India’s Section 377 law (repealed in 2009 but reinstated in 2013) criminalises private consensual sexual conduct between adults of the same sex. It also undermines effective HIV programming and violates human rights.
But the Global Fund supported Pehchan programme – focused on strengthening community systems to deliver an effective HIV response for sexual minorities - is proving a catalyst for change.
Abhina Aher manages the Pehchan programme which supports 200 community-based organisations to provide HIV prevention services to MSM, transgenders and hijras in 17 Indian states.
Abhina was born a biological boy and grew up in a middle-class neighbourhood of Mumbai, India. Now 37, she has undertaken a long and arduous journey, rejecting her biological sex and becoming a hijra - a member of India’s ancient transgender community.
Last month, Abhina celebrated as India's Supreme Court recognised the constitutional rights of transgender people. The decision redefines the state's obligation to them as one of India's most marginalised groups, including ensuring their equal access to health care, education, and other social services. She said, "What we have done is that we have put a foot inside a door, which is a door of hope, and we will open it — very, very soon."
Shaleen Rakesh is a gay rights activist who has been at the forefront of the gender and sexuality movement for the last twenty years. He was the primary petitioner for the Public Interest Litigation against Section 377 on behalf of the Naz Foundation (India) Trust in 2001.
But the change in legal status for hijras came hot on the heels of ‘Black Monday’ – 11 December 2013 – when the Indian Supreme Court upheld Section 377 of the Indian Penal Code, thereby recriminalising same-sex sexual behaviour.
Shaleen, a Director at India HIV/AIDS Alliance, commenting on the reversal of the law, said, “My own country did this. It’s no longer a colonial legacy. It’s my own country that is telling me I’m a criminal.”
The LGBT and HIV community in India is rallying again. The ‘207 against 377’ campaign brings together the 207 organisations implementing the Pehchan programme to protest against the judgement upholding Section 377.
On 6 February, the campaign organised a national consultation that was attended by LGBT community members and leaders from across India. Shaleen said, “The consultation identified priority actions to move advocacy forward, including recording individual cases of abuse faced by the LGBT community.”
With the support of the Global Fund, the team is systematically monitoring and reporting on human-rights related barriers to HIV and health services. In 2013 alone, there were 797 reported incidents of harassment and abuse reported through Pehchan’s network of 200 CBOs.
So how does it work? In response to an incident – whether discrimination in a health clinic, police abuse, or community violence – the victim contacts a district-level ‘Crisis Response Team’ based in the local Pehchan CBO. These are made up of three to four individuals, including community members and legal representatives who are able to quickly advocate on behalf of that client.
Catalyst for change
Few programmes - in India or elsewhere - have attempted to engage MSM, transgender and hijra community organisations at the geographic scale of Pehchan. It is the Global Fund’s largest single-country grant to date focused on the HIV response for vulnerable sexual minorities.
Two factors are key to Pehchan’s success. Firstly, despite the law (pre-2009 and now), the Government of India’s national HIV strategy has specifically included a comprehensive package of services for MSM since 1999. However, India remains a remarkable exception; in far too many low and middle income countries, the criminalisation of homosexuality is used as a primary rationale for simply doing nothing.
Secondly, the nature of the Global Fund as a multilateral financing mechanism with its commitment to national ownership has enabled the development of a community systems strengthening programme for sexual minorities in India. This would have been more difficult to fund through other channels such as bilateral donors or government domestic spending, both of which are subject to more immediate political pressures.
Nonetheless, as India and Pehchan show, in all epidemic contexts if civil society, government, and donors work together to develop and fund a wider range of programmes we can address the prevention needs of MSM and transgender communities around the world.
- India accounts for roughly half of Asia’s HIV epidemic with approximately 2.1 million people living with HIV. The Government of India has conservatively estimated that there are 2.3 million MSM and transgenders in the country, of whom 412,000 are considered to be at high risk for HIV infection. Prevalence among MSM is 4.43% and among transgenders is 8.82% (against an overall adult HIV prevalence of 0.27%).
- Pehchan is implemented by Alliance Linking Organisation India HIV/AIDS Alliance in consortium with Humsafar Trust, PNRO, SAATHII, Alliance India Andhra Pradesh, Sangama, and SIAAP and aims to reach more than 450,000 MSM, transgenders and hijras by 2015.
- The protracted struggle by activists like Abhina and Shaleen to overturn Section 377 was documented in 2011 by India HIV/AIDS Alliance in this short film, Securing the Right to Love.