World AIDS Day: Strengthening LGBTI persons’ human rights is critical for HIV response

Human rights violations of people living with, or at risk of HIV, particularly LGBTI persons, continue to have major consequences for the effectiveness of the HIV response, write Marc Angel and Sophie in t’ Veld.

By Marc Angel and Sophie in 't Veld

Marc Angel (LU, S&D) is Co-Chair of Parliament's LGBTI Intergroup and Sophie in 't Veld (NL, RE) is Co-Chair of MEPs for SRR

01 Dec 2020

The theme of this year’s World AIDS Day is “Global Solidarity, Shared Responsibility”, a topic that is at the heart of the work of the European Parliament’s LGBTI Intergroup.

The Intergroup, with a membership of over 150 parliamentarians, monitors the rights of lesbian, gay, bisexual, transgender and intersex (LGBTI) people in the European Union Member States and beyond. It monitors the work of the European Union, actively works to mainstream LGBTI concerns in relevant reports and liaises with civil society to advocate for their needs at the European level.

However, there are still crucial changes to be undertaken and we must join together to fully guarantee and protect the human rights of LGBTI people. This is why the Intergroup warmly welcomes the collaboration with the Secretariat of the United Nations Joint Program on HIV/AIDS (UNAIDS).

UNAIDS has built an inspiring track record as a bold human rights defender, standing with LGBTI persons and other people at risk of or living with HIV around the world, and seeking their guidance in ensuring tailored approaches to address the specific issues and needs, as part of the HIV response.

UNAIDS has also spoken out about human rights violations of LGBTI people in some EU Member States, calling to uphold the rule of law and protect the rights of LGBTI people.

Winnie Byanyima, Executive Director of UNAIDS, said that human rights violations, including criminalisation, are among the biggest barriers to ending the AIDS epidemic among LGBTI people.

She added, “Evidence shows that when you remove punitive laws and create an enabling environment for all key populations to enjoy their human rights, including LGBTI people, they can come forward to claim their right to health and receive the services they need free of stigma and discrimination.”

“When you remove punitive laws and create an enabling environment for all key populations to enjoy their human rights, including LGBTI people, they can come forward to claim their right to health and receive the services they need free of stigma and discrimination”

Winnie Byanyima, Executive Director of UNAIDS

We face the uncomfortable truth that human rights violations - including stigma and discrimination, violence, punitive laws and practices - determine the impact of the HIV epidemic on our community of people.

Worldwide, at least 73 countries and territories criminalise same-sex relations between consenting adults and six countries have even imposed the death penalty as a sanction for such cases.

This not only means that millions of individuals are at risk of arrest, prosecution, and imprisonment because of who they love, but they are also at greater risk of HIV infection.

Gay men and other men who have sex with men are 26 times more at risk of acquiring HIV than the rest of the population and for trans persons the risk is 13 times higher.

Furthermore, almost one quarter (23 percent) of 1.5 million new adult HIV infections globally in 2019 were among gay men and other men who have sex with men, and another 2 percent among trans women, living outside Africa, according to UNAIDS data.

So why is this? Well, human rights violations prevent LGBTI people from accessing HIV prevention and treatment services. Trans people who experience stigma in healthcare settings are 2.4 times more likely to avoid health services.

In African countries that criminalise same-sex sexual activity, gay men and other men who have sex with men were more than twice as likely to be living with HIV. For example, in Zimbabwe, where homosexual acts are illegal, many men who have sex with men do not know their HIV status or have access to treatment.

“We face the uncomfortable truth that human rights violations - including stigma and discrimination, violence, punitive laws and practices - determine the impact of the HIV epidemic on our community of people” Marc Angel (S&D) and Sophie in t’ Veld (Renew Europe)

This is not only a matter of concern for our partner countries, but it is also a major issue on our own doorstep.

The European Centre for Disease Prevention and Control (ECDC) showed in a 2019 report that availability of PrEP (pre-exposure prophylaxis) in Europe was fragmented, due to a PrEP gap for about 500,000 men who were very likely to use PrEP but unable to access it.

This is disturbing, because PrEP is highly effective at preventing HIV acquisition when taken as prescribed and is furthermore regarded as an essential element in the ‘combination prevention’ necessary to reach the Sustainable Development Goal of ending the AIDS epidemic by 2030.

The incomplete access to HIV services, most importantly to PrEP, puts the health of LGBTI people across Europe at risk. This situation is inexcusable: it is fully preventable, if only political choices would prioritise such access.

The marginalisation of LGBTI people in various EU Member States goes hand in hand with a real threat to their health and safety. This needs to stop.

The 2016 United Nations General Assembly High-Level Political Declaration on Ending AIDS recognised that discrimination, particularly discriminatory and abusive use of law enforcement powers, creates significant barriers to people’s health and wellbeing, including their access to HIV prevention, treatment and care services - barriers that governments have committed to removing.

Stigma and discrimination have been shown to increase violence, abuse and harassment against LGBTI people and cause significant harm to their physical and mental health and wellbeing, their inclusion in society and their ability to access work, education and essential (health) services.

The COVID-19 Crisis has worsened these barriers for LGBTI people, as has been well documented by both the ECDC and UNAIDS globally.

COVID-19 has increased the stigma and discrimination of LGBTI people and worsened their access to basic – yet life-saving – HIV health services because of closure of services, interruption in access to medicines and deprioritised health interventions.

Research has indicated that COVID-19-related service disruptions could lead to more than 500,000 extra AIDS and TB-related deaths. Indeed, COVID-19 has highlighted an important lesson learned from the HIV response: health is critically interlinked with human rights, as well as other critical issues, such as socio-economic and gender inequality.

The human right’s dimension in the fight against HIV is paramount. We cannot tolerate the discrimination and stigmatisation of LGBTIQ persons and other vulnerable groups when it comes to access to prevention and treatment. EU Member States have to set an example in this global fight.”

As Co-Chair of the LGBTI Intergroup and Co-Chair of MEPs for SRR, we will continue our efforts to ensure respect and further the right to health and wellbeing for LGBTI people, particularly those at risk of and living with HIV.

We will do so by working towards its reflection in official European Parliament positions. We will not only the monitor the rights of LGBTI people but also the consequences of their violations in terms of health and HIV in order to leverage influence in Parliament and with the Council and Commission. 

We will continue to engage with civil society in the EU and in partner countries to comprehensively understand and monitor the challenges faced by LGBTI people and those at risk of and living with HIV for improved legislative monitoring and amendments. These concerned efforts must reflect the European Union’s global solidarity in action.

Lastly, as an Intergroup, we will be closely engaged in the 2021 UN High Level Meeting on HIV/AIDS to monitor the commitments of the EU Member States, so that we do not backslide on the international community’s commitments made towards our LGBTI people, but also to ensure that we reach the target of ending AIDS as a public health threat by 2030 for all people at risk of and living with HIV, in all their diversity.

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