Despite these advances, governmental stigma still acts as a barrier to reaching global targets of reported HIV cases. In many countries sex is still a taboo topic and homosexuality is frowned upon. Discriminatory laws and policies regarding homosexuality and HIV can alienate and exclude people living with HIV, reinforcing stigma in society (Hagopian, 2017). Widely held negative views on homosexuality are limiting health provisions as governments refuse to invest (Wong, 2007). Anti-homosexuality laws undermine actions to fight the epidemic as people fear to seek the help they need. In order to reduce stigma, governments must amend old-fashioned views to allow inclusive programmes to be implemented (, 2017).  The LGBT community also faces employment discrimination, including refusal of employment or termination of work based on their HIV status (Jis, 2012). The Equality Act 2010 protects individuals in the workplace, replacing previous anti-discriminatory laws. The act states that ‘no person should be discriminated against based on gender, age, disability, race, religion or sexual orientation’ (Gov.UK, 2018) A study investigating employment stigma against HIV positive individuals found that between 8%-45% of respondents lost their job or source of income due to their HIV status, and 5%-54% of people reported discriminatory reactions from co-workers who had discovered their status (Teo. R, 2012). These percentages vary between countries depending on views on homosexuality. HIV-positive LGBT individuals also face discrimination within healthcare in many countries, based on sexual orientation, lifestyle choices and livelihoods, resulting in many people avoiding medical help (Todrys. K, 2009). Treatment may be refused or delayed due to HIV statuses. When treated, contact is minimised, patients are isolated and often extorted to pay supplementary fees (UNAIDS, 2017). The denial of reproductive and sexual health rights can be detrimental to reducing stigma within society; it perpetuates self-stigma and prevents LGBT people from seeking support, isolating them and often causing depression. In addition to this, confidentiality of patients is not respected: a patient’s HIV status is often disclosed without their authorisation.  Under international Human Rights laws, there is a legal obligation for healthcare providers not to discriminate against patients, and to provide health information that is accurate (UNAIDS, 2017). Judgement and lack of respect from healthcare professionals deters people from accessing treatment.  What can be done to tackle HIV stigma and homophobia?  Public campaigns targeting specific key populations have had a positive impact on society. The ‘Start talking. Stop HIV’ is aimed at gay and bisexual men to allow them to openly discuss HIV testing, their status, condom use and treatment (CDC, 2017). These campaigns address underlying drivers of stigma against social attitudes towards sexual orientation (, 2018). Pride events are large scale public campaigns to tackle homophobia, with an estimated nine hundred Gay Pride events every year (Ross, 2016). These events promote equality and challenge attitudes, especially in countries with a somewhat hostile environment towards the LGBT community. Pride events have been used to increase awareness of HIV within the community. LGBT organisations in Uganda have been setting up pride events to distribute lubricants and condoms (Interpride, 2018).   Alongside public campaigns, education in schools has an integral role in tackling HIV stigma and homophobia. Educating school children aims to reduce LGBT prejudice, enable conversations around the topic and overcome stigmatised attitudes in the community. Good sex and relationship education prepares the generation to make well informed sexual health decisions and understand the importance of protection and seeking sexual healthcare (Terrence Higgins Trust, 2016).  In addition, community based organisations are having a positive impact on communities by tackling opinions at their roots. With increased funding, these organisations are able to target LGBT individuals who are at risk of HIV discrimination, stigma and violence, and offer them the help they need. They can provide counselling service, and educate members of the general public to combat homophobia by campaigning for tolerance. Community based organisations are also in a better position to support those living in more rural, inaccessible areas, which provides life-saving sources to unknown networks of people requiring support (Gay Times, 2016).    Conclusion The empowerment of the LGBT community is essential in fighting the HIV epidemic. Facing stigma through campaigning, education and improving health services will improve the standard of life for many individuals. A more inclusive outlook is needed through decriminalisation of same-sex activity. Although progress is being made, there is still a long way to go to tackle homophobia and HIV stigma (Avert, 2017).     

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