Shedding the dreaded HIV skin

Sonam Penjor Paro

Transgender, sex workers, men who have sex with men and drug users are considered key population groups who are particularly vulnerable to Human Immune Deficiency Virus (HIV).

They also face lack of adequate access to health and social services, and sometimes they are also referred to as ‘vulnerable’ groups.

A facilitator from OxMedia consultancy firm, Nidup Gyeltshen presented their findings during the two days media literacy training on media engagement on HIV and key population groups in Paro which concluded on 19 March which was organized by the Lhak-Sam.

Lhak-Sam is a non-profit organization which works to help the lives of People Living with HIV (PLHIV) in Bhutan. Lhak-Sam (BNP+), a network of positive people in Bhutan was formed in September 2009 by a group of positive people in Thimphu with the main aim of supporting each other.

Nidup Gyeltshen presented their finding and said that members of all key groups continue to experience intense stigma and discrimination, legal barriers and constraints to accessing services and often low prioritization by the public health systems.

He presented that due to self, perceived and enacted stigma, these key populations remains highly hidden and are likely to experience mental health problems. Leading many use alcohol and drugs as coping mechanism. And their disconnection from the health systems makes it harder for them to access health services and medication.

Globally, sex between two men is 27 times more likely to acquire HIV, and sex workers are 13 times more likely to become infected with HIV than adults in the general population.

According to the UNAIDS, sex workers are those female, male transgender adults and young people who receive money and goods in exchange for sexual services.

Those group who are involved in sex activities, he presented that they are facing issues of criminalization in many countries drive this key population underground. “Sex is illegal by law and hence sex workers are not known and cannot reach to provide health services although they are considered at risk of contracting and transmitting HIV in the community.”

The findings also show that they also face issues that they are disowned by family, friends societies and their employers and do not receive social support. “Many sex workers do not avail health services fearing persona and legal consequences and they are usually associated with women which is a major myth.” Also they are considered as one of the groups that are most likely to respond well to HIV prevention programs.

Similarly, for transgenders, according to the UNAIDS, are 49 times more likely to be living with HIV than the general population.

Transgenders experience high levels of stigma, discrimination, gender-based violence and abuse, marginalization, and social exclusion.

They are also more likely to have dropped out from the school, move away from family and friends, and faced workplace discrimination limiting their educational and employment opportunities.

And only the means of living for the most viable form of income, especially for transgender women is through sex work, shows the finding.

For people who use drugs and other alcoholic related products, despite the increased risk of contracting HIV for people who use drugs, they are among those with the least access to HIV prevention, treatment and healthcare.

The finding further shows that they also face varying levels of social stigma and discrimination. Due to the criminalization of drugs use, accessing other healthcare services are a major challenge since they are usually stigmatize by friends, families, and teachers and even looked down by the health workers while availing health services.

Similarly, for people living with HIV, they too faces numerous challenges. However, the studies shows that HIV is no longer means of certain death, due to the tremendous advancement made in science and medication, many HIV patients now have the same life expectancy as a person who does not have the virus.

However, stigma and discrimination continue to remain exceedingly high among the general population. “Stigma has become more dangerous than the virus itself.”

Stigma deters access to HIV testing and treatment services, making onwards transmission more likely. The removal of barriers to these services is key to ending the HIV epidemic.

In every setting key population, they are disproportionately affected by HIV and have higher morbidity and mortality rates than the general population.

Meanwhile, the finding shows that in most countries inadequate coverage and poor quality of services for key population groups continue to undermine the response to HIV.