Human Rights, Stigma and Discrimination
HIV/AIDS is still a problem in Thailand. The Asian Epidemic Model has projected that with an intensive and extensive prevention and care efforts, Thailand would still have about 17,000 new infections in 2010. The 2008-2009 UNGASS Country Progress Report highlighted that human rights related to AIDS did not receive optimal priority.
It recognized that like gender, HIV/AIDS and human rights as well as stigma and discrimination have been recently used as a cross–cutting issue to mutually form a continuing platform to address the issues related to the so-called “AIDS Rights Protection” in changing dynamics with regard to national conventions, including 2009 National Human Development Report and the 11th National Social and Economic Development Plan, and the UNPAF for 2012-2016.
Clearly, there is a need to address HIV/AIDS and human rights as well as stigma and discrimination. A recent goal was to reduce new infections by half, increase universal access to prevention, treatment, care and support and ensure at least 80% of social supports among those who are affected by HIV. AIDS rights, stigma and discrimination are still national priority issues that could affect other programme interventions for HIV and AIDS prevention, treatment, care and support.
In other words, it is the need to include supporting social services and a guarantee of fundamental rights and protection as the key supporting and enabling elements of any successful AIDS programme. Some initiatives have started. A joint UN programme has built good foundation for basic databases, training capacity, legal service setting and supporting mechanisms. There are also two major existing programmes addressing human right issues related to HIV and AIDS but both programmes are relatively new and small.
The recent experiences also confirm that there is a need to do more by building from what they have done in terms of policy advocacy, attitude change and capacity building as well as enhancement of key mechanisms to ensure continuing and strong platforms to address HIV and human right related issues at all levels. Finally, there is a need to include the initiation and long-term use of data sets and indicators in the national monitoring and evaluation system.
UNAIDS’ “Getting to Zero” Strategy provides for “zero discrimination” as one of the three overarching goals. The UN still recognizes HIV and human rights as well as stigma and discrimination as one of the strategic priority issues and supports the implementation of the programme on AIDS rights protection and stigma-discrimination. However, it is important to review what role the UN family should play to strategically add value to the national AIDS response, especially to the AIDS rights protection system given that the UN has limited resources.
In 2008-2009, the UN Joint Team on HIV/AIDS worked closely with CSO partners under the joint programme on development of a stigma index and broader HIV/AIDS rights advocacy. Under this programme, there were key outcomes that have both confirmed the importance of continuing efforts to jointly and strategically address stigma and discrimination and building a working basis for all HIV and rights concerned government agencies and key stakeholders. The programme outcomes were, for example, stigma index survey findings showing the existence of types and causes of rights violations throughout the country. The study found that some of the people living with HIV who were also sex workers or men having sex with men (MSM) faced double or triple forms of stigmatization and discrimination. This presents an obvious barrier to access to counseling and testing services as well as treatment and care.
Currently UNDP participates in a joint programme that assists national partners and stakeholders in creating and strengthening mechanisms and systems to ensure access to justice and enable an environment in which stigma and discrimination would be no longer a barrier to block HIV prevention and care services. It purports to contribute to the joint programme outcome of enabling environment with better attitudes, policy and practices toward HIV and AIDS and human rights as well as stigma and discrimination The UN joint programme has four specific objectives, outlining the four interrelated result areas:
- National and sub-national mechanisms on stigma-discrimination prevention and AIDS rights protection officially established and well functioning.
- Key stakeholders in government sector, private business partners and CSOs mobilized and supporting stigma and discrimination prevention education services in pilot settings and groups
- Improved legal hotline service/AIDS rights protection centers and call volume increased in pilot and neighbouring provinces
- National data sets on HIV and human rights as well as stigma and discrimination are effectively used in the UNGASS’s National Composite Policy Index (NCPI)
National Guidelines for HIV Prevention among MSM and TG
UNDP also is working with the Royal Thai Government on a National Guideline for HIV Prevention among MSM and TG. HIV prevalence among men having sex with men (MSM) and transgender people (TG) remains at a crisis level in the country, the highest reported in Bangkok at 31.1% among MSM and 16.7% in 2010 and the highest among all key affected populations. TGs and MSM in urban areas of Thailand today are said to be twenty times more likely to be living with HIV than people in the general Thai population.
The Thailand National AIDS Strategy (2007-11) aims to reduce new infections by half; identified MSM and TG as a priority population, and intends to create a “policy enabling environment that support intervention among MSM and TG.”
As Thailand prepares to embark with its new National AIDS Strategy (2012-2016) with its Getting to Zero vision, focus is being given to scale up prevention among key affected populations, particularly MSM and TG. This includes a specific provision on managing quality services delivery and increased coverage for MSM and TG interventions. It is expected that the strategy will be finalized this year and the operational plan to follow after. Guidelines by which MSM and TG strategies and activities will be implemented are critical to the success of the response in Thailand. Thailand has existing national HIV guidelines on PMTCT, VCT, ARV and harm reduction but it has no existing guideline regarding prevention among MSM and TG. This initiative will directly address this policy gap. Contributing to this, a national guideline is an essential tool to operationally manage the planning and budgeting of HIV interventions among MSM and TG in Thailand and manage quality of the prevention services at the ground.
In 2010, the Bureau of AIDS, TB and STI, Department of Disease Control, Ministry of Public Health supported by UNDP Thailand launched “A Road to National Guidelines for HIV Prevention among MSM/TG in Thailand” project which is expected to generate existing practices in MSM and TG HIV prevention as evidence for recommendation on the national guidelines for MSM HIV prevention in Thailand. In this national guideline, UNDP hopes to increase access to and utilization of effective prevention, treatment, care and support services for HIV and AIDS, increase HIV prevention services among MSM and TG in Thailand is standardized and consistently applied to programme implementation.
In the big picture UNDP aims to established national guidelines on HIV prevention among men having sex with men and transgender people in Thailand and the guidelines are locally implemented.
Building Strength on Strength: Lessons from Community Responses to HIV in Northern ThailandBuilding Strength on Strength
This publication is the product of a joint partnership of the Faculty of Nursing of Chiang Mai University, the Thailand International Development Cooperation Agency (TICA) of the Ministry of Foreign Affairs and the United Nations Development Programme (UNDP) in Thailand. The preparation of this publication brought together key eminent experts, government officials, academics, NGOs and people living with or affected by HIV in a long process of consultations and dialogues.