Converging Epidemics: COVID-19, HIV & Inequality

Community-led Lessons for Funders

This report —commissioned by FCAA in partnership with the Elton John AIDS Foundation (EJAF)—highlights:

  • How marginalized communities have been impacted by COVID-19 in the U.S. and globally, and what their key evolving needs have been as the pandemic has progressed;
  • Examples of community-led innovations, adaptations and bright spots (see below);
  • Lessons learned from private funders’ emergency COVID-19 responses; and
  • Recommendations for funders, global health institutions, and governments—including the new U.S. administration—to guide their efforts going forward.

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Case Studies

Read about examples of community resiliency, flexibility, and creativity during the pandemic as highlighted in a series of case studies.

Global Snapshot
    • The “One Egg a Day” crowdfunding initiative, started by an organization of people who use drugs in Vietnam, raised support for food, clothes, and cash for hundreds of affected families.
    • Using informal crowd-funding initiatives, sex workers in Australia, Thailand, Ukraine, and many other locations raised funds to provide accommodations for sex workers who were evicted for defaulting on their rent.
    • In Durban, South Africa, a new harm-reduction center offering clean needles and other services was established through an innovative, first-ever public-private collaboration.
    • In Barcelona, Spain, a harm-reduction organization extended the hours of operation for its drop-in center, resulting in a higher number of women and gender non-conforming people accessing the facilities; provided an expanded range of services to meet the needs of clients, including support initiatives for self-healing, bonding, wisdom sharing, self-defense, and solidarity; and enabled clients to access a new shelter with a safe consumption site, run by the municipality and another NGO.
    • In India, activists creatively secured essential service permits and started delivering ARVs on motorbikes in hard-to-reach areas. This helped to prevent ARV disruptions at a time when many PLWH could not attend ARV clinics due to lockdowns and travel restrictions that made it impossible to use public transport.
    • Virtual rapid clinic surveys were conducted in Nepal to influence health access advocacy needs for PLWH.
    • Harm reduction groups in China mobilized to transport methadone across the border for use in Myanmar.
    • MSF set up outdoor gazebos at existing primary clinics to enable quick and safe COVID-19 screening.
    • An adaptation that didn’t work: The City of Cape Town created a forced isolation site for homeless people during the pandemic without consulting groups on the ground or public health specialists. The initiative was a colossal failure and has since closed.

U.S. Snapshot
  • Harm reduction organizations in West Virginia, San Francisco, and Baltimore added community housing programs to their outreach and syringe exchange services.
  • Harm reduction programs modified their drop-in services to outdoor spaces.
  • CBOs that provided case management services added food pantries and food delivery programs.
  • To help people reentering the community due to overcrowding in jails, a Chicago corrections program modified its services to provide technology devices and training.
  • A CBO in Selma, Alabama, started a community garden to help people obtain fresh produce.
  • A CBO in Memphis, Tennessee, pivoted to create sex worker safety kits.
  • The COMPASS Initiative Break Room created a weekly virtual hangout space to increase connections and decrease stigma in the U.S. South.
  • The Coalition for Rights and Safety for People in the Sex Trade in Seattle achieved a breakthrough in long-standing advocacy to revoke a “loitering order” that criminalized sex workers amid COVID-19.
  • Two intersectional organizations focusing on transgender people of color harnessed the COVID crisis and Black Lives Matter movement to significantly increase support for housing initiatives:
    • Glitz raised $1 million to buy an apartment for the unhoused, including people released from Rikers Island, and No Justice No Pride raised money from individual donors for needed housing.