February 21, 2024








May 16, 2023
By Ralf Jürgens, Senior Technical Coordinator, Human Rights, Community, Rights and Gender (CRG), Global Fund

On this International Day Against Homophobia, Biphobia and Transphobia, we can celebrate some important steps being taken for the rights of LGBTQI+ people, leading to progress in the fight against AIDS. Last year, at least three countries joined 45 others that have decriminalized consensual same-sex sex over the past 30 years.

But this progress comes against a backdrop of intensified repression of LGBTQI+ people in many countries.

I wish this blog was written by one of the brave LGBTQI+ activists the Global Fund is honored to support. But in too many places, even sharing ideas publicly is dangerous for them.

As of March 2023, some 64 countries still criminalize consensual same-sex relationships, six of which make such conduct punishable by death. Several countries are now considering draft laws with such draconian provisions.

as UNAIDS notes, criminalizing same-sex relationships will only increase the disproportionate HIV risk that LGBTQI+ people already face.For example, a 10-Country Study in Sub-Saharan Africa HIV rates among gay men and other men who have sex with men were found to be twice as high in places with these criminal prohibitions as in countries without such laws.

For more than five years, the Global Fund’s Breaking Barriers program has supported community partners in 20 countries working to overcome barriers for LGBTQI+ people and others facing widespread and unjust criminal sanctions. Human rights-related barriers to health services.

Portrait of the author, Ralf Jürgens

Ralf Jürgens, Senior Technical Coordinator for Human Rights, Community, Rights and Gender (CRG), Global Fund.

While the law cannot be achieved overnight, much can be done in the short term to build advocacy coalitions and programs to challenge the law and get as much access to justice as possible.

For example, where it can be done safely, the Global Fund supports community-led monitoring of incidents of discrimination, violence and other abuse against LGBTQI+ people, which can provide a solid information base for advocating for legislative reform.

Breaking Down Barriers also supports the mobilization of large numbers of peer paralegals—in this case, LGBTQI+ people who know their communities and can help people file and follow up on complaints about violations of their rights.

Even when the law is bad, paralegal support can help people with abusive situations and can refer people to legal aid if needed. In Ukraine, for example, peer paralegals help maintain people’s access to health and harm reduction services even during wartime. Where LGBTQI+ people are at risk because of social attitudes and criminalization, the Global Fund supports safe houses and other measures to protect fellow paralegals and the people they serve.

Thanks to support from the Global Fund, healthcare providers in many countries are being helped to provide respectful services for MSM and transgender people. In some countries, even when consensual same-sex relationships are illegal, it is possible to find safe spaces where health professionals can hear directly from members of the LGBTQI+ community about the challenges they face and the compassionate services they seek.

Community-based monitoring of the quality of health services for key populations complements this activity. In some countries, members of the LGBTQI+ community are also likely to engage constructively with police and prosecutors, often resulting in more humane law enforcement.

An effective global HIV response means not giving up on the struggle for a life of dignity for all LGBTQI+ people.