Widespread discrimination based on HIV-status, sexuality and gender identity 

PLHIV, MDS and trans women have plenty in common, but they also experience stigma and discrimination in some different ways. PLHIV generally feel that life has improved for their community, at least in Port Moresby and other major urban centres, and they credit ART for much of this improvement. By contrast, MDS and trans women tend not see significant improvements in the levels of community acceptance. This difference can be partly explained by the shift in understanding of HIV. Once people understand that HIV is just another health issue rather than a highly contagious death sentence, it can be approached in an entirely different way. But many Papua New Guineans remain opposed to homosexual or transgender ‘lifestyles’. There is an active debate around the degree to which pre-colonial PNG accommodated homosexual behaviour or transgender expression, but the more common community view does not embrace this idea. While many MDS and trans women believe strongly that they have always had a place in PNG society, even they don’t think this argument likely to be highly persuasive in the short-term.

 

The experience of violence for trans women is especially horrifying. Most trans women report multiple experiences of violence, often at the hands of uniformed personnel (police, army officers, security guards), but also at the hands of families and communities. These experiences have often involved sexual assault and rape.

 

Many MDS continue to hide their sexuality, at least to some degree. This brings with it its own burdens, but it affords a degree of protection from the discrimination and violence experienced by trans women. MDS who are ‘out’ are much more vulnerable, and yet still they seem slightly safer than their trans women friends.

 

Not surprisingly PLHIV were more likely to focus on violations of their rights to health care, especially ART. Access to secure and affordable ART supplies is critical for PLHIV. It keeps them alive, but it also profoundly shapes the way they are treated within their communities.

 

Control of information and confidentiality were more likely to be issues for PLHIV and MDS than for trans women. Again, the reason for this is obvious. Trans women are in many cases unable or unprepared to hide their status, so are less concerned with privacy. By contrast, PLHIV and MDS are very invested in ensuring that information about their status is controlled tightly.  

 

MDS and trans women are more likely to see regional differences in the ways they are treated as an indication of cultural variation – Highlanders are considered less tolerant that people along the coast and in some cases this tolerance even looks like acceptance. By contrast, PLHIV thought their experiences shaped by the extent to which ART distribution and HIV awareness had penetrated PNG. In areas where residents possessed a sound knowledge of HIV transmission and where ART was available, discrimination was likely to be lower. These areas were likely to be urban centres, but the location of the urban centre (Highlands v coast) was not thought to be critical.  

 

MDS and trans women were far more likely than PLHIV to talk about violation of their right to ‘be themselves’. This was especially the case for trans women. Trans women were far more likely to talk about being prevented from moving around freely. This was their way of discussing safety, or more pointedly the lack of it, as soon as they moved outside of their homes or communities (however these communities had been formed). This focus on the inability to move around without being threatened or assaulted was consistent with the high rates of violence reported by trans women interviewees. Clearly, and understandably, this violation of human rights is the one that most preoccupies the minds of trans women.