Stigma-Free Health Care

Heartland Alliance International provides high quality, stigma-free health care to key populations at risk of HIV/AIDS and sexually transmitted infections (STIs), including men who have sex with men, female sex workers, and people who inject drugs. Since 2009, HAI has worked at the intersection of health and human rights to develop and implement effective programs to successfully reach heavily stigmatized and hard-to-access key populations in Nigeria and Côte d’Ivoire with comprehensive HIV and STI services.


The Need

While the number of new HIV infections among adults has not increased globally since 2010, key populations – including men who have sex with men, female sex workers, and people who inject drugs – are most vulnerable to contracting HIV infections. In 2015, 45% of all new infections were among these groups, according to UNAIDS.

Individuals from key populations are often highly marginalized, facing stigma and, in some countries, penalization for engaging in same-sex sexual relationships, sex work, or drug use. As a result, these groups receive little attention from health care providers and sometimes fear accessing mainstream health care services.


HAI partners with peer-led grassroots organizations to provide HIV/AIDS and STI care to key populations in Nigeria and Côte d’Ivoire. HAI works to strengthen these local organizations, empowering them to provide discreet, compassionate, and competent HIV services in an often hostile legal and cultural environment. HAI trains these organizations in leadership, management, financial, and monitoring and evaluation skills and uses a peer educator model to reach marginalized and hidden populations.

Peer educators provide HIV/AIDS and STI care for key populations through one-on-one and group discussions, sharing information about risk reduction and facilitating behavior change. Peer educators also promote lubricant and condom use, HIV testing and care, and STI screening and treatment. By training female sex workers and LGBT individuals as peer educators and as paralegals to respond when individuals are arrested on unfair grounds, HAI helps members of these marginalized communities access services that they otherwise wouldn’t have used, while also empowering members of the community with the skills and confidence to effect change around them.