Silvia and Mluleki General Secretary of NAPWA,South African  network of people living with HIV

Silvia and Mluleki, General Secretary of NAPWA,South African network of people living with HIV

This is going to be my last post of the year and I would like to dedicate it to a deeply inspiring meeting I attended in in Cape Town South Africa a couple of weeks ago.

I was part of a privileged group of over 20 advocates who work to promote the rights of people living with HIV defined ” Key Populations”. We were invited to South Africa for 3 days by the Global Network of People Living with HIV (GNP+) to contribute to a consultation on how national and regional networks of people with HIV can work better and being more inclusive and better representative of those groups.

There is still quite a lot of debate about who these “key populations” are: mainly the term is used to define the groups of people who are at most risk of acquiring HIV, as well as those who, when HIV positive, face multiple layers of stigma and discrimination. Previously they were referred as “High Risk Groups”, but this definition was rejected because it inherently “blamed” those who often are most vulnerable, of bringing HIV onto themselves by taking risks.

A narrow description identifies key populations as: men who have sex with men, people who do sex work, people who use drugs and transgender women and men. Many women living with HIV argue that because gender norms and patriarchal power imbalances compound our vulnerability to HIV and exacerbate our experience of stigma and discrimination when living with HIV, we, as women, should also be considered as a key population. There is still not consensus on this.

Personally I agree with this vision that women are a key population, especially since we are so disproportionately affected by HIV. The specific way in which HIV impacts on us, and the importance of advancing the rights of all women, but especially women with HIV, has been creatively adressed in the report produced by UNAIDS “Women Out Loud”, released just a few days ago. The report includes a wealth of in depth gender specific data on women and HIV as well as the contribution of 30 women living with HIV activists, offering insights and strategies on how to end AIDS. I have co-written the second chapter on women who use drugs with Frida Iskander from Indonesia and Fila Jung from the US.

Personally I think that it is critical to include women and a gender analysis in our work with key populations. Challenging gender norms and promoting women”s rights go hand in hand with questioning notions of femininity and masculinity. Overcoming limiting and limited notions of what it means to be a woman or a men are central to an approach that promotes equality and dignity of all gender identities: including gay men and women, bisexuals, transgender men and women, intersex people, and generally the queer community which doesn’t identify with a binary hetero-normative vision of gender roles.

I would like to leave you for this year with some images from the posters we designed at the Key Population consultation in Cape Town illustrating some of the key advocacy issues we face.

One of my favourite posters was a clear call for solidarity among key populations:


I also really liked the advocacy priorities for South Africa: 1) access to good quality treatment, 2) access to good nutrition 3) ending criminal prosecution of HIV transmission.


The invisibility of transgender people, who are disproportionately affected by HIV


The plight of sex workers. Here is Daisy a sex worker, pictured with her high heels and lovely hair, crying because she cannot access health care, testing, condoms, and very often gets criminalised. Daisy was very witty, in face of horrible discrimination. She told us that when she went to the HIV health centre she was refused treatment. They told her: come back with your husband. She replied “I can come back with YOUR husband!”


The divisive and stigmatising use of punitive laws, against sex work, drug use and transmission of HIV.


We also went to visit SWEAT an organization that campaigns and promotes the rights of people who do sex work. Here is a posters used in their advocacy.


It was a deeply inspiring meeting. I was humbled and moved by hearing some of the most appalling stories of discrimination and abuse, but also uplifted by the courage and resilience in the face of enormous hardship, prejudice and rejection. If you are interested you can read more on the meeting here.

Please, please please…. take some time before Christmas to  support the People Living with HIV Call to Action, also promoted by GNP+

Call to Action




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