amfAR’s GMT Initiative is Combating the Stigma and Discrimination that Fuel HIV Infections among LGBT Worldwide

By: Lucile Scott, amfAR

Since its inception in 2007, amfAR’s GMT Initiative has provided financial and technical support to over 164 community organizations working on the front lines of the epidemic to reduce the spread and impact of HIV among gay men, other men who have sex with men, and transgender individuals (collectively, GMT) in low- and middle-income countries. Worldwide, as treatment access and prevention science improves, stigma and discrimination is often the main barrier to reducing infection rates and improving access to care among GMT. Stigma and discrimination affect every aspect and stage of HIV treatment and prevention, from putting individuals at greater risk of engaging in high-risk behavior that can lead to HIV infection to preventing them from accessing health and testing services to stopping governments from targeting them with HIV treatment and prevention efforts—though they are often one of -- if not the-- most impacted populations in that government’s country.

amfAR launches a new report providing the first-ever
comprehensive analysis of the financing and implementation
of HIV programs for GMT in Southern Africa

The GMT Initiative provides funding and support for localized capacity-strengthening mentoring. This helps grantee partners develop advocacy, outreach, and training programs that target GMT, healthcare providers, governments, and the general population to reduce the stigma and discrimination they face. Many are doing this work in countries where homosexuality is illegal, and HIV rates are high.

Through these programs, our grantees

-train and empower members of the GMT community to perform peer HIV services and advocate for their rights

-train healthcare workers about how to provide GMT with stigma and discrimination-free care

-advocate for governments to overturn discriminatory policies that deny GMT rights, including proper healthcare

-train the governments about how to better reach GMT with HIV messaging once they have removed policy and legal barriers to doing so. 

The organizations also organize campaigns, performances, protests, and more that aim to educate the general population about the GMT community. The GMT Initiative continues to support our partner organizations as they grow and work to formalize and evaluate their programs to improve their impact and to better understand and pass on to others what strategies work most effectively.

In the past year, while our grantees have witnessed many milestones in combating stigma and discrimination, they have also witnessed much backlash to that progress. For instance, in Uganda, advocates recently succeeded in convincing the government to include GMT in their national HIV strategy. However, in December the Parliament passed a law criminalizing “promotion of homosexuality,” forcing those providing GMT with HIV services, including our grantee partner Spectrum Uganda, to—at-the-least temporarily—shut those services down. While that bill has not yet been signed into law by the President, similar bills passed in Nigeria and Russia were. They have also severely and, unless they are repealed, permanently curtailed our grantees’ and other organizations’ ability to do HIV outreach among GMT, reversing years of progress, and wasting millions of dollars in global AIDS funding.

amfAR grantee-partner SOMOSGAY's new
 men's health center during its launch party

But in Armenia, as a similar law was under debate (that has not passed), grantee partner We for Civil Equality worked with doctors, social workers and human rights structures within the Armenian government to create a strong medical referral system to help GMT living with HIV access non-discriminatory care and obtain their life-saving medications. And in Paraguay, our long-time grantee partner SOMOSGAY opened a men’s health center created to cater to the needs of GMT. Three grantee partner organizations in Togo hosted a workshop for members of the media on how to improve their stigmatizing portrayals of GMT. And in Argentina, grantee partner Asociación de Travestis, Transexuales, Transgéneros Argentinas (ATTTA) started shooting a documentary to educate the general population about the discrimination and barriers to equal rights that trans people experience each day.

A film shoot for amfAR grantee-partner ATTTA's documentary
about the fight for trans rights in Argentina  

As Yves Yomb, executive director of Alternatives-Cameroun, told us in July, shortly after a string of attacks against Cameroonian LGBT activists and organizations forced Alternatives to shut down their HIV outreach operations, “We know this revolution will take time, as do all the revolutions in the world.  We don't know if we will see the result, but we hope in 10 or 20 years, people will say the fight for gay rights began in 2005, and thanks to them we have the rights that we have at this moment.”

 And these are just a few of our grantee partners’ stories and successes. To read more about how they confront and combat stigma and discrimination, please read our GMT Initiative blog, Grassroots. 

International Day of the Girl

International Day of the Girl encourages us to draw our attention to the inequalities facing young girls across the world. We are called to take a critical look at whether or not girls are given the same opportunities as boys in terms of access to education, financial stability, and sexual empowerment. Here at the Stigma Action Network, we are most concerned with how girls are affected by the HIV epidemic. After examining the data related to this topic, we ultimately found that:

• In sub-Saharan Africa, young women aged 15 to 24 are up to 8 times more likely than young men to be living with HIV.[1]
• Worldwide, young women account for 66% of young people living with HIV.[2]
•  Women living with HIV are more likely to experience violence as result of their status, than men living with HIV.[3]
• Prevalence of first forced sex among adolescent girls is as high as 48% in some countries, which further maintains the HIV epidemic.[4]

While these facts are indeed surprising, the factors that perpetuate them are even more alarming. Three of these most significant factors are outlined below.

• Girls’ Lack of Empowerment: According to global statistics, girls are significantly poorer, less educated, and as a result less financially and socially empowered than their male counterparts. This power imbalance reduces young women’s choices as they negotiate their sexual health and relationships, often giving them little choice in determining if and when to have sex, and in cases of consensual sex, whether that sex is safe. Furthermore, poverty prevents underprivileged girls from receiving adequate health care and education, and as such resources are essential in fighting the HIV epidemic, breaches in these areas may lead to HIV infection.

• Biology: The risk of becoming infected during unprotected sex is two to four times greater for women than for men, and for young girls, the risk can be even higher.[5] This biological disparity gives further evidence as to the importance of educating girls about their sexual health and rights, specifically as they relate to HIV.

• Culture: And lastly, cultural mores may encourage men to have many sexual partners.[6] This is particularly problematic surrounding the issue of child marriage, as such customs can facilitate the spread of HIV to girls in high-risk areas. And given that one-third of the world’s girls are married before they reach the age of 18, such practices can have quite widespread and devastating effects.[7]

As you can see, there are a multitude of socio-economic and biological factors that put girls at a higher risk of HIV. But what is the solution to this problem? And how can we curb these inequalities and give girls the power to take control of their sexual health?

Carol Bellamy, Executive Director of UNICEF offers up her thoughts:

“Education is crucial to success against the pandemic. 

In fact, UNICEF remains convinced that until an effective remedy is found,

 education is one of the most effective tools for curbing HIV/AIDS”

Luckily, the following organizations are contributing to the fight against HIV by educating girls about the importance of and how to protect themselves by engaging in safe sex! Here are a few #StigmaWarriors who are doing great work with girls on HIV education:

Girls Learn International, Inc

Girls Learn International, Inc. takes a unique approach to girls’ education by partnering American schools with schools in foreign countries where girls do not enjoy the same educational opportunities as boys. This organization functions as an after school program that offers service oriented learning to young girls. Participants in the US chapters learn of the challenges facing girls in their partner schools including child marriage, trafficking, poverty, sexual health, and educational disparities. Money that is raised domestically goes towards purchasing textbooks, teachers' salaries, meals, and transportation in partner schools. Girls Learn International, Inc. has 47 partnerships in the following countries where HIV rates are notably high: Afghanistan, Bangladesh, Cambodia, Ghana, India, Kenya, Nepal, Pakistan, Tanzania, Uganda, and Vietnam. Learn more about this organization and how you can help support the education of girls across the world. 

Maasai Girls Education Fund

On the Top 10 list of countries most affected by HIV/AIDS, Kenya comes in at #4. Girls living in poverty have less control over their sexual health, both because of lack of education and because of sexual abuse. "A large, national survey of secondary school girls in Kenya found that 40 per cent of those reporting sexual activity indicated that their first sexual experience was forced or that they were 'cheated into having sex.'"[8] The Maasai are nomadic pastoralists originating from the lower Nile valley with a strong traditional culture that often prevents females from receiving an adequate education. Only 48% of Maasai girls in Kenya enroll in school, and only 5% of those who enroll reach the secondary school level.[9] Such educational disparity can further facilitate the spread of HIV, as girls who remain uneducated are not only unable to make sexually sound decisions, but are also unable decisions that may secure a promising future. The Maasai Girls Education Fund works to combat this, however, by providing a safe environment where girls can receive a quality education. Donations to the Maasai Girls Education Fund go towards buying uniforms, books, and helping to pay tuition. What makes this organization stand out are their community workshops that attempt to reverse cultural beliefs and norms that discourage young girls from enrolling in and committing to school. And as enrollment in school is the best HIV prevention method available to girls (as noted by the World Bank), this organization’s work can surely make a difference.

Commit 2 Change

Young women are the victims of heavy abuse in India as well, in part because they are viewed as the less desirable of the two genders: over 25,000 of adolescent girls are malnourished and suffer from illness and medical neglect [10]. Commit 2 Change is dedicated to supporting female orphans in India by providing them with secondary education, with a particular emphasis on sexual health and HIV/AIDS prevention. Millions of children across the world have become orphaned after losing their parents to HIV/AIDS. Orphaned children are more likely to become impoverished and less likely to be enrolled in school as a result. A study done by UNICEF reveals that "the irony is that orphans are frequently deprived of quality education, which is the very thing they need to help protect themselves from HIV" [11]. India ranks #3 on the Top 10 countries most affected by HIV/AIDS.

The SAN congratulates the above-mentioned organizations (and others around the world!) who are doing great work to educate girls about safe sex and to prevent the spread of HIV among this particularly vulnerable population. However, The Girls Insights report conducted by the International Center for Research on Women found that "girls said they still lack even the most basic knowledge, autonomy and other assets critical for their health and empowerment." This demonstrates that even more must be done if we are to stop the spread of HIV and related stigma!

We hope that more organizations accept the challenge of incorporating sexual education, including education around HIV, into curriculum for young girls and adolescents. Programs must also be developed in a way that empowers girls to use this education to make sound decisions about their own sexual health. Together, with this sort of integrated approach, we can help girls gain control over their lives and futures, and help make a future without HIV a reality.

(Visit UNICEF for more details.)

National Gay Men's HIV/AIDS Awareness Day: A Guest Blog by Daniel Bauer

Special Thanks to Daniel Bauer for sharing his work with the Stigma Action Network, 

in celebration of National Gay Men's HIV/AIDS Awareness Day.

To view the original blog entry, click here.

As a very out and proud gay man and 10 year warrior living with HIV/AIDS, I stand tall in an effort to bring a greater awareness to this year's National Gay Men's HIV/AIDS Awareness Day on September 27, 2012.


This morning I was searching the internet to see how this year's awareness day is shaping up; and to find elements of hope that would not only inspire me but also lend a voice to a call to action. In my search, I came across the following powerful statement by Frank J. Oldham Jr., President and CEO of the National Association of People with AIDS. I believe he sums up what I is a very necessary call to action as a gay man - a call to action I feel I must embrace and put into motion. In his words, I share this with you:


"We have a responsibility. To the quarter-million brothers and lovers we have buried. To the allies who have supported our fight for treatment access and civil rights. To ourselves.

We have a responsibility – to know our own status. Every gay man who is active with multiple partners (or thinks his partner may be) needs to get tested every three months.

We have a responsibility – to know how to protect ourselves and others. We’re excited about the potential of treatment-as-prevention and PrEP, but we all still need to keep our condoms handy.

We have a responsibility – to be as open as we can be about being HIV-positive. Sometimes disclosure isn’t safe, and safety comes first – but our brothers need to know they know people just like them who are living with the virus. And any new partner needs to know our status before the clothes come off.

We have a responsibility – to demand access to healthcare for ourselves and for all Americans. It’s not just a human right, it’s common sense. It costs the public sector more to ignore epidemic than to deal with it, and we need our elected officials to know we know that.

We have a responsibility – to demand to be treated as “normal.” We are normal. We should insist on marriage because it’s our right, and because it forces our neighbors to reconsider the homophobia that gave the HIV epidemic its opportunity to explode in the gay community and move on from there.

We have a responsibility – to love. Last year on National Gay Men's HIV/AIDS Awareness Day, we gave a Positive Leadership Award, NAPWA's highest honor, to Alvin Collins and John Sullivan. Alvin had been one of the unlucky few who, despite the best modern treatment for HIV, don't do well. John stuck to Alvin through thick and thin – and Alvin stuck to John. Alvin died this Spring. We have a responsibility to honor that love.

We have a responsibility. We changed the world in the eighties, insisting on treatment and research when Washington didn’t want to hear us. Today we have the medical and behavioral prevention tools we need to make new HIV infections a thing of the past. We insisted then. We can do it again."

So on this day - I will embrace these words and calls to action above! I hope you too will join and follow me!

I am Daniel and I am living pozitively! Thank you for following my blog!

An exclusive from Josh Robbins of imstilljosh.com

Breaking news from Josh Robbins of imstilljosh.com!

In our interview on June 17^th, 2013, Josh revealed the next incredible contribution he is making to the community of people living with HIV. He is going to be creating an I’m Still Josh (ISJ) HIV phone/tablet app!

“I have looked at all the HIV apps on the market and while they all have their own individual amazingness, there is no particular one that I would go ‘hell yeah this is the HIV app for those of us living with HIV,’” said Josh, when explaining his desire to create his own app.

Josh’s goal is to make an HIV app that will be truly useful for people living with HIV.

Some of his ideas for an ISJ HIV app include a:

• Discrete icon: it would be hidden behind what looks like a camera application so the icon doesn’t, according to Josh, “scream HIV”
• Password: so no one but the user can access the user’s personal information
• Health newsfeed: with the latest HIV research and information. The newsfeed will be interactive and not promote any one individual health product or pharmaceutical organization.
• HIV data tracker: This will track information  such as a user’s CD4 count, viral load, etc.  All data will be able to be translated into a graph or table.
• But wait there’s more! Furthermore, users will be able to send this data to their computer, email, or wherever they want in the event they want it for their records or to share with a physician. As with all other aspects of the app, there will be no identifying information on these files to connect it back to the user.

Sound interesting? Is there something you would like to see on the ISJ HIV app? Josh would love to get your feedback on what you think would be an important feature to include! If you have a great idea (and if you are part of our SAN community, we are certain you do!) contact Josh!

In order to make this app a reality, Josh is currently in the process of raising $3,000. If you would like to make a contribution click here!

The SAN looks forward to seeing this awesome new application from Josh and ISJ! We are certain it will have as big an impact in the community of advocates and people living with HIV as Josh himself has!

A big, big thank you to Josh for an amazing interview! Be sure to check out the blog post or the podcast if you haven’t already! And to learn more about Josh and his amazing work visit his website, Facebook, and Twitter!

An Interview with "Stigma Warrior," Josh, from imstilljosh.com

Josh Robbins learned on Jan. 24, 2012 that he was HIV positive. He “decided to make a blog because [his] new circumstance of being newly poz [wasn’t his] death sentence… or even close to what defines [HIM] as Josh.” His blog has gone on to inspire many allies and people living with HIV, and he continues to a strong figure in stopping the spread of stigma.

Visit imstilljosh.com to learn more about this incredible individual!

Listen to the podcast of this interview! 

SAN:  You have been running your blog for about a year and a half now—what has been one of the most memorable moments or learning experiences?

Josh: When I started the blog, I didn’t know what it was or would be—and I still feel that way sometimes. Through this medium, I am just sharing my experiences and journey and what it has been like for me to live with something day-to-day, month-to-month, and now over a year that I was completely scared of as a gay man.

With that said, it has been a process of seeing this platform grow and handling the unexpected responsibility that comes with it. I have been surprised with the amount of people who engage with me through I'm Still Josh (ISJ). Almost every day someone contacts me and shares their very personal stories which I am honored and humbled to hear. That has really been the biggest thing from imstilljosh.com and so I feel partly a responsibility to respond to those people for sharing that. I want to thank them for investing their time and for hearing about my continuous journey.

SAN: What do you think your impact has been in terms of stigma reduction?

Josh: What I found is that we have these digital stigma warriors (and I like to include myself in that) who are changing the way people think about HIV. There are different ways of understanding HIV, for example: as an HIV negative person who thinks HIV is the worst thing that could happen to you and living in fear of it; and then as an individual who is diagnosed and realizes it is not a death sentence and you can still be you. Closing those mental barriers and taking down those walls --it requires talk from people and organizations like ours to do this. That is what I feel like I am a part of and what I have committed to thus far.

I believe that if we catch people who are recently diagnosed and we catch them early enough and encourage the hell out of them then we have the ability to change them from being victims to heroic stigma warriors who educate the community about what HIV is, how to prevent it, and how to live alongside people like us. That encouragement period of time is so important to me and that is what I have concentrated the most on. That part of my life has the most success. It is something I am very passionate about.

SAN: Well I saw you started an encouragement wall on Facebook, so that is a very concrete way that you are digitally supporting people.

Josh: Yes! And I haven’t officially launched it yet—but my goal is for it to be the largest digital encouragement wall for those recently living with HIV. What I am doing is getting quotes from different significant people to influence how those who are recently living with HIV feel about themselves.

The idea actually came from the AIDS Quilt. It is so big and people are constantly adding to it, and that’s what I hope to see from the Encouragement Wall on ISJ. Eventually users will be able to come to the site and make their own and have their work immediately added to the wall. I am excited to see how it develops with people’s different words, pictures, and forms of expression.

“If you don’t talk about HIV, and you don’t 

talk about those elements that turn 

into stigma—how can you ever 

combat it and end it?”

SAN: That sounds great! Us too! What do you think the most effective way for people to reduce stigma is (aka be a #StigmaWarrior)?

Josh: I think that HIV needs to become real to individuals and their networks by talking about it in a very personal way. It requires a bit of trust and vulnerability from people--like myself--who are living with HIV. Furthermore, it is equally as important for people to stand up as allies to and speak out for the community of people living with HIV.

The whole reason I got involved with this was because I went to a group therapy session for people living with HIV in Nashville. Everyone seemed to have an attitude of defeat.

They told me: “Josh, you just don’t understand what it is like to hear these words, for people to not want to date you because of this virus.”

My response was: “If you don’t talk about HIV, and you don’t talk about those elements that turn into stigma—how can you ever combat it and end it?”

For me that was an epiphany --when I left and I refused to shut up. From that, I have really learned to and convinced myself that I am going to be ok, all of which has really reduced my internal stress as well as helped my health and impacted my view on HIV.

SAN: Very true. Well, those are all my questions. Thank you again so much for taking the time to do this interview. It has been a real pleasure.

Josh: Same here, but before we go I want to tell you something… 

Check out the exclusive story Josh gave the SAN!