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Great Progress made, but much more to be done for the left behind in HIV prevention in Botswana

“I face violence from the community for being “different,” and not only that, as a Transgender woman, I do not receive adequate health care because health care providers in clinics discriminate against us and are sometimes verbally abusive” said 28 year old Trans-gender woman, Nelly Thobega in Francistown on 05, June 2018

Ms. Thobega, has not gone to clinics in a few years because of the stigma she has faced at health care facilities in the past. As a result, she often resorts to self-medication whenever she falls ill.

“I am not the only one, there are many of us who simply do not bother to go to health care facilities anymore because we know we will be treated unfairly and will not receive the proper medical care we need” she said. This is the plight of many LGBTIs in Botswana.

Some of the challenges that Key Populations face are punitive laws which make same-sex sexual acts illegal. As a result of the laws, health-care providers often discriminate against Key Populations and sometime do not give them adequate treatments as they do not want to be implicated. Negative Attitudes towards female sex workers and men who have sex with men is therefore a concern amongst key populations.

Important steps have been made so far. The Ministry of Health and Wellness (MoHW) has established a multi-stakeholder technical working group to spearhead efforts to increase access to HIV prevention services for female sex workers and men who have sex with men.

At the moment, key populations access HIV prevention services from donor-funded NGOs in selected locations. UNFPA is supporting the MoHW to develop minimum service packages to guide service delivery.

While HIV prevalence is high in the general population at 18% and 21.9% for adults aged 15 to 49 years old, it is exceptionally high among key populations. According to the BAISIV study, 13.1% of men who have sex with men (MSM) and 61.9% of female sex workers (FSW) in Gaborone, Francistown and Kasane respectively live with HIV. Therefore, key populations therefore remain a critical group if Botswana is to end the AIDS epidemic by 2030.

Stakeholders from FHI 360, Nkaikela Youth Group, BONELA, Sisonke, Captive Eye Organization, Pilot Mathambo Center for Men’s Health, Men for Gender Justice, LEGABIBO and NACA at the meeting to finalize HIV prevention packages for Key Populations in Francistown, 05-07 June 2018.