1. Key Populations: Making Them Matter in the Global HIV Response Inextricable Links: HIV and Human Rights Kevin Osborne, LINKAGES Project Director 2 March 2015 USAID Mini-University

2. Why Human Rights? Human Rights Public Health HIV Public Health Versus Human Rights

3. What is the Link between Key Populations and Human Rights? HIV prevalence among key populations is much higher than among the general population: 12 times higher for sex workers 19 times higher for gay men and other men who have sex with men (MSM) 28 times higher among people who inject drugs 49 times higher among transgender women Source: UNAIDS 2014 Gap Report

4. What is a Human Rights Approach to HIV Prevention, Care and Treatment? PEPFAR’s Human Rights Action Agenda 1) Expanded access to non- discriminatory HIV prevention, treatment and care for all people, including LGBT persons 2) Increased civil society capacity to advocate for and create enabling environment 3) Increased gender equality in HIV services and decreased gender-based violence Source: PEPFAR 3.0 Controlling the Epidemic: Delivering on the Promise of an AIDS-free Generation

5. Human Rights Issues Across Key Populations Penalties for HIV non-disclosure, exposure or transmission are widespread Limited funding and attention to work with key populations Decreasing funding for civil society organizations’ human rights-related activities Source: UNAIDS 2014 Gap Report

6. Sex Workers, Human Rights Abuses 116 countries have punitive laws against sex work Stigma and discrimination prevent service uptake and limit the quality of provision Violence against sex workers is common – Workplace violence – Intimate partner violence – Perpetrators at large – Organized non-state and state violence Sources: 1. Open Society Foundation. 2012. The Global Commission on HIV and the Law: Sex Workers 2. WHO, et al. 2013. Implementing comprehensive HIV/STI programmes with sex workers: practical approaches from collaborative interventions.

7. “Community empowerment and enabling sex workers to organize and work together for their own benefit is a fundamental component of reducing their vulnerability to HIV.” - Ruth Morgan Thomas, Global Coordinator of the Global Network of Sex Work Projects

8. Gay Men and Other MSM, Human Rights Abuses 78 countries criminalize same-sex sexual acts Stigma and discrimination are barriers to accessing services and disclosing risk behaviors Violence against gay men and other MSM is widespread Percentage of gay men and other MSM who report physical, psychological or sexual violence in selected countries Source: UNAIDS 2014 Gap Report

9. “There have been so many hate crimes, people get beaten up just for being them… you get harassed, beaten, arrested just for being you.” - Jamie Mburu, Kenya MSM, Empowerment Program

10. Transgender People, Human Rights Abuses Discrimination and social marginalization Inability to obtain legal documents Very limited access to transgender-friendly health services Widespread violence Source: Transgender Europe’s Trans Murder Monitoring TDOR 2014 update Source: Reisner, et al. 2013. Transgender Technical Report A Review to Inform the PEPFAR Programming

11. “The international community must take concrete steps to halt the needless pain and suffering among transwomen who, deprived of basic human rights to health, work, and function in society, are then further marginalized by their own governments. The time to act is now!” - JoAnne Keatley, Director of the Center of Excellence for Transgender Health

12. People Who Inject Drugs, Human Rights Abuses People who inject drugs are almost universally criminalized Punitive laws, including compulsory rehabilitation, limit access to services High levels of stigma and marginalization, including from health service providers Police harassment and violence Source: UNAIDS 2014 Gap Report

13. “The key to managing this epidemic in this community does not lie in judgment or prejudice — but rests on both strengthening community empowerment and providing access to comprehensive harm reduction services including needle and syringe exchange programs within an enabling legal environment.” – Eliot Ross Albers, Executive Director of the International Network of People Who Use Drugs

14. What Are Some Human Rights Activities? Agency Engagement of KPs (GIPA for KPs) Advocacy Rights and social justice education Policy and practice Reporting and prosecuting human rights violations Alliances Health care worker trainings to reduce stigma and discrimination Violence prevention and response, such as police and judicial trainings Working with media

15. Select LINKAGES Activities to Secure, Protect and Promote Human Rights M-watchers and M-friends social protection network to reduce stigma and discrimination in Ghana against MSM, female sex workers and KPs living with HIV Research on experiences of violence in Latin America and the Caribbean with transgender women and MSM Development and implementation of a health care worker training that addresses stigma against and the human rights of all KPs in Africa and Asia LINKAGES Advisory Board includes global representatives of the four key population networks

16. Thank You “Those who advocate for expanding the circle of human rights were and are on the right side of history, and history honors them… We are called once more to make real the words of the universal declaration. Let us be on the right side of history.” – Secretary of State, Hillary Clinton (2010)