Transformative empowerment is mostly not given by ‘experts from the outside,’ but happens when the most affected people themselves rise to take back power to transform their lives and wellbeing. “When we put people first, then we cannot just address one or two issues they face,” rightly says Amrita Sarkar of India HIV/AIDS Alliance who has worked on a range of issues related to transgender people since last 23 years.

“When I was working in rural Odisha with transgender communities years back on HIV prevention, I remember one of them told me that ‘they do have access to condoms, but can I give them education or help with income’? By giving them support for non-formal education or increasing their income generation options, our healthcare programmes will also become more effective,” said Amrita.

If we want to serve the communities, we need to address their needs that are not being met.

“For communities that are already marginalised (such as, sex workers or LGBTQIAP people), HIV adds another layer of stigma and discrimination which people are facing. On one hand we must strengthen community-led monitoring as well as community system strengthening, and on the other hand, continue to build capacity of the marginalised communities so that they can contribute and engage meaningfully,” said Amrita.

“We have to integrate health and development services in existing HIV services for key populations. Non-communicable diseases (NCDs), such as cardiovascular diseases, cancers like cervical or anal cancers, diabetes, chronic respiratory diseases, mental health issues, among others, should be integrated. Holistic approach, along with community leadership, holds the key to reach the unreached,” said Amrita. “Why are other services that transgender people may need, such as hormone replacement therapy or specific surgeries, not yet integrated?”

Put People First was the mantra which brought all of us together this year at the world’s largest AIDS conference (25th International AIDS Conference or AIDS 2024). But are we ready to walk the talk and move from rhetoric to action on the ground?

Cervical cancer is an AIDS-defining illness and the most common cancer among women living with HIV globally. “When I look back at the conference last month, a pre-conference session on cervical cancer was important. We need to pay more attention in integrating cervical cancer in HIV programming which will be important for so many people, including transgender people, female sex workers, among others. Other forms of cancer such as anal cancers must get due attention too, especially for gay men........

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