Dignity and resilience in the HIV response: four inspiring stories of courage, perseverance and determination to end discrimination in Thailand

As the COVID-19 pandemic enters its third year, its impacts continue to disproportionately affect marginalised groups who are already experiencing widening inequalities and bear the hardest socio-economic hit from the crisis. Often neglected or remaining underrepresented, communities of people living with and affected by HIV continue to experience delays in access to critical services and increased stigma and discrimination. But as witnessed again, stories of courage and resilience, even among the most excluded and stigmatised, are emerging as they mobilise to ensure the right to live a full and productive life and live it with dignity, free from discrimination or judgment.

On Zero Discrimination Day, March 1, the United Nations in Thailand joins the global movement of solidarity to end all forms of discrimination, calling for urgent action against discriminatory laws that result in people being treated differently, excluded from essential services or being subject to undue restrictions on how they live their lives, simply because of who they are, what they do or who they love. Featured as part of this year’s theme ‘Remove laws that harm, create laws that empower,’ the United Nations in Thailand are showcasing inspiring stories of activism, community-led initiatives and how UN partners are working to end prejudice, stigma, discrimination and criminalisation as part of achieving the Sustainable Development Goals.

For the UN Resident Coordinator a.i. in Thailand, Géraldine Ansart, removing discriminatory laws and ending inequalities – whether due to health status, gender, sexual orientation, ethnicity, disability or even migration status, such as discrimination faced by irregular migrants – is ultimately about human rights.

“The appeal for zero discrimination should recognise the equal worth and dignity of every person, not only as an ethical imperative but an obligation arising out of our values towards human rights.”

Without addressing HIV-related stigma and discrimination, the world will not achieve the goal of ending AIDS as a public health threat by 2030. Thailand joined the Global Partnership for Action to Eliminate All forms of HIV-Related Stigma and Discrimination in early 2020. Since then, a national multi-sectoral and costed action plan from 2021-2025 has been developed and serves as a roadmap to strengthen and revitalise the partnership between stakeholders to implement and scale-up programmes towards zero discrimination.

Dr. Patchara Benjarattanaporn, UNAIDS Country Director for Thailand:

“Ending discrimination is critical to ending AIDS. Structural inequalities obstruct access to HIV prevention and treatment services. The UN Joint Team on AIDS in Thailand prioritises efforts to reduce discrimination, remove punitive laws and create legal and enabling environments that empower communities and people affected by HIV towards achieving zero discrimination. A multisectoral partnership is critical if we are to succeed.”

What it’s like to be an (HIV) positive CEO; barred by the judicial HIV ban; harvesting against hunger and AIDS in rural Thailand; a teacher’s decade-long service to students with HIV; or an innovative partnership delivering HIV/AIDS care in communities – these are just some examples of courage, inclusion, and important transformations that are helping to tackle stigma and discrimination in Thai society, which often have been led by young people.

A few years back, “Pea,” a 22-year-old law student, had too asked himself if he might ever be able to achieve his lifelong dream of becoming a judge–only because his blood carries this virus.

“When I think about it, I cry sometimes. If this is really how it works, there’s nothing I can do,” he says. “Many people living with HIV have been asked to leave their jobs after getting a blood test. There have been lawsuits, and they’ve actually won, but it didn’t get them their jobs back.”

Although the criteria for achieving a judicial posting does not explicitly require a blood test, the application process does require a health certificate that requires the test. The practice is prevalent, especially among judicial agencies, which has set a rule demanding applicants to reveal their HIV test results in the process.

“Everyone is equal, regardless of gender or nationality. Suppose it doesn’t affect your ability to work. In that case, it shouldn’t be used as a job criterion,” he insists passionately and hopes that his story can help lead to change in the longstanding, prejudiced employment culture that requires a blood test from job applicants, specifically designed to screen out people who are living with HIV.

“This world is built for everyone,” he says, that discrimination must stop, not only in judicial agencies but in every part of society. “No one should suffer from discrimination. Society should become a better place to live because there will then always be some space in this world for everybody.”

Since 2020, The Thai Network of Youth Living with HIV (TNY+), with support from UNICEF Thailand, has been promoting key messages around HIV positivity, acceptance, reduction of stigma, and discrimination on social media. Their recent social media campaign, involving a video series has already been viewed more than 700,000 times, which addresses the misconceptions about HIV and shows how people can live positively with HIV. It documents the lives and struggles of people living with HIV and people around them, from students, teachers and village chiefs, to business owners and community health volunteers. It highlights that discrimination against people living with HIV comes from fear, not fact.

Read more about Pea’s story on The Isaan Record and the social media campaign by TNY+ and UNICEF Thailand.

Surang Janyam was one of the first to step up to help sex workers whose lives were upended by the pandemic. Her expertise as Director of the Service Workers in Group Foundation or SWING, a community organisation that has worked with the United Nations Development Programme (UNDP) in Thailand, has benefitted over 2,000 sex workers in the country.

Sex workers are among the most vulnerable and marginalised in any society and among those most at risk during the pandemic, which is why Surang advocates for sex workers' rights and gender equality, arguing for the necessity of meaningful inclusion. "Governments need to pass laws that protect people and enforce non-discriminatory policies to ensure vulnerable groups are not excluded and feel safe. Laws that criminalise sex work must be abolished. Sex work is work and must be protected under the labour law, same as any other profession,” she explains.

Sex workers who identify as gender minorities, including lesbian, gay, bisexual and transgender (LGBT), tell us that they face multiple and intersecting forms of discrimination. They are subjected to stigmatisation, hate speech and attacks.

An online survey in May 2020 by UNDP Thailand and the Asia-Pacific Transgender Network furthermore revealed that almost half of LGBT people surveyed (47 per cent) lost their jobs or were forced to go on unpaid leave after lockdowns were imposed. Similarly, 51 per cent of the LGBT respondents stated that they did not receive any COVID-19 related government assistance, and only 22 per cent received financial support. The same survey showed that around 14 per cent of LGBT respondents experienced increased intimate, family, or gender-based violence or economic violence while staying at home.

UNDP joined forces 💪 with @EmpowerThailand+ Sisters Foundation + SWING Thailand + Rainbow Sky Association of Thailand 🇹🇭to distribute basic relief materials to sex workers, who are often left behind, benefitting over 2000 sex workers. #LeaveNoOneBehind #COVID19 pic.twitter.com/FlPVmj6UvD
— UNDP Thailand (@UNDPThailand) July 10, 2020

Like Pete, 19-year old Noom* decided to retake control of his life as lockdowns and illnesses brought on by the pandemic dramatically increased challenges for people who use drugs in their access to social and mental health services, in addition to the tools and support meant to help them avoid dying from an overdose or acquire infectious diseases, known as harm reduction.

“Access to harm reduction services had made it possible for me to get treated for Hepatitis C before it became serious,” says Noom, who felt these services, or even just a safe space to speak, was an embrace. “I could consult the nurse anytime, whether it was about using drugs or anything else. There were family problems too. I didn’t live with my mum, and my dad died. I’ve now stopped using drugs. I’m feeling a lot better,” he says.

More than just about responses to HIV and hepatitis C, evidence shows that client-centred harm reduction services effectively prevent the health and social impacts of drug use, promote support of healthier, safer communities, and are cost-effective for public health systems.

Illicit drug use and stimulants have continued during the pandemic, while the availability of information on safer use and safer drug injection kits, for example, remains scarce. In societies where biased norms and fear of facing legal implications related to drug use persist, the consequences of isolation can fuel even more drug use, leading to more isolation, and ultimately a vicious cycle that is complex to break out of.

To respond to this chronic issue, the UN Office on Drugs and Crime (UNODC) has joined hands with Ozone Foundation Thailand, a peer-led harm reduction NGO. Their goal is to advance the health and human rights of people who use drugs, enabling them to make positive choices for their health, their families and communities.

“For people who use drugs, it’s hard for them to talk to people or to ask for help or support,” says Verapun Ngammee, executive director of Ozone. “If one day they stop taking drugs but are infected with HIV/AIDS, get cirrhosis from hepatitis, or develop a disability or other vascular complications from injected drug use, that harm will be greater than the drugs themselves.”

*Real name withheld to protect identity.

Read more about UNODC’s work on harm reduction.

This year’s Zero Discrimination Day will be an opportunity to focus on the urgent need to “Remove laws that harm, create laws that empower.” Such laws or biased norms that continue to persist, include laws on sex work, same-sex sexual relations, the use or possession of drugs for personal use and the non-disclosure, exposure or transmission of HIV, that result in people being treated differently, excluded from essential services or being subject to undue restrictions on how they live their lives, simply because of who they are, their sexuality, their physical or invisible disabilities, what they do or who they love. Read more and see how you can take action for more inclusive societies today: https://www.unaids.org/en/2022-zero-discrimination-day

UNAIDS, the Joint UN Programme on HIV/AIDS (UNAIDS), is taking the lead to mark the Day, preparing a concept note, and digital campaign for this year’s commemoration.

Compiled and edited by the UN Resident Coordinator Office in Thailand, with much appreciation to the contribution from UN country team colleagues, including from UNAIDS, UNDP Thailand, UNICEF Thailand, UNODC Regional Office for Southeast Asia and the Pacific, other partner organizations, where the materials that inspired this article were originally published.