Neo Mohlabane

The late breaker session highlights the intersection of multiple pandemics – HIV, Covid-19, and stigma amongst key populations. The findings highlight the need to involve members of key populations, transform health care facilities into safe spaces and address multiple intersecting inequities that hamper acceptance and access to life-saving treatment.

The interaction of HIV and COVID-19 is well known, particularly in terms of the risks for severe COVID-19 illness among people living with HIV (PLWH). However, the findings from a Canadian survey of 246 adults living with HIV, suggests that Covid-19 vaccine confidence, governmental trust, and acceptance is high. On the other hand, social inequities including stigma and discrimination can hinder access to life-saving treatment among some transgender people. Phillip Schnarrs from the University of Texas reported on a community-based participatory project that explored the preferences, needs, and barriers to uptake of longer-acting formulations of PrEP amongst transgender and gender-diverse Texans. The key findings highlight individual, interpersonal, health systems, and structural barriers to acceptance and access to long-acting PrEP amongst transgender persons. Further, Thomas Carpino’s study conducted amongst sexual minority men in the US corroborates that stigma is a key factor that underlies the risk to infection and hindrance to treatment access. The studies highlight the urgent need for the co-development of multi-level interventions that involve key populations as ambassadors and the creation of safe and friendly health facilities if health inequities that exacerbate risk and hamper access to treatment are to be overcome.

While the studies advocate the need for more research to identify factors that exacerbate the exclusion of key populations from the HIV prevention cascade, there are exclusions along the lines of race, ethnicity, and nationality that are inherent to these studies. Amongst key populations, there are minority groups including refugees, persons with disabilities, and Indigenous communities that continue to be marginalized. Intersectional analytical approaches can thus, assist in making HIV research, response, and prevention more inclusive and as stated by Session Chair, we need to “work together in unity to bring solutions” to the plight of HIV.