PrEP, a Ugandan activist speaks, transgender rights in India and “sex slave rescue” . . .We’re reading about lessons from the most affected populations

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NewWWRI have not been silenced – In this commentary published on the International AIDS Society blog, Ugandan physician Paul Semugoma discusses the barriers gay African men face in accessing HIV/AIDS services, and how the epidemic is driven in part due to societal, cultural, and legal discrimination against sexual minorities. “…I have come to understand that fear and prejudice about our sexuality have stood like a range of mountains between us and prevention, care, and management of HIV,” he writes. Semugoma alludes to Uganda’s recently passed anti-homosexuality law, writing “It is this prejudice that considers advocacy and education about safer gay sex a ‘promotion of homosexuality.’ It is this prejudice that makes our efforts to save lives an offence in the eyes of the law.” Semugoma writes that we must overcome our own ignorance and prejudice against sexual minorities to overcome barriers to HIV services.

Recognition of India’s third gender could boost Global Fund-supported programs for sexual minorities – In this post included in Aidspan’s latest Global Fund Observer newsletter, Karanja Kinyanjui outlines how the Indian Supreme Court’s ruling in April that transgender people should be treated as a third sex in public facilities could help reduce the stigma that prevents transgender Indians from accessing health services, and also help improve effectiveness of Global-Fund supported programs. With HIV prevalence as high as 8.8 percent among transgender Indians, HIV/AIDS programs need to be tailored to meet the unique needs of the Indian transgender community, said James Robertson, executive director of India’s HIV/AIDS Alliance. “Earlier HIV prevention efforts included transgenders as a sub-group of MSM and did not respond adequately to the distinct needs of transgenders and failed to understand the challenges and contexts that contribute to HIV risk for these populations,” said Robertson. The progress from this recent ruling may be hampered by the Supreme Court’s recent reversal of a 2009 High Court ruling decriminalizing homosexual behavior. “This law has had a chilling effect on India’s gay community and is wider-reaching than the transgender law, with deeper implications for outreach, awareness and work to reduce stigma against the population.”

View on Gender: A menu of choices for HIV prevention – Pre-exposure prophylaxis should be included as a viable HIV prevention method for people most at risk, such as female sex workers, according to this article by Joshu Howgego on SciDev. The question remains, however, on how to make drugs best available for PrEP, which has shown to be effective in clinical trials. Anna Wheelock, a behavioral scientist at Imperial College London, says there are several demonstration projects ongoing to show if PrEP works in real-life situations, including a project looking at PrEP use by transgender Indians. “Everyday life is different from a clinical trial, which is a very controlled environment,” she says. “PrEP is for women, men and transgender people at risk of infection who have made the informed decision to opt for that prevention method from a pool of different alternatives,” she says. “PrEP, however, is not as innocuous and cheap as condoms. Thus, countries may need to prioritise certain groups, depending on their HIV epidemic.”

The Price of a Sex-Slave Rescue Fantasy – “Now Ms. Mam has been exposed before her donors and the Western media who anointed her and made fighting sex trafficking a kind of industry in itself, while sex workers suffered the consequences,” says this New York Times op-ed on the resignation of anti-sex trafficking crusader Somaly Mam from her own foundation this week. Ms. Mam resigned after a Newsweek article exposed that stories – including Ms. Mam’s own story — of girls sold into sexual slavery that the foundation had highlighted to raise funds, as well as “awareness” of sex trafficking, were fraudulent.  Appearing in the same publication where Nicholas Kristof’s columns detailed graphic descriptions of the abuse and torture endured by “victims” “rescued” by Ms. Mam’s work, this op-ed highlights the conflation of sex work and sex trafficking. That conflation has driven such ill-considered policies as the U.S. “anti-prostitution oath” which prevented U.S. AIDS-fighting money from supporting sex worker led organizations. The op-ed notes that “accurate data, effective protection of victims, and the support of workers in their own organizing” has been recommended to protect women involved in sex work.  With the U.S. Supreme Court having ended the anti-prostitution oath requirement last year, this piece highlights the importance, when trying to improve the lives of marginalized people of responding to realities on the ground, rather than myths.

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