Janet Rice (Victoria, Australian Greens) Share this | Link to this | Hansard source

This Saturday, 1 December, is World AIDS Day, a day held every year to raise awareness across the world and in the community about the issues surrounding HIV and AIDS, a day for people to show support for people living with AIDS and HIV, and a day to remember those who we have lost. It's also a day for people to learn about HIV, to take action to reduce the transmission of HIV and to support people in our community who are living with HIV and ensure they can live and participate fully in our community, free from stigma and discrimination.

I'm pleased to say that HIV infection is declining amongst men who have sex with men, and this is due to the rise of the use of pre-exposure prophylaxis, otherwise known as PrEP. In one trial in New South Wales, HIV infections declined by almost one-third, and the declines were highest amongst Australian-born men and those living in the 'gay' suburbs of inner Sydney. However, reductions among non-English speaking immigrants were lower: for example, there was only a 21 per cent decline for men born in Asia. But the most concerning statistic was that we've seen a 33 per cent increase in new HIV diagnosis rates amongst Aboriginal and Torres Strait Islander people, compared with the 22 per cent decrease in newly diagnosed HIV rates amongst Australian-born non-Indigenous people. This is attributed to higher proportions of Indigenous people with HIV going undiagnosed and the low uptake of PrEP. In fact, of the almost 17,000 people in PrEP trials in Australia, only around 200 are Indigenous. This disparity must be fixed. We need targeted efforts to encourage the uptake of PrEP in Aboriginal and Torres Strait Islander populations. We also need to ensure that the needs of all Aboriginal and Torres Strait Islander people, including brotherboys, sistergirls, and gay, bisexual, transgender and intersex people, are met in public health prevention efforts and service provision.

While we've seen some good progress in the overall decline of HIV rates in Australia, the fact remains that stigma for people living with HIV remains a real issue, particularly for those in the LGBTIQ+ community. Reducing stigma leads to more people getting tested, and early testing is essential for the elimination of HIV. There is a very important role for government to play in this. I commend the listing of PrEP on the PBS and would like to acknowledge the massive community campaign and the hard work of LGBTIQ advocacy organisations and activists, and health organisations, that led to this. Without this listing, PrEP would have remained prohibitively expensive, costing around $5,000 per year. Its listing will continue to reduce HIV transmission, but what's also needed is further government resourcing of interventions, such as testing and culturally appropriate education programs, if we are to end the transmission of HIV in Australia. The Greens will continue to advocate for federal action to address HIV and continue to fight the stigma that people with HIV experience.

The stigma of HIV is strongly linked to the still ongoing stigma of being same-sex attracted and outdated attitudes that the disease is due to being gay, and, in some circles, still presented as punishment for being gay. Stigma, of course, is strongly connected with discrimination. Where legal and illegal discrimination against same-sex-attracted and gender-diverse people continue, people feel lesser. They feel that they have to struggle with their sexuality and gender identity, rather than feeling valued and respected in society for who they are and feeling they can be out and proud. So removing HIV stigma starts with removing discrimination against LGBTIQ+ people, and a good place to start is in schools, ensuring that LGBTIQ+ students feel safe and respected for who they are. The government needs to step up to make sure that this is the case.

And it's not just on home turf that the Australian government needs to step up. We need the government to be doing more to advance the rights of LGBTIQ+ people globally. While marriage equality has been at the forefront of media attention in Australia and while marriage equality is legalised now in 26 countries, the reality is that, for many LGBTIQ people around the world, being who they are is a risk to personal safety; living freely is only a dream; violence and discrimination are daily occurrences.

Just last week voters in Taiwan rejected same-sex marriage in a referendum. While Taiwan is more progressive than other Asian countries in terms of LGBTIQ rights—with some legal prohibition against discrimination in work and education and with transgender people being allowed to change their legal gender—the result of this referendum is devastating. My heart goes out to all the Taiwanese people who were hopeful that this reform would be an important step towards equality, and we will continue to stand with Taiwanese LGBTIQ+ communities until they achieve this important reform.

But things are worse elsewhere. In 73 countries worldwide, including in our Asia-Pacific region, consensual sex between same-sex adults is illegal, and punishments range from fines and imprisonment to the death penalty. In the last 12 months or so, our other close neighbours have cracked down on LGBTIQ people. In Indonesia there have been raids on gay bars, and in 2017 more than 200 LGBTIQ people were arrested under a law enacted to target them. In Malaysia, punishments facing LGBTIQ people are severe, including fines, prison sentences and even caning. This year two women were convicted for attempting to have sex in a car parked in a public area and were caned before an audience in a courtroom. Human Rights Watch notes discrimination against LGBTIQ people is pervasive in Malaysia.

In countries such as Indonesia and Malaysia, the marginalisation of LGBTIQ communities fuels the rates of HIV and AIDS. In 2007, the Malaysian Minister of Health was banned from advocating the use of condoms to prevent the spread of the disease due to a concern that this would imply an endorsement of sexual conduct outside of marriage. And there's a correlation: countries where homosexuality is illegal are countries with elevated rates of HIV. Where homosexuality is criminalised, men are much more likely to avoid HIV testing and less likely to learn about safer sexual practices. Criminalisation also destroys LGBTIQ networks and communities, and therefore the ability to implement HIV prevention strategies. Australia's strong LGBTIQ networks and community have been acknowledged as one of the most important elements in our success in reducing HIV transmission compared to many other countries.

There are also very concerning LGBTIQ rights abuses in Chechnya and elsewhere in Russia, and there's the attempted rollback of LGBTIQ rights under the Trump administration, including the push to ban transgender people from the military and removing protection for transgender prison inmates. In Brazil, of course, there is a newly elected president who has declared that he is a proud homophobe.

But we also, looking more positively, need to acknowledge and celebrate the positive steps and achievements we've made globally in achieving and advancing LGBTIQ rights. There are five countries in the world that have constitutions that explicitly guarantee equality for citizens on the basis of sexual orientation and gender identity, and five countries whose constitutions provide protections based on sexual orientation, and the number of these countries is only going to continue to grow. Just a month ago in India, the British colonial era law banning homosexuality was struck down. Thousands of people marched to celebrate, chanting, 'We got our freedom!' One of the marchers said:

It will take one more generation for social acceptance, but the fear factor is gone. I'm enjoying my life as a free citizen now.

We are seeing LGBTIQ activists emboldened around the world.

I would urge our government to build on the good work they are already doing both in our region and globally to advance LGBTI rights as well as in HIV protection. Since the 1980s Australia has taken a range of measures to achieve a sustained low prevalence of HIV and AIDS. Federal and state governments responded proactively in 1982 once HIV was identified. This was a cross-party response, and it was only possible by putting people's needs above politics. There were often many controversial programs that were implemented and, most importantly, we publicly talked about the risk factors for HIV transmission. Australian communities mobilised to prevent HIV transmission. We were able to do it in Australia. We were able to work with the communities most affected. We can help make it happen around the world.