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19-year-old Joseph Ikatlholeng attends the Botswana Family Welfare Association (BOFWA) clinic in Gaborone every three months to receive antiretroviral treatment for HIV. He’s currently at university, studying for a degree in transport and logistics. “I hope to start my own transport business, maybe in the future an airline,” he says, laughing at the grandeur of his dreams.   Joseph first came to BOFWA when he and his boyfriend decided to start practicing safe sex in March 2017. “I had put myself in risky situations so thought I should get tested for HIV,” he says.   After learning he was HIV positive, Joseph tried out a few clinics to receive his treatment, but found BOFWA to be the most confidential and friendly. Sitting in the clinic behind the doctor’s desk, he says, “I never have any problems coming here. I feel comfortable here. At [the government clinic] there is no privacy; most of my friends are there. Sometimes if you go there you find them suspecting something, and everyone will be knowing your status. That’s why I prefer BOFWA.”     Feeling safe is important to Joseph, who regularly faces discrimination as a man who has sex with other men. “Last week I was walking along, and these guys came past in the car shouting “gay, gay, gay.” I experience that treatment a lot.”    Now, he and some LGBTI friends in Botswana are trying to work with their community to change the status quo about LGBTI people in the country. “We’re trying to tell the elders that we are here, we’re trying to change perceptions that LGBTI people are not just on drugs and having sex,” he says.  

“I’m a sex worker and peer outreach worker for the Nkaikela Youth Group. We reach the other sex workers because we are the ones that know them. We go to their houses, we go to the hotspots like clubs and the street; we reach them and encourage them to come here [to the Youth Group],” says Jackie Selelo, 34, sitting in one of the temporary office buildings at the Nkaikela Youth Group in Gaborone.   With the support of BOFWA nurses, the Nkaikela Youth Group provides a range of sexual health care to sex workers: “They need health services for STIs, smear tests, HIV tests, and to be enrolling onto antiretroviral treatment for HIV,” Jackie explains.   Female sex workers are in a particularly high-risk group for contracting HIV – the prevalence rate is 61.9% among the community – so having access to testing and treatment is vital. However, Jackie says many women don’t feel safe going to the government clinic. “They don’t accept us. It’s like we’re doing this because we want to, and just bringing disease. We’re not comfortable there and so sex workers are not [being tested and treated] in large numbers. Before BOFWA we were dying in large numbers because we were afraid of those clinics.”     The difference between being treated by the staff at BOFWA is huge, according to Jackie. “We get a good service with BOFWA, they’re helping us to come for tests and they’re treating us good. With BOFWA if you come for HIV testing and were positive they would initiate you on to treatment the same day. Any problem you could discuss with them without fear, like they are your brothers and sisters.”   She’s concerned that if funding continues to be cut, BOFWA nurses will stop coming to the Youth Group completely. “If they stop it will be difficult for us. We will die, we will be infected,” she says.  

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"I suspect I contracted HIV from my sex work. There were times I had to engage in risky sex, depending on the money on the table." Gabatswane used to go to the BOFWA clinic in Selebi Phikwe for treatment. “I enjoyed the confidentiality that they had there, compared to the government [clinic] where everyone knows everything. It was comfortable talking to the BOFWA providers.” Due to the Global Gag Rule’s funding cuts, the BOFWA clinic has been forced to close. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Goabaone, sex worker & peer outreach worker "I've been a female sex worker for 5 years and a peer outreach worker for the last two. I was looking at the problems that us sex workers encounter, and thought that this peer outreach system might be able to help,” says Goabaone, explaining how she came to work with MCDA. Since the Global Gag Rule funding cuts the scheme has ended, and she now has to refer them to the government clinic. BOFWA was different: “At BOFWA we felt free, there is no stigma. They didn’t ask [how you got the infection], they just treated you every time,” Goabaone says. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Jackie, sex worker & peer outreach worker “I’m a sex worker and peer outreach worker for the Nkaikela Youth Group. We reach the other sex workers because we are the ones that know them. We go to their houses, we go to the hotspots like clubs and the street; we reach them and encourage them to come here [to the Youth Group],” says Jackie, 34. “We get a good service with BOFWA, they’re helping us to come for tests and they’re treating us good. With BOFWA if you come for HIV testing and were positive they would initiate you on to treatment the same day. Any problem you could discuss with them without fear, like they are your brothers and sisters.” Read Jackie's full story here Share on Twitter Share on Facebook Share via WhatsApp Share via Email Joseph, university student Joseph, 19, first came to BOFWA in 2017 when he and his boyfriend decided to start practicing safe sex. “I had put myself in risky situations so thought I should get tested for HIV,” he says. After learning he was HIV positive, Joseph tried out a few clinics to receive his treatment but found BOFWA to be the most confidential and friendly. Sitting in the clinic behind the doctor’s desk, he says, “I never have any problems coming here. I feel comfortable here. At [the government clinic] there is no privacy; most of my friends are there. Sometimes if you go there you find them suspecting something, and everyone will be knowing your status. That’s why I prefer BOFWA.” Read Joseph's full story here Share on Twitter Share on Facebook Share via WhatsApp Share via Email Keanantswe, BOFWA client A few months after beginning her HIV treatment the BOFWA clinic was forced to close due to the Global Gag Rule funding cuts. “In April I received a call from my nurse telling me the clinic is being closed. She gave me tablets for two months up to June 2018. She told me I will get transferred to a government clinic," Keanantswe says. Although getting treatment is now much harder for her, she has to continue going every month or risks getting sick and even dying. “We have lost so much without BOFWA, not only me, but many women. I wish it would open again,” she says. Share on Twitter Share on Facebook Share via WhatsApp Share via Email

Milan Khadka was just ten years old when he lost both his parents to HIV. “When I lost my parents, I used to feel so alone, like I didn’t have anyone in the world,” he says. “Whenever I saw other children getting love from others, I used to feel that I also might get that kind of love if I hadn’t lost my parents.” Like thousands of Nepali children, Milan’s parents left Nepal for India in search of work. Milan grew up in India until he was ten, when his mother died of AIDS-related causes. The family then returned to Nepal, but just eight months later, his father also died, and Milan was left in the care of his grandmother. “After I lost my parents, I went for VCT [voluntary counselling and testing] to check if I had HIV in my body,” Milan says. “After I was diagnosed as HIV positive, slowly all the people in the area found out about my status and there was so much discrimination. My friends at school didn’t want to sit with me and they humiliated and bullied me,” he says. “At home, I had a separate sleeping area and sleeping materials, separate dishes and a separate comb for my hair. I had to sleep alone.” Things began to improve for Milan when he met a local woman called Lakshmi Kunwar. After discovering she was HIV-positive, Lakshmi had dedicated her life to helping people living with HIV in Palpa, working as a community home-based care mobiliser for the Family Planning Association of Nepal (FPAN) and other organisations. Struck by the plight of this small, orphaned boy, Lakshmi spoke to Milan’s family and teachers, who in turn spoke to his school mates. “After she spoke to my teachers, they started to support me,” Milan says. “And after getting information about HIV, my school friends started to like me and share things with me. And they said: ‘Milan has no one in this world, so we are the ones who must be with him. Who knows that what happened to him might not happen to us?” Lakshmi mentored him through school and college, encouraging him in his schoolwork. “Lakshmi is more than my mother,” he says. “My mother only gave birth to me but Lakshmi has looked after me all this time. Even if my mother was alive today, she might not do all the things for me that Lakshmi has done.” Milan went on to become a grade A student, regularly coming top of his class and leaving school with flying colours. Today, twenty-one-year-old Milan lives a busy and fulfilling life, juggling his college studies, his work as a community home-based care (CHBC) mobiliser for FPAN and a burgeoning music career. When not studying for a Bachelor’s of education at university in Tansen, he works as a CHBC mobiliser for FPAN, visiting villages in the area to raise awareness about how to prevent and treat HIV, and to distribute contraception. He also offers support to children living with HIV, explaining to them how he lost his parents and faced discrimination but now leads a happy and successful life. “There are 40 children in this area living with HIV,” he says. “I talk to them, collect information from them and help them get the support they need. And I tell them: ‘If I had given up at that time, I would not be like this now. So you also shouldn’t give up, and you have to live your life.” Watch Milan's story below:      

“Family Planning Association of Nepal is playing a crucial role in protecting the rights of female sex workers in the whole of Nepal” says Jamuna Sitvla, senior programme officer at Family Planning Association of Nepal (FPAN). There are around 40,000 sex workers in Nepal. Around 1,300 are infected with HIV. FPAN is working to increase awareness among sex workers to practice safe sex and to use condoms to protect from HIV. "One challenge is that when female sex workers carry condoms, if the police find the condoms, they criminalise the women. Some of the sex workers have been organised via different organisations in order to protect their rights. Now the Supreme Court has given an a ruling that policemen have to ensure the sexual rights of female sex workers have to be addressed. This decision includes that women can carry condoms: that is their right. The second decision is that sex workers have the right to organise. Some sex workers are afraid of asking heir clients to wear condoms and this increases their risk of contracting HIV but the more confident sex workers are ensuring that their clients wear condoms". "In 2017 there was a huge conference held at FPAN, with sex workers invited as panelists. People had the opportunity to understand the problems they were facing. One of FPAN’s great successes was to invite the criminal department of police, policy makers and sex workers to come under one roof. We gathered them in the FPAN venue and they made a commitment that from now on the female sex workers will be treated with respect, with dignity, will not be criminalised."   Stories Read more stories about our work with people living with HIV

Lakshmi Kunwar married young, at the age of 17. Shortly afterwards, Lakshmi’s husband, who worked as a migrant labourer in India, was diagnosed with HIV and died. “At that time, I was completely unaware of HIV,” Lakshmi says. “My husband had information that if someone is diagnosed with HIV, they will die very soon. So after he was diagnosed, he didn’t eat anything and he became very ill and after six months he died. He gave up.” Lakshmi contracted HIV too, and the early years of living with it were arduous. “It was a huge burden,” she says. “I didn’t want to eat anything so I ate very little. My weight at the time was 44 kilograms. I had different infections in my skin and allergies in her body. It was really a difficult time for me. … I was just waiting for my death. I got support from my home and in-laws but my neighbours started to discriminate against me – like they said HIV may transfer via different insects and parasites like lice.” Dedicating her life to help others Lakshmi’s life began to improve when she came across an organisation in Palpa that offered support to people living with HIV (PLHIV). “They told me that there is medicine for PLHIV which will prolong our lives,” she explains. “They took me to Kathmandu, where I got training and information on HIV and I started taking ARVs [antiretroviral drugs].” In Kathmandu Lakshmi decided that she would dedicate the rest of her life to supporting people living with HIV. “I made a plan that I would come back home [to Palpa], disclose my status and then do social work with other people living with HIV, so that they too may have hope to live. I said to myself: I will live and I will let others living with HIV live”. Stories Read more stories about our work with people living with HIV

“When I was 14, I was trafficked to India,” says 35-year-old Lakshmi Lama. “I was made unconscious and was taken to Mumbai. When I woke up, I didn’t even know that I had been trafficked, I didn’t know where I was.” Every year, thousands of Nepali women and girls are trafficked to India, some lured with the promise of domestic work only to find themselves in brothels or working as sex slaves. The visa-free border with India means the actual number of women and girls trafficked from Nepal is likely to be much higher. The earthquake of April 2015 also led to a surge in trafficking: women and girls living in tents or temporary housing, and young orphaned children were particularly vulnerable to traffickers. “I was in Mumbai for three years,” says Lakshmi. “Then I managed to send letters and photographs to my parents and eventually they came to Mumbai and helped rescue me from that place". During her time in India, Lakshmi contracted HIV. Life after her diagnosis was tough, Lakshmi explains. “When I was diagnosed with HIV, people used to discriminate saying, “you’ve got HIV and it might transfer to us so don’t come to our home, don’t touch us,’” she says. “It’s very challenging for people living with HIV in Nepal. People really suffer.” Today, Lakshmi lives in Banepa, a busy town around 25 kilometres east of Kathmandu. Things began to improve for her, she says, when she started attending HIV awareness classes run by Family Planning Association of Nepal (FPAN). Eventually she herself trained as an FPAN peer educator, and she now works hard visiting communities in Kavre, raising awareness about HIV prevention and treatment, and bringing people together to tackle stigma around the virus. The government needs to do far more to tackle HIV stigma in Nepal, particularly at village level, Lakshmi says, “Attitudes of younger people to HIV are not changing fast. People still say to me: ‘you have HIV, you may die soon’. There is so much stigma and discrimination in this community.” Stories Read more stories about our work with people living with HIV

"My husband used to work in India, and when he came back, he got ill and died," says Durga Thame. "We didn’t know that he was HIV-positive, but then then later my daughter got sick with typhoid and went to hospital and was diagnosed with HIV and died, and then I was tested and was found positive." Her story is tragic, but one all too familiar for the women living in this region. Men often travel to India in search of work, where they contract HIV and upon their return infect their wives. For Durga, the death of her husband and daughter and her own HIV positive diagnosis threw her into despair.  "My neighbours used to discriminate against me … and I suffered violence at the hands of my community. Everybody used to say that they couldn’t eat whatever I cooked because they might get HIV." Then Durga heard about HIV education classes run by the Palpa branch of the Family Planning Association of Nepal (FPAN), a short bus journey up the road in Tansen, the capital of Palpa.  "At those meetings, I got information about HIV," she says. "When I came back to my village, I began telling my neighbours about HIV. They came to know the facts and they realised it was a myth that HIV could be transferred by sharing food. Then they began treating me well." FPAN ran nutrition, hygiene, sanitation and livelihood classes that helped Durga turn the fortunes of her small homestead around. Durga sells goats and hens, and with these earnings supports her family – her father-in-law and her surviving daughter, who she says has not yet been tested for HIV. "I want to educate my daughter," she says. "I really hope I can provide a better education for her." Stories Read more stories about our work with people living with HIV