South Africa is currently hosting the 17th International Conference on AIDS and STIs in Africa, where one underserved community is crying foul, claiming they have been left out of HIV programmes.
From 7-11 December, thousands of the world's leading scientists, policy makers, activists, government leaders - as well as a number of heads of state and civil society representatives - are gathered in Cape Town to discuss how to achieve the vision of a world with zero new HIV infections, zero discrimination and zero AIDS-related deaths.
The conference is an important regional event that contributes towards overcoming the HIV and TB epidemics in Africa, yet many transgenders - one of the population groups most at risk of new HIV infections - believe they are rarely considered in HIV policy and programming.
Now more than ever
The conference theme "Now more than ever: Targeting Zero", to drive the international community to break down barriers to HIV and AIDS treatment. It also seeks to take stock of past achievements and challenges in order to scale up the African response in the context of the Millennium Development Goals.
But according to Beyonce Karungi, a transgender woman from Uganda, HIV programmes do not target transgender and lesbian women because they are viewed not to be a threat to the HIV epidemic.
"We've been left out of programmes, we've been left out of preventive and awareness messages, we've been left out of care and treatment; it's like we don't exist and are seen as a pariah in society or non-existent," she said.
Poor access to HIV prevention services
The transgender community lacks access to HIV preventive and skilled health care as well as facing social, economic and institutional stigma because many HIV prevention programmes for most at risk populations are directed towards men who have sex with other men. Existing prevention efforts do not meet the needs of most transgender people, so they do not seek health care or disclose their HIV status.
Due to the stigma and discrimination they face, a lot of transgender women are pushed into sex work to support themselves because potential employers do not want to engage them, regardless of their skills and expertise.
In many countries sex work is a criminal offence and when a transgender woman (someone whose biological sex is male but who self-identifies their gender as female) gets arrested they are locked up with men instead of women who they identify with. In the cells they are often subjected to emotional, psychological and physical torture by other inmates and sometimes by security officers.
Transgender sex workers at more risk
According to an international analysis published in 2008 in the Journal of Acquired Immune Deficiency Syndromes, transgender female sex workers are at four times greater risk of contracting HIV than other female sex workers.
Jay, from Uganda, said: "The conversation to include transgender people and lesbians in programming is long overdue and we hope that this conference will provide answers and solutions to the challenges facing us."
Beyonce concluded: "It's high time they include us in HIV programmes as we urgently need to access these preventive services, care and treatment because we are human beings and deserve to be treated equally, but above all it's high time we were given an equal chance to voice our views in public discussions and we hope that this conference will be a platform for us to be heard."