HIV Does Discriminate: The Worldwide Fight Against Stigma & Discrimination
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In a reversal of a long-standing public health mantra, one of the key messages from AIDS 2014 is that HIV does discriminate. In the last of a three-part series, writer Linda Villarosa lays out the populations most at risk and focuses on MSM and transgender people’s fight for their rights. Go here to read Part 1, which describes the populations most at risk. Go here to read Part 2, which spotlights the issues that sex workers face.
The most clear-cut link between discrimination and stigma and HIV is the repressive anti-LGBT laws that have cropped up in hot spots all over the world. Without a doubt, they are driving the epidemic underground and away from health care in a number of African countries.
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Ifeanyi Orazulike, who runs a clinic for MSM and trans women in Abuja, the capital of Nigeria, put it bluntly: “We have evidence to show that the law is killing people.”
Earlier this year, Nigeria passed legislation mandating a 14-year prison sentence for anyone entering a same-sex union and a 10-year term for a person or group supporting gay clubs, societies, organizations, processions or meetings. Public displays of affection by gay men and lesbians are also illegal.
Globally, an estimated 76 countries criminalize same-sex sexual activity. In a study of 4,000 MSM worldwide, one in 12 reported being arrested for or convicted of same-sex behavior. Sub-Saharan Africa had the highest rate at 24 percent. The same research shows that getting tangled up with law enforcement results in less access to medical care.
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Orazulike traveled to AIDS 2014 in Melbourne, Australia, to talk about how the anti-gay laws are affecting access to health care for MSM. “[Our clinic] used to have about 60 people a month; post-law, it is down to about 10 to 15 people,” he said, speaking at a standing-room-only press conference that looked at stigma and discrimination affecting MSM and trans women.
“The research shows that around 73 percent stopped accessing health-care services for fear of being discriminated against and for fear of being arrested for who they are,” Orazulike added. “For fear of going to prison, people preferred to stay at home on their sick bed.”
In Nigeria, HIV prevalence is about 4 percent, but it’s much higher among MSM—44 percent in Abuja and 27 percent in Lagos. MSM represent an estimated 3.5 percent of the Nigerian population but account for more than 40 percent of new HIV infections.
Needless to say, Nigerian officials deny that the legislation is affecting MSM health. “The government keeps saying law does not affect service provision,” said Orazulike. “But when you tell people that they are going to go to jail for 14 years for being who they are, how can it not make a difference?”
At one point at the press event, a Nigerian journalist demanded to know where Orazulike collected his data, because “MSM are not that common in Nigeria.”
Surprised, Orazulike responded, “It is quite incredible to hear for the first time in my life doing this work for the past eight years that gay men are not common in Nigeria. I am a gay man; I am Nigerian.”
He then pointed to a group of his friends sitting in the front row and added, “They don’t live in Australia; they live in Nigeria. We are very visible.”
When the Issues Collide
A number of factors—race, gender identity, stigma, criminalization and sex work—come crashing together in the case of Monica Jones, an African-American transgender woman from Phoenix. Last year the Arizona State University social work student essentially was arrested for “walking while trans,” under an ordinance that allows police to pick up anyone who “manifests an intent to commit or solicit an act of prostitution.” Though Jones has engaged in sex work in the past, she says she was arrested after accepting a ride to a bar in her neighborhood from two men who turned out to be undercover cops.
“Walking while trans is a way to talk about the overlapping biases against trans women and against sex workers,” explained Jones, who came to AIDS 2014 to discuss her case and also offered a sassy lip-synched dance performance at the main stage of the Global Village.
“They can arrest me for who I am and what they think I am, and the problem is worse in low-income [communities] and communities of color. African Americans make up 50 percent of new HIV infections,” Jones continued. “This is all connected.”
As the conference ended, delegates were already looking toward 2016 in Durban, South Africa. Though AIDS 2014 began on a somber note with the tragedy of Flight MH17 and the deaths of six colleagues, the mood at the conference center remained energized, determined and hopeful.
Australian human rights advocate Michael Kirby summed up the collective feeling during his plenary address. Referring to those who died in the plane crash, he said, “They would demand that we renew and redouble our efforts. This is not a time for silence.”
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This article is republished from The Black AIDS Institute.
Linda Villarosa has covered HIV/AIDS since the early days of the epidemic and has attended the International AIDS Conference six times. She traveled to Melbourne as a volunteer reporter for Black AIDS Daily with her daughter, Kali.