Wednesday December 1 marks World AIDS Day. Almost 38 million people are living with HIV worldwide, and two-thirds of them are in Africa. Focus on Côte d’Ivoire and Mauritania.
Côte d’Ivoire, one of the most affected countries
The prevalence in adults is 3% but it is much higher in certain categories of the population. NGOs call them “key populations”: sex workers, gay men and drug users. It is with them that we must do prevention and screening tests every three months. “Given their access to the health service, which is reduced in several countries, taking into account questions of social rejection, discrimination, violence and harassment by the state or not, the restrictive laws and policies that exist and the criminalization of behavior, all this puts key populations at increased risk which also weakens their access to health services “, explains Papa Abdoulaye Dème, one of the leaders of Coalition Plus, a network of NGOs fighting against AIDS. For people who test positive, the treatment is free.
To reach these marginalized people, NGOs hire peer educators, people from the targeted community, a sex worker or a former drug user for example. People who know the field perfectly, who are able to identify their peers and encourage them to get tested. Because we must not forget that HIV is a taboo subject: some do not want to take the risk of being even more marginalized. And these peer educators provide a climate of trust and confidentiality.
Since last year, these key populations have a new category by the Ivorian government: transgender people, especially transgender women. Previously, they belonged to the same category as gay men although their situation is specific. “A study, conducted by Alliance Côte d’Ivoire, gives a prevalence rate of around 23.6% within the transgender community, explains Latiyah Orneill, executive director of the association transgender and rights. Eight in ten transgender women do sex work. “
“When they have unprotected sex, the pay is even higher, I think that’s one of the main reasons there is a high prevalence rate within the transgender community.”
Latiyah Orneill, Executive Director of the Transgender and Rights Associationto franceinfo
In ten years, the number of new cases has been halved in Côte d’Ivoire, as has the number of deaths. But beware, the virus affects more and more young people aged 15 to 24.
In Mauritania, the challenge of screening and managing a hidden epidemic
In Mauritania, 23% of people in the homosexual community are infected with HIV, while the prevalence rate is only 0.3% in the general population. Penalized, stigmatized, they do not dare to go to healthcare structures. “I am always afraid, even for the simplest of diseases, even a pimple or an infection, I cannot go to the hospital and I will hide it, which can even lead to complications until death., says Charihan, who at 25 has often been the victim of insults and violence. This is why we often have STIs [infections sexuellement transmissibles] and we hide it until it develops and becomes an incurable infection. “
The penal code punishes with the death penalty any “unnatural act with an individual of his sex”. Even if the law is not enforced, these young homosexuals prefer to be tested for HIV by community actors, without judgment or discrimination. Khatré is also homosexual, he is proud to help his community by working for the association SOS Pairs educators. “We provide psychological and medical support, he explains. If the individual is homosexual, it is his orientation, it does not concern us. “
“We fight, we beg the law: give us all the rights for health only. We do not fight for freedom because we can not give freedom to homosexuals in Mauritania, it is an Islamic Republic . “
Khatré, association SOS Pairs educatorsto franceinfo
Abdallahi Ould Sidi Ali, of the national secretariat for the fight against HIV / AIDS, ensures that civil society can intervene without hindrance throughout the country. “Mauritania derives its penal code from Muslim law, it has signed universal conventions on human rights and there is a split in the judiciary, executive and political power., he assures. The state wants to penetrate these populations to improve the response against HIV-AIDS. “
Without respect for human rights, it is impossible to eliminate HIV-AIDS by 2030, recalls UNAIDS.