World Hepatitis Day 2013: Making Hepatitis C a Priority

Sixteen million people inject drugs worldwide. Three million live with HIV, and two-thirds of them live with Hepatitis C. (Photo by Francis Joseph for India HIV/AIDS Alliance)

Sixteen million people inject drugs worldwide. Three million live with HIV, and two-thirds of them live with Hepatitis C. (Photo by Francis Joseph for India HIV/AIDS Alliance)

A dear friend of mine was struggling as a single mother, working two jobs and balancing drug use. To make things simpler, she quit the jobs and started working from home. Unfortunately, her drug use turned out to be more problematic than anticipated. Her situation was further complicated when she was diagnosed as positive for Hepatitis C, a viral disease that leads to the inflammation of the liver and related complications.

With no medical insurance, she faced a financial challenge to cover the six-month long treatment. At first, she got contributions from family and friends and then a loan, and lastly she sold her jewellery. She recovered only to be hit with the virus again. This time her condition deteriorated so quickly that she was not able to make it through a second round of treatment. Only half of those who are treated actually recover. My friend’s is just one of the many stories of people struggling with Hepatitis C.

Hepatitis C represents a huge public health problem in India and globally. According to the World Health Organization about 150 million people are chronically infected with the Hepatitis C virus, and more than 350,000 people die every year from Hepatitis C-related liver diseases. The Hepatitis C virus is more infectious than HIV. An estimated 10–12 million people in India are infected with Hepatitis C, including 50 percent of people who inject drugs (PWID) nationally and 90 percent of PWID in the northeast. Left untreated, Hepatitis C can lead to liver cirrhosis, liver cancer or liver failure.

Hepatitis C is especially of concern for those co-infected with HIV, as several studies have shown that HIV-Hepatitis C co-infection leads to increased rates of disease progression. PWID are especially vulnerable to infection by both HIV and Hepatitis C; co-infection rates are as high as 93% among PWID in Manipur. However, unlike first- and now second-line HIV treatment, which is available to people living with HIV who need it in India, Hepatitis C treatment is not available in government hospitals largely due to its high cost, and health programmes for PWID typically do not screen patients for Hepatitis C due to the unavailability of treatment. Consequently, this results in high morbidity and mortality among PWID.

To address this concern, our Government of the Netherlands-supported Hridaya programme disseminates information on Hepatitis C prevention through outreach and counselling sessions at drop-in centers (DICs) in 36 sites in four states: Bihar, Jammu, Haryana and Uttarakhand. The programme also identifies clients and refers them for testing. Those found to be Hepatitis C-positive are further educated on self-care and positive prevention. The programme’s outreach team works with spouses and families of PWID, explaining Hepatitis C risk and prevention in the context of injecting drug use.

To address the growing problem of HIV-Hepatitis C co-infection among women who inject drugs, our Elton John AIDS Foundation-funded Chanura Kol project has initiated Hepatitis C interventions. Women enrolled in the project are educated about transmission risks, prevention strategies, and the importance of testing.

With both programmes, Alliance India is working to ensure that Hepatitis C prevention education and treatment literacy become a priority for PWID and a core part of this country’s efforts to improve the lives and health of PWID.

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The author of this post, Simon W. Beddoe, is Advocacy Officer: Drug Use & Harm Reduction.

With funding from European Commission, the Asia Action on Harm Reduction programme supports advocacy to increase access by people who inject drugs (PWID) in India to comprehensive harm reduction services and reduce stigma, discrimination and abuse towards this vulnerable population. The three-year programme in the beginning will primarily engage with PWID and local partners in Bihar, Haryana, Uttarakhand, Delhi and Manipur and  gradually extend its reach across India.

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Technical Support for a Stronger HIV Response in South Asia

The Alliance Regional Technical Support Hub, South Asia team in New Delhi. (Photo by Shaleen Rakesh for the South Asia Hub)

The Alliance Regional Technical Support Hub, South Asia team in New Delhi. (Photo by Shaleen Rakesh for the South Asia Hub)

A transgender from Coimbatore in Tamil Nadu, Padmini takes pride in her role as a Technical Support Provider (TSP) for Alliance India’s Koshish programme. Supported by European Commission, Koshish advocates for sexual and reproductive health and rights (SRHR) of people living with HIV (PLHIV) and key populations in India. She enjoys a sense of satisfaction as she supports community-based organisations (CBOs) for men who have sex with men, sex workers and transgenders in her home state, helping them take their advocacy agenda on SRHR forward. She makes regular technical support visits to these CBOs and provides them handholding support in organisational development.

Padmini is one of the many TSPs trained by the Alliance Regional Technical Support Hub for South Asia (South Asia Hub) through the Koshish programme. Working with CBOs to identify candidates from key population groups with potential to be good trainers, the Hub has developed a pool of TSPs for Koshish by working with community members like Padmini. With ongoing backstopping to the TSPs, the Hub ensures that the technical support provided is of good quality and meets the needs of programme CBOs. The model encourages TSPs to build on their own experiences and training to further transfer their knowledge and skills to CBOs. This approach has demonstrated measurable results in improving the capacity of CBOs to advocate for SRHR programming for PLHIV and key populations.

Serving a range of clients from different sectors, the technical support provided by the South Asia Hub is based on a philosophy the emphasizes long-term technical assistance, local capacity building, and effective transfer of skills. Stressing South-to-South cooperation, the Hub contributes to the development of organisations able to have a sustained impact on challenges in HIV/AIDS and public health. For example, the South Asia Hub has been engaged by donors like the Global Fund to Fight AIDS, TB and Malaria and GIZ to provide technical assistance to their grant recipients to improve performance.

In diverse contexts and settings across nine countries in the region, the South Asia Hub offers technical support solutions in organisational development, programme implementation, financial & grant management, monitoring & evaluation, and research. In response to the specific needs of each assignment, the Hub follows a thorough and participatory process, which includes active engagement with the client to develop clear terms of reference; sourcing an appropriate consultant or team; management of contracts and logistics; consultant supervision; and the development of deliverables that reflect our commitment to excellence.

To learn more about the South Asia Hub and our work, please visit our website or mail us at info@southasiahub.org.

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The author of this blog Amit Kumar Pandey is Technical Officer, Alliance Regional Technical Support Hub, South Asia.

The Alliance Regional Technical Support Hub for South Asia was established to build the capacity of civil society organisations, government and the private sector in the region to respond more effectively and efficiently to HIV/AIDS. The South Asia Hub primarily serves nine countries in South Asia: Afghanistan, Bangladesh, Bhutan, India, Maldives, Myanmar, Nepal, Pakistan, and Sri Lanka. The South Asia Hub is part of the global technical support network set up by the International HIV/AIDS Alliance that leverages the Alliance’s implementation and capacity building expertise from around the world. In South Asia, we draw on the experience of a range of regional partners and on a pool of proven consultants who reflect our commitment to excellence and impact.

From India with Love: Bringing Pehchan to the Trans-Health Conference in Philadelphia, USA

Phil2_final“FINALLY!!!” read the email from Jacsen, coordinator of this year’s Trans-Health Conference in Philadelphia, as he sent my plane tickets on the morning we were scheduled to travel. The ticket had already undergone three corrections to my name, and I had lost all hope that I would actually make my maiden trip to the US to attend the Philadelphia Trans-Health Conference. With this news, my apprehensions vanished!

It all started last November with a forwarded email about the conference. An annual event started twelve years ago, the Trans-Health Conference gives the transgender community a platform to discuss issues that affect our health. Excited by the prospect of bringing our experience in India to this meeting, my colleague Simran Shaikh and I proposed a workshop on Equal Access/Equal Health: Empowering transgender and hijra communities across India through advocacy, community mobilization and capacity building under Pehchan programme with the objective to share good practices introduced for transgenders and hijras in India under our Global Fund-supported Pehchan programme. Our proposal was accepted, along with a scholarship award from the conference that made our participation possible. With travel arrangements in place, we were on our way.

During our journey to America, Simran and I did not miss any opportunity to sensitise the people we met about our lives as transgenders. We interacted with airport staff, custom officers and screening guards. I still remember during the security screening in India, a police official was astonished that two hijras were carrying cameras and laptops. He could not stop staring at us as he found himself rethinking his attitudes towards our community. British Airways staff accompanied us through the mad rush at Heathrow airport in London to help us make our flight connection. One acknowledged his ignorance as he waved goodbye, ‘I wish I’d made an attempt before to understand the transgender community. It took me 30 years to make the first step!’

The three-day conference in Philadelphia was a joyous occasion for us to represent India’s transgenders and hijras. The organizers reported 3,500 people had registered. The biggest surprise for me was the number of young transgenders between 14 and 21 years of age, not only participating but conducting workshops on issues like transition and family support along with their parents, who discussed support group formation and the importance of safe spaces for trans youth. Sessions covered a range of topics, including: intersexuality; feminisation and hormonal treatment; HIV & AIDS; dealing with trauma; naturopathy and yoga; and spirituality and religion. It was eye-opening to realise across the globe how similar the challenges of transgenders are: rights, security and dignity.

One of the most interesting sessions for us was experience sharing and story-telling. In this session, we described the Pehchan Hijra Habba and highlighted how through community capacity building and visibility efforts, we can build inclusive, conscious communities that legitimize and honour all forms of gender identity. Our workshop on Pehchan was attended by more than thirty trans community members, many from the US but others from around the world. People were astonished with the sheer scale of the programme and the implementation strategies adopted under Pehchan, including how we are collaborating with government. Natalie, who travelled from Israel, shared the progress being made by transgenders in her country also with government support.

As we said our goodbyes to the many new friends we’d made in Philadelphia, it was amazing to realise the common points connecting the global transgender movement. In some ways, India has a remarkably progressive understanding of the trans community. In trying to understand the trans experience in other countries, it gave us new insights into the complex challenges that India faces in responding to the needs of gender minorities. We were honored to meet trans leaders from around the world at the conference, and it gave us great pride to share our own efforts to improve transgender and hijra health and helped us cherish the charismatic leadership of India’s transgenders and hijras who paved the way for us.

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The authors of this blog, Abhina Aher and Simran Shaikh, represented Alliance India at the 2013 Trans-Health Conference in Philadelphia. Abhina is Programme Manager: Pehchan and Simran is Programme Officer: Pehchan.

With support from the Global FundPehchan builds the capacity of 200 community-based organisations (CBOs) for men who have sex with men (MSM), transgenders and hijras in 17 states in India to be more effective partners in the government’s HIV prevention programme. By supporting the development of strong CBOs, Pehchan will address some of the capacity gaps that have often prevented CBOs from receiving government funding for much-needed HIV programming. Named Pehchan which in Hindi means ‘identity’, ‘recognition’ or ‘acknowledgement,’ this programme is implemented by India HIV/AIDS Alliance in consortium with Humsafar Trust, PNRO, SAATHII, Sangama, and SIAAP and will reach 453,750 MSM, transgenders and hijras by 2015. It is the Global Fund’s largest single-country grant to date focused on the HIV response for vulnerable sexual minorities.

The Best of Times, the Worst of Times: Do WHO’s New ARV Guidelines Serve the Needs of Key Populations?

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One of the highlights of the recently concluded 7th IAS Conference on HIV Pathogenesis, Treatment and Prevention in Kuala Lumpur, Malaysia, was the launch by World Health Organization (WHO) of new Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection.

Announced on 30 June 2013 at a satellite session, the new guidelines, if implemented at scale, could help avert an additional 3 million deaths and prevent 3.5 million more new HIV infections between now and 2025. At their core is the idea that earlier initiation of anti-retroviral (ARV) drugs will help people living with HIV (PLHIV) live longer and healthier lives.

The new guidelines recommend initiation of anti-retroviral treatment (ART) in all adults who have a CD4 count of 500 cells/mm3 or less, and priority should be given to individuals who have CD4 counts less of 350 cells/mm3 or less. Additionally the new guidelines also recommend that ART should be initiated immediately for PLHIV coinfected with TB or Hepatitis B and for those in serodiscordant couples. It also calls for Initiation of ART in all children infected with HIV below five years of age, regardless of WHO clinical state.

Soon after the launch, one of the conference participants, a self-identified MSM living with HIV, aptly described the new recommendations to me: ‘It was the best of times, it was the worst of times.’ One of the guiding principles behind the new recommendations is ‘promoting human rights and health equity,’ and for the first time WHO clinical ARV guidelines acknowledge the distinct challenges faced by key populations affected by the epidemic—men who have sex with men, transgenders, people who inject drugs, and female sex workers.

This is great progress for many reasons. The failure of the global HIV response to adequately acknowledge and address the barriers that prevent key populations from accessing treatment and related clinical services continues to be a gap of significant proportions. Structural, legal, institutional, and social forces keep key populations from entering into the continuum of care. For example, Alliance India conducted operations research in 2012 to assess the quality of HIV-related services for MSM and transgender populations in India. The research identified specific issues such as lack of confidentiality, lack of privacy, overall unfriendly environment at the service centre, and insensitivity amongst health-care providers at this country’s ART centres.

In fact, a recently published article in the New India Express describes how India’s transgenders continue to face serious barriers to accessing HIV treatment and other health services. Rather than face discrimination and stigmatizing attitudes, too many are avoiding clinics and not getting the care they need.  One transgender describes her experience, ‘When we go to big hospitals, the nurses send us away. They refuse to examine us because they feel disgusted to make physical contact with us.’

In India and elsewhere, key populations are routinely denied their right to health. They are refused treatment and other services and have little or no access to care and support. Like it or not, these are still the worst of times for too many key populations. Though these guidelines do offer hope and optimism, we need to reimagine how key populations access health services and ensure that governments and donors like the Global Fund and PEPFAR include expanded access for key populations as an essential component of their supported treatment programming. If we take the lives of key populations seriously, the promise of the WHO’s new ARV guidelines might just guide the way to a better future.

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The author of this post, Yadavendra Singh, is Senior Programme Officer: Capacity Building for Alliance India’s Pehchan Programme.

With support from the Global FundPehchan builds the capacity of 200 community-based organisations (CBOs) for men who have sex with men (MSM), transgenders and hijras in 17 states in India to be more effective partners in the government’s HIV prevention programme. By supporting the development of strong CBOs, Pehchan will address some of the capacity gaps that have often prevented CBOs from receiving government funding for much-needed HIV programming. Named Pehchan which in Hindi means ‘identity’, ‘recognition’ or ‘acknowledgement,’ this programme is implemented by India HIV/AIDS Alliance in consortium with Humsafar TrustPNRO,  SAATHII, Sangama, and SIAAP and will reach 453,750 MSM, transgenders and hijras by 2015. It is the Global Fund’s largest single-country grant to date focused on the HIV response for vulnerable sexual minorities.

Community Collectivisation to Sustain HIV Prevention: Findings from Avahan in Andhra Pradesh

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Community collectivisation empowers key populations such as female sex workers, men who sex with men and transgenders to voice their concerns and more confidently exercise their right to access healthcare and social welfare schemes. Photo by Peter Caton for India HIV/AIDS Alliance

Community collectivisation can help develop a stronger sense of purpose and interconnectedness among key populations (KPs) such as female sex workers, men who sex with men and transgenders. Sometimes known as ‘community mobilisation’, community collectivisation enables these groups to utilise their experience of vulnerability to overcome barriers they face and realize reduced HIV vulnerabilty and greater self-reliance. Collective action by KPs also empowers them to voice their concerns and more confidently exercise their right to access healthcare and social welfare schemes.

With support from the Bill & Melinda Gates-funded Avahan programme, a recent study led by Niranjan Saggurti of Population Council in collaboration with India HIV/AIDS Alliance was designed to demonstrate if community collectivisation is associated with consistent condom use and STI treatment seeking behaviours among female sex workers (n= 3,557) and high-risk men who have sex with men/transgenders (n=2,399) in Andhra Pradesh. Recently published in the journal AIDS Care, the study generated significant positive findings.

Entitled ‘Community collectivization and its association with consistent condom use and STI treatment seeking behaviors among female sex workers and high-risk men who have sex with men/transgenders in Andhra Pradesh, India’, the study showed that high levels  of collective action and participation in public events by both populations led to higher levels of consistent condom use, increased STI treatment seeking from government facilities, and improved ability to negotiate condom use.

The findings confirm the value of sustained community system strengthening to empower communities to meaningfully engage in national HIV prevention efforts and show the key role played by community collectivisation as an essential strategy to encourage consistent condom use and health seeking behaviours among KPs.

Read the complete study here.

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The author of this post, Dr. Parimi Prabhakar, is Director of Alliance India’s Regional Office in Hyderabad.

The Avahan India AIDS Initiative (2003-2014) is funded by the Bill & Melinda Gates Foundation. The programme aims to reduce HIV transmission and the prevalence of STIs in vulnerable high-risk populations, notably female sex workers, MSM, and transgenders, through prevention education and services such as condom promotion, STI management, behavior change communication, community mobilization, and advocacy. Avahan works in six states, and Alliance India is a state lead partner in Andhra Pradesh.

Alliance India at IAS 2013 Kuala Lumpur

The 7th Conference on HIV Pathogenesis, Treatment and Prevention is taking place this week in Kuala Lumpur. India HIV/AIDS Alliance is participating in this year’s meeting, including presenting four posters on our work. Congratulations to our staff for this great achievement.

Understanding Barriers Faced by Transgender and Hijra Communities in India to Accessing Gender Reassignment Services

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Not a ‘Minor’ Issue: Does HIV Prevention Programming Address the Vulnerabilities of Adolescent MSM and Transgenders under 18 Years?

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Mixing Sex and Drugs: Socio-demographic Factors Associated with Sexual Risk Behaviour among PWID

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Re-tooling Data Quality:  Implementation of an automated validation tool to improve data quality in large-scale HIV interventions for female sex workers under Avahan programme in Andhra Pradesh, India

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Four Years to a Different Me: Reflections on the Anniversary of the 377 Decision

On July 2, 2009, the Delhi High Court read down Section 377 of the Indian Penal Code, decriminalizing homosexuality in India. Four years on, the impact of this historic ruling still resonates in the lives of LGBT Indians. Photo by Peter Caton for India HIV/AIDS Alliance

On July 2, 2009, the Delhi High Court read down Section 377 of the Indian Penal Code, decriminalizing homosexuality in India. Four years on, the impact of this historic ruling still resonates in the lives of LGBT Indians. Photo by Peter Caton for India HIV/AIDS Alliance

‘I still cannot forget that moment. Though it happened some four years back, the memories stay with me. I tried every possible way, but it refuses to fade away. I live with it every moment of my life,’ said Shilpa in a soft voice.

I met Shilpa last week during a train journey to Jaipur. It was an early morning train, and mercifully there were not many passengers in my coach. I tried to catch some sleep, but as the train crossed into the Delhi cantonment station, I heard the loud voices of some hijras on board the train begging for money. As the three of them entered my compartment, one of them caught my attention: she stood at 5’2’’, had a petite frame and dressed in impeccable floral salwar suit. With an attractive smile and an elegant grace that preserved her dignity, she put forward her hennaed right hand to bless every passenger and beg.

The other two hijras of slightly shorter stature than the first stood behind her in complete silence but with same gesture – hands forward in expectation of at least a five-rupee coin. Many passengers ignored them, turning their heads away, cursing under their breath but loud enough for others to hear, ‘Oh God! What have I done today to see such cursed faces so early in the morning.’ All three of them pretended otherwise, but it clearly showed that they had internalized this humiliation and indifference.

As the one in the floral salwar approached me, I smiled and said, ‘Hi.’ She was perplexed at first, a bit hesitant as to how to return my greeting. Was it the first time that a stranger greeted her or even acknowledged her presence? Before she could respond, I gestured for her to sit next to me. Surprisingly, she sat without any reluctance. ‘This is going to be an interesting journey,’ I thought to myself. She silently signaled to the other two though her big kolhed eyes to continue begging in other compartments.

‘Hi, I am Rahul,’ I introduced myself in Hindi. Her smile broadened, ‘My name is Shilpa.’ Our conversation began but soon I realized it was she who took the lead, asking about my occupation, my trip to Jaipur, where I live in Delhi, where I’d stay in Jaipur. Then I asked about her life. She talked about how beautiful her childhood was and got excited as if unraveling some mystery. The other passengers looked on in disbelief, but I didn’t care. She described the delight of wearing her mother’s make-up, albeit secretly, and her desire to be an air hostess as they are so beautiful and always dress so nicely.

As she grew, she told me, she realized she could never achieve her dreams because she was born a male. In adolescence, her family scolded her for being feminine. She recalled one day in 8th class: ‘My teacher took attendance and when he called my name, he questioned derogatorily, “Are you like this since birth? So sissy, such a disgrace to your family.” Everyone in class laughed loudly. I stood there frozen. I did not know how to react. My eyes were in tears. No matter how hard I tried, I could not hide my feelings. One of the students commented, “Look he is crying like a girl…sorry, she is crying like a girl, or better still, it is crying like a girl.” After a while, the class resumed, but I did not speak to anyone. I could not concentrate.’

Shilpa continued, ‘There was no one I could share my pain of being “other”…or my joy. For my classmates that day was like any other, but it changed my life forever. Everything changed for me from that moment.’ Her eyes were moist, but this time she controlled her tears. After a few seconds, she carried on in the same soft voice, ‘I did not go home that day. I sat in a park. Ram Niwas Garden. In Jaipur. At around five in the evening, I noticed others like me, feminine just like me, wearing ladies’ clothes, jewelry, even lipstick. “So I am not alone,” I thought to myself.

‘I took courage and walked up to them. I stood in front of them. One of them noticed and smiled, “Who are you, beta?” I did not reply. Another continued, “Have you lost your way home?” Again I stood motionless just watching them in awe. The third one touched my cheeks and said to the others, “This boy is like us,” and then turned to me, ‘Am I right?” I smiled, nodding in agreement. They asked about my family, but I refused to say a word. They offered me tea and biscuits which I gladly took. Later they took me to their home, a dera where hijras live, a different world for me.

‘There were so many like me. They offered me female clothes. Though too big, I was happy to wear them. I danced the whole evening in that long skirt. I remember it clearly, a magenta ghaghara. Nobody called me names for wearing it. Everyone called me beautiful in that dress. I slept peacefully that evening, perhaps the best sleep ever. Next morning, the senior hijra whom everyone addressed as “guru” re-named me “Shilpa” and declared that from then on I was her daughter. I was so happy now to have an identity, one that resonates with my personality, my emotions and my desire to be a woman. From then I started my life as Shilpa and moved to Agra to live with my nani, the mother of my guru.

‘Did you ever try to reconnect with your family?’ I asked. ‘This is my family. I live with my family,’ came the answer. I corrected myself, ‘I mean your biological family.’ Unhappiness overcame her face, and she replied, ‘Yes, I tried to but through my neighbors. They told me that initially my family was a bit worried, but they neither searched for me nor filed a police report. Later they performed my last rituals and after that, my brother declared proudly that my family was finally free of the curse of “that feminine creature.” When I came to know all this, I was depressed and thought to end my life. My nani suggested that I do daily prayers, meditation, yoga but nothing helped. I still get nightmares. When I hear a group of people laughing, that memory of a fourteen-year-old being humiliated by his classmates and teachers returns.’

She stopped. I was quiet. She looked out of the window. After a few moments, she said that this was the first time she had ever shared her personal story with anyone. Then she added, ‘Believe it or not, I am grateful to my parents for performing my last rites. I never expected any dignity in my lifetime or in death.’

As she stood to leave, I quickly asked her if she remembered the date of the school incident. She turned back and said, ‘How can I ever forget that day. It was a day of my death and rebirth. It was July 2nd, 2009.’

July 2nd, 2009!

I gasped, remembering it as the same day of the Delhi High Court’s historic judgment on Section 377 of Indian Penal Code was read. It held that that the criminalization of homosexuality was unconstitutional, noting that:

If there is one constitutional tenet that can be said to be the underlying theme of the Indian Constitution, it is that of ‘inclusiveness’. This Court believes that the Indian Constitution reflects this value deeply ingrained in Indian society, nurtured over several generations. The inclusiveness that Indian society traditionally displayed, literally in every aspect of life, is manifest in recognizing a role in society for everyone. Those perceived by the majority as “deviants’ or ‘different’ are not on that score excluded or ostracized.

Where society can display inclusiveness and understanding, such persons can be assured of a life of dignity and non-discrimination. This was the ‘spirit behind the Resolution’ of which Nehru spoke so passionately. In our view, Indian Constitutional law does not permit the statutory criminal law to be held captive by the popular misconceptions of who LGBTs are. It cannot be forgotten that discrimination is antithesis of equality and that it is the recognition of equality which will foster the dignity of every individual. 

Shipla’s rebirth coincided with a transformation in Indian society itself. Just as Shipla’s story is not yet fully told, the 377 decision’s impact is still being written. Now even four years on, the transformation has only just begun.

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The author of this post, Yadavendra Singh, is Senior Programme Officer: Capacity Building for Alliance India’s Pehchan Programme.

With support from the Global FundPehchan builds the capacity of 200 community-based organisations (CBOs) for men who have sex with men (MSM), transgenders and hijras in 17 states in India to be more effective partners in the government’s HIV prevention programme. By supporting the development of strong CBOs, Pehchan will address some of the capacity gaps that have often prevented CBOs from receiving government funding for much-needed HIV programming. Named Pehchan which in Hindi means ‘identity’, ‘recognition’ or ‘acknowledgement,’ this programme is implemented by India HIV/AIDS Alliance in consortium with Humsafar Trust, PNROSAATHIISangama, and SIAAP and will reach 453,750 MSM, transgenders and hijras by 2015. It is the Global Fund’s largest single-country grant to date focused on the HIV response for vulnerable sexual minorities.