Key Population Heroes: Finding meaning and renewed purpose after my HIV diagnosis

Written by Christio Wijnhard, Project Coordinator for the LINKAGES Project at Foundation He+HIV, Suriname

Even though Clarence suspected that he might HIV-positive, the 24-year-old was shocked when he first learned his status. “I cried and I cried. I wanted to commit suicide. I thought it was the end for me.”

When Clarence first accepted his sexuality, he just began experimenting and never thought about practicing safe sex. But he lived in a small village where news traveled fast. When people started talking about two of his former sexual partners being HIV-positive, he realized the risks involved.

The young Surinamese man met a health navigator working for Foundation He+Hiv (FHH), a LINKAGES implementing partner. They had met before on social media, but the health navigator invited him for a one-on-one conversation at FHH.  The health navigator then determined that Clarence had been risky in his behavior and advised HIV testing. “At first I was reluctant to go for an HIV test. But, after thinking about it, I agreed.” Clarence’s health navigator motivated him to not be afraid and pointed out the importance of knowing his status for sure. Finally, on November 7, 2016, the health navigator accompanied him to a health care facility.

Christio

Clarence looks out the window.   Photo credit: Christio Wijnhard

 

The outcome was devastating at first. “I have two dogs, Bruce and Chulo, and I could see their chain in front of me because that was what I wanted to use to kill myself.” Clarence was embraced by his health navigator, who shared with him some surprising information that changed the way he would view his HIV-positive status.

 

“He told me he was also infected with the virus. At first I would not believe it because he was a normal-looking man on the outside.” Looking back, Clarence can honestly say that this moment changed his life. “Hearing and seeing someone that was also infected, but looked very healthy, took away the feeling of being alone and lonely. It took away my fear of dying.”

When the time came to start medication, Clarence had some difficulties. The side effects were too much to handle, and he even stopped taking his medication because of them. His health navigator and the specialist at the Academic Hospital had serious talks with him. The doctor even told him bluntly: “If you don’t take your medication, you will die. Is that what you want?” Finally, the health navigator decided to bring Clarence for a talk with the project coordinator.

The project coordinator asked Clarence about his dreams and his goals. Clarence shared that he was worried about his cousin.  “She is my favorite cousin. I love her very much but she is risky in her behavior, like I was.” Then, they started talking about the possibility of her being HIV-positive as well. When the project coordinator asked Clarence what he would do if his cousin was infected and did not take her medicine, Clarence replied, “I would tell her not to be stupid and take her medication of course!”

Clarence paused for a moment, before saying, “Okay, I get it!”

Today, Clarence is still working on accepting his status. Twice a month he attends MSM support group sessions, which focus on self-empowerment. He meets up once every few weeks with his health navigator. He also uses the psychosocial care services at FHH, and he joined the group for the annual retreat of key population members who are living with HIV.

“I feel super fantastic! Because of the coaching, I was able to define what I liked. I am very interested in photography and I would like to take dance classes, and I might pursue a career as a male model someday.” Clarence also told his health navigator that he no longer wanted to be accompanied by him when he needs to visit the health care facility. “I feel empowered enough to visit health care facilities on my own.” Clarence also started writing about his feelings in a dairy.

“I feel great, really. And I want to work on improving myself because I want to be a good example for other people dealing with acceptance of their HIV status. I want them to know that it is not easy but if I can make these changes and be happy and work towards a good life living with HIV, so can they! I want to be their inspiration.”

 

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.

Bongi hugs Reggie

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.

 

Commemorating the International Day Against Homophobia and Transphobia

Part 1 written by Rolande Lewis, Program Officer, LINKAGES

Part 2 written by Irwin Iradukunda, Director of Programmes for Mouvement pour les Libertés Indivduelles (MOLI) and key population activist in Burundi

Part 1

On Tuesday, May 17, The International Day Against Homophobia and Transphobia (IDAHOT), was celebrated around the world. Homophobia and transphobia adversely affect key populations (men who have sex with men, transgender people, sex workers, and people who inject drugs) and can be manifested in many ways, including discrimination, refusal of health care services, and violence. In communities where public opinion is largely negative toward lesbian, gay, bisexual, and transgender (LGBT) people and violence against them is common, such attitudes are sometimes also held by health care workers. These negative attitudes not only prevent LGBT people from accessing quality health care in general, but also discourage them from seeking HIV treatment, care, and prevention services specifically.

During a December 2015 trip to Côte d’Ivoire (to meet with LINKAGES partner organizations), I learned that a mob had attacked and severely beaten a young man (or trans woman; it is unknown which) who was on his way to attend an HIV prevention event hosted in a neighborhood in the capital, Abidjan. He was attacked because he was considered “effeminate.”  On this same day, a memorial service was held for a young man who had been poisoned by his family because they suspected that he might be homosexual.

In Côte d’Ivoire, where homosexuality is legal, violence and stigma are still obviously real dangers. In other countries, such as Burundi, penal codes against homosexual activity greatly increase the risk of violence toward the LGBT community. However, activists and advocates in Burundi (and many other countries where homosexuality is illegal) are actively working to make lasting social changes for LGBT rights both within their communities and their countries at large. Following is the perspective of one such activist.

Part 2

Burundi is one of the 33 African countries where homosexuality is criminalized and where individuals who are either perceived as or identify as LGBT are persecuted and discriminated against.

Hence, Burundi has experienced a remarkable increase in HIV prevalence within the populations of gay men, other men who have sex with men (MSM), and transwomen from 2011 to 2014.[1] Some of the main reasons for the increase include the narrow gender and sexuality norms that are relayed by opinion leaders and make homosexuality an “abomination”; the lack of competent and accepting health services for gay men, MSM, and transwomen;[2] the lack of active participation and decision-making power of key populations in the design and implementation of HIV programming; the limited support for organizing and strengthening advocacy movements by key populations; and the criminalization of homosexuality and sex work.

These crosscutting issues linked to HIV prevalence contribute to and spring from widespread ignorance related to sexual diversity, which perpetuates homophobia, biphobia, and transphobia and entrench access to health and public services both in Burundi and across the world.

Endnotes:

[1] In 2011, the CNLS conducted a HIV prevalence rate and socio-behavioral survey on HIV/AIDS focused on high-risk groups conducted that found a 2.4% rate within the MSM constituency. In 2014, the Burundi Priorities for Local AIDS Control E orts (PLACE) Report highlighted an HIV incidence amongst MSM high as 6%.

[2] A big part of the few accessible LGBT friendly health services are located in the capital city, Bujumbura.