fully engaged in climate responses.

Komal Narayan, a Fijian climate justice activist, became fascinated during her postgraduate programme in development studies about how climate change overlapped with ethics and politics. “The effects of climate change are felt most acutely by the people who are least responsible for causing the problem,” she said. This motivated her to be more active and vocal about the issue, leading to her participation, together with other young delegates from Fiji, in the twenty-third United Nations Climate Change Conference, held in Bonn, Germany, in 2017.

“My goal in life is to be part of a society that is focused on addressing the issues of climate justice and encouraging and motivating more young people to be more involved in this space, as I believe that this issue is not just yours or mine but an issue that is at heart for the entire Pacific,” Ms Narayan said.

Ms Narayan was also one of the Green Ticket Recipients for the United Nations Youth Climate Action Summit in September 2019, where she was involved in a youth-led dialogue with the United Nations Secretary-General.

“As givers of life, as dedicated mothers, thoughtful sisters, domestic influencers and active contributors to socioeconomic development, we women have the power to give impetus to the global climate movement,” Ms Narayan said. “It’s about time that women and girls are given equal opportunities and equal access to resources and technology to be able to address climate justice. Countries, specifically government and civil society, should be playing a key role in this.” 

AnnMary Raduva, a year 11 student at Saint Joseph’s Secondary School in Suva, Fiji, believes that climate justice must recognize the connection between humans and the environment and how vulnerable we are if we don’t do something today.

“In the Pacific region, our indigenous communities depend intimately on the ecological richness for subsistence, as well as economically, and this dependence makes our people sensitive to the effects of extreme weather events, and we cannot ignore them. We have a close relationship with our surroundings and are deeply spiritual and culturally connected to the environment, and ocean, and this relationship has positioned us to anticipate, prepare for and respond to the impacts of climate change,” Ms Raduva said.

In 2018 she wrote to the Fijian Prime Minister asking him to relook at the Fiji Litter Act 2008 to classify balloon releasing as littering in Fiji. Ms Raduva soon realized that talking about balloon releasing was not enough, however, and that she had to find eco-friendly alternatives to amplify her message. The idea of planting mangroves along the Suva foreshore soon came to her.

Since 2018, she has initiated six planting activities and has planted more than 18 000 mangrove seedlings. She was invited to New York, United States of America, in September 2019 to march for climate justice at a United for Climate Justice event organized by the Foundation for European Progressive Studies. She stood in solidarity with the indigenous communities that are on the forefront of climate change as it advances in the Pacific region.

Ms Raduva has faced discrimination as a young female activist and has been mocked as a “young, naive girl”. She was told that she must not talk about climate change because activism is reserved for boys and adults. However, she believes that ensuring the participation of women, children and lesbian, gay, bisexual, transgender and intersex people and other minority groups in climate change talks is a priority for any institution or organization that aims to champion climate change issues.

Varanisese Maisamoa is a survivor of Cyclone Winston, which in 2016 was one of Fiji’s most powerful natural disasters. In 2017, she formed the Rakiraki Market Vendors Association, working with UN Women’s Markets for Change project—“We want to empower our market vendors to be climate-resilient,” she said. Through UN Women’s leadership training, she learned to be confident when speaking out about the issues affecting market vendors and to negotiate with the market council management.

Ms Maisamoa represented her association on the design of the reconstruction of Rakiraki’s market, which now features infrastructure resilient to a category 5 cyclone, a rainwater harvesting system, flood-resistant drainage and a gender-responsive design.

Ms Narayan, Ms Raduva and Ms Maisamoa are among the Pacific women who are pushing for more of a voice in and inclusiveness for women and girls in climate action. Their activism is working to reduce discrimination against women and girls, which results in inequalities that make them more likely to be exposed to disaster-induced risks and losses to their livelihood, and to build resilience for women to adapt to changes in the climate.

Ms Maisamoa’s story has been republished with permission from UN Women’s Markets for Change project, which is a multicountry initiative towards safe, inclusive and non-discriminatory marketplaces in rural and urban areas of Fiji, Solomon Islands and Vanuatu that promotes gender equality and women’s economic empowerment. Implemented by UN Women, Markets for Change is principally funded by the Government of Australia, and since 2018 the project partnership has expanded to include funding support from the Government of Canada. The United Nations Development Programme is a project partner.

Emihle Dlamini (not her real name) lost both her parents to AIDS-related illnesses when she was young, so she was raised by her grandmother. For years, Ms Dlamini didn’t know that she was born with HIV. She was given medicine, but was told it was for tuberculosis. South Africa had approximately 260 000 children living with HIV in 2018. Around one third lived in the KwaZulu-Natal province that Ms Dlamini lives in.

One day, Ms Dlamini attended a lesson at school run by the Community Care Project, where she learned about HIV and was offered an HIV test. The result came as a shock, “I was in total disbelief. I knew that I was not sexually active, but my family had never told me that I was HIV-positive,” she said.

Ms Dlamini experienced feelings of anger, confusion and sadness. “Why did my family not tell me? On many occasions, I stopped taking my “tuberculosis” treatment because I wondered why I was taking it for so many years,” she said.

Many people do not disclose their HIV status out of fear of the stigma and discrimination that, despite improvement, remains a real barrier to people seeking access to health services. Particularly affected are young women seeking protection from sexually transmitted infections, as well as HIV diagnosis and treatment. Every day in South Africa, 200 adolescent girls and young women aged 15–24 years are newly infected with HIV.

The Community Care Project has shown the importance of equal and free access to primary and secondary education as a gateway to other social and health services. Almost 163 000 children (0–14 years) living with HIV in South Africa were receiving antiretroviral therapy in 2018, but many are still missing out: an estimated 66 000 children did not even know their HIV-positive status.

The project is accustomed to breaking the silence surrounding HIV as well as managing and reducing its effects. Founded in 1999, it is a faith-based organization from KwaZulu-Natal that helps communities and families manage HIV and respond to stigma and discrimination. Since 2007, it has partnered with secondary schools to run awareness programmes and provide services that help schools and pupils understand and demystify HIV. It also provides care for orphans and other vulnerable children and their families.

The Community Care Project provided Ms Dlamini and her grandmother with counselling by an auxiliary social worker, to help them come to terms with the HIV diagnosis and to ensure that Ms Dlamini follows a sustained treatment programme. Ms Dlamini says she is now coping much better with her situation emotionally and mentally. She has a better understanding of HIV and sexual and reproductive health and is adhering to her medication. She feels that she can have a bright future.

“The Community Care Project taught me positive life skills. I learned how to cope with my HIV status, deal with stigma and help others to do the same,” she says. “One day I would like to be a motivational speaker and empower my peers at school with HIV information and how to live without judgement.”

Ronie Zuze believes in the power of information. Not only did it save them (Ronie uses the pronouns them/they/their), they are convinced that it can change lives and mindsets.

As the first born, their father was ecstatic when he was told he had a son, they recounted. “I was born with ambiguous genitalia, so doctors assigned the male gender,” Ronie said.

Ronie grew up as a boy until the age of 16 years.

“That’s when my body started developing some female features, despite the fact that I associated myself with being a boy,” the Zimbabwean said.

Ronie’s father panicked and sent Ronie to live in another town with his former wife.

“My father became very confused and fearful of the stigma and discrimination,” Ronie said, “so he sent me away.”

Ronie’s mother cautioned them—she immediately told they must now be a girl—to be careful around other people. “Sleepovers and contact sports were forbidden,” Ronie recalled.

Ronie believes the shame around who they were propelled them into a tailspin of denial and self-hate. “I attempted to kill myself two to three times and consumed excessive amounts of alcohol and drugs,” Ronie said.

They started seeking out help on the Internet, convinced there were others in the same situation, which led to a slew of information about what it meant to be an intersex person.

Intersex people are born with any of several variations in sex characteristics, including chromosomes, gonads or genitals that do not fit the typical definitions of male or female.

“The flood of information empowered me to understand who I was,” Ronie said. “I stopped being shameful of myself.”

Most of the people they engaged with were in Europe or North America. “If 1.7–2% of the global population is intersex, then I knew there must be more than just me in Africa,” Ronie said, brushing aside a dreadlock.

Ronie joined a local group for lesbian, gay, bisexual, transgender and intersex people and initially self-identified as a lesbian, but it did not feel right. Even the community didn’t understand intersex people, Ronie said. That’s when they decided to become a voice for people like them and started an organization, the Intersex Community of Zimbabwe, in 2018. Ronie now identifies as non-binary.

“As an activist, it means I empower other intersex people, I speak for those who cannot speak out, I encourage them to be proud and I provide information to them as well as support them,” Ronie said.

Ronie spends a lot of time with other intersex people and their immediate families. They pound the pavement telling parents to let nature take its course and not rush into assigning one gender to their intersex children. They believe an intersex person should decide for themselves when they are old enough to make that decision.

“I know there is a lot of stigma and misconceptions about intersex bodies, but parents need not panic,” Ronie said. “I want intersex people to know there is nothing to be ashamed of, so be proud.”

People who use drugs are often highly stigmatized and face high levels of discrimination. Women who use drugs, however, are doubly stigmatized and discriminated against—because of their drug use and because of their gender. They are also more exposed to gender-based violence and human rights violations that put them at risk of HIV and other infections.

Worldwide, few harm reduction programmes tailor their services to meet the needs of women, and gender-based discrimination may make them unwelcoming. HIV-related services also often don’t cater for the needs of women who use drugs.

As part of efforts to reach out to women who inject drugs, the India HIV/AIDS Alliance is working with the Punjab Government, through its Ministry of Health and Family Welfare at the Civil Hospital in Kapurthala, to develop a comprehensive harm reduction model for women who inject drugs in Punjab.

The hospital is developing a holistic and person-centred approach through a harm reduction clinic that provides services tailored to meet the needs of women. Employing a one-stop shop approach, HIV and harm reduction services are present in one facility. Clients are provided with a range of options, including opioid substitution therapy, needle–syringe programmes and naloxone, an effective treatment for opioid drug overdoses, which they can access free of charge at a time that suits them the best.

“When we didn’t have our women’s harm reduction centre, accessing opioid substitution therapy from other centres was a real challenge. The male users harassed us for sexual favours,” said Preeti Singh (not her real name), a client of the clinic.

The clinic works in partnership with local nongovernmental organizations to ensure that women who inject drugs can access other services, including counselling, HIV testing and sexual and reproductive health services. A menu of gender-sensitive services has been developed that draws on experience from India and other Asian countries. Women are service providers, community mobilizers and beneficiaries of the project.

“Initially my husband and my in-laws did not allow me to go access opioid substitution therapy from the women’s harm reduction centre. Now that I am on antiretroviral therapy and healthier, they know it works!” said Kiran Sharma (not her real name), a client of the clinic.

The project is also focusing on the creation and strengthening of community forums, organized by the State Drug User Forum together with the India HIV/AIDS Alliance. The forums aim to gather information from the perspective of the women themselves, to understand and respond to cross-cutting issues, including gender-based violence and stigma and discrimination, as well as to strengthen the delivery of HIV and harm-reduction services.

“Like my peers, I also went to the centre for seeking help with my withdrawals, and I was surprised to find many services for girls like us. What I like most was that there was help to take care of my child,” said Monica David (not her real name), a client of the clinic.

Started in February 2019, the project has already attained its target of reaching 150 women who inject drugs. The clinic has had a dramatic impact on the women’s lives, improving awareness about HIV, hepatitis C and tuberculosis prevention and testing and linking them to further treatment and care based on their need.

The project will be assessed later in the year and the evidence used for introducing and scaling up the model in India and elsewhere in Asia.

The UNAIDS Country Director for India, Bilali Camara, said that the project is timely. “We must continue to work collectively to close the gaps that continue to leave behind women who use drugs. Ending the AIDS epidemic as a public threat by 2030 depends on advancing a social justice and inclusion agenda that demands access to integrated health services free from discrimination, with the meaningful involvement of the communities,” he said.

When Tahmina Khaidarova was married it was in accordance with her family’s cultural traditions—her parents chose her cousin to be her husband. She rarely saw her husband, who worked in another country, returning home to Tajikistan only for short visits once a year. When her little daughter fell seriously ill and died, she hoped to get pregnant again to ease the pain of her loss. During a medical examination, she was diagnosed with HIV. Soon her husband died of an AIDS-related illness.

Today, Ms Khaidarova is the Director of the Tajikistan Network of Women Living with HIV (TNW Plus), which educates women on HIV, protects their rights and breaks the vicious cycle of stigma against women living with HIV. She overcame her self-stigma and became a leader in fighting for the rights of women living with HIV in Tajikistan.

Ms Khaidarova explained that women who are aware of the risk of contracting HIV from their migrant husbands often can’t talk to them about using a condom. “I understand how serious the problem is, but I cannot ask my husband to use a condom, he will not understand,” one woman told Ms Khaidarova.

Women living with HIV in Tajikistan tell stories of discrimination. They can be driven from their home by their husband’s relatives and may be prevented from seeking medical services, including antiretroviral therapy and treatment for tuberculosis. They are also often subjected to domestic violence, with their husbands prohibiting their wives from seeking treatment or being told to leave their home, along with their children. After their husband’s death, they can endure violence and abuse by their husband’s family, especially in rural areas.

When women living with HIV seek help, they can face a new challenge—stigma and discrimination from health-care workers. Many women are told that they cannot have children in the future, or that they should only marry a man living with HIV or that they should not marry and have sex.

“Stigma and discrimination against women living with HIV can have devastating consequences. It can stop them accessing the health services they need, tear families apart and profoundly affect their ability to live a normal life,” said Ms Khaidarova. “Stigma and discrimination must be stopped, and stopped now!”

The need to counter stigma and discrimination against women in general and against women living with HIV has been recognized by the government. Women were included as one of the priorities in the national development strategy. The new national AIDS programme for 2021–2025 includes a separate block on human rights and reducing stigma and discrimination against women living with HIV.

To bring attention to the issue of HIV-related discrimination in the family, in society and, too often, in medical settings, Ms Khaidarova took part in the #InSpiteOff social media campaign. Featuring the right of women living with HIV in eastern Europe and central Asia to live with dignity and respect, the #InSpiteOf campaign featured Instagram stories showing different aspects of women living with HIV and challenged the stereotypes and myths that surround the virus.

A common feature of all the women featured in the campaign is that they were supported at a critical time in their lives by their loved ones, women’s organizations or communities and are now not only living with HIV and challenging society’s stereotypes, but helping others.

“I told my story in order to help those women who face the same challenges today. I strongly believe that we all together can break the vicious cycle of stigma against women living with HIV in Tajikistan. We have to cope with our own fear in order to fight stigma and discrimination in society,” said Ms Khaidarova.