COVID-19 disrupts access to SRHR for Zim’s LGBTI Community

LESBIAN, gay, bisexual, trans and intersex (LGBTI) people may be particularly vulnerable during the COVID-19 pandemic according to a paper by the United Nations titled COVID-19 and the human rights of LGBTI people.

Amongst the LGBTI community are people living with compromised immune systems, including some persons living with HIV/AIDS who also face a greater risk fromCOVID-19.

However, the community continues to face massive stigma and discrimination at the hands of health workers and society. With the coming in of the COVID-19, and given an overloaded health system in Zimbabwe, services for LGBTI people which include HIV treatment and testing among others have somehow been interrupted or deprioritized.

In Zimbabwe, major LGBTI friendly health institutions were turned into COVID-19 treatment and management centers, plunging prospects of accessing services for the LGBTI community into disarray.

To get an insight into some of the challenges faced and measures taken by the LGBTI community to ensure access to essential Sexual and Reproductive Health services during the COVID-19 induced lockdown, our Editor, Michael Gwarisa (MG) spoke at length with the Gays and Lesbians Association of Zimbabwe (GALZ) Director, Chester Samba (CS).

MG: How has the situation been like in terms of access to essential Sexual and Reproductive Health and Rights (SRHR) for the LGBTIQ community since the commencement of the Lockdown two months ago?

CS: The impacts of the imposed lockdown have not spared access to SRHR for LGBTI communities. Most facilities that LGBTI friendly are within CBDs of most major cities i.e Harare, Bulawayo, Gweru, Mutare and Masvingo and the travel restrictions has meant limited access to SRHR services that include ART, PREP, PEP and STI treatment.

Due to the short notice, some members of the LGBTI community have been reporting cases of drug stock out and the heavily Police manned roadblocks has posed as a major challenge to transgender individuals due to the disparity between the gender marker on their national IDs and the way they  present.

MG: As an institution, what measures have you put in place to ensure the LGBTIQ community access critical health services during the lockdown period?

A two-day clinic has been introduced at our Harare offices every Tuesday and Friday to offer comprehensive SRHR services to the LGBTI community. It’s a one stop shop were all services are accessible and available under one roof that include HIV testing, counseling services, initiation into ART, PREP, PEP and Sexual and Gender based violence intervention services. Plans are underway to replicate the model in other GALZ Drop in centers across the country.

MG: During the lockdown period, public transport has been a major challenge, how did you overcome such a hurdle?

CS: GALZ has been providing transport services to  LGBTI person experiencing challenges in accessing SRHR services in Harare, Bulawayo, Masvingo and Mutare.  LGBTI persons are picked and returned home to friendly health facilities free of charge. Counseling services are available online as well and  in some towns, partnerships have been created with other NGOs to offer SRHR to LGBTI person in their preferred setting through outreach basis

MG: The National Aids Council at the beginning of the lockdown invited people living with HIV and on ART to collect at least three months’ supply of drugs. What measures have you put in place to ensure LGTIQ living with HIV don’t miss out on medications?

CS: GALZ has taken note of the collecting three months medication and has raised awareness through its peer educators and social media platforms. LGBTI living with HIV have responded positively through adherence and seeking assistance whenever they encountered challenges in accessing three or more months’ dosage of essential medication.

The established two day clinic at the Harare has come in handy to supply multiple months drug supply and LGBTI have been benefitting through referral to outreach services  by other Community based organizations

MG: PrEP is a critical drug in the prevention of HIV infection for high risk population including LGBTIQ community. How accessible has been this drug to the LGBIQ community during the lockdown?

CS: PrEP is widely accessible mostly for urban communities and GALZ has been able to offer assistance through direct service and referral services. In a few cases, LGBTI who request for PREP have been assisted through linkages to closer health facilities or at times it sent to them through courier

MG: Before the lockdown, how has been the uptake of PrEP by the local LGBTIQ community and could we say the drug is being embraced?

CS: GALZ has generally noted low uptake of PREP amongst LGBTI community which can be alluded to a number of factors varying from limited advertising of the commodity, stigma associated with the commodity and storage challenges especially for young key populations

MG: The LGBTIQ community continues to face stigma and discrimination from society and healthcare service providers. How easy has it been to access health services during the lockdown considering most health centers have been turned into COVID-19 management centers?

CS: Access to health care has always been a challenge due to a number of factors and COVID has exacerbated the challenge. Fortunately service delivery through outreach, the work of peer educators at grassroots level  and robust use of social media and other virtual platforms has enabled access to SRHR services for LGBTI and other Key Populations

MG: The issue of GBV has been reportedly on the rise during Lockdown among heterosexual relationships. What’s the situation like in the LGBTIQ community and how many cases of GBV did were reported during this lockdown period?

CS: GALZ has attended to handful cases of domestic violence and intimate partner violence among the LGBTI community. This can be alluded to a number of factors such loss of livelihoods, stress and pressure from the current socio-economic and political environment. Counseling and medical services have been offered to both survivors and perpetrators of violence and broader awareness raising has been made to the broader LGBTI community.

MG: What other challenges have you been facing in accessing critical SRHR services under the prevailing Lockdown?

CS: Most LGBTI community members like most Zimbabwean citizens have reported mental health challenges such as stress, anxiety, depression due to fear and phobia of COVID 19. This was rife within the first three weeks of the lockdown and has in some way affected uptake of SRHR services as focus had been on COVID. Other challenges include interrupted services as one of the major LGBTI friendly facilities (Wilkins) was turned into a COVID Centre as well as restricted movement.

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