Promoting access to healthcare for trans and gender diverse persons in Zimbabwe in the context of HIV

Abstract

Zimbabwe has significantly curbed its HIV epidemic, but there are still gaps in coverage for certain groups, particularly transgender and gender diverse (TGD) persons. TGD persons face high rates of HIV infection, limited epidemiological data, and societal and legal factors that hinder their access to healthcare. Using the Human Rights Based Approach (HRBA) as the main theoretical approach, the research examines the legal and policy frameworks in Zimbabwe, that impact on HIV healthcare access for TGD persons. The research being qualitative in nature, analyses international human rights instruments, policies, health guidelines, national laws, and strategies, and draws lessons from South Africa, Kenya, Malta, and Argentina for recommendations in improving access to healthcare for TGD persons in Zimbabwe.

The findings show that despite TGD persons recognition as priority groups in HIV interventions in Zimbabwe, there are gaps in the law and constitution of the country which lead to systemic healthcare disparities. These mainly involve stigma and discrimination at health facilities, lack of comprehensive information for both TGD persons and the health practitioner and economic challenges faced by TGD persons. A key barrier to access to services has been the criminalisation and legal gender recognition for TGD person which further pushes them to the margins of society.

Key recommendations include legal reform that place emphasis on equality and non-discrimination. Legal reform should include decriminalisation of sexual and gender diverse persons, having gender laws that explicitly recognise TGD persons and provide constitutional protections for sexual and gender minorities. There is need to strengthen advocacy for TGD persons’ rights on international and national platforms, through opening the space for civil society engagement. Directly linked to access to HIV services, there is need for a revision and update of national policies, guidelines, and HIV strategies to include the needs of TGD persons and the provision of gender affirming health services.