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As we honor Lesbian, Gay, Bisexual, Transgender, Queer, and Intersex (LGBTQI+) Pride Month, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) stands with members of the LGBTQI+ community and remains committed to providing person-centered treatment and services to those living with HIV globally.

In solidarity with President Biden’s commitment to advancing the human rights of LGBTQI+ persons , PEPFAR remains dedicated to the vital work ahead of ending AIDS as a public health threat by 2030 and protecting human rights. We continue to ensure equitable access for all to quality HIV prevention and treatment services; build enduring capabilities across public health systems; and form lasting partnerships through community and civil society engagement and multilateral and private sector collaboration to advance the health and lives of LGBTQI+ individuals.

With over $100 billion invested in the global AIDS response, the U.S. government, through PEPFAR, has saved more than 21 million lives, prevented millions of HIV infections, and supported more than 20 countries to achieve epidemic control of HIV or reach their HIV treatment targets.

As of December 2021, PEPFAR has supported 18.2 million people with antiretroviral therapy (ART), including a total of more than 211,000 gay men and other men who have sex with men and more than 9,500 transgender people. From October through December 2021 alone, PEPFAR enrolled roughly 14,500 gay men and other men who have sex with men and 1,000 transgender people on ART and over 33,000 gay men and other men who have sex with men and more than 2,200 transgender people on antiretroviral pre-exposure prophylaxis (PrEP) to prevent HIV infection.

While we celebrate progress, we cannot achieve control of the HIV epidemic and the 95-95-95 goals outlined in the Global AIDS Strategy 2021-2026 if we do not also address stigma, discrimination, violence, and punitive laws and policies that foster inequality and an inequitable HIV response, especially among people who are the most vulnerable to HIV. We must work with partners to address the laws, policies, and practices that make it harder for the populations most impacted by the epidemic to receive the HIV services and support they need.

Looking ahead to the Country Operational Plan 2022  (COP 2022) implementation – which will begin in October 2022 – PEPFAR will continue to prioritize key populations, including those among the LGBTQI+ community. In an effort to fortify programs and strategies in service to those who are most vulnerable to HIV and discrimination worldwide, PEPFAR will increase funding to more than $235 million (pending congressional approval) in support of HIV prevention and treatment services for key populations, including an acceleration of PrEP access for key populations, marking an increase compared to COP 2021.

In addition to investments in HIV prevention and treatment services for key populations, PEPFAR programs will prioritize and take specific steps to tackle structural barriers that impede the scale-up of services for key populations.  Addressing these structural barriers will include improving the enabling environment for HIV service delivery; mitigating harmful policy and social norms that fuel stigma, discrimination, and violence faced by key populations; strengthening the capacity of key populations organizations; and strengthening the key population competency of HIV service providers. Our teams will also work across the U.S. government and with other partners to address these barriers in a proactive manner.

We will pursue new collaborations and partnerships to expand the reach of our work, specifically across the U.S. government and with multilateral efforts. Today, PEPFAR is announcing a new $3.78 million co-funded collaboration with the United Nations Development Programme to further the implementation of the Global AIDS Strategy and counter discriminatory laws that impede key populations’ access to HIV services.

PEPFAR expects its programs to reach more than 1.2 million gay men and other men who have sex with men and more than 55,000 transgender people with HIV prevention services during Fiscal Year 2023, according to preliminary targets. PEPFAR aims to enroll more than 43,000 gay men and other men who have sex with men and more than 5,000 transgender people on ART, along with more than 150,000 gay men and other men who have sex with men and more than 8,000 transgender people on PrEP. By the end of Fiscal Year 2023, PEPFAR plans to support more than 250,000 gay men and other men who have sex with men and more than 16,000 transgender people on HIV treatment.

As a global community, if we can provide equitable access to HIV treatment and prevention services with compassion and integrity, we can deliver a brighter future for all.

About the Author: Dr. John Nkengasong serves as U.S. Global AIDS Coordinator and Special Representative for Global Health Diplomacy at the U.S. Department of State. 

U.S. Department of State

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