Advocacy Strategy and Plan to Reduce Stigma and Discrimination Against Key populations

Key population groups such as transgender people, sex workers, men who have sex with men, and drug users and people living with HIV face varying degrees of social stigma and discrimination. Key populations prefer to remain hidden due to prevailing stigma and discrimination, and a lack of understanding and low acceptance from friends and families. The gender barriers review and service package review reports document reports of abuse on KPs ranging from bullying to sexual violence and assault. Low educational attainment and lack of employment opportunities are common themes, and many suffer from mental illnesses such as depression, anxiety, and frustration, and use of drugs and alcohol as coping mechanisms. Empowering KPs requires systematic awareness raising to increase understanding and acceptance among the public and specific advocacy actions to address stigma and discrimination in health care and other social settings. There is also need to strengthen CSO and KP capacities to ensure their voice and partnership in the national HIV prevention and response.

Save the Children-Bhutan office as country sub-recipient for Bhutan under the Global Fund’s multi-country regional grant for Sustainability of HIV Services for Key Population in Asia (SKPA) project, with the Australian Federation of AIDS Organization (AFAO) as the Primary Recipient, supported the development of a comprehensive advocacy strategy and plan to reduce stigma and discrimination faced by the key populations. The strategy was developed in close coordination with the National AIDS and STI Control Program (NACP), Ministry of Health and the Key Population CSOs and Networks, and involved a series of focus group discussions, individual interviews, and national workshops. Advocacy actions identified are under four key issues:

1. Improving access to health services for KPs by increasing the uptake of HIV and STI related services among KPs;
2. Providing legal protection and promoting legal literacy among KPs to make them realize their rights and privileges in society, thus empowering them;
3. Improving their socio-economic conditions by bringing about greater understanding among family members and friends to accept their sexual orientation, sexual characteristics and support them; and,
4. Changing institutional settings for KPs to enjoy their rights by inculcating positive behavioural change in schools, institutes, and workplaces, thereby reducing frequency of abuse and harassment, and providing KPs with equal opportunities.

Key advocacy interventions to be taken forward in 2021, prioritized in coordination with KP CSOs and Networks and the NACP, MoH are – the development of KP-friendly service package and SOPs; awareness sessions for MoH, national, referral and key district hospitals/HISCS/BHUs to sensitize on KP-friendly health service requirements and SOPs; training for relevant health workers on revised service package (including SOGIE, mental health, gender-based violence, SRHR, STIs, alcohol and drug use) and SOPs; sensitization of law makers and enforcers and relevant organizations on legal/policy/socio-economic barriers faced by KPs; Community based monitoring and community feedback mechanism support for KPs to achieve goal of KP-friendly health services; and facilitating dissemination of key messages through radio spots, TV spots and other social media.