Neglected or unaffected!: investigating the exclusions and silences around Lesbians Bisexuals and Queer (LBQ) women and HIV in Kisumu, Kenya

Several scholars contend that women who have sex with women (WSW) have been excluded from the public health, HIV and research discourse. Several studies have described LBQ women who are living with HIV as being invisible, ignored, neglected, and understudied. This exclusion has been attributed to perception that LBQ women may not easily contract HIV since they do not engage in penile sexual relations which has resulted to the epidemiological classification of LBQ women as being a low-risk group. The perception of LBQ women as a HIV low risk group is associated with their exclusion in HIV research, programming, services and the healthcare system. Since LBQ women are still at risk of HIV and some are already living with HIV, such exclusion from HIV services and programs may further aggravate the situation of LBQ women living with HIV as well as those who are at risk of HIV infection. As a result, it is imperative to unravel how the exclusion is produced in HIV programming and healthcare system so as to know how to address them. Against this background, the current study employed a feminist standpoint perspective to investigate the discourse around LBQ women’s risk of contracting HIV and its implications in terms of LBQ women’s exclusion in HIV programming, HIV vii service delivery, HIV research and the society. Specifically, the study wanted to find out: What are LBQ women’s perceptions of their risk to HIV?; How is exclusion of LBQ women from HIV programming and HIV research, and HIV service provision produced?; How is exclusion of HIV positive LBQ women produced?; and What are the effects of the perception that LBQ women are at low-risk of HIV? Through interviews and focus group discussions with LBQ women participants from Kisumu the study gathered data. The findings of the study revealed the intersecting individual, social and factors which contributed to the exclusion of LBQ women living with HIV fuelled by HIV stigma as well as sexual stigma. The intersection of societal attitudes about LBQ women and HIV with the marginalizing structures of HIV service delivery and programming is seen to generate limitations on the agency of LBQ women to navigate access to HIV services and programs. The recommendations drawn from the findings of the study to address the factors hindering LBQ women from successfully accessing HIV services and information include creation of support groups and standalone LBQ-tailored health facilities for LBQ women, inclusion of LBQ women in strategic decision-making spaces of HIV programming, creation of safe spaces for LBQ women living with HIV, knowledge based trainings and sensitizations to health care services providers on LBQ women’s HIV issues and the demystification of myths and misconceptions around LBQ and HIV through awareness creation through adequate relevant research in LBQ and HIV issues.