“If I want to see the change, I need to be the change,” said Aniz Mitha, the Executive Director of Community Health Rights Advocacy (CHeRA), an organization that works with male sex workers in Malawi. When Mr Mitha speaks of change, he does so with the quiet and unwavering authority of someone who knows what he is talking about.

From a conservative Muslim family in Malawi, Mr Mitha was thrown out of the house at a young age when his parents found out that he was gay. With nowhere to go and no means to support himself, he fled to Johannesburg, South Africa, where he spent many years as a sex worker. “For me, I was looking to survive; I wasn’t thinking about my health,” he said.

When he became ill, he took an HIV test, and he learned that he was living with HIV. Being an illegal immigrant, he couldn’t access health-care services in South Africa. He returned to Malawi, where he began HIV treatment and started CHeRA. “I thought: how can I help others not go through the same experience that I did?” he said.

CHeRA raises awareness and builds the capacity of male sex workers on HIV prevention and treatment, sexual and reproductive health and rights, economic empowerment, psychosocial support and access to justice. Through a UNAIDS funding arrangement, it recently reached more than 250 male sex workers in three priority districts in Malawi, distributed more than 30 000 condoms and lubricant and linked six male sex workers living with HIV to care and treatment. In another programme funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria, the organization has trained 50 peer educators and distributed more than 6000 condoms and condom-compatible lubricant.

Mr Mitha is keenly aware of the many challenges that face male sex workers, having faced them himself. “In Malawi, sex work is not recognized as work, so there are no laws to protect sex workers. Also, most of our male sex workers are gay men or men who have sex with men, so they live in fear of arrest because homosexuality is illegal in Malawi,” he said.

Stigma and discrimination is institutional, he said. “Male sex workers are not recognized as a key population in the HIV response in Malawi, so we are not prioritized in government plans. And negative attitudes from health-care workers push us away from care.” Read more via UNAIDS