Stigma and strategy in Pakistan's HIV prevention sector

NGOs often portray commercial sex workers, injecting drug users, transgender people (hijrae), and homosexual men as quasi-legal persons who are locked in a policing-criminality relationship with the state, and who therefore need them to mediate this relationship. By advancing such portrayals, NGOs in Pakistan's HIV prevention sector capitalize upon the presumed cultural difference of the so-called risk groups of HIV. They appropriate stigma against these groups as a strategy to access funds and to fortify their own position as brokers in the unstable donor-dominated funding landscape of HIV prevention. In doing so, the NGO leaders and members end up stabilizing stigma and reinforcing its attendant inequalities in the socially conservative environment of Pakistan. The discriminatory legal framework that criminalizes sex outside marriage and non-therapeutic use of drugs goes unchallenged by NGOs, despite their apparent support for universal human rights, partly because the status quo stabilizes these organizations' position as brokers between state and donor agencies and the so-called risk groups of HIV.