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.

Key Population Hero: Who is afraid of HIV?

Written by Mario Schauer, founder of Rompiendo el Tabú

I was born in Honduras, a country identified as predominantly conservative and traditionalist. A country where people have to learn about human sexuality along the way and not in textbooks. A country where if you contract HIV, it is not just an infection to be treated, but something you have to learn how to hide.

Disclosing your HIV status to one friend means everyone in your social circle will also soon know about you. And it is certain that some of your friends will go away out of fear of also being labeled HIV-positive. Everywhere you go you will find people who will reject you. Many people will no longer view you as an individual or a professional, but instead as an “AIDS sufferer.” This is despite the fact that HIV and AIDS are not interchangeable and that HIV is now generally controllable with medications and a healthy lifestyle.

mario!

Photo Credit: Mario Schauer

Your sex life will become very complicated even if it’s a stable relationship. If your partner accepts you with your HIV status, you still will have to educate the rest of his/her family in order for you to have a peaceful marriage.

In my case, my condition became public when some of my coworkers stole my medical history, made photocopies, and then distributed them among all the media organizations they could find, with the sole purpose of disclosing my HIV status. Despite the death threats and all the difficulties I encountered, I’m surviving this virus more resistant and agile than ever.

It has been 10 years now that I’ve been living with HIV, and today my commitment is to support those people who are newly infected or at risk of infection. I also strive to help people pursue sexual education according to their personal needs and interests.

My experience led me to discover my passion to help others and has also allowed me to develop a genuine interest in learning more about HIV and AIDS. Because the virus affects the immune system, I’ve learned how important nutrition, health, education, and medical checkups are…and with all that I’ve lost my fear of talking about taboo issues.

My learning was self-directed and made me realize that we lacked a project that will enable other people to learn what I have. And that is how Rompiendo El Tabú was born, a social movement created to break down traditional barriers. Our mission is simple: break down social taboos by educating people and engendering interest their in learning about preventive sexual health.

HIV came into my life unexpectedly and I felt like it destroyed everything I’d accomplished. After that, it seemed like I only had two options: will myself to die or move forward. I chose the second option and today, 10 years later, my project is making a real start. It reminds me of a 747 airplane take-off – difficult at the beginning, but once it takes off, it will keep moving upward.

I love what I do. I get great satisfaction offering a warm helping hand to someone who needs it, without judging him or her. Above all, I love my work, so my job and my life are my top personal accomplishments.

Today, if somebody were to ask if I were afraid of having HIV, my answer would be NO.

To break a taboo we need to talk about the taboo.

 

Follow us on line. Click www.rompiendoeltabu.com

 

¿Miedo al VIH?

Escrito por Mario Schauer, fundador de Rompiendo el Tabú

Nací en Honduras, un país predominantemente conservador y tradicionalista, donde la educación sobre la sexualidad humana es algo que se debe aprender en el camino y no en textos. Donde haber contraído el VIH no sólo es una infección a la que hay que tratar, sino que también hay que saber ocultar.

Revelar tu condición de VIH a una sola persona implica que todo tu círculo social se va a enterar y algunas personas se alejarán de ti para evitar ser tildados como VIH positivo. El rechazo estará a la orden del día, dejarás de ser una persona o un profesional y tu nuevo título o etiqueta será “EL SIDOSO”. Esto a pesar del hecho de que el VIH y el SIDA no son intercambiables y que el VIH ya es generalmente controlable con medicamentos y un estilo de vida saludable.

mario!

Photo Credit: Mario Schauer

Tu vida sexual se volverá complicada, aun cuando se trata de un relación estable. Si tu pareja te acepta con tu condición de VIH, te tocaría educar a el resto de su familia para que puedas tener un matrimonio tranquilo.

En mi caso, mi condición se hizo pública a través de personas afines a mi labor que robaron mi historial médico, sacaron copia de ello y lo distribuyeron a todos los medios de comunicación que pudieron con el fin de revelar mi condición. Sin embargo a pesar de las amenazas de muerte y muchas dificultades, sobrevivo al virus más fuerte y ágil que nunca.

Llevo 10 años con él y mi trabajo ahora es apoyar a las personas que están recientemente infectadas o en riesgo de infección. También me esfuerzo para ayudar a todo quien busque de una educación sexual según sus intereses personales.

Esta experiencia de vida, aparte de ayudarme a encontrar mi pasión por ayudar a los demás, me permitió también generar el interés por aprender más sobre temas que tengan que ver con el VIH. Resulta que este virus afecta el sistema inmunológico, en otras palabras, todo lo que tiene que ver con alimentación, salud, educación, sexualidad, chequeos médicos y por eso, se pierde el miedo a hablar sobre temas tabú. Por medio de educación autodidactica aprendí más de lo que esperaba y me di cuenta que faltaba realizar algún proyecto que hiciera que las personas también supieran lo que hasta ahora había aprendido. Así nace Rompiendo el Tabú, un movimiento social que permite romper barreras tradicionalistas sin promover la violencia.

Nuestra misión es simple: romper los tabúes sociales por medio de la educación y generar interés en las personas por querer aprender sobre salud sexual preventiva.

En un plano más personal, el VIH llegó a mi vida sin esperarlo, revolvió todo lo que había hecho y destruyó todo lo que existía a mi alrededor. Tras ese evento, mi vida solo tenía dos opciones: echarme a morir o salir adelante. Yo escogí la opción dos y hoy en día, 10 años después, mi proyecto va arrancando como un 747 iniciando vuelo – cuesta al principio, pero cuando se levanta, alza para arriba.

Amo lo que hago, me satisface ayudar a alguien con necesidad de una mano amiga sin juzgar y, sobre todo, amo el trabajo así que mi labor y mi vida son mi máximo logro personal.

Hoy puedo decir que debido a las circunstancias soy mejor persona. Si me preguntan ¿Le tienes miedo al VIH como una enfermedad mortal?, hoy puedo responder que NO.

Para romper un tabú hay que hablar del tabú.

 

Síguenos en http://www.rompiendoeltabu.com

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.