We believe that the end of AIDS is possible if there is more focus on key populations. Our project in South Africa addresses barriers faced by the LGBT community related to their sexual and reproductive health and rights. Driven by community champions, we work to realize competent and LGBT-friendly healthcare facilities; legislation supportive to LGBT people’s rights and needs; increased access to psychosocial services and a strong LGBT community that holds the government to account.
Entrenched homophobia, discrimination and poverty
South Africa is considered a newly industrialised country, being ranked as an upper-middle income economy by the World Bank. Despite having the seventh highest per capita income in Africa, poverty and inequality are widespread. Lesbian, gay, bisexual, transgender, and intersex (LGBTI) people in South Africa enjoy a progressive legal framework protecting their rights. In general, no laws at the national or sub-national level pose significant obstacles to LGBTI people, and, given the courts’ commendable record in using The Constitution to address discriminatory legislation, laws that may emerge as discriminatory may be easily addressed. Nonetheless, some laws could be improved, especially for intersex and transgender people. While the South African legal and policy groundwork is promising pro-LGBTI political momentum has been obstructed by profound social inertia. There is more progress to be made regarding social attitudes about sexual orientation and gender identity and expression (SOGIE). South Africa has the largest HIV epidemic in the world. In 2015, an estimated 7 million people were living with HIV, with a national HIV prevalence rate of 18.9% among the adult population. The prevalence among MSM is between 10.5 – 49.5%. Stigma and discrimination and lack of capacity among healthcare workers are seen as major barriers in accessing health services for LGBTI people. Efforts have been largely financed by South Africa’s own domestic resources ($1 billion annually), but the gap between available and required funding for HIV, STIs and TB is expected to grow.
LGBT people claim a right-based HIV and SRHR response
Bridging the Gaps works with a Theory of Change approach. A Theory of Change is a description of a list of events that is expected to lead to a particular desired outcome. It is a visualization how change is believed to happen. In 2016, LGBT representatives developed a Theory of Change that consists of short-,medium, and long term outcomes. The specified Theory of Change of the LGBT people project in South Africa describes how we plan to realize competent and LGBT-friendly healthcare facilities; legislation supportive to LGBT people’s rights and needs; increased access to psychosocial services and a strong LGBT community that holds the government to account.
Through innovation and by building on previous work, we will strengthen civil society organisations’ ability to:
1. We facilitate community development
- Building a strong LGBTI movement to hold the government accountable for poor service delivery and constitutional protection.
- Organizing safe spaces and workshops for LGBTI people to increase knowledge on sexualities, gender, human rights and how to claim human rights within various structures/departments of government. and how to
- Organising community dialogues to discuss human rights, discrimination and marginalization of different groups in society.
- Implementing a participatory national needs-assessment on (psychosocial) health and well-being.
2. We advocate for the continuously strengthening of services and upholding human rights
- Participating in government structures, meetings and campaigns geared towards social cohesion, fighting harmful cultural practices, and the reduction of violence and crime against LGBT people in South Africa.
- Engaging Trans* and Intersex activists, their rights and health allies and policy makers, in discussions and advocacy around specific service provision to Trans* and Intersex persons.
3. We deliver inclusive, rights-based and gender sensitive services
- Enhancing greater awareness of specific stigma and discrimination barriers faced by key populations and key populations living with HIV when accessing services.
- Promoting greater community demand for and integration between HIV, sexual and reproductive health services for key populations.
- Increasing health literacy through outreach, workshops and peer-education.
- Providing direct services like, HIV testing and counselling.
- Strengthening alliances with local (sensitized) healthcare providers.
- Training, monitoring and providing ongoing support with service providers to improve the quality of their service to key populations.
4. We foster global and in-country process and partnerships that reinforce results
- Participating and representing the community in the national LGBT sector within the SANAC structures to support advocacy around increased and coordinated LGBT health programming.
Our project builds on the strong advocacy work and service delivery of our partners Durban Lesbian and Gay Community and Health Centre, OUT Wellbeing, Triangle Project, Gender Dynamix, ANOVA, EPOC and NAPWA to put LGBT health issues on the political agenda and provide rights-based health services. Their work is internationally supported by COC, MSMGF and GNP+.