Key populations face new HIV infection burden

Adolescents, young women, men who have sex with men, and female sex workers (key populations) still bear a heavy burden of new HIV infections, Batlhalefi Leagajang, the deputy coordinator at the National AIDS and Health Promotion Agency (NAHPA) has stated.

He made this remark at a recent engagement meeting between NAHPA and the senior management of the Botswana Police Service (BPS) in Gaborone, where they discussed HIV, human rights, key populations, and law enforcement issues. Leagajang highlighted human rights barriers hindering access to essential HIV programmes, including stigma, discrimination, gender-based violence (GBV), and harmful gender norms.

He added that individuals living with HIV and key populations often encounter various stigmas that overlap with other stigmatised health conditions like tuberculosis, as well as aspects of their identity such as economic background, gender, occupation, and sexuality.

“Experiences of discrimination may include physical abuse, denial of health services, loss of jobs, housing denial, or arrest/police harassment where specific key populations’ behaviours are criminalised,” he explained.

Leagajang referenced a recent study, Stigma Index 2.0, which revealed that people living with HIV experience more internalised stigma than external stigma, potentially due to their living environment.

“This stigma and discrimination hinder access to HIV services and decrease adherence to ARV medication, leading to poor physical and mental health,” he stated.

Leagajang highlighted the escalation of GBV, including intimate partner violence, sexual violence, abuse of women and children, and attacks on LGBTQ individuals and sex workers.

He referenced the 2013 relationships study, which reported that 70% of women experienced GBV at least once in their lifetime, with a prevalence rate 24 times higher than the cases reported to the police.

However, the successful conviction rate of GBV cases remained less than one percent, illustrating a twin epidemic of sexual and gender-based violence. Leagajang further explained that sensitising law enforcement officers on the rights of vulnerable populations and how to support their access to justice was crucial for promoting non-discriminatory, safe environments. He noted that while in-service sensitisation of law enforcers had been conducted on a smaller scale and ad hoc basis, a comprehensive response was needed to strengthen ongoing partnerships with the BPS and promote rightsbased policing for Key and Vulnerable Populations (KVP).

“As a first step towards capacity building, NAHPA has proposed orienting senior officers on the links between law, policing, human rights, and KVP, aiming to facilitate buy-in and promote ownership in rolling out the initiative for empowering members of the BPS to enforce laws and regulations with knowledge, evidence, empathy and compassion,” he explained. He envisioned that these orientations would guide law enforcement officers in areas concerning vulnerable populations.

“These orientations and capacity building will also guide law enforcement officers in areas such as investigations, arrest, detention, and the use of force concerning populations most vulnerable to HIV,” he added.

This stigma and discrimination hinder access to HIV services and decrease adherence to ARV medication, leading to poor physical and mental health