Key populations! Now who exactly are they and why do we refer to them as key populations? The easiest way to understand them where HIV and AIDS is concerned is that they are groups of people within the general population who are most at risk of contracting HIV, the virus that causes AIDS.
Key populations include both male and female sex workers, men who have sex with men, transgender people and sometimes vulnerable groups of people who for some reasons cannot access proper healthcare and treatment for the ailments they suffer from.
Prostitution is seen as a criminal activity in some countries of which Ghana is one. At the just ended 21st edition of the International AIDS Conference held in Durban, South Africa, and organized by the International AIDS Society, Chief Inspector Thomas Salifu Ndeogo of the Public Health Department of the Ghana Police Service made a presentation on who the focus should be on regarding issues of morality when enforcing the law. In the presentation, he made mention of the fact that some time ago, the Police arrested alleged sex workers at various places within the country and used condoms they were carrying as evidence of their sex trade. Now the first question here is, if agencies like the Ghana AIDS Commission, civil society organizations and NGOs are calling for safer sex practices through the correct and constant use of condoms, how then do you arrest someone and possibly prosecute them for carrying condoms?
Ghana has recorded significant progress in the fight against HIV and AIDS over the last decade. The national prevalence has plateaued around 1.3% in the general population within the 15-49 year gap for the past few years. However, the situation with persons within the key populations is different and worrisome as their prevalence rate is about fifteen times higher than that of the general population. For instance among men who have sex with men, the prevalence is 17% while it is 11% among female sex workers according 2015 IBSS. The worrying situation can further be attributed to some social, political, religious and legal settings and challenges that do not promote access to treatment and care services for these groups of people.
The conflict of promoting safer sex amongst the population, and using condoms as evidence to prosecute sex workers is a bad situation that stands in the way of advocates, law enforcement agents and the very people who need to be protected.
In a country like Ghana where some laws are sometimes created based on prejudice, fear and myths but not on science or research, issues of intolerance and human rights violations will be on the increase.
The Ghana Police Service together with John Hopkins University developed a training manual which focused on stigma and discrimination reduction among key populations. The manual is in two parts which are the training school manual and the in-service manual for Officers already in the Service. This is targeted at improving knowledge of police officers in the area of HIV/AIDS and its related stigma and discrimination practices.
The AIDS Control program of the Ghana Police Service is also trying to educate the officers on issues relating to HIV and AIDS and their role as law enforcement agents in mitigating the increase in prevalence. Together with the UNFPA Ghana office, a program using focus group discussions was implemented in six out of the fourteen Police Regions of the Service to solicit information on how the Police will identify sexual minorities or key populations, how they can define and analyse laws that classify key populations and to increase the understanding of what constitutes the causation of a sexual offence as against public morals as stipulated in the Criminal offences Act 29/60.
The focus group discussions brought to light the low levels of knowledge on identification of possible offenders especially among junior officers. In a response as to how a female sex worker can be identified, some responded that they are identified based on the skimpy short dresses, long earrings, exposed breasts, chains on their legs, fancy hairstyles and their location especially at night.
The discussions also brought to light the fact that some officers of the Ghana Police Service did not fully understand the Criminal Offences Act where the description of offences relating to unnatural carnal knowledge were concerned. Issues on what constitutes sexual offences against public morals also found the officers generally lacking.
From these focus group discussions among the various sub jurisdictions, the Service realized that the Personnel need to be sensitized on being more professional in their dealings with every segment of the society. Some senior officers admitted that sometimes they find themselves in puzzling situations where they try to protect the rights of these key populations but they are compelled to go after them due to political and societal pressures.
Laws are usually more rigid than issues bothering on morality, hence the two must be decoupled while a greater supervision of personnel, especially those in the patrol teams was called for.
The Ghana Police Service, noting some of the discrepancies in the dispensation of their duties, and how closely those dispensations bothered on the rights of some of these individuals agreed to sensitize its personnel in order for them to better understand the intricacies of dealing with people within the different population units. Some may ask why the focus on key populations. Well this has a simple explanation. Persons within the key population groups are not always confined to those groups. For instance a man who has sex with other men could also be having sex with a woman in the general population. This woman could be having sex with another man who also could be with another woman. Hence, assuming that the man who has sex with men and then women has HIV, or contracts HIV from his male partner, he will succeed in infecting the woman who then will infect the man and the infection could go on and on. In the same vein, a female sex worker may have lovers who are not her clients. Assuming she contracts HIV she can pass it on easily to her male lover who is not her client who may also pass it on to another woman. Bottom line is, issues affecting the key populations can hit and destabilize the gains already made lowering HIVE prevalence in the general population. Attention must therefore be given to the members of the key population groups if Ghana want to win and keep HIV infection at lower prevalence.
The program implemented by the Ghana Police Service realized that acceptance of key populations and their uniqueness is a major breakthrough to reforms. Meaningful engagement with them will be able to ensure consensus building, transparency and sustainability of programs.
Chief Inspector Thomas Ndeogo acknowledged the administration of the Ghana Police Service from the Inspector General and The Ghana AIDS Commission and thanked them for being committed to ensuring that the Police personnel get the requisite trainings needed to be more efficient in the discharge of their duties and for getting involved with the reforms.
***Content picked from Chief Inspector Ndeogo’s presentation at the 21st International AIDS Conference 2016.
SOURCE: Sakyiwaa Mensah