The IDUIT offers practical guidance on implementing HIV programs for people who inject drugs

Written by Brun Gonzalez, Chair of Board of Directors of the International Network of People who Use Drugs (INPUD) and Judy Chang, INPUD Executive Director

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Photos provided by: Brun Gonzalez

The Injecting Drug User Implementation Tool (IDUIT), jointly developed by INPUD and the United Nations Office on Drugs and Crime (UNODC), was released this April and is the fourth publication in a series of tools on implementing HIV programs with key populations. It offers practical guidance on implementing HIV programs for and with people who inject drugs (PWID) across the HIV care continuum and contains examples of best practices from around the world that can be used to support efforts to plan programs specific to the PWID community. The tool covers prevention, care, treatment, and support interventions and focuses on partnerships with or by PWID organizations.

The IDUIT is the product of a collaborative process between PWID, advocates, service providers, researchers, government officials, UN agencies, development partners, and nongovernmental organizations. The tool provides a strong platform for emphasizing the importance of community empowerment in reaching PWID with HIV services.

 

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“The IDUIT is the result of a very positive and important collaboration between the United Nations and the international community of people who use drugs that reflects… high-level participation and engagement that answers the affirmation ‘nothing about us without us’ in a meaningful and constructive way,” said Brun Gonzalez.

A multidisciplinary group of people came together for a consultation meeting in Bangkok to elucidate optimal approaches for designing, developing, and implementing comprehensive services that meet the real needs of the PWID community. When developing the tool, it was also important to maintain a broad focus on issues that other key populations most at risk for HIV often face.

The sessions were attended by representatives from the UNODC, the Joint United Nations Programme on HIV/AIDS, the World Health Organization, civil society specialists, and members of the PWID community. Individuals working on health and harm reduction service provision, community organizing, and advocacy campaigns brought their unique experiences to the table to discuss best practices and efficient models based on community involvement and strengthening.

The convergence of “top-down” and “bottom-up” perspectives allowed for a rich, comprehensive process that brought together the best of both worlds to develop the IDUIT: the evidence-based, biomedical model and the pragmatic, rights-based model derived from what was referred to as “community wisdom” during the consultation.

It is essential to seek representation of and participation from the people who are immediately affected by the decisions being made when looking to improve harm reduction services and implementation tools. The IDUIT is one step in a long process of fine-tuning and updating the mechanisms set in place at an international level.

WE NEED TO TALK ABOUT “REGGIE”: THE IMPORTANCE OF INTEGRATING LGBTQ MESSAGING WITH HIV INFORMATION

Written by Georgia Arnold, executive director and founder of the MTV Staying Alive Foundation, and executive producer of the award-winning “edutainment’ campaign, MTV Shuga.

MTV Shuga is a 360 mass media campaign that uses the power of entertainment to generate positive sexual and reproductive health outcomes amongst young people. At the core of MTV Shuga is a TV drama, which follows the lives of a group of young friends as they encounter sexual, social, and educational challenges throughout their adolescent years. Following on from two seasons in Nairobi and another two set in Lagos, the fifth season has been produced in South Africa for the very first time.

The issue of HIV and AIDS among young people is as important today as it has ever been. Every day, 1,300 adolescents around the world are infected with HIV.

In the run-up to National Youth HIV & AIDS Awareness Day on April 10, we are reminded of the need to challenge the stigma surrounding HIV and AIDS and empower young people to take charge of their sexual and reproductive health.  One of the ways we can achieve this is by breaking down the taboos surrounding adolescent sexuality.

Across many countries in the world, the idea of sexual activity among young people carries strong negative connotations. Accurate and judgement-free conversations with young people about sexual behaviors or safe sex practices are few and far between, meaning that many teenagers are uninformed and misguided when it comes to sexual health.

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Photo Credit: MTV Shuga

This is particularly true in the case of the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community who, in the rare cases where information on sex and sexuality are provided, are often entirely ignored or are described as wrong.

Holding open, in-depth, and inclusive discussions about sexuality is imperative in our efforts to reduce HIV transmission and ensure that those living with HIV have access to care. Such conversations allow us to break down rigid norms attached to young people’s sexual behavior and sexual orientation.

This represents the first, and most important step, in ensuring that all young people feel able to access the necessary information and sexual health services available. After all, you can’t get information that protects you from HIV if you are afraid that your questions about your sexual behavior will be met with discrimination and disdain from your health care provider.

As part of our work on MTV Shuga, we aim to challenge harmful norms by fusing hard-hitting entertainment with important social, sexual health, and educational principles.  In our latest series set in South Africa, a new character Reggie – who is trying to understand his own sexual orientation – represents the medium through which LGBTQ messaging and HIV information can be successfully merged.

In Africa, where MTV Shuga is primarily broadcast, most countries have anti-homosexuality legislation and members of the LGBTQ community are often marginalized. Even in South Africa, where LGBTQ rights are legally enshrined, 55% of LGBTQ people live in fear of discrimination because of their sexual orientation. These data emphasize the need to talk about and create empathy for the “Reggies” of this world, but in a way that is carefully produced to maximize our potential impact.

This is a particularly complex endeavour as we broadcast in countries where LGBTQ storylines are not permissible. Although we cannot change existing laws, we can traverse state borders through our mass-media approach. Making use of digital platforms, such as YouTube, has allowed us to reach those living in places where LGBTQ stories are rarely told, and circumnavigate broadcasting regulations.

Young people face so many challenges throughout their formative years; the added burden of hidden sexual orientation has adverse implications for their health and well-being. We need to create safe spaces where all young people are free to explore who they are, including their sexual orientation, and get the information they need to live healthy and productive lives. While our approach may vary depending on the environment, the end-goal must always remain the same: to challenge harmful norms and affect a positive change in all young people’s sexual lives. Incorporating LGBTQ messaging in a sexual health context is an important way to realize this goal.


For more information on the important work being carried out in the LGBTQ community in South Africa, ANOVA and OUT represent two leading organisations in this field. These groups promote the need to incorporate HIV information with LGBTQ messaging as a means of generating positive sexual health outcomes among South Africans.

 

United Nations High-Level Meeting’s Political Declaration Zero Draft Released: Early Highlights and Important Next Steps

Below is a reposting of a press release from the The Global Forum on MSM & HIV (MSMGF). 

On April 18th, the United Nations Mission co-facilitators, Zambia and Switzerland released the “Zero Draft” of the political declaration for the United Nations High-Level Meeting on HIV/AIDS (HLM). MSMGF thanks the governments of Zambia and Switzerland for facilitating an inclusive process in developing and releasing the Zero Draft. This draft builds on the 2011 Political Declaration, aligning with the Sustainable Development Goals (SDGs) and emphasizing evidence-based strategies needed to effectively fast-track the end of AIDS:

  • The Zero Draft includes several key points that address gender and sexual and reproductive health. These include point #28, which explicitly notes “that progress towards gender equality and women’s empowerment has been unacceptably slow…” In addition, point #59 aligns with SDG #5 “Gender Equality” – “Investing in transformative AIDS responses will contribute to Gender Equality and Empower Women and Girls.” Importantly, this point commits to “end all forms of violence against women and girls…”
  • The Zero Draft in point #29 explicitly notes “that many national HIV-prevention strategies provide insufficient access to services for key populations that epidemiological evidence shows are at higher risk of HIV.” As was the case in 2011, it explicitly states that men who have sex with men, people who inject drugs, and sex workers are key populations, along with transgender people, prisoners, and migrants. The draft furthermore makes clear in evidence-based terms the extreme risk faced by these populations, including that men who have sex with men are 24 times more likely than adults in the general population to acquire HIV, people who inject drugs are 24 times more likely, sex workers are 10 times more likely, and transgender people are 49 times more likely.
  • The Zero Draft in point #30 explicitly notes “the lack of global progress made in reducing transmission of HIV among people who inject drugs” and moreover identifies the “insufficient coverage of highly effective harm reduction programmes, the marginalization and criminalization of people who inject drugs which hamper access to HIV services,” and notes “with concern that gender-based stigma and discrimination often act as additional barrier for women who inject drugs to access HIV services.”
  • The Zero Draft in point #36 explicitly notes “the increasing number of new HIV infections in the Middle East and North Africa, where new infections are concentrated among sex workers, men who have sex with men and people who inject drugs,” that in Eastern Europe and Central Asia “new infections continue to increase, largely among people who inject drugs,” “resurgent epidemics” in cities in North America and Western Europe “where men who have sex with men, transgender people, sex workers and their clients, and people who inject drugs are at particularly high risk,” and “that the epidemic is concentrated among key populations in Asia and the Pacific as well as in Latin America and the Caribbean.”
  • The Zero Draft aligns with SDG #10 “Reduced Inequalities” in point #60 – “Ensuring the rights of all people to access high-quality HIV services and commodities will narrow the inequalities gap within and among countries.” This point explicitly states the need to “ensure access to tailored HIV combination prevention services to key populations.” Furthermore, it boldly commits to “saturate areas with high HIV incidence” with “a combination of tailored prevention interventions,” including provision of condoms, harm reduction, and PrEP “with particular focus on key populations and young people.” Moreover, it explicitly states that key populations are an appropriate focus of “evidence-based prevention measures.”
  • The Zero Draft aligns with SDG #16 “Peace and Justice” in point #61 – “Removing punitive laws, policies and practices that block access to HIV services and ending HIV-related stigma and discrimination will promote just, peaceful and inclusive societies.” This pointboldly commits “to remove punitive laws, policies and practices…related to overly broad criminalization of HIV transmission, same-sex sexual relations, sex work and drug use…”

What Advocates Can Do Now

As MSMGF discussed in its earlier community update last week, there are several key advocacy opportunities to ensure the above language of the Zero Draft is retained in the lead-up to the High-Level Meeting (HLM) in June. These include:

  • Provide direct feedback toUN mission delegations in New York City. This will be most effective through in-person meetings in New York City but can also occur via requests for email and phone conversations with local country delegates.
  • Provide direct feedback via local civil society to government ministries in country capitals. Depending upon the specific country, these ministries will likely include the Ministry of Health and the Ministry of Foreign Affairs. In some countries, this may include smaller ministries, such as ministries that address gender, social inclusion, and vulnerable populations.It will be especially valuable to provide country-level data to ministries, such as data on key populations and gender and sexual and reproductive health from UNAIDS Country Progress reports.
  • Consult with regional civil society partners, who have provided inputs for the HLM political declaration via “regional position statements.” ICASO has compiled themhere.

The scheduled dates for negotiations (“readings”) of the political declaration by UN member states are as follows:

  • April 25-26: 1streading of Zero Draft
  • April 28-29: 2ndreading
  • May 18: 3rdreading (unofficial suggested date – still to be confirmed)
  • May 26: 4threading (unofficial suggested date – still to be confirmed)

In addition, the co-facilitators Zambia and Switzerland will hold an informal meeting with civil society, the private sector and other stakeholders next Tuesday, April 26 from 8:30-9:45 EST, webcast live on http://webtv.un.org/live.

For reference, MSMGF’s Unfinished Business policy brief, describes the substantial evidence base that underlines the need for bold action to address HIV among gay and bisexual men and other men who have sex with men in the UN HLM political declaration.

MSMGF will be working in close consultation with the Platform to Fast-track the Global HIV and Human Rights Responses for Gay, Bisexual Men and other Men Who Have Sex with Men, in addition to other civil society networks. We will continue to keep our constituents informed about future next steps.

About MSMGF: MSMGF has worked since its founding in 2006 to encourage targeted, tailored, better-resourced, and rights-based sexual health services for gay men and other men who have sex with men (MSM) worldwide, through its advocacy and technical support work. As a global network, MSMGF has successfully influenced HIV responses at the local level through shifts in global- level policies and has effectively utilized public health as an entry point for advancing the human rights of LGBT people. MSMGF currently supports programs in 15 countries.

The David Kato Vision and Voice Award Steering Committee Announces a New Secretariat in Commemoration of the Anniversary of David Kato’s Death

Below is a reposting of the press release from the The Global Forum on MSM & HIV (MSMGF) on the recent transition in secretariat for the David Kato Vision and Voice Award.

The David Kato Vision and Voice Award (DKVVA) Steering Committee is pleased to announce a transition in secretariat for the DKVVA. The secretariat of the award was founded at the International Planned Parenthood Federation (IPPF), then moved to the Global Forum on MSM and HIV (MSMGF) for the past two years. During MSMGF’s tenure as secretariat, DKVVA selected two awardees from hundreds of impressive global nominees and built a successful partnership with the Teddy Awards of the Berlin International Film Festival for heightening visibility of the awardees and prize. The DKVVA Steering Committee now transfers the secretariat to the Kaleidoscope Trust.

The Kaleidoscope Trust was established in London in 2011 to advance the human rights of lesbian, gay, bisexual and transgender (LGBT) people in countries where they lack their equal rights. The Trust’s mission is to: listen to the voices of LGBT people whose human rights are threatened by discrimination; amplify their messages and draw on their expertise to persuade public and political opinion to work as a catalyst for meaningful change. Hosting the David Kato Voice and Vision Award Secretariat is one of the concrete ways in which the Trust can recognise and support LGBTI leaders to carry out their activism in the face of challenges including systematic discrimination and capacity constraints.

The David Kato Vision and Voice Award has been given annually since 2012 in recognition of David Kato’s life and work and as way to respond to the injustice of David’s murder in Uganda on the 26th of January 2011. The award recognizes the leadership of individuals who strive to uphold the numerous dimensions of sexual rights for LGBTI people. Previous award recipients have been Maurice Tomlinson, Ali Erol, Sou Sotheavy and Martha Tholanah.

The Kaleidoscope Trust is looking forward to working closely with the award Steering Committee which includes leadership from Sexual Minorities Uganda, International Planned Parenthood Foundation, Herbert Smith LLP, and MSMGF. Further details on the award and the commencement of the next annual award process will be forthcoming soon.

About MSMGF: MSMGF has worked since its founding in 2006 to encourage targeted, tailored, better-resourced, and rights-based sexual health services for gay men and other men who have sex with men (MSM) worldwide, through its advocacy and technical support work. As a global network, MSMGF has successfully influenced HIV responses at the local level through shifts in global- level policies and has effectively utilized public health as an entry point for advancing the human rights of LGBT people. MSMGF currently supports programs in 15 countries.