Dominican Republic: Understanding HIV stigma and discrimination

In 2009 Profamilia and Redovih y Asolsida led a study using the People Living with HIV Stigma Index, to discover the type of stigma and discrimination faced by people living with HIV (PLHIV) in the Dominican Republic. There were a number of interesting results:

Almost one in four respondents reported that their rights as PLHIV have been violated. Most common forms of discrimination were verbal aggression, emotional violence, verbal and physical threats, harassment and exclusion from family activities. One in ten of those interviewed had been refused a job and eight per cent had been refused health services. In general women were more affected by these forms of discrimination than men.

Violence against women living with HIV was extremely common. Thirty-four percent of the women had been pushed, shoved or had something thrown at them, and eleven per cent had been threatened with a weapon.

Thirty per cent of the women and seventeen per cent of men had been advised against having children. Twenty per cent of women had been forcibly sterilized.

The research was an empowering experience for many of those interviewed as well as the interviewers. The interview process helped the interviewees identify experiences of discrimination and violence that they had not realized before. It also enabled the provision of education, counselling and service referrals where necessary.

The results of the study are an important tool for advocacy, development of public policies and programs. Dulce Almonte, Redovih’s president said:

“The Stigma Index is a base to fight and demand our rights, to participate in meetings regarding national plans and present proposals, raise our voices regarding the high incidence of stigma and discrimination at the workplace, socially and especially in the health sector.”

All those involved in the study agree that the results achieved constitute invaluable tools to address stigma and discrimination against PLHIV, especially against women. One interviewee summed this up perfectly:

“I really like it that this study was about discrimination, as, being HIV-positive, this I what I have lived with most.”

This is one of the twenty-four, real-life stories highlighting how IPPF's work is having a real impact in the lives of people around the world. 'In A Life' is available at: http://www.ippf.org/en/Resources/Reports-reviews/In+a+life+2010.htm

Annie Lennox asks HIV to become part of our ‘common language’, at launch of photography exhibition

A new photographic exhibition ‘Exposures: lives lived in the shadows and light of an epidemic’ was opened this week at the Embassy of Japan in London.

The exhibition was opened by H.E. Ambassador Shin Ebihara and Annie Lennox, HIV campaigner, founder of the SING campaign and singer/songwriter.

It showcases the work of the IPPF Japan Trust Fund for HIV and AIDS, and some of the many lives it has touched. The exhibition marks the tenth anniversary of the IPPF Japan Trust Fund.

The IPPF Japan Trust Fund is a partnership between the Government of Japan and the International Planned Parenthood Federation. Established in 2000, the Japan Trust Fund has been a pioneering programme that has actively provided some of the most stigmatised and marginalised communities around the world with essential services.

Ten years on, IPPF Member Associations in Africa, Asia and the Middle East have implemented more than 110 Japan Trust Fund projects in 40 countries. The breadth and scope of their work is evident in its reach and the array of project highlighted in “Exposures”, including: 

• Supporting women engaged in sex work to access HIV and sexual health services and stand up for their rights in the conflict prone districts of Nepal
• Ensuring that package of workplace HIV services are available for construction workers and surrounding communities during the construction of the second Mekong International Bridge on the border of Laos and Thailand
• Working with organizations of people living with HIV in Cameroon, to secure their right to have a family and prevent mother to child transmission of HIV
• Meeting the sexual and reproductive health needs of people who use drugs, and their sexual partners, in Nagaland, India
• Increasing access to integrated HIV and sexual and reproductive health services for returning refugees in Rwanda, and addressing gender-based violence within these communities

H.E. Ambassador Shin Ebihara, said: “Japan is committed to helping achieve the Millennium Development Goals (MDGs). Last week at the United Nations, Prime Minister Kan announced the new “Kan Commitment”, promising to provide 5 billion US dollars in health and 3.5 billion US dollars in education over the next five years. He also offered to host a MDGs follow-up conference in Japan next year.　Japan believes active collaboration with civil society is important in achieving the MDGs. It is therefore my sincere hope that today’s event will provide a good opportunity for strengthening our ties with the IPPF and civil society.”

Annie Lennox, said: “It is such a challenge to put a face to HIV – a virus that you can’t see and often goes unnoticed. The images in the photo exhibition show so many diverse people, from so many diverse places; Nagaland, Ethiopia, Palestine…. What combines their experiences is stigma. Even here in the West, in the UK, there is still such strong stigma. HIV needs to become part of our common language. 

"Real change is happening through initiatives like the ones showcased in this exhibition. What has been achieved by this partnership between the Government of Japan and the IPPF in 10 years has been amazing. And just imagine what can be achieved in the next 10 years. I am honoured to be part of it.”

Kevin Osborne, Senior Adviser HIV and AIDS at the International Planned Parenthood Federation, said: “Today, there are proven and compelling arguments supporting the linkages between HIV and sexual and reproductive health. But 10 years ago these arguments were not well understood or accepted. 

It is a sign of incredible foresight that, in 2000, the Government of Japan supported IPPF to integrate HIV services into our sexual and reproductive health programmes. The images and stories highlighted in ‘Exposures’ illustrate the positive impact of the IPPF Japan Trust Fund for HIV and AIDS on the lives of many on the margins of society. It provides a compelling argument for scaling up our joint efforts.”

'Exposures: lives lived in the shadows and light of an epidemic' can be viewed until 12 October 2010 at the Embassy of Japan, 101 – 104 Piccadilly, London W1J 7JT.

For further information please contact Paul Bell at IPPF on: 44 (0) 207 939 8233 or pbell@ippf.org

For more information on the SING campaign please visit www.annielennoxsing.com

Indonesia: Men matter

Rahmad has been working in the construction industry since he was 17 years old, a job with short term contracts which require men to work far from home and away from the company of their wives. He says for these men, there are few more important things after receiving their weekly wages than seeking pleasure.

‘I am 31 years old, a husband and father of two children. I work as a steel concrete labourer for one of the construction companies that are developing the Tanjung Priok Access Road.

I‘m lucky because I can go home everyday as I’ve rented a small house near the project site. But for men who live far from their families, to relieve stress they will look for sex workers, male or female. Their wages are about $3–5 a day, but they’ll happily pay $5–20 to have sex. If they are not having sex, they’re getting drunk.

Although most of us have heard from the media about gonorrhoea, syphilis and HIV, and that they can be transmitted through sexual intercourse without a condom, most don’t pay any attention. I… no, my friends buy antibiotics or herbs if they feel uncomfortable or feel pain around their genitals. Do we visit the doctor? No way, it would be shameful. Sometimes I feel guilty that men don’t care about the risk to our wives.

One day my foreman asked me and some friends to attend a discussion during our lunchtime. At first we objected but he insisted that we join the other workers. At first, I could not believe it! A young man from the Indonesian Planned Parenthood Association (IPPA) was speaking frankly about sex. He explained what a sexual transmitted infection (STI) is and all about HIV and how it can be transmitted. He also distributed a leaflet with information on STIs and HIV, and the address and telephone number of his organization. Not only did he visit us regularly, but so did his colleagues. Over time, many workers considered these educators as friends. They helped us to understand about STIs and HIV and have encouraged us to use a condom when having sex. We were also allowed to use their mobile health services to have genital examinations and blood tests.

I now see some of my colleagues trying to look for condoms on pay day, although they are still ashamed to ask for them! How long should this programme should continue? I suppose for as long as men work far from home.’


This is one of the twenty-four, real-life stories highlighting how IPPF's work is having a real impact in the lives of people around the world. 'In A Life' is available at: http://www.ippf.org/en/Resources/Reports-reviews/In+a+life+2010.htm

Pakistan: Delights, Dogs and Destiny

 Fatima* is a sex worker who has become involved with a peer education group set up in Quetta, Pakistan, to increase HIV prevention and care among sex workers.

‘I nearly quit on my first day as a peer educator because a pack of dogs was set on me! I’d been to a brothel and the owner refused to let me talk to her sex workers. I can earn up to 30,000 rupees ($350) a night as a sex worker. Being mauled by dogs for 4,000 rupees ($47) per month as a peer educator hardly seemed worth it. I’m so glad I didn’t quit because I later helped save a woman’s life.

My manager came with me the next day. She reassured the owner, Auntie, that nobody planned to change her girls’ attitude towards sex work and that we were concerned only about their health and safety.

My eyes fell on a frail woman sitting in a corner in agony. The emptiness in her eyes made me wonder what she might have been going through. I tried talking to her, but was stopped. Before leaving, I scribbled and hid my telephone number under the sofa, making sure the hollow-eyed woman noticed.

Her name was Zeba*, and she called me the same night. Sounding petrified, she whispered that she needed medical attention and help. The next morning my manager and I visited Auntie, armed with ‘gifts’ including medicines and condoms. She was happy for us to distribute these among the girls.

We told them about the ‘Drop-in Centre’ run by Rahnuma Family Planning Association Pakistan where free medical check-ups are conducted by doctors. We reassured everyone that the medical attention provided was non-judgemental and stigma-free, and Auntie finally gave her girls permission to visit.

Zeba needed medicines for sexually transmitted infections and post abortion care. After she was stabilized, she shared her story. She was a mother – though her three children lived with their grandmother in Gujranwala village. She came to Quetta five years ago to work in a toy factory, but soon found herself sold by the factory owner to Auntie. Unfortunately, Auntie discovered Zeba talking to us, and Zeba disappeared without a trace.

I later found Zeba at the Drop-in Centre. Her time with us had given her confidence to stand up for herself. She had more than 18 clients a day, but before meeting me she only got a minor percentage, but now she felt better and had the courage to negotiate a better deal.

I am still a sex worker, but my work as a peer educator has given me a great sense of achievement.’

*Name changed to protect confidentiality


This is one of the twenty-four, real-life stories highlighting how IPPF's work is having a real impact in the lives of people around the world. 'In A Life' is available at: http://www.ippf.org/en/Resources/Reports-reviews/In+a+life+2010.htm

Sudan: Stigma-free treatment

Living with HIV in Sudan is not easy. The media demonises HIV, this is both a symptom and a cause of the high level of HIV related stigma and discrimination faced by people living with HIV in Sudan. This stigma affects their access to medical treatment as well as care and support services. The head of a stigma-free HIV-clinic opened by the Sudan Family Planning Association takes up the story:

‘Our biggest problem in Sudan is knowing how to give people living with HIV a decent life. Our priority is finding support for people living with HIV that allows them to live positively and access the medical services they need. The situation in Sudan is very difficult. Many people living with HIV do not want to go to government health facilities as they often have a harrowing experience as the following examples show:
Through the Sudan Family Planning Association, we have been able to open a centre where people living with HIV can receive stigma-free HIV treatment, care and support services such as voluntary counselling and testing, prevention of mother-to-child transmission, antiretroviral therapy and treatment for sexually transmitted infections and opportunistic infections. There is also counselling and psychosocial support available for people living with HIV as well as home care visits. We do all this so people living with HIV can live a normal, decent life and have access to the support, treatment and care they both require and need.’

“I had a cut in my hand, so I went to the emergency unit at my local hospital. When I was seen by the doctor, he was about to seal my wound when I realised that he was not wearing gloves. When I told him to put gloves on, he looked surprised and asked me why? I told him I was HIV-positive. He told me to wait where I was and that he would be back shortly. He never came back but left me bleeding in the treatment room so I bandaged myself and left.”

“People living with HIV cannot bear the public hospital. This is because the doctors there refuse to deal with us. I will always go to the HIV clinic if I can, to avoid being stigmatized by the doctors and nurses in the public hospital.”

This is one of the twenty-four, real-life stories highlighting how IPPF's work is having a real impact in the lives of people around the world. 'In A Life' is available at: http://www.ippf.org/en/Resources/Reports-reviews/In+a+life+2010.htm

Iran: The longest night of the year

In a clothing factory in southern Tehran, Yalda, a 19 year-old girl, earns a living folding and packing clothes eight hours a day. The last four years have been a roller coaster for her, as she explains:

‘My name Yalda means ‘the longest night of the year’. I think it reflects my past, which has been long and dark. I lost my mother at the age of seven and had to take on a mother’s role, while raising my younger sister.

At 15, I committed a sin under Islamic law. I lost my virginity to my boyfriend Mohammad, who had promised to marry me. My father is very conservative and religious, so could not accept this. I was left with no option but to run away with Mohammed.

My life quickly spun out of control. It all started with my first cigarette. That cigarette became the gateway to a life of addiction. The first time I got high I had no idea what to expect, but once it hit and I started feeling the tingle I couldn’t help but smile. For the first time I was able to escape my life. I moved on to drugs to numb the pain, shut down my brain and get through the day. Mohammad and I felt free. We shared needles for drugs, and enjoyed sex with no fear of sexually transmitted infections.

Things changed when the drug addiction set in. Mohammad wanted to sell me to fund his daily fix. Scared and heartbroken I ran away. I was 17 years old, with no money or place to stay. I turned to sex work to survive but I was often raped, beaten and had nowhere to sleep but the park.

An outreach team associated with the Family Planning Association of the Islamic Republic of Iran (FPAIRI) approached me one night. I registered at their clinic and saw their gynaecologist. After receiving some counselling I decided to test for sexually transmitted infections and HIV. The HIV test result was positive.

The staff at FPAIRI were very supportive. They gave me free condoms and information on safer sex practices. I learnt about contraceptives, preventing sexually transmitted, and life skills development. They also helped me access methadone therapy and offered me vocational training to find work. These free services helped me back on my feet. I first decided to become a peer educator to help other girls and then I retrained and took a job at the clothing factory.’

This is one of the twenty-four, real-life stories highlighting how IPPF's work is having a real impact in the lives of people around the world. 'In A Life' is available at: http://www.ippf.org/en/Resources/Reports-reviews/In+a+life+2010.htm

A 'miscarriage' of justice

On Sunday 22nd August I mentioned that a number of women are imprisoned in Guanajuato (the state in Mexico where the World Youth Conference took place) for having an abortions and that some of these women had been imprisoned for having a miscarriage! There is finally some good news on this story - see below:

7 women in 'miscarriage' cases freed in Mexico
By MARK STEVENSON (AP) – 17 hours ago
MEXICO CITY — Seven women in Mexico serving prison terms of up to 29 years for the death of their newborns were freed Tuesday after a legal reform enacted in the state of Guanajuato lowered their sentences.

The women's cases case drew national attention in Mexico and their release is unlikely to staunch the fiery debate about whether some conservative states are trying to overzealously enforce bans on elective abortion by charging women who may have suffered miscarriages.

The complete story is available here: http://www.google.com/hostednews/ap/article/ALeqM5gwlqCTH27c7bNv925zRTxUNsnhuwD9I3GER00

However,the women were not absolved, but rather released under a legal reform passed by the state and abortion is still illegal in the majority of cases. There is a lot way to go to ensure that women have the right to choose and access safe abortion services in Guanajuato.