LGBT in Zimbabwe still queer

 Picture taken from www.milehighgayguy.com

The first reported case of AIDS in Zimbabwe occurred in 1985.  By the end of the 1980s, around 10 percent of the adult population was thought to be infected with HIV. However, 30 years later stigma and discrimination based on sexual orientation or gender identity continues to drive new HIV infections and is an obstacle to treatment efforts.

The right to health is entitled to everyone. Access to HIV treatment, care and support belongs to everyone. Can the same be said when it comes to Lesbian Gay Bisexual Transgender (LGBT) communities in Zimbabwe?

Censual sexual intercourse between men is still criminalised in Zimbabwe.  This criminalisation of consensual intercourse between people of the same sex fuels  homophobic and transphobic which is arguably the number one factor that has made it hard for the LGBT community to access sexual reproductive health and rights (SRHR) services.

The LGBT community in the country seems to be invisible and almost non-existent. Barriers of stigma, human rights violations continue to dog this community especially for people that don't have the financial muscle to seek assistance from private health institutions. SRHR services are so far accessible when preferred identity is assumed. 

I spoke to quite a number of people from the LGBT community at the sexual rights centre (SRC) stand and they shared with me several obstacles faced when it comes to the right to health.

“I went to the clinic the other day. I was consulted by a nurse. I shared with her my fears that I could be infected with an STI. She was polite, understood my fears at first but her attitude changed until I revealed to her that my partner - female, wasn’t aware of what I had been facing. She closed her book and told me to leave because; it wasn’t possible for one female to infect the other with an STI. I left without getting any help. Weeks later, when I had enough money, I went to a private surgeon, who treated me this infection without questions asked,” said Ramone*

According to a survey conducted by the SRC, it was revealed that people from the LGBT communities are more afraid of the attitudes they have to deal with when testing for HIV rather than knowing their HIV status.

 “While total engagement with the government and main health institutions remains a hard to reach goal due to the level of homophobia and transphobia in the country, much can still be done to increase access to health services in Zimbabwe by the LGBTI community. In the fight and reduction of HIV, there is need for increased awareness of transmission of HIV and STIs to decrease the vulnerability for this community,” said Samantha Ndlovu, SRC programs coordinator.

UNAIDS has set a 90:90:90 target for 2020 to accelerate reaching epidemic control 90 percent of PLHIV know their status, 90 percent of those that know their status are adherent on ART, 90 percent of those on ART are virally suppressed.

This year World Aids Day 2015 Theme has been envisaged to be “Getting to Zero” by the World AIDS Campaign. There will never be a “getting to zero” when stigma and discrimination is not completely wiped out especially on key populations such as LGBT. Until Zimbabwe comes to point when access to HIV treatment, care, support and all forms of health services, favours no sexuality, efforts made to reduce Africa’s prevalence rate will just go unnoticed.

40 % of minors in Zimbabwe sell sex

Picture taken from chronicle.co.zw

Forty percent of young people in Zimbabwe started selling sex before the age of 18, it has been revealed.

According to The Aids Fonds – Stepping Stones, Sexual Rights Centre (SRC), a Bulawayo based organisation, conducted a needs assessment among young people selling sex.

The findings stress the importance of recognised minors and young people selling sex as a reality that requires a pragmatic response to ensure protection of their SRH rights, as well as their human rights

The Aids Fonds – Stepping Stones project is funded by the Ministry of Foreign Affairs of the Netherlands is being implemented in 18 countries across Latin America, the Middle East, Africa and Asia. Community based organisations conducted needs assessments in Botswana, Egypt, Ethiopia and Zimbabwe. The research entailed in-depth interviews (Unstructured and semi-structured), a section of survey and focus group discussions in 12 countries, with 635 participants between 14-28 years of age.

Topics included needs, desires and obstacles in daily life; the context of selling sex; experiences with violence; knowledge of their; ways of generating income; and access to health services.

“Poverty, escaping a restrictive home environment and peer pressure to upgrade lifestyle, None of the participants consider themselves forced to sell sex by others.”

The human rights of minors and young people selling sex are often violated by the police as 51 percent are not aware of having legal rights.

“All participants started to have exchanged sexual favours with the police to avoid arrest. The police rarely file reports of violence against young people selling sex.”

Stigma and discrimination by health professionals often hampers young people selling sex to access   sexual and reproductive health and rights (SRHR) services.

“Sixty-seven percent experience stigma and discrimination because they sell sex. They prefer to visit traditional healers instead of qualified health professionals.”

Recommendations from findings included: “Creation of support and referrals systems for minors and young people selling sex. There is need to sensitise health professionals and police to reduce stigma and harassment of minors and young people selling sex.”

Minors and young people who sell sex are one of the most marginalised and vulnerable groups in society. When community organisations encounter minors working on the streets and in brothels, they face a difficult: how to work with them without risking being seen as encouraging them into the sex industry? As a result, young people and minors selling sex are often ignored in sexual and reproductive health, HIV and human rights interventions, despite their vulnerability.

Stigma against MSM continues to rise in Africa

African Men for Sexual Health and Rights (AMSHeR) launched a preliminary report that documents the typology of stigma and discrimination faced by (Gay Men, Men who have sex with men (MSM), Transgender who are HIV – positive (GMT+) at the recently ended 18^th International Conference on AIDS and STIs in Africa (ICASA) 2015.

The report also speaks on the best practices in addressing stigma and discrimination against GMT+ .

According to Kennedy Otieno who is the overall GMT+ coordinator, the preliminary report was based on a literature review and key informant interviews carried out between September 28th and October 26th, 2015. An online survey is also planned as an immediate follow up to key informant interviews.

Picture taken from the body.com

“The protocol was inspired by key topics from the Stigma Index of People living with HIV. Experiences of GMT+ explored stigma and discrimination community, social and service settings. Additional questions exploring the structural determinants of stigma and discrimination – such as access to redress/remedy - were included in the protocol.

“16 GMT+ individuals were selected as key informants for in-depth interviews. The individuals were selected through nomination and recommendation by the GMT+ group and AMSHeR member organisations. Interviews were conducted along the themes and topics agreed in the protocol,” He added.

None of the reviews described direct experiences of stigma and discrimination People living with HIV (PLWHIV) or within LGBT groups. However, the UNAIDS review of stigma index reports in East Africa revealed specific themes, which could be linked to discrimination:

•             LGBT Organisations (including those working on HIV issues) feel excluded from the stigma index process as a whole.

•             In the review, LGBT groups felt that the sampling methodology did not reach their membership and that the Index also did not include questions that reflected their issues or concerns. And more specifically, the question of stigmatisation on the basis of sexual orientation or gender identity within PLWHIV communities is never asked.

In Liberia, it was revealed that they were not being included in the study from the start, but after much lobbying and advocacy some GMT + individuals were selected to participate. Despite this effort; subsequent issues arising from GMT+ participation were never analysed or published in the final report.

GMT+ populations are especially vulnerable due to specific stigma and discrimination related to the socio-cultural environments, their identities and sexual practices.
The review of stigma index reports reveals that rights abuse, inability to access care and experiences of stigma and discrimination were more frequently reported by GMT+ respondents than the general HIV group.

The report notes the higher vulnerability of GMT+ due to their sexual orientation/practices.  The report also notes the difficulty of reacting to cases of discrimination or right abuses:  “These cases are more complex: the non-acceptation of those practices does not facilitate a favourable action to defend them”. Furthermore, the Gambia report noted that “key populations” (in general) “are hidden and silent even among PLHIV network and support groups”.

How GBV connects with HIV

Gender based violence (GBV) is rooted in socio-economic inequality and can take many forms including emotional, mental, sexual, verbal, and physical abuse. GBV can affect males and females but women and children are most vulnerable because they are seen as occupying inferior positions to men.

Although it is argued that women are biologically more vulnerable to HIV infection, it has been found that women who are exposed to GBV are also more likely to be HIV-positive because of the small tears in the vagina which allow HIV to enter the body can occur during the often violent act of rape while the use of condoms cannot be effectively negotiated for by most women.

In an interview with Nontyatyambo Makapela from the AIDS legal network (ALN), a human rights organisation based in South Africa, I came to realise that violence and other rights abuses against women have become an integral part in the women’s rights discourse. Meaning there is arguably a  link between high cases of GBV against women and the high HIV prevalence rate by women.

“Our rights are violated everywhere as women, and because of my gender I am more prone to discrimination. There are double layers, different layers of violations that women have to go through so basically these are the realities of faced by women in the contested of HIV,” says Makapela.

 Picture taken from www.jamaicaobserver.com

She further explains how women are more vulnerable to HIV: “In reality a woman can get access to a female condom at the clinic but it’s another story when she gets home she is then compelled to negotiate the use of that female condom with my partner.”

Recently, the National Aids Council (NAC) identified gender imbalances as one of the key drivers of HIV. According to research, women in Zimbabwe account for more that 60 percent of the 1.2 million people living with HIV in the country.

Now it is therefore our role to play as society to ensure that women are not at risk to such factors that will at the end of the day make them vulnerable to diseases like HIV.

1.2 million condoms distributed at ICASA 2015

There is a renewed emphasis on condoms at the18th edition of the International Conference of AIDS and STIs in Africa (ICASA) in Harare, Zimbabwe from 29 November to 04 December 2015 as a campaign promoting their use and availability has been re-launched with the distribution of over one million condoms.

The CONDOMIZE! Campaign aims to highlight the effectiveness of condoms, male and female, for HIV prevention and calls on governments, donors and users to intensify access to, and demand for, quality condoms as a primary defence against HIV.  It advocates investing significant resources and materials into promoting condom use as the most efficient and available prevention technology in the global AIDS response. Challenging the stigma that still often surrounds condoms is also a key objective.

Picture taken from twitter.com

According to Adrian Gonzatez, creative director for CONDOMIZE, the most popular condom during ICASA 2015 was the glowing condom.

“A total of 1.2 million male condoms and 15 000 female condoms were put aside for distribution before, during and after the conference. The condoms that glow in the dark proved as the most favourite amongst members of the public because we completely ran out of them by Wednesday,” he added.

The initiative was born during the 2010 International AIDS Conference in Vienna and is a partnership between UNFPA and The Condom Project, in close collaboration with Bahamas Red Cross; DKT International, a social marketing NGO; Durex, the Female Health Company, the International AIDS Society and UNAIDS.

In addition to mass condom distribution, rap music with short videos has been created, using key messages from senior international leaders about the importance of condom use. These messages are being shown on TV screens throughout the conference.

Gonzatez said CONDOMIZE is campaign of attraction than promotion in modern and exciting ways by helping people understand very serious issues and the need to encourage condom use.

At ICASA 2015, the campaign is using education, distribution of the condoms, negotiation of condom use and destigmatisation.

The campaign noted that there is a considerable shortfall in condom availability in a number of countries. For example, in 2011 in sub-Saharan Africa there were only nine condoms available per man per year and only one female condom for every 10 women. These condoms were mostly provided by donors as most low- and middle-income countries do not have a budget line for condom procurement.

Condoms are not demons

Condoms must be used even if they are not prayed for says Pastor Paul Sanyangore at the CONDOMIZE zone during the 18th edition of the International Conference on Aids and STIs (ICASA) 2015.

Sanyangore's words of wisdom came barely a month after he prayed for condoms during a church service which left many questioning the moral element of having condoms in church.

"I encourage people to play it safe. Condoms are there to help you. They must be used even if they are not prayed for but if someone comes and says I should pray for them - I will. Condoms are not from the devil," said Sanyangore.

Although he said HIV is from the devil, he highlighted that condoms only protect people from HIV the physically.

 “With condoms, they are made to address the physical side of HIV but we need to also understand that HIV has a spiritual side. HIV is also a demon, from the devil. With my spiritual expertise, I can only address what I can, what I am able to address. So when I pray for them (condoms) I will be addressing the demon of HIV. The anointing and the power of God protects spiritual.

“Condoms are just a physical side of HIV, the anointing or the power of God addresses the spiritual side. If u came to me and they say pastor pray for it, I will pray for it,” said the man of God.

Sanyangore further explored the spiritual angle of HIV which has not been talked about by most spiritual leaders in the country.

“Condoms are not demons, condoms are not bad. You need to understand that if you put HIV, and put a condom there and if I tell you to pick from the two which one is from the devil?” he said.

The man of God also mentioned the role that churches can play in the fight against HIV and reaching the 90:90:90 target by UNAIDS.

“We are a church we believe in families, infact we are a product of families. The more people talk about these things in the families the more they are addressed,” Sanyangore said.

However, there were other members of the public that did not go well with Sanyangore’s sentiments.

“The issue of anointed condoms is not an issue. Condoms should not be anointed because they go through quality assurance test… There is no use to take condoms to church and have them anointed,” said a participant during the dialogue.

The remarks by Sanyangore come at a time when there seems to be a gap in churches as far as condom education is concerned and the methods that congregates can use to protect themselves from HIV.

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Breaking down barriers

Today, which is the international day of disabled persons, comes at a time when language and physical barriers continue to affect people living with disability.

Commemorations during the 18^th International Conference on AIDS and STIs in Africa (ICASA) 2015 will be done at the Disability Zone in the Community Village later on during the day.

This year’s theme is: Inclusion matters: access and empowerment of people of all abilities.

“The intersection of World Aids Day on December 1 and the World Disability Day on December 3, provides an opportunity to reflect on the effectiveness of the global AIDS response for the 1 billion people,15 percent of the world’s population, who live with a physical, sensory (i.e blindness, deafness), intellectual or mental health impairment. Unfortunately, there is little encouraging to report,” read a statement from the International Disability and Development Consortium (IDDC) HIV and Disability Task Group.

Arguably a greater barrier than stigma and prejudice is ignorance of what it means to live with a disability. Need for greater awareness extends to government and public health officials, health providers and community outreach workers, the very people charged with ensuring that HIV education and services, and more broadly, sexual and reproductive health, universal health coverage and gender based violence (GBV) programmes reach everyone.

In an interview with Dr Aida Zerbo from Handicap International in Senegal and also the manager of Project Access, a plethora of challenges that threaten matters of inclusivity were highlighted.

“In Africa, when it comes to access to sexual reproductive health and rights, there is no available information which in the long run fuels misconceptions such as AIDS being a myth and that it is curable. Without readily available, adequate and inclusive information, people living with disabilities are the faced with a big challenge of access health services.

“In the few instances where information could be there, challenges of language, physical and basic communication barriers make it impossible for disabled people to interact directly with health services providers. At the end of the end, there is no way of knowing if one has received the right services for the problem they have,” she said.

Dr Zerbo also mentioned that the right to privacy for people living with disability was violated by most service providers owing to communication barriers.

“When it comes to counselling, before or after testing, so many times we have heard and experienced cases whereby the confidentiality of disabled persons are broken due to the introduction of a third party who plays the role of the interpreter because most health services providers lack inclusive training on how to deal with such people,” she added.

The annual observance of the International Day of Disabled Persons was proclaimed in 1992, by the United Nations General Assembly resolution. The observance of the Day aims to promote an understanding of disability issues and mobilise support for the dignity, rights and well-being of persons with disabilities. It also seeks to increase awareness of gains to be derived from the integration of persons with disabilities in every aspect of political, social, economic and cultural life.