Garfield and volunteers at Sisters Foundation in Pattaya, Thailand distributed emergency relief supplies to the transgender community during the first outbreak of COVID-19 in April 2020. Photo credit: APTN

More than a year has passed since the COVID-19 was declared a pandemic. COVID-19 cases and deaths continue to rise, with some countries seeing dramatic surges in cases in recent months. Increasing inequality and stigma and discrimination towards people living with HIV and key populations continue to disrupt peoples’ access to HIV prevention and treatment services.  

Since the first COVID-19 outbreak in the region, UNAIDS Asia Pacific has continued to work alongside regional key population networks to support communities to mitigate the impact of the pandemic. Through a regional project ‘Strengthening the regional community response to the needs of key populations in the context of COVID-19 in Asia and the Pacific’ funded by UNAIDS AP, with general support from the Department of Foreign and Trade of Australia (DFAT), key population networks promoted access to relevant and timely information about COVID-19 targeted to key populations and people living with HIV, assessed their challenges and needs and recorded best practices from community-led responses. 

During the first implementation phase between April and July 2020, networks have been able to compile best practices of community-led responses from several countries across the region, launch a youth-friendly website with COVID-19 related resources for young key populations, carry out rapid assessments on the needs of people and women living with HIV, produce newsletters with useful COVID-19 information and curate series of feature stories of leaders and organizations in the COVID-19 response. After taking stock of the positive impact that the first phase has had, UNAIDS AP renewed the project from August 2020 to March 2021. 

As part of the second phase, the Asian Network of People who Use Drugs (ANPUD) collected best practices from communities of people who use drugs in Bangladesh, Myanmar and Nepal. Drawing on network members’ experiences, ANPUD compiled a best practice report highlighting innovative approaches to address gaps in HIV and drug-related service delivery during COVID-19. The report shows that community groups in Bangladesh were active in establishing the One Meal a Day programme, an emergency food distribution initiative for street-based drug users supported by UNAIDS, to at least 60 people who use drugs. The report brings attention to various UN-community partnerships that supported multiple initiatives, including livelihood support programmes, provisions of personal protective equipment (PPE) and masks, and programmes to allow people who use drugs to take home methadone and antiretroviral therapy. The report also details various initiatives in Myanmar where community-based organisations actively provided HIV testing and treatment, hepatitis testing, needle–syringe services and methadone supplies during COVID-19. While in Nepal, young key populations found a way to deliver the door-to-door provision of antiretroviral therapy, opioid substitution therapy and sterile needle–syringes.

In Asia and the Pacific, women living with HIV amplified learnings from the HIV response and applied them to the COVID-19 pandemic using tools and techniques to support their peers and local organisations. The International Community of Women Living with HIV Asia Pacific (ICWAP) launched the #GenderMatters campaign in November to coincide with the 16 days of activism against gender-based violence. The campaign gave voice to women and girls living with HIV from across the region about the critical need to address gender-based violence and the challenges in accessing health services during the COVID-19 pandemic. As part of the project, women-led organisations in Nepal, India and Malaysia conducted a series of workshops on gender, SRHR and U=U for women and girls living with HIV to ensure timely access to information during the pandemic. In Nepal, ICWAP collaborated with FC2, a female condom enterprise, to provide female condom demonstrations and facilitated discussions around HIV, SRHR and laws and policies that protect women and girls living with HIV from gender-based violence. And in India and Malaysia, HIV and SRHR education were integrated with skills-building workshops to ensure that women and girls walked away with additional skills such as making soap.

In an increasingly more digital world, digital activism is being used to bring about social and political change. Youth Voices Count (YVC) initiated the QueerxBodies series that celebrated queer activism amid COVID-19 through interview-style discussions with influencers from the Asia-Pacific region to call attention to the intersectionality between being queer with important personal and social issues, such as race, religion, HIV status, neurodiversity, disability, indigenous culture, and more. Ten interviews were conducted to convey stories that were bold and insightful. In the series, influencers from India, Kiribati, South Korea, the Marshall Islands and other countries recount stories of where young people are active in the COVID-19 response. The series highlighted various projects and initiatives led by young people to address challenges faced by queer and LGBTQ+ communities. QueerXBodies is an excellent story-telling example that encapsulates young people’s role in challenging inequality in this growing divided world through their involvement and use of digital media.

The COVID-19 pandemic has starkly revealed the vast social, economic and health disparities experienced by trans and gender diverse communities even further. The Asia Pacific Transgender Network (APTN) developed and launched the Trans Resilience Report – Stories of Hope, Pain, and Survival from the Trans Movement During the COVID-19 Pandemic in an effort to record testimonies and data from trans and gender diverse communities during COVID-19, and share the work of country partners in rolling-out their COVID-19 Community Support Fund. APTN synthesised findings from an online rapid assessment into key advocacy messages, dug deep into socio-economic impacts of the pandemic and developed infographics to help inform strategies and interventions responding to trans and gender diverse experiences and needs in the context of COVID-19. The report uncovered alarming trends faced by trans people, including delays in access to services, increased stigma and discrimination from health care providers, loss of income and exclusion from social protection schemes and the overwhelmingly negative impact of COVID-19 on mental health. Through the regional project supported by UNAIDS, APTN built on the Trans Resilience Report and developed an accompanying Social Media Toolkit which includes infographics profiling APTN partner organisations, featured articles from experts in mental health to human rights, and ‘Stories from the Streets’ – a collection of mini-stories and testimonies capturing the different voices of the trans community and their resilience during COVID-19.

To share more information about COVID-19, its impact at the community level and the important contribution of community-led organizations, APCOM continued to work on the Covid-19 Effect Series, a newsletter covering the pandemic’s impact among diverse SOCIESC communities, key populations and people living with HIV and their access to HIV prevention and treatment services. The main outcomes have been summarised in the Highlight Series that has been launched in collaboration with UNAIDS AP on the 1st of March, Zero Discrimination Day. In parallel, APCOM developed fact sheets and informative materials targeted to the MSM communities. The materials include information on COVID-19 prevention, PrEP (including ED-Prep and injectable PrEP research), HIVST (and other STIs), ChemSex, and accessing treatment and staying on treatment as prevention (U=U). On top of that, APCOM organised a series of advocacy webinars with community leaders and key population networks to showcase reliance, innovations and challenges to mitigating the impact of COVID-19 on HIV service delivery.

Sex workers and key populations are among those who have been hit hardest by the COVID-19 pandemic and its consequences. To better understand how the lived realities of sex workers have been impacted by the pandemic, the Asia Pacific Network of Sex Workers (APNSW) documented case studies, best practices and testimonies of sex worker community-led organisations that have responded to the crisis. The project was supported by UNFPA and UNAIDS and focused on three countries in the region, including Bangladesh, Myanmar, and Indonesia, which involved collecting qualitative information through open-ended discussions with sex workers and community outreach workers. The report uncovered multifaceted trends related to loss of livelihoods, income and homelessness. Sex worker community-led organisations have responded to the crisis by modifying their existing programming to meet urgent and immediate needs and reach their most vulnerable communities. For instance, they have reallocated existing program funds to deliver food aid, subsidise emergency housing, and ensure sex workers living with HIV have access to ARVs and HIV services. Despite many countries in the region grappling with curbing the spread of COVID-19, APNSW continues to work closely with sex workers organisations and networks to advocate for their rights and support emergency relief efforts.

Throughout the region, community groups, community-based organisations, and networks join efforts – many with limited resources, to serve communities that have been most impacted by the pandemic. Through the combined efforts of all partners involved, small or large, have contributed to making a difference in the lives of key populations and people living with HIV. UNAIDS AP and key population networks will continue to share the achievements and challenges faced by these community-led responses in an effort to ensure that vulnerable groups are not left behind and given accurate and timely information to protect themselves.

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