Supporting Social Change to Curb Violence and Eliminate HIV in Guyana, by Anne Stangl of ICRW

By Anne Stangl

*This blog originally appeared on ICRW

As I fly home from the humid, vibrant and bustling Georgetown, the capital city of Guyana, I am a bit overwhelmed by the daunting task the country faces to address the high levels of intimate partner violence, sexual assault, child abuse and suicide in the country.

Over the last week, my colleague Jocelyn Lehrer and I had the privilege of speaking with people working at community-based organizations throughout the country who are an integral part of tackling these challenges. Peer educators, social workers, nurses, counselors, people living with HIV, LGBT advocates, and survivors of violence all took time from their important work to speak with us about their efforts to create a path forward for Guyana.

My visit to the South American nation was the kick-off trip for ICRW’s grant work under Advancing Partners & Communities (APC), a USAID funded project, implemented by JSI Research & Training Institute, Inc., in partnership with FHI 360. ICRW is assisting in the implementation of the project in Guyana over the next three years, helping to strengthen the capacity of local organizations in Guyana to provide HIV prevention, care and treatment services to key populations at heightened risk of HIV infection, including women, men who have sex with men, transgender individuals and sex workers. Reaching these populations is critical for eliminating new HIV infections in Guyana, but extremely challenging, as these groups face high levels of stigma, discrimination and violence in society.

Given mounting global evidence that sexual assault and partner violence are directly linked with HIV infection, it is crucial for Guyana to tackle these key drivers of the HIV epidemic head-on.

During the trip, I learned of the great work these organizations and individuals are doing to support survivors of gender-based violence and to ultimately break the cycle of violence so that no woman or girl has to experience it in her daily life. From training police to be gender- and LGBT-sensitive, to supporting abused women, men and transgendered individuals in accessing justice, to sheltering women and children when their homes are unsafe, I could see firsthand that change is coming to communities in Guyana.

And while these conversations gave me great insight into the powerful individuals working to reduce violence in Guyana, I did see something worrying.

In interview after interview, themes began to emerge: Gender-based violence is pervasive. Services for survivors are limited or very difficult to access. Marginalized populations such as men who have sex with men, transgendered individuals and sex workers are at heightened risk of experiencing violence. Resources are limited for carrying out community- and national-level programs to change harmful gender norms and break the cycle of violence.

The stories shared by these frontline workers were reinforced daily by headlines in the local newspaper: a police officer charged with sexually assaulting a young man with a wooden police baton; a 23 year old who murdered his 14-year-old girlfriend and then hung himself. 

Despite these challenges and the ubiquitous headlines, I am cautiously optimistic about what we can accomplish.

On our final evening in Georgetown - the country’s largest urban center- we attended a production of “Before Her Parting” at the National Cultural Center. The play was written by Mosa Mathifa Telford, directed by Tivia Collins and staged by Merundoi Incorporated - a community-based organization that utilizes entertainment to educate the public, affect individuals’ attitudes and behaviors, and shift social norms. The gripping drama portrays a reality that’s all too common in Guyana in which young woman is murdered by her husband, who then kills himself. The plot could have been ripped straight from recent headlines.

The play also explores the intergenerational cycle of abuse that fosters violence generation after generation in Guyanese society: A woman is abused by her husband and is violent toward her son; her son grows up to beat and ultimately murder his wife, and the cycle continues. The play was followed by a facilitated discussion with the more than 400 audience members, ranging from students to teachers to civil servants, and a panel of speakers from various government institutions. It was heartening to hear these young Guyanese demand both action to reduce violence and expanded services to support survivors.

It is my hope that though USAID’s Advancing Partners and Communities Initiative, ICRW and John Snow International will be able to strengthen the capacity of local organizations so they are better equipped to respond to gender-based violence in Guyana and can continue to facilitate social norm changes to reduce violence and reduce the spread of HIV infection.

Above all, from my time in Guyana, I saw hope and determination. Hope that the next generation will not see the type of endemic violence that has pervaded Guyana for decades, and be determined to tackle these problems head-on. It’s important that those of us in the global community echo that hope and determination, too. We need to ensure that community workers and advocates have the tools to end these human rights violations as well as to empower women and girls to live free from fear of violence or abuse.

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Thank you to Anne for allowing us to share this post. If you would like to know more about what Anne does at ICRW, check out her twitter feed.

For National Youth HIV/AIDS Awareness Day: A Timeline of HIV in American Children

Happy National Youth HIV/AIDS Awareness Day, #StigmaWarriors! Today our blog post will be about the history of HIV and HIV-related stigma and discrimination in children and young adults. As you’ll see, the United States has come a long way from the early days of the HIV epidemic, especially when it comes to the care and treatment of children and young adults who are living with HIV. So let’s get started with our history lesson!

1969

The first known case of AIDS in children/young adults in the United States wasn’t discovered to be AIDS until 1987. Robert Rayford, a sixteen year old from St. Louis, Missouri, died of a mysterious illness in 1969 [1], several months after checking himself into the hospital for treatment. When doctors performed an autopsy, they found several abnormalities, and were so baffled by Robert’s illness that they preserved samples of his tissue. In 1987, several years after the HIV epidemic was first identified in the United States, those same doctors tested Robert’s tissue samples, and they came back positive for HIV.

1982

On December 10th, the CDC reported a case of unexplained immunodeficiency [2] (later determined to be HIV) in an infant who had received a blood transfusion. Over the next several weeks, twenty-two more cases of infants [3] who were either living with or had died from unexplained immunodeficiency were reported. Most of the children were diagnosed with immunodeficiency after a blood transfusion or it was found that the condition was transmitted to them through their mother.

1985

Ryan White [4], a hemophiliac who contracted HIV from a blood transfusion, was kicked out of Western Middle School in Kokomo, Indiana, after it was disclosed to school officials that he was living with HIV. After a drawn out court battle, White was allowed to return to school, but his parents decided to withdraw him from Western and enrolled him in Hamilton Heights High School in Cicero, Indiana, where school officials and students welcomed him with open arms after being educated about HIV. This was the first nationally known case of the effects of HIV stigma.

In December, the US Public Health Service released the first recommendations for the prevention of mother-to-child transmission [5].

1987

A federal judge ordered the DeSoto County School Board in Arcadia, Florida, to allow the three HIV-positive Ray brothers (Ricky, Robert, and Randy) to attend school after they were kicked out because the parents of other children did not want children living with HIV to attend the school [6]. The brothers were hemophiliacs and most likely contracted HIV via blood transfusions. After the judge’s decision was handed down, other parents began withdrawing their children from school, and on August 28th the Ray’s home was burned down, prompting them to flee Arcadia [7].

1988

Elizabeth Glaser, wife of Starsky and Hutch star Paul Michael Glaser and a mother living with HIV, founded the Pediatric AIDS Foundation (now the Elizabeth Glaser PediatricAIDS Foundation) [7] after their daughter Ariel died of AIDS. At this time there were no approved antiretroviral drugs for children living with HIV, and the Glasers' son Jake was dying of AIDS. Through lobbying, the EGPAF was able to get the FDA to approve antiretroviral treatments for children.

1989

Ryan White spoke before the President’s Commission about the HIV Epidemic about the HIV-related stigma he faced after his diagnosis [8], and emphasized how HIV education helped him be more accepted at his new school in Cicero. As a result, schools across the nation implemented education programs about HIV in health classes.

1990

HIV activist Ryan White died in April at the age of eighteen. Four months later, President George H. W. Bush signed the Ryan White CARE Act [9] into law, which provides government funding for HIV/AIDS research. It has been reauthorized four times, most recently in 2009.

1998

Five years after Ricky Ray’s death, Congress enacted the Ricky Ray Hemophilia Relief Fund Act [10], which authorizes payment to hemophiliacs and other people living with blood clotting disorders who were infected with HIV via contaminated blood transfusions between 1982 and 1987.

2002

Twenty years after HIV was confirmed in children, approximately thirteen million children and young people were living with HIV, mostly in Africa [11].

2006

The first National Women’s and Girl’s HIV/AIDS Awareness Day was commemorated on March 6th.

2013

In March, doctors at the CDC confirmed that a toddler in Mississippi [12] who had been diagnosed with HIV at birth had been “functionally cured” of HIV, leading to hope for a cure in children who were transmitted HIV in utero. One year later, the toddler was still free of HIV.

The first National Youth HIV/AIDS Awareness Day was commemorated on April 10th.

2014

In March, an infant in California was confirmed to be“functionally cured” of HIV [13] after receiving the same treatment as the Mississippi toddler who had been “functionally cured” of HIV one year earlier. The CDC is currently trying to work out clinical trials in order to find a cure for children prenatally exposed to HIV.

The Future

What an amazing timeline! It truly shows how the treatment of people living with HIV, especially children and young adults, has changed. Twenty years ago there were no treatments for children living with HIV, and now there are two toddlers who have been functionally cured of it! Isn’t modern medicine amazing? And now, children living with HIV don’t have to worry about being kicked out of school if their condition is diagnosed. Ryan White and the Ray brothers’ legacy is proof of that.

Who knows what the future holds? What we know it holds is a lot of hope for those living with HIV to potentially find preventative vaccines or even cures. It also holds hope for lives free of HIV-related stigma and discrimination.

Happy National Youth HIV/AIDS Awareness Day!