Liberian CSOs: “Stigma, Discrimination Hindering Key Populations’ Involvement To End AIDS”

By: Christophina P. Nyanneh, LHRJN Fellow

Like other countries in the world, Liberia seems to be making progress toward reaching the 95-95-95 strategy adopted in 2016 by the United Nations General Assembly to reach its target of ending AIDS as a public health threat by 2030.

This strategy calls for 95% of people living with HIV (PLHIV) to be aware of their HIV status by getting tested; 95% of those tested to be placed on treatment, and 95% of people tested and on treatment should be virally suppressed. 

However, with just eight years remaining, much needs to be done ranging from the involvement of key populations (KPs), the willingness of stakeholders and government to support the national HIV response, and reducing stigma and discrimination.

In accordance with the 2030 strategy, it is expected that 1.7 million AIDS-related deaths will be prevented if the global communities work together.

But many experts believe that the global target cannot be achieved in the absence of key populations (KPs) and other vulnerable groups’ involvement in programs implementation and policies development.

Key and vulnerable populations include Lesbians, Gay, Bisexual, Transgender, Intersex, and Queer (LGBTIQ) community, Persons Living with HIV (PLHIV), sex workers, and people who inject drugs among others.

Stigma and discrimination against these populations which are said to be on the increase are hindering the achievement of the 95-95-95 target.

In Liberia, findings from the 2018 Integrated Biological and Behavioral Surveillance Survey (IBBSS) launched in 2021 highlighted that Men who have sex with men account for 37.9% of HIV prevalence, 27.6% for transgender women, 17.6% for Uniformed service personnel, and 16.7% for female sex workers.

Others are, 9.6% for Transport workers, 14.4% for people who inject drugs, 5.5% for Inmates, 3.8% for Mobile traders, and 3.0 for miners, 3.0%.

The primary reason for conducting the IBBSS was to determine the level of knowledge, perceptions, beliefs, and attitudes about HIV, Syphilis, and Viral Hepatitis, as well as to determine key HIV risk factors, especially with regard to the HIV status and morbidity among key and vulnerable populations in Liberia. 

The report indicated that eliminating stigma and discrimination against Persons Living with HIV (PLHIV), Key Populations (KPs), and vulnerable groups will need deliberate commitment from policymakers and state actors in putting these groups of people at the center of testing, treatment, viral load suppression, programs implementation and ensuring access to health care services.

Speaking in an interview with the Liberia Health and Rights Journalists Network (LHRJN), the Executive Director of Stop AIDS in Liberia (SAIL), Evans L. Adofo disclosed that they are making tremendous strides in the national response to end AIDS by 2030, but stigma and discrimination remain obstacles.

Mr. Adofo said the progress is based on the different services and interventions that are available for persons living with HIV, key and vulnerable populations.

Evans L. Adofo, SAIL Executive Director 

He said, “Looking at the National Strategic Plan II, the Integrated Biological and Behavioral Surveillance Survey (IBBSS), the Spectrum estimates, stigma index, it gives us the direction as to what to do in terms regarding the national response. But we need to address societal stereotyped stigma and discrimination.”

“Our campaign on ending stigma and discrimination is very high, that’s why the national response had developed the stigma and discrimination Action plan to reduce stigma in terms of the services within the various health facilities,” Mr. Adofo said.  

He observed that religious, cultural beliefs and resentful behaviors are key contributors to increased Stigma and discrimination against persons living with HIV, key and vulnerable populations in the country.

“If stigma and discrimination are not addressed by the country, achieving the 95-95-95 target will be hindered. These acts have the ability to prevent key and vulnerable populations from adhering to treatment,” Evans said. 

Like Evans Adofo, Reuben T. Willie, Monitoring and Evaluation (M &E) Manager of LEGAL Association of Liberia stressed the need for more funding to full the involvement of Civil Society organizations in reaching the 2030 target.

Reuben T. Willie, LEGAL M&E Manager

LEGAL Association of Liberia is an organization that supports and works directly with key populations especially, the LGBTIQ community to ensure a safe environment for sexual minority groups that are being marginalized by societal norms.

Mr. Willie said, “LGBTIQ-led organizations in the country including LEGAL are limited because the funding that comes into the country for key populations implementation is not reaching them directly.”

He believes that it will be difficult to end AIDS by 2030 without repealing discriminatory laws on our books as well as addressing stigma and discrimination.

Mr. Willie: “Societal norms, the penal code of Liberia Section.14.72 criminalizes sexual minority groups, the lack of funding, unavailability of Sexually Transmitted Infections (STI) treatments and lack of livelihood are issues serving as barriers for the full involvement of key populations in ending AIDS by 2030.

“We need action to tackle these policies, repeal these intentional specific languages placed in those policies by removing the criminalization of consensual acts done by consenting adults,” Mr. Willie said.

Recently, the Liberia Initiative for the Promotion of Rights, Identity, Diversity, and Equality (LIPRIDE) Coalition said for Liberia to be on par with other countries in ending AIDS by 2030, PLHIV’s adherence to treatment and reducing stigma and discrimination is critical. 

LIPRIDE Coalition is a conglomeration of like-minded rights organizations advocating for a safe and free space in Liberia that accommodates everyone for the enjoyment of every human rights, void of stigma and discrimination.

Mr. Maxwell W. Monboe, Coordinator of LIPRIDE speaking at an advocacy forum in commemoration of World AIDS Day 2022 urged relevant government institutions to address stigma and discrimination against persons living with HIV, hate speech, and rejection directed at key population groups, and the existence of laws and policies that tend to narrow the space for equal access to health services for all.

Madam Frances W. Bestman, Executive Director of White Rose Alliance (WRA) for her part told LHRJN that Liberia is making gains toward the 95-95-95 strategy, but a lot more needs to be done by relevant institutions to achieve the goal.

Madam Frances W. Bestman, WRA Executive Director 

Madam Bestman named the lack of safety and security protection for front liners in the national HIV response, lack of domestic funding, criminalization of key population groups who are hugely affected by HIV and other health conditions, stigma and discrimination as issues that could hinder progress if care is not taken.

White Rose Alliance is an organization that works directly with key population groups, mostly sex workers to promote healthy life choices.

“We are usually being targeted because of the work we do, we need security for the safety of our workers and funding to execute our work smoothly without disturbance or fear of the public,” Madam Bestman said.

Dena T. Smallwood, Program and Project Assistant of LEGAL Association of Liberia wants coordination and collaboration amongst civil society organizations (CSOs) to fight in addressing discrimination, and stand as one.

“When there is a sexual and gender-based violence issue that involves members of the general and key populations, we the LGBTIQ-led organizations join in the fight, but when it comes to matters of the LGBTIQ community, we are being left alone to fight for ourselves,” Dena said.

She observed that “this might not allow us to reach our 2030 target.”

The National AIDS Commission of Liberia (NAC) had said, “unless we come together to deal with the issues that the LBBSS study presents, the goal of ending AIDS would be undermined. If we as a country are to celebrate the end of AIDS, we must discourage stigma and discrimination, and embrace diversity and tolerance in all sectors of the country.

Mr. Lewis Wright, Commissioner for Program and Policy of NAC speaking at the official launch of the IBBSS report said, collective effort is required in reducing stigma and discrimination in Liberia.

This fellowship story was supervised by the Liberia Health and Rights Journalists Network (LHRJN), with funding from the American Jewish World Service (AJWS).