BRIDGING THE GAPS

Key populations (sex workers, people who use drugs, lesbian, gay, bisexual and transgender people) are hit hard and disproportionately by HIV, with a million new infections a year – that’s half the total worldwide. It is often difficult for them to have any control over the risks they face. They have to deal with a toxic mix of legal, political and social factors which can institutionalise stigma and social exclusion.

Linara, David, Rajesh, Bradley and Cindy invite you to step into their world and experience what it is like to be a drug user living with HIV in Nepal, a young gay man in Botswana or a sex worker in Uganda. Through their photo stories, we want to create more visibility about the challenges they encounter and the HIV risks they face.

linara, kyrgyzstan

Linara lives in Osh, Kyrgyzstan. She is 42 years old and has just given birth to her third child. Linara has a long history of using drugs and the doctors urged her to get rid of her unborn baby.

Linara grew up in a family with one brother and one sister. Her mother worked for 30 years as a weaver, until the factory where she worked shut down. It was just after the collapse of the Soviet Union, and the economic conditions were very poor. To feed the children Linara’s mother started to deal drugs. She served many years in prison as a consequence.

THE FIRST TIME
Linara started to use drugs when she was 15. Since then, she has used different kinds of drugs. Osh is located on a major drug trafficking route, so drugs are always available and cheap. Linara did various basic jobs to buy drugs.

Linara’s two daughters are married and have children. Linara has a very warm relationship with them. Linara: ‘My daughters never used drugs. I sometimes smell cigarette smoke around one of them, but she wouldn’t smoke in my presence.’

DENIAL OF MEDICAL CARE
About one year ago Linara met her husband Artyom. Artyom always dreamed of a child. He was really excited about Linara’s pregnancy and started to fix up a small house for the three of them.

Initially Linara was denied medical care during her pregnancy because a residence registration stamp was missing in her passport. Podruga (‘Girlfriend’), the only organisation in Osh that exclusively supports women who use drugs, arranged Linara’s papers. Linara had been coming to Podruga since 2012 for food, washing and shelter. Podruga also referred her to a methadone programme. She has not taken methadone for six months.

GIVING BIRTH TO A FREAK?
When Linara could finally visit a private family planning centre, the gynaecologist said her child would be a freak. He urged her to get rid of the baby.

‘“You are old, you have a long history of drug use. This will be a difficult pregnancy and delivery”, the doctor said. It was a nightmare. I’m strongly against abortion. After weeks of crying, I finally told Artyom. We went to Podruga for support.’

Linara and Artyom decided to stop using drugs together. Podruga referred them to a methadone programme. They both quickly decreased their dosages to 15 milligrams. Sometimes they even secretly spit it out. ‘Podruga is the place where I feel at home, where I get support no matter what challenges I face’.

BABY BOY
Linara gave birth to her son Arseniy at a state maternity hospital. The delivery went smooth. Arseniy looks like his father, which makes him very proud. ‘Perhaps only the boy’s eyes are like mine – also very big.’

david, kyrgyzstan

David is 29 years old. He is a refugee and lives in Kyrgyzstan with his boyfriend Dimitry. Both are originally from Uzbekistan, one of the most dangerous countries in the world for lesbian, gay, bisexual and transgender (LGBT) people.

HOLDING HANDS
Five years ago David and Dimitry went home after visiting a friend. ‘When we crossed an underpass holding hands, we heard someone shouting at us. We were taken to the police station, where they beat us and said they would kill us. In addition we were forced to write a statement about our sexual relationship and they threatened to tell my relatives and work colleagues. We could leave if we paid 500 US Dollars. A friend brought the money.’

David worked as an engineer for an international corporation. When he had to go on a business trip, he received a phone call. ‘A man who introduced himself as an official of the Ministry of Internal Affairs wanted to see me. When I met him, he stated that he knew everything about me.

From that day on I knew they were not going to leave me alone. I left my job, because I feared the consequences for my brother who worked with me.’

The pressure on David and Dimitry was huge. They went to a psychologist for support. Unfortunately she happened to know Dimitry’s father, and she told him about their relationship. ‘His father locked him up, took his passport and phone, and cut him off from the internet. After one week Dimitry escaped in his pyjamas.’

LABRYS
‘After Dimitry’s escape, I looked for human rights organisations in Uzbekistan and appealed to international organisations. This was all in vain, because of the political regime in Uzbekistan. Luckily, the LGBT organisation Labrys in Kyrgyzstan offered assistance. We had to leave the country as soon as possible and applied for a new passport. Unfortunately, the head of the passport office collaborated with Dimitry’s father and refused to give the document. Dimitry made a deal with the psychologist. She told his father that he needed the passport to register in the clinic, where she would treat him for homosexuality. This worked and we left Uzbekistan.’

LGBT ACTIVIST
David has been living in Kyrgyzstan for three years now. First he was not allowed to work, and did not receive government support.

Thanks to a gap in legislation, David managed to arrange the necessary papers from the Ministry of Labour allowing him to work. ‘At Labrys I coordinate LGBT initiative groups and partnerships in Central Asia. As a member of a rapid response team I also support victims of violence. We accompany them to law enforcement agencies, for example.’

‘Because we’re still not safe, we are trying to get a visa for the USA. It will be hard to leave everything behind again. But it doesn’t matter where you are, but who you are with.’

BRADLEY, BOTSWANA

Bradley Fortuin lives in Botswana. He is 26 years old and gay. His mother died of AIDS when he was only 9 years old.

Bradley has a younger brother and a sister, who is studying theology. He has very little contact with his younger brother. When Bradley’s mother died, the family fell apart and the children were scattered amongst family members. At first Bradley lived with his grandmother, but she also died. So Bradley and his siblings went to live with their aunt. Bradley now lives with his uncle in Gaborone. His uncle is single.

UN-AFRICAN
Bradley’s uncle is a priest and has great difficulties with Bradley’s sexuality. He does not accept it at all and says it is ‘un-African’. Yet, he looks after Bradley and takes his responsibilities seriously. Nevertheless, Bradley finds it difficult to be entirely himself in the presence of his uncle. Religion somehow gets in the way. His uncle tells Bradley that he will go to hell.

Bradley says that it is very difficult to grow up as a gay man in a heavily Christian family. ‘I feel a lot of pressure to hide who I really am. There is no happiness inside myself.’ For Bradley it does have an impact on his university work. Bradley: ‘LGBT people are more likely to perform badly and fail, but education is the key for most young LGBT people.’ Bradley studies ICT. ‘When I graduate from university and get a job, that is when I can leave my uncle’s house and get my own place.’

On Sundays Bradley likes to spend time in the gym, while others go to church.

FRIENDS
Bradley had several relationships. But bringing home a boyfriend is not an option because of his uncle. He gets tested for HIV twice a year. Friends are very important to Bradley. One of Bradley’s best friends is Kat. Kat was born in a man’s body, but feels a woman and now happily lives as a woman. Kat is a transwoman. Bradley: ‘My best friend is straight and she offers support and gives me words of encouragement and assurance. The fact that I have decided to open up and talk to someone has really made me feel better and given me better and peaceful perspectives.’

LGBT SUPPORT GROUPS
Bradley works as a volunteer at LeGaBiBo (Lesbians, Gays and Bisexuals of Botswana), a local NGO that advocates for equal rights for LGBT people. They also organise support group meetings to share experiences. They meet in public spaces, under a tree, as renting a meeting place is rather difficult for them. ‘When we talk to someone, be it a counsellor, a friend, a teacher or even a stranger, we drop the burden that has been weighing us down and making us feel worthless. Talking about our challenges really helps. It avoids situations such as substance abuse and even wanting to commit suicide.’

EQUALITY FOR LGBT PEOPLE
According to Bradley policy makers need to understand that he is not different from any other human being in this world. ‘Just because the person that we love is of the same sex, that does not make us less human nor less deserving of the same benefits that heterosexuals have. LGBT people-friendly counselling centres should be established to support young people to deal with their issues. They should be able to get assistance without being stigmatised and judged,’ argues Bradley.

Bradley wants the laws of his country to be changed to allow all persons, regardless of their sexual orientation, to be able to get married and have children. ‘It all starts with the church. The church has a lot of influence on how the laws in Botswana are made and implemented. If the church can speak for LGBT people, then maybe the laws will be more progressive.’

Dream
For Bradley the big challenge regarding his sexual orientation is self-acceptance and self-love. ‘There is a lot of low self-esteem and low self-confidence amongst LGBT people. Many LGBT people are not aware of their value and their potential. Other problems include acceptance by family and friends, access to HIV/AIDS and other STIs treatment, and financial instability.’ Bradley: ‘I dream of graduating and having my degree. I dream of a world where everyone is accepted for who they are, a place where LGBT people are not killed for loving but can celebrate who they are. I dream of a place where I can walk with my husband in the mall holding hands without people staring. I use the word ‘husband’ because getting married and raising a family is part of my dream.’

Cindy, Uganda

Cindy lives in Kampala, the capital of Uganda, with her two daughters Sheila (19) and Esther (15). Cindy is divorced and because of that her life is not that easy. She is looking after her two girls on her own. At the moment she can only make ends meet by secretly working as a sex worker. Sex work is heavily stigmatised in her society.

Cindy’s daughters do not know that their mother is working as a sex worker nor do the neighbours. Usually sex workers do not tell their families about their job. And like most secret sex workers, Cindy works far away from where she lives. She changes clothes at work.

LIVING WITH HIV
Cindy knows she is living with HIV. This sometimes gives her stress, particularly when she is picked up by the police, which happens from time to time when you do sex work. She did not tell her relatives and friends that she is living with HIV. Not even her two daughters know about it. She is getting treatment since 2010. Thankfully her daughters are not living with HIV. Cindy had them tested a few years ago.

The three of them live in a small rented house of 20 square meters. It is not as good as the house they had before, but in the end that was too expensive for Cindy. Living in this cheaper house means she can save a bit of money each month. Her dream is to buy her own house one day. For Cindy this is very important, as she wants her daughters to inherit the house. So they have a place to stay if something happens to her.

PAINTING
Cindy’s parents were divorced and she grew up with her grandmother. She has four sisters. Her brother died a few years ago. She was trained to be a secretary and work in an office, but she hardly ever worked in that field.

Her passion is painting, and the big painting in the living room is her pride. A few other paintings she made when she was still at school, have been sold. ‘It’s a pity that materials are so expensive. I would have loved to be a painter.’ Dancing is another hobby. Cindy and her daughters have fun together and sometimes dance in front of the television.

Sheila is the only one living at home at the moment. Her younger sister Esther is now at a boarding school, This is common practice in Uganda, as sending your child to boarding school is often cheaper than paying transport to and from school every day. And it is too tricky for children to take regular buses, especially for girls on their own. There are no school buses. So Esther comes home every three months for a few days only. Sheila usually cannot wait to see her sister again. For several years, when Cindy was working in South Sudan, Sheila looked after her younger sister. She did the household jobs and even had to earn some money to buy the necessary food. It was a tough time. The girls were constantly worried about their mother being in a country that was torn apart by war and violence.

HONOUR
Now that Cindy is back home, she is an almost overprotective mother. Cindy does not want Sheila to hang out in the streets. She is worried that something might happen to her if she meets the wrong people. For Cindy it is very important that her daughter’s honour is intact. She keeps her in the house as much as she can, and this is why Cindy bought a television set, a DVD player and lots of movies. Actually Sheila’s dream is to study mass communication and media and be a famous television or radio presenter. Sheila takes life as it comes and she does what her mother tells her to do, helping with the household tasks like washing, cleaning and cooking. But she does not always feel safe in the house, because they are the only family in the neighbourhood without a man in the house. It may cause problems, one day.

Although she is old enough to go out, Sheila spends most days at home and never invites friends to come around. She is afraid to be laughed at, because they are poor. She chats with her friends through WhatsApp and only occasionally she meets them in the city. ‘Let them think we are living in a mansion. I rather keep friends a bit at a distance, as my experience is that they can turn you down. It happened a few years ago. My best friend suddenly started to tell nasty stories about my mother. That made me feel so sad and I don’t want that to happen again.’

rajesh, nepal

Rajesh Ji lives in Nepal. He is 37 years old and until six years ago he was actively using drugs. Rajesh is living with HIV. His wife and other family members do not know he is HIV-positive.

The only relative who does know, is his sister. She works in the Emirates as a maid. She will be coming over soon and Rajesh is planning to tell his family then that he’s living with HIV, when she is around for mental support. People living with HIV face a huge stigma in Nepal, even bigger than people who use drugs. Rajesh: ‘I think my family knows that I have HIV, but nobody talks about it. My medicines are on top of a cupboard in the room, so they could know.’ Rajesh wants to tell his father, but he does not have the strength to do so. Rajesh’s wife and children have not been tested for HIV.

SHELTERED ACCOMMODATION
Rajesh comes from a farming family. He has a farm just outside Bhaktapur. He is using the farm as sheltered accommodation for people who use drugs. In exchange for some work on the farm, they get food, medicines and a safe place to sleep. The tomatoes they are growing are not sold on the nearby market. Because of the HIV stigma, locals do not want to buy products from Rajesh. So he has to go to a market much further away where people do not know his background. ‘There isn’t much knowledge about HIV. People still believe you can get it from bad drinking water.’

EARTHQUAKE
The recent earthquake had a powerful impact on Rajesh’s family. Their house was destroyed. At the moment Rajesh is renting two rooms in a friend’s house. But it is tight-fit for him, his parents and his wife and two children. 

They have to cook and sleep in just two rooms. The house is 3 kilometres from their old house, which means a longer walk to school for the children. Rebuilding the old family house is close to impossible. The new building regulations are making it more expensive and at the moment Rajesh cannot afford it. He has to look after the whole family.

The earthquake also had a positive impact on Rajesh’s life. Before, he was facing a lot of stigma and discrimination from the people in his village. But Rajesh never hesitated to help those same people just after the earthquake and offered them shelter in his farm. He distributed food among the children and women. It definitely changed the way people look at him.

HEALTH
For Rajesh it is important to live a regular life. He needs to drink a lot of water to keep his liver clean and he needs to take his medication at fixed times. ‘When I was still actively using drugs, it was all very tiring. In my country drug use is criminalised, and society stigmatises people who use drugs. I constantly had to
lie about everything. That takes a lot of energy. Now that I am off the drugs I don’t need to make up stories about my whereabouts anymore. I am finally free.’

The ART medicines are free for Rajesh. Even just after the earthquake in Nepal, HIV medicines were widely available. But he needs to be tested every three to six months because of an allergic reaction he had with other medication. This is not an easy process. Most of his veins are not suitable to inject anymore, due to his previous drug use. It is even hard to use a needle for a simple blood test.

Rajesh can only use an area between two fingers. ‘When I use a needle it feels like a gun shot in my body. I even start to sweat heavily.’ The nurses find it difficult to look at, so Rajesh injects himself at a quiet spot in the hospital, with a male nurse.

PEER COUNSELLOR
Besides working at his farm, Rajesh is a peer counsellor for Youth Vision, a partner organisation of Bridging the Gaps. Today he is meeting a couple who made a 350 kilometre journey to get support in the city. They do not want anyone to know that they are living with HIV. The stigma is too big. At Youth Vision they get treatment and learn how to live with HIV.

Rajesh is very grateful to Youth Vision. Once the organisation supported him, and he still sees his counsellor often.

The tattoos on Rajesh’s body are dating back to when he was using drugs. ‘The dragon I got done with a friend who was also using drugs. We were both high. To finish the tattoo it took a full day. My friend is dead now, by the way.’