LGBTI people living with HIV and AIDS continue to fight a double struggle in Ecuador. Their dual vulnerability impedes HIV prevention, treatment, and care efforts. Equidad offers different services, but many community members do not use them. They prefer to remain invisible. Therefore, Equidad also focuses on shedding secrecy. Mandy Geise investigated barriers and facilitators to accessing HIV services in Ecuador.

What was the aim of your investigation?

My research in Ecuador looked into sexual orientation and gender identity, HIV and AIDS, stigma, and citizenship. I investigated how social experiences of people living with HIV and AIDS within the LGBTI community function as barriers to HIV prevention, treatment, and care. Barriers and facilitators to accessing HIV services in Ecuador had not yet been thoroughly explored. Besides providing new insights about the location and community, the research had a particular focus on the meaning of sociopolitical shifts and the strategic position of people living with HIV and AIDS to be agents of change. In collaboration with Equidad, I conducted the research in Quito, the capital of Ecuador, in the period February-May 2014. Equidad is an organisation that contributes to a better well-being of LGBTI people and the defence of their human rights.

Your master’s thesis contains the findings of the fieldwork in Ecuador. Can you give a summary?

People living with HIV and AIDS in the LGBTI community of Ecuador continue to fight a double struggle. They battle HIV and AIDS, and they face pervasive discrimination, stigma, and exclusion linked to sexual orientation and HIV status. This dual vulnerability impedes HIV prevention, treatment, and care efforts. Ecuadorian LGBTI people mention experiences of conflicts with health care professionals as a reason for not using health care services. Although Equidad offers testing and counselling services and functions as a gateway for access to treatment, many in the community it serves are not utilising the services out of fear of discrimination. LGBTI people living with HIV and AIDS attempt to avoid discriminatory attitudes by remaining silent about either their sexuality or HIV status, or both, leading to secrecy and invisibility. Equidad aims to shed this secrecy, but cannot, on its own, instigate a society-wide shift in attitudes towards sexuality and sexual rights. Furthermore, reaching out to an invisible group is nearly impossible. Empowerment can only bank on its potential when LGBTI people and people living with HIV and AIDS can speak up and be spoken to.

What are hopeful developments in Ecuador?

Despite the pervasiveness of stigma, a more open attitude towards people with ’other’ sexual orientations slowly spreads through Ecuador, partially on account of Equidad’s ceaseless work. Recent inclusionary constitutional provisions for equal rights and non-discrimination have increased opportunities to make claims to cultural, social, and political rights and to hold state actors accountable for violations. State institutions like the Ombudsman embolden the promise of equal treatment of all citizens, although the state also operates as a limiting factor, for example by failing to initiate sensitisation campaigns. Jimmy Medina, project officer at Equidad, pointed out that ’the promise of increased visibility and empowerment cannot be fulfilled if a discussion about sexual and health rights is smothered by ideology and fear. Equidad’s arms are too short to reach everywhere, and we need the government and the whole Ecuadorian society as partners in this fight.’

How important are civil society organisations in Ecuador?

In the recent sociopolitical shift, non-governmental organisations that are in close contact with the community, like Equidad, play a key role. They foster empowerment and function as a ligature between society and state actors. There are opportunities and necessities for Equidad to collaborate with the government of President Rafael Correa, and to back up its stance with research documents such as my thesis. The research findings boosts Equidad’s influence.

Click here to read Mandy’s thesis.