By UNAIDS Regional Director Dr César Núñez

TODAY, May 17, the world marks International Day Against Homophobia, Transphobia and Biphobia (IDAHOT). This observance is meant to draw the attention of the public, decision-makers and the media to the challenges faced by lesbian, gay, bisexual, transgender and intersexed (LGBTI) people. Usually, this is an opportunity to explore societal issues such as violence or discriminatory laws. This year’s theme comes closer to home. The focus is on the role of families in the well-being of their LGBTI members.

The realisation or revelation that a young person’s sexual orientation or gender identity is at odds with cultural norms or religious teachings is distressing for many families. Some relatives respond with uneasy silence. CARIMIS, a 2014 online survey in the Caribbean, showed that one in three MSMs actually kept their sexuality a secret from their families. Other families attempt to use unproven and dangerous methods to change their loved ones. All too often young people are abused, rejected, disowned or put out. In Latin America, 44–70% of transgender women and girls have felt the need to leave home or were thrown out of their homes.

There is a clear link between the social vulnerability caused by family rejection and HIV. A 2013 Jamaica study found that HIV rates were highest among men who have sex with men who had experienced adverse life events including homelessness and physical violence. Even in less extreme cases, family rejection and the prejudice sexual minorities face in the wider society can create psychological distress, fuelling self-harm and risk-taking. A seminal 2009 study found that higher rates of family rejection were linked to poorer health outcomes. Lesbian, gay, and bisexual young adults who reported higher levels of family rejection during adolescence were three times more likely to report having had unprotected sex.

So what can we do? Together, we must devise strategies to give young people and their families the support and information they need to cultivate open communication and reduce HIV vulnerability. Governments, civil society and faith communities can all play a part. Across the region there are examples of innovation to address this issue.
Pride in Action,a non-governmental organization housed at the University of the West Indies, Mona,offers LGBT students of tertiary and secondary-level institutions in Jamaica safe, appropriate and accessible support systems. Through peer support, students are empowered to address low self-esteem, negative self-images and feelings of isolation. The organization also provides staff development and advocacy support with a view to making university campuses more inclusive.

In Trinidad and Tobago the Collaborative HIV/AIDS Management Programme (CHAMP) is a joint effort between the Anglican church and the Family Planning Association of Trinidad and Tobago. It brings parents and young people together to develop communication skills, while addressing issues such as peer pressure and family life. The programme offers education about HIV and sexuality and has offered support to families confronting challenges.

Now more than ever, the peoples of Latin America and the Caribbean are discussing the complex issues surrounding sexuality and gender identity. In the past year, court rulings in Belize, Guyana and Suriname have prompted widespread dialogue about laws, rights and justice. More and more, civil society and the media are shining a light on the fact that four of every five killings of transgender people occur in Latin America.
Our region has lots of work to do in our parliaments, streets, schools and communities. This year’s IDAHOT is a reminder that we must also address these issues in our homes