Step Up the Pace Against Section 377 in India

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In December 2013, the Indian Supreme Court upheld Section 377 of the Indian Penal Code recriminalizing homosexuality in the country. The months since the judgement have been a time of uncertainty for the LGBT community about what lies ahead. The recent general elections saw political parties taking various positions on LGBT rights which resulted in heated debates in the media. Just last week in a surprise move, the new Health Minister spoke in support of gay rights. Through all this, the curative petition challenging the Supreme Court judgement is waiting to be heard.

The reaction from the LGBT community has ranged from anger and anguish to action inspiring the formation of new queer collectives and new projects responding to the needs of the community. The environment is a mixture of mistrust and determination, from watching one’s back to stepping up the tempo. This week, the International AIDS Conference is meeting in Melbourne, Australia to understand and discuss, among other issues, the HIV response for the communities of men who have sex with men and transgenders. Alliance India will be highlighting our “207 against 377” campaign that brings together the 207 organisations implementing Pehchan to fight Section 377.

As activists, community groups, and AIDS organizations come together to discuss important health and social issues facing sexual and gender minorities, it’s time to pause and take a hard look at what Section 377 means. It’s a law which oppresses LGBT communities for sure, but it is also an impediment to the realisation of basic human rights in the world’s largest democracy. Doing away with this law will influence other struggles against social injustice in a vastly complex country where people are oppressed not only because of their sexual orientation, but also their caste, class, religion and gender. Reading down 377 will be a victory for every citizen of India and for every human being across the world.

Please join Alliance India in the ‘207 against 377’ campaign. Visit our booth (#616) at AIDS 2014 to learn more.

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Shaleen Rakesh is a gay rights activist and was instrumental in filing the Section 377 petition on behalf of Naz Foundation (India) Trust in 2001. Shaleen manages the ‘207 against 377’ campaign at India HIV/AIDS Alliance, where he also serves as Director: Technical Support. The campaign brings together the 207 organizations implementing the Pehchan programme on a common platform to undertake advocacy at national, state and district levels to protest against the 11th December 2013 Supreme Court judgment upholding constitutional validity of Section 377 of the Indian Penal Code thereby recriminalizing same-sex sexual behaviour. 

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“Do we count?” A question for AIDS 2014 and beyond

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Every two years, researchers, implementers, policy makers, and community activists come together at the International AIDS Conference to take stock of the pandemic: Where are we now? Where have we been? Where are we heading? Discoveries are heralded and strategies dissected. There are always more questions than answers, but there is one question that needs to be answered at AIDS 2014 and beyond: Do we count?

Do the lives of men who have sex with men, people who inject drugs, sex workers, transgenders and even people living with HIV — especially those from these key affected populations — really count? On a basic level, the answer must be a resounding and unequivocal “YES!” Every human life counts. Every life has equal value. Yet, while an affirmative chorus may echo in the halls of the conference, easy rhetoric will not be enough.

Data analysis by UNAIDS indicates that as many as half of all new HIV infections globally occur in key populations. This should come as no surprise. The disproportional concentration of the virus in these groups is hardly news, shaping the trajectory of the epidemic and driving the complex stigma that still defines HIV/AIDS.

Though we are frequently reminded that we are in the era of evidence-based public health, data-driven decision-making, and performance-based metrics, the evidence on HIV vulnerability in key populations is routinely ignored. We aren’t even counted in many places. Surveillance fails to find us. Not surprisingly, funding for HIV services responsive to our needs remains slight.

Slowly but surely the message is getting through. The large players in the global HIV response are lining up to affirm their commitment to these (new?) priorities. On July 11, 2014, the World Health Organisation released a long-awaited and rapidly developed publication, Consolidated Guidelines on HIV Prevention, Diagnosis, Treatment and Care for Key Populations. It is an impressive document written and reviewed by a Who’s Who of experts working with and representing these groups.

There can be no doubt about the sincerity or good intentions of the guidelines’ authors, and this document has the potential to influence policy and practice globally. Yet questions persist in the willingness of institutions — governments, donors, development agencies and civil society — to embrace their fundamental responsibility to the health of key populations and invest accordingly in a sustained and broad-based effort to end the unremitting toll of HIV and AIDS on our lives.

New technical guidelines and progressive policies can be applauded, but to make the difference intended, they must be applied. In order for them to be applied, investments must be targeted to fill these gaps and expanded to match the scale of our need. The proof of commitment will be in the expansion of funding invested in programming for key populations. Now is the time to prove we count.

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The author of this blog, James Robertson, is Executive Director of India HIV/AIDS Alliance  in New Delhi.

Alliance India brings together committed organisations and communities to support sustained responses to HIV in India. Complementing the Indian national programme, we work through capacity building, knowledge sharing, technical support and advocacy. In collaboration with partners across India, Alliance India supports the delivery of effective, innovative, community-based HIV programmes to key populations affected by the epidemic.

Out of the Shadows: Women who Use Drugs in India

AIDS2014 _FB_Postcard_CK memeWomen who use drugs are collectively failed by India’s HIV response! This systemic neglect involves government departments, civil society and the private sector. While government programs have done well to address issues of women’s empowerment and increase their access to education, health and social entitlements more broadly, there are virtually no initiatives that address the various specific needs of women who use drugs.

Out of the 120 hospital-based de-addiction centres run by the Government of India’s Department of Health and Family Welfare and over 400 NGO-run centres through the Ministry of Social Justice and Empowerment, none are focused on issues of women, and most have little experience in supporting women who use drugs. A few private facilities cater to these needs, but they are expensive and out of reach for most women.

While the Department of AIDS Control is now funding Targeted Interventions for HIV prevention among these women, they are limited to the north-eastern part of the country. Besides this, interventions are primarily designed for male drug users, although some of which have been able to successfully reach their female partners with services.

Alliance India, along with NGOs like Sahara Aalhad, Voluntary Health Association of Meghalaya, SASO, Shalom and Dedicated Peoples Union to name a few, have demonstrated viable models of gender-responsive services for female drug using populations. Effective interventions include healthcare provided by female providers; counselling; referral to sexual & reproductive health services; harm reduction services (access to clean needles and syringes and Oral Substitution Therapy); detoxification and HIV-related care, diagnostics (blood tests required before and during antiretroviral therapy); prevention of parent to child transmission of HIV; safe spaces for women; and legal aid.

In our new film Out of the Shadows: Women Who Use Drugs in India activists and community members describe their challenges and their need for accessible, targeted, and quality harm reduction interventions to improve their health and protect their rights. Marginalized and unreached, these women are not well served by current interventions, and unsafe sexual behaviour and shared injecting equipment significantly increase their risk for HIV and hepatitis C infection. Exclusion, discrimination and violence further compound their vulnerability.

Women who use drugs need to emerge from the shadows, and programming in India can no longer afford to ignore them and the difficulties they face. There is a clear need for leadership and support to expand interventions for them by both government and civil society. We owe it to those women who are still in darkness and afraid to come out and live healthy and dignified lives.

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The author of this post, Simon W. Beddoe, is Advocacy Officer: Drug Use & Harm Reduction, at India HIV/AIDS Alliance in New Delhi.

With funding from European Union, the Asia Action on Harm Reduction project 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 through engagement with PWID and local partners in Bihar, Haryana, Uttarakhand, Delhi and Manipur.

The Avahan Decade

Avahan India AIDS initiatiive focused its efforts on key populations

So much has been written about Avahan – by implementers, academics, and journalists – that to write more might be unnecessary. Many have reflected on the complexity of the programme and its ambition. What would it take to have an impact on the HIV epidemic in India’s highest burden states at a scale usually expected only of government? The learnings of Avahan are ample and thusly well documented. India’s fascination with Avahan’s donor surely was a story unto itself and told many times.

Yet, for me, the central contribution of Avahan is simple, and remarkably, it still remains radical today. Leveraging the prestige and resources of the Bill & Melinda Gates Foundation, Avahan focused its efforts on key populations, groups whose social marginalization previously all but ensured that their needs would not be adequately prioritized in spite of their disproportionate vulnerability to HIV.

Before Avahan arrived, India had already recognized that sex workers were an important driver of the country’s epidemic. The data told this story, and the government had a plan. Other key population groups like men who have sex with men and people who inject drugs were similarly targeted. Yet, capacity in the government to meet these challenges was limited. Apprehension about HIV was just part of the problem. How does a government effectively protect the health of groups that are criminalized and pushed to the margins of society?

What Avahan did – putting key populations first – should have been game-changing for the global AIDS response. How little the global AIDS response has actually changed now a decade later is testament to how difficult it is to break through the stigma and discrimination that define this disease. For all our talk in public health about evidence-based responses, what is done about AIDS still passes through a moral and political filter. Though we know we can find HIV concentrated in sex worker, MSM and drug using populations worldwide, we still don’t invest resources to match the relative scale of the epidemic in these groups.

Avahan showed it can be done. The Gates Foundation deserves great praise for its vision and resolve. The Government of India’s National AIDS Control Organisation (now, Department of AIDS Control) and the State AIDS Control Societies were essential collaborators, giving the programme the space it needed to show impact. Avahan’s implementing partners took the programme to the community level in six states across the country, with Alliance India working in Andhra Pradesh. Together, over the Avahan decade, we had the journey of a lifetime, empowering vulnerable communities and changing the trajectory of India’s epidemic.

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The author of this post, James Robertson, is Executive Director of India HIV/AIDAlliance. This post is based on his foreword to the Alliance India publication Empowering Key Populations for Sustainable HIV Prevention: Avahan in Andhra Pradesh 2003-2014.

Avahan India AIDS Initiative (2003-2014) was a focused prevention initiative funded by the Bill & Melinda Gates Foundation that worked in six states of India to reduce HIV transmission and lower the prevalence of sexually transmitted infections in vulnerable high-risk populations – female sex workers (FSWs), men who have sex with men (MSM), transgenders, people who inject drugs (PWID) – through prevention education and services, such as condom promotion, STI management, behaviour change communication, community mobilization, and advocacy. Alliance India was a state lead partner for Avahan in Andhra Pradesh (AP).

LGBT Intolerance: A Common Bond between Nigeria and India

The fight against 377 will continue in India even as many countries adopt regressive laws.

The fight against 377 will continue in India even as many countries adopt regressive laws.

Five years ago today – July 2, 2009 – was a historic day for India’s gay movement. On that day, the Delhi High Court decriminalised homosexuality. This ruling marked a sea change, a transformative moment when a history of intolerance was at last ended.

Though correct, the judgment was sadly impermanent, being overturned by the Indian Supreme Court last December, reinstating an archaic law from the British colonial era that criminalized homosexuality as “against the order of nature.” A month later, Nigerian President Goodluck Jonathan signed the controversial Same-Sex Marriage Prohibition Bill, which bans not only same-sex marriage, but also homosexual behavior, organisations that advocate for gay rights, and even gatherings of members of the LGBT community.

Current laws in both India and Nigeria disregard the basic rights of each country’s citizens. Bisi Alimi, the first Nigerian to come out on national television there, said, “The difference between India and Nigeria is that while in India, it’s the penal code regarding homosexual behaviour that has been reinstated, Nigeria has actually gone through a process of constitutional criminalisation of homosexuality and homosexual relationships.”

While the criminalisation of homosexuality in Nigeria is certainly more sweeping than India, these laws are not confined to simply policing private spaces. The law in India has been often used to justify harassment of sexual and gender minorities in public. India is also experiencing an uptick in cases of violence against the LGBT community, although most go unreported, and for the ones that make news, there is little justice. Nigerian rights activists are already documenting similar injustices and violence.

“The advent of this new law has brought about a system legitimising brutalities. We have seen an increase in witch hunting of LGBT people, accusing them based on assumption. Five people have been charged so far, and many awaiting trials,” Bisi adds.

Some have compared the hatred of homosexuality of Nigerians to their love for football, the only two issues on which the country stands united. A recent public poll in the country shows that 98% of Nigerians think homosexuality is wrong. This contrasts with India where, at least, the educated middle class shows some support for gay rights. A recent poll conducted among Hindustan Times readers showed 80% opposed criminalization of homosexuality.

LGBT activists in Nigeria, like most of their colleagues in Africa, operate in extremely hostile and challenging environments. They remain under-resourced and severely isolated. India’s LGBT movement has greater access to resources and more support, although even some queer rights activists still struggle to be “out.”

“Now with the law, provision of services to LGBT people – including HIV services – is illegal. That means charities doing this work will have to close, and many have started folding up already. This will not only affect HIV prevention services but also treatment. Many men who need antiretroviral therapy will not be able to access it easily, and if they do at all, it will have to be done underground,” says Bisi.

Despite differences in the nature and magnitude of the homophobia, the impact of these laws reaches beyond LGBT communities in both Nigeria and India, impeding the work of civil society, public health workers and human rights defenders. Above all, what is happening in Nigeria, India and unfortunately too many other countries is a severe blow to the momentum of the global LGBT movement and is a huge cause of concern for human rights around the world.

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The author of this post is Shaleen Rakesh, a gay rights activist and was instrumental in filing the Section 377 petition on behalf of Naz Foundation (India) Trust in 2001. Shaleen manages the ‘207 against 377’ campaign at India HIV/AIDS Alliance, where he also serves as Director: Technical Support. The campaign brings together the 207 organizations implementing the Pehchan programme on a common platform to undertake advocacy at national, state and district levels to protest against the 11th December 2013 Supreme Court judgment upholding constitutional validity of Section 377 of the Indian Penal Code thereby recriminalizing same-sex sexual behaviour. 

India HIV/AIDS Alliance (Alliance India) is a diverse partnership that brings together committed organisations and communities to support sustained responses to HIV in India. Complementing the Indian national programme, Alliance India works through capacity building, knowledge sharing, technical support and advocacy. Through our network of partners, Alliance India supports the delivery of effective, innovative, community-based HIV programmes to key populations affected by the epidemic.