This is among the topics that were discussed at the AIDS conference held in June in South Africa. The stigmatization of certain groups – like men who have sex with males (MSM) as well as transgender groups – hinders treatment plans and the adherence of people to the treatment. These groups also are at greater risk of developing HIV because of increased levels of discrimination, stigmatisation, and the criminalisation of.
The research we conducted as part of a 3-year project about the stigmatization of HIV that is linked to young people who have gender or sexually diverse backgrounds. The study, which was achieved in Malawi, Zimbabwe, and Zambia, included the participation of 156 people.
The research identified three key conclusions:
Criminal laws, as well as strongly negative social-cultural and religious convictions, have created deeply rooted indifference about gender and sexual identity.
Participants reported repeated instances of verbal harassment or being gossiped over, as well as physical assault.
Other groups of people living who suffer from HIV claimed that their lives have been made more bearable by the fact that public acceptance and awareness of HIV has increased over time. But HIV-related stigma has rediscovered its power when it was linked to gender and sexual identity and adverse consequences for adhering to antiretroviral treatments.
Our research has provided fresh evidence of the deep-rooted anxiety and fears about various forms of stigmatization in the lives of young MSM and transgender females in southern Africa.
Criminalising sex
In 13 countries across both southern and eastern Africa, legislation and policies are in place to criminalize homosexual relations between gays and lesbians, as well as assist in stigmatising trans and gay individuals.
Recently, Uganda passed the Anti-Homosexuality Act of 2023 that is a law that punishes homosexual acts with life prison. Many of the acts deemed “aggravated homosexuality” are liable to death.
The study also revealed that youth were able to come up with different strategies for managing their lives. For instance, deciding when to declare or identify as a person suffering from HIV or as an individual belonging to the sexual minority community in the other and rarely both simultaneously.
The constant stress and anxiety associated with living with HIV and the anxiety of being judged can be a major influence on the health and well-being of a person.
The pressure of hiding their identity led to various physical, emotional, and mental vulnerability. Depression-related symptoms and the frequent use of alcohol were obvious.
In total, 42% of participants have considered suicide at more than one time. One participant, an 18-year-old
I feel as if I’m insignificant, that I’m useless. In the society I am looking at HIV I’m homosexual, and people are able to isolate me. This is why I am not at ease, and I’m not able to get to work, get some money, or whatever. And, sometimes, I decide if I can die today, I can rest. There are a variety of thoughts that come to mind when I’m disturbed … At times, my parents attempt to soothe me, but inside, I’m very disturbed.
Along with symptoms of depression, a high frequency of drinking was also evident.
There were a few options to help with these stigmas and stigmas, with the ones that came closest to the offering being provided through “sexual minority friendly” organizations or run by peers who were sexual minorities themselves.
The fear of being exposed
Being observed taking antiretroviral treatment or having it discovered in the possession of a person indicated that the person had HIV. Certain people would prefer to skip doses occasionally or for longer durations instead of suffering the actual or feared stigma that comes with the stigma of being “found out” as someone living with HIV.
A young man of 24 reported to us:
The reason I decided to put off taking my medication was when my partner asked me to visit his home since he lives in Zomba, I haven’t revealed the details of my HIV situation to my partner, and therefore, I am unable to take the ARVs with me to Zomba. Consequently, I’m not able to travel there with the ARVs.
A 19-year-old told me:
It can be difficult for me to deal with because when people don’t like you, you may feel like taking a break from the medicine. “Maybe I’m being lazy; I’ll just die. It is a problem for me quite a bit.
We also discovered that:
Many of the participants received their information from LGBTIQ and their friends without their consent. The stigma of HIV-related illness is common in members of the LGBTIQ+ community and has several negative consequences.
The majority of participants continue to feel or be afraid to face stigmatization due to their sexuality at health facilities. This also restricted their access to health care and their retention in healthcare.
Individualized HIV services, specifically for certain populations that included younger MSM and transgender females, did not reach everyone in rural areas; they were most neglected.
In their own experiences, gay youth and transgender females were acquainted with the negative consequences of stigmatization and yet were frequently excluded from decision-making and planning roles.