The International Community of Women Living with HIV (ICW) joins our sisters, partners and stakeholders in health to mark this year’s Zero discrimination day marked annually March 1st.
ICW reiterates our call to action to all Governments and stakeholders to intensify efforts to end discrimination of women living with HIV in health care settings.
ICW in partnership with GNP+, ICW East Africa and our local networks has produced a series of qualitative research projects focusing on the perspectives of women living with HIV on retention and adherenceto key programs such as Early Infant Diagnosis programs, PMTCT and treatment for life – a central theme and response research participants, across research topics, across geographies and diverse experience— is the devastating impact of negative and discriminatory healthcare provider attitudes and actions on adherence, retention and ultimately the health and well-being of women living with HIV and their children
Armed with this evidence ICW has been raising awareness about the negative impact of stigma and discrimination on our ability to access and adhere to treatment; have supported the call to arms from our sisters, allies and partners in key populations about the damaging impact stigma has particularly to prevention HIV acquisition.
ICW acknowledges that this is not a problem of the past- this is a problem today, now and it is urgent for the lives and wellbeing of women living with HIV and for our shared goals to reach 90 90 90.
We applaud UNAIDS for taking leadership that has resulted in the increased focus and recognition on the impact and ill-effect of discrimination against people living with HIV and key populations in healthcare. This focus reflects concerns and realities that networks of people living with HIV and other groups most impacted by HIV have been drawing attention to and documenting for years. With this increased focus it is critical to ensure that all approaches to addressing discrimination are rights and evidence based and critically embody principles of GIPA and MIPA, gender equality, community engagement and respect for key populations.
A deliberate approach to engage community in the design, monitoring and evaluation of responses to discrimination and injustice is not only essential for the success of these efforts to address discrimination but to ultimately achieve justice for individuals and communities who have experienced discrimination. We encourage commitments to supporting the ongoing work to document stigma & discrimination and respond to it particularly by communities of people living with HIV.
In addition, efforts to end discrimination must result in enduring structural changes and mechanisms that ensure that the efforts undertaken now and the shifts and improvements in thinking and behavior in all service delivery systems but primarily healthcare are lasting. These structural shifts should include:
- Ensuring that communities are engaged in program monitoring and evaluation particularly around stigma, discrimination and other forms of human rights abuses, lack of informed consent, violations.
- Enabling policy frameworks within healthcare settings eliminate discrimination and enable communication and resolution of discriminatory actions and practices.
- Contributing to enabling environments: including how healthcare systems are using evidence and human rights based frameworks to encourage reforms to laws and policies that negatively impact key populations. We encourage consideration of the way health systems can play a role as advocates for the evidence and rights based HIV response in the face of increasing criminalization of key populations particularly from the LGBTQI community, IDU and sex work communities as well as the criminalization of HIV exposure and transmission.
- Accountability Mechanisms including Safe reporting mechanisms within healthcare systems that enable safe reporting of violations of rights are essential. These reporting mechanisms are not enough without a response to discrimination. Healthcare service providers AS well as individuals and communities must be able to safely report discrimination and rights violations. These systems including reporting mechanisms, support for people who report and importantly, the inclusion of demonstrable responses to discrimination including consequences for those who perpetrate and reforms to policies or practices that enshrine discriminatory practices.
- Scaling up: Ending discrimination requires scaling up key programs within systems at all levels and importantly empowering communities to continue to hold systems accountable.
ICW remains committed to working with all stakeholders in order to realize an enabling environment in which all women and girls living with HIV live free of gender oppression, realizing and claiming our full rights inclusive of sexual, reproductive, legal, social, economic and health rights.