LEARNING August 18, 2016

Multi-Country South Asia Global Fund HIV Programme in AIDS 2016

The International AIDS Conference is the biggest gathering of experts, opinion leaders and community advocates on any global health or development issues in the world. First convened during the peak of AIDS epidemic in 1985, the Conference continue to provide a distinct platform for the intersection of advocacy, human rights and science in eradicating the epidemic.

AIDS 2016, or the 21st International AIDS Conference, was held in Durban, South Africa, from 18 to 22 July 2016, and the Multi-Country South-Asia Global Fund HIV Programme (MSA) family, in which UNDP Bangkok Regional Hub acting as the Principle Recipient of the grant, was proud to attend and contribute to the Conference. Funded by the Global Fund, MSA sent its community advocates to be part of a global action of working together and reaching the people who still lack access to comprehensive treatment, prevention, care and support services.

APCOM spoke to four MSA community advocates to discuss their contribution to and experience in AIDS 2016.


Header - Shankar

Acting as APCOM’s Advocacy and Programme Manager, Shankar’s engagement in the Conference was crucial to both APCOM and MSA’s strategic role. His involvement to AIDS 2016 included, inter alia, facilitating MSA-supported Turning the Corner: Investing to community systems and KAP strengthening for an effective HIV response, giving lecture at Islam and Christianity on Sexual Diversity and Sexual Health session and panelling at Attaining 90-90-90: Accelerating Urban AIDS Responses.

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What was the discussion during “Turning the Corner” session?

There were questions around how APCOM can take lead to the communities at both national and regional level relating to advocacy, strategic information, PrEP and many others. To which, I responded that we at APCOM are confident to continuedly built the capacities of our MSA partners with a stronger and more responsive community strengthening system – in which  different levels and types of support required in each MSA partners will be carefully examined and responded strategicly.

What do you learn the most from AIDS 2016, and how you think you can leverage that to your MSA work in the future?

During the Trans Pre-Conference, I had learnt a new  framework to design, implement and evaluate HIV and advocacy activities for trans communities. Titled Implementing Comprehensive HIV and STI Programmes with Transgender People: Practical Guidance for Collaborative Interventions (TRANSIT), the toolkit also discusses community-led outreach, safe spaces, and the use of information and communications technology in programming, while offers strategies for managing programmes and building the capacity of trans-led organizations. I believe TRANSIT will come really handy to guide us in rolling out the trans-specific MSA works in the future.

More over, at the ViiV Healthcare booth, I got to learn the development of PrEP injection, which will serve as an alternative to oral PrEP. I see how PrEP injection, which expectedly requires one injection every six months, will be more feasible and inviting towards high-risk key populations. As APCOM has been taking the community lead in rolling out the PrEP in Asia-Pacific region, including collaborating with PrEP advocates from our MSA partners, I believe that APCOM will commit in making this novel form of PrEP more accessible to high-risk MSM and trans communities in the region, within and outside of MSA programme.

 

Header - Richa v2

Representing MSA Sub-Recipient Humsafar Trust (India), Programme Manager Richa Salvi showcased “Impact of Decentralized and Reduced Government Funding on HIV/AIDS Program for MSM And TG Population in India” abstract in AIDS 2016’s Poster Session. The abstract points out that many States in India have hidden MSM and TG population who are, unsurprisingly, difficult to reach. Humsafar Trust’s targeted interventions had successfully reached out to this population through tactical outreach strategies. High turnover of staff, especially peer educators and outreach workers, however, has affected outreach program and has increased risk of HIV transmission among MSM and TG population due to unavailability of prevention services. Timely and adequate disbursement of funds by states is, therefore, the need of the hour to implement effective HIV/AIDS prevention program for MSM and TG population. Learn more about Richa’s abstract here.

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Tell us any interesting discussion you had while presenting your abstract.

Priyanka Vora, a journalist from India-based media Scroll came to my presentation and we had a thoughtful discussion on the impact of the reduced India’s national HIV funding – which NACO denied – on other key population such as female sex workers and IDUs. We built a consensus on how the funding should’ve been decentralized to realise “access equity rights now” in India.

In addition, given how my abstract focused on 2015’s fiscal year, many asked me on the current funding status. To that, I shared that NACO has revised the strategy of financing and, today, funds are disbursed centrally from NACO to respective SACS. Other discussions I had revolved around the fact that HIV was not public health priority for some of the States governance as HIV prevalence among gen pop is decreasing. This “wrong picture” indicates that there is a need to advocate for prioritization of financing of HIV programne for key populations such as MSM and TG, just like what MSA has been working on.

Did you engage in other sessions? If yes, tell us what you shared there.

I was a panelist of  “Turning theCorner: Resource mobilization and sustainability” session, organised by APCOM in MSMGF Networking Zone. I shared Humsfar Trust’s experience on in-country training on resource mobilization and sustainability strategy development that was initiated through APCOM’s regional training under MSA programme. I explained that donor funding is shrinking for middle-income countries such as India. In recent HLM on Ending AIDS, MSM and TG communities were not given the priority they deserve. Against this backdrop, there is a need for CBOs working on issues of MSM and TG to develop their own resource mobilization and sustainability strategies.

What do you learn the most from AIDS 2016, and how you think you can leverage that to your MSA work in the future?

I learnt about new advances in HIV testing and PrEP. HIV self-testing has been introduced in countries such as Thailand and Vietnam, and I hope it will soon be available in India’s healthcare system. Once it’s introduced, I believe HIV self-testing kit can be a much more strategic response to reach “hidden” key populations, such as MSM and TG communities, who often lack access to services due to the discrimination and stigma they face.

I visited the booth of ViiV healthcare, in which I met Dr. Piotr Budnik, medical lead HIV from GSK. Dr. Budnik shared that they are in process of launching injectable PrEP, which will require a dose (of injection) that’s much less than the frequency of oral PrEP. Even though MSA does not support service delivery component in India, I believe that these new advances can be pilot-tested through MSA grant’s operational research studies.

 

Header - Biraj

Representing MSA Sub-Recipient Bandhu Social Welfare Society (Bangladesh), Training Manager Masbah Ahmed presented “Strategies for Improving Services and Programmes to Address Gender-Based Violence (GBV) against MSM and Transgender People in Dhaka” abstract in AIDS 2016’s Poster Session. Based on a qualitative studies conducted under MSA programme, the abstract denotes that 90% of MSM and TG community members in Dhaka face a variety of physical, sexual and verbal abuses ranging from being teased by people on the streets to rape and murder. Two key perpetrators were police officers and healthcare providers, and thus, creating barriers for MSM and TG individuals to accessing legal and healthcare services. Learn more about the abstract here.

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Tell us the discussion you had with those who come to your abstract presentation.

It’s fascinating to see that some people still think that GBV is exclusive to women only. Some others think that the violence faced by MSM is more of a sexual orientation-based, as opposed to gender-based. I do think, however, that the fact that a lot of perpetrators are the one who conforms to the notion that all men should act masculine while the feminity only belongs to women, the term gender-based does apply to MSM. In addition, it’s apparent that GBV towards MSM and trans individuals is not exclusive to Bangladeshi society. A lot of people came up to me to discuss how they can address gender-based violence within their local context. It is interesting to see that many agree that a localised HIV prevention programme can be crafted as one of the ways to eradicate GBV in that area.  At the same time, GBV -if it’s spread unnoticedly and accummulate becoming a ‘culture’ – may amplify the spread of the epidemic among the victims.  When the law or policies do not offer protection to the basic rights of marginalised community to begin with, access to HIV services among the victims will get curtailed even further.

What do you learn the most from AIDS 2016?

I’m intrigued, and excited, with what the scientest have in store to end the epidemic. The HVTN 702 study, for example, could lead to the first approved vaccine for HIV. New researches advancing the search for microbicides, long-acting prevention, and multi-purpose prevention technologies are equivalently captivating. I just hope that all of these “promises”, if it comes to fruition, will be accessible by MSM and transgender communities living in low- and middle-income countries such as South Asian nations.

 

Header - Tinesh v2

Hailing from Humsafar Trust, India, Advocacy Officer Tinesh presented “Creating Enabling Environment to Reduce Vulnerabilities of MSM towards HIV/AIDS through Key Stakeholder’s Sensitization” abstract in AIDS 2016’s Poster Session.  By analyzing the workshops conducted to 655 stakeholder individuals in India, the abstract concludes that community-led stakeholder sensitization is key in creating and fostering rational attitudes toward MSM. Enabling environments further empower MSM to seek healthcare and legal aid thus reducing their vulnerabilities to violence and HIV. Community involvement and wider replication of similar activities are strongly needed to promote human rights, overall wellbeing and social justice toward marginalised communities such as MSM. Learn more about Tinesh’s abstract here.

 

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What do you learn the most from AIDS 2016?

A lot of discussions I had with fellow community advocates I met in the Conference aimed towards a topic around India’s Section 377. Through discussion here and there, I learnt that it is extremely important to establish in advance legal and organizational frameworks to resolve issues intellectually and analyse impact of the colonial laws that criminalize sexual activities and its related work interventions.