In another follow-up post on the recent release of the (MSMGF) The Global Forum on MSM & HIV February policy report for 2010 I would like to put some of the suggestions and concerns in the context of the subjected title where I feel we have missed key opportunities for the local level that require very little funding if any and simple approaches that could have been effective which may have helped to reduce our rates of infection in the MSM population here.
We now have an infection rate of 30%.
It is well known that the social events such as lymes, parties and meetings are where larger numbers of GLBTQ persons can be reached in one go or repetitiously. Despite the fact that the MSM population has always been naturally migratory due to several negative homophobic and social causes in our environment these social events offer a chance to do some serious interventions that ought to have the assistance of the party promoters themselves and other key volunteers who are willing to work, the difficulty with the volunteers as I have come to realize is that they do not necessarily wish to engage the present set of groups and organizations that operate just now as many feel disillusioned by the systems over the years.
The recommendations as provided in the MSMGF document entitled “Reaching, Men who have sex with Men in the Global HIV Aids Epidemic,” are still worth exploring despite many of them have been espoused before and worded differently in other reports and documents from various groups and individuals.
Here are a few:
Under the heading - Expanded coverage of quality HIV-related services for MSM
Services and information tailored to the needs of gay men and other MSM are essential for the effective prevention, treatment and care of HIV and AIDS. HIV prevention messaging focusing exclusively on heterosexual transmission has led to misconceptions among MSM in various parts of the world that sex between men carries no risk of HIV transmission.13 14 Similarly, the word “sex” in certain contexts can indicate reproduction,15 again leading to dissociation between male-to-male sex and an understanding of HIV risk.
Clear and targeted information campaigns that appropriately address the risk of HIV transmission between men are necessary tools for effective HIV prevention. This must be coupled with access to a full complement of HIV prevention technologies, including condoms and water-based lubricants, that enable MSM to protect themselves and their sexual partners. For instance, when water-based lubricants are expensive or not widely available, oil based products like Vaseline and body creams are more commonly used instead4 which break down latex condoms and render them ineffective.
“MSM are considered to be a hard to reach group. For those of us working with this community, we have noted that it is large in size, and found across the nation in rural, peri-urban and urban centers. The current HIV programmes within the country are exclusively for heterosexuals. This prevents MSM from accessing prevention materials and other services that they require to address their health needs.”
Samuel Matsikure, Programmes Manager- Health,
Gays and Lesbians of Zimbabwe (GALZ), Zimbabwe, MSMGF Steering Committee Member
This is not much of a difference here in Jamaica as mot of our healthcare systems are designed for a heterosexual operated environment.
MSMGF Recommendations
• As highlighted in the 2009 AIDS Epidemic Update, programs to address HIV among MSM should constitute an important part of any national AIDS control plan.
• All nations should provide a minimum package of services for HIV prevention among MSM adopted. The Bangkok experience, documented in a 2009 consultation convened by UNDP, WHO, UNAIDS and others,16 includes five categories of interventions:
o peer and outreach education,
o free distribution of condoms and lubricants,
o use of targeted media,
o sexually transmitted infections (STI) screening and treatment, and
o voluntary HIV testing.
• Programming should ensure that HIV service providers have the necessary knowledge, tools and training to provide services to MSM, including the transfer of specialized clinical skills and anti-homophobia training. Furthermore, these must be made available and accessible to MSM in all areas, including urban, peri-urban and rural.
Under - Increased investment in effective HIV prevention, care, treatment, and support programs for MSM
Since the beginning of the new millennium, an unprecedented amount of attention and funding has been channeled toward combating the global HIV & AIDS epidemic.8 This has allowed tremendous progress to be made. Over the last ten years or so, a steadily growing response to this crisis from public, private and non-profit agencies globally,9 has made available significant financial resources to HIV-disease initiatives particularly in mid- and low income countries. A recent UNAIDS report10 documents the many successes of the heightened AIDS response, namely an increase in ART coverage from 7% in 2003 to 42% in 2008 among children and adults, and in one year, a 35% increase in the number of health facilities providing HIV testing and counseling in low- and middle-income countries from 2007 to 2008
However, while UNAIDS estimates that sex between men accounts for between 5 and 10% of HIV infections worldwide,11 only 1.2% of all HIV prevention funding is targeted toward MSM.12 Although transmission rates vary considerably between countries, this is still a clear indication of global priorities in HIV investments therefore necessitating a more evidence-informed strategy for the future.
MSMGF Recommendations include:
Country governments, humanitarian and global health institutions, donors, and national and international AIDS control organizations should ensure that financial and human resources committed to addressing HIV among MSM are proportional to HIV disease burden.
• In countries and regions where HIV prevalence data among MSM does not exist or is inadequate, capacity building for research to map the epidemic must be urgently prioritized. This will inform optimal targeting of HIV programs, as well as the allocation of public health resources.
• Key donors, including the World Bank and the UN, should prioritize a global ‘mapping analysis’ of funding investment in MSM programs in order to assess current levels of investment and provide a baseline for evaluating forward progress.
While there is a need for financial investments to carry out the well needed programs and interventions I feel we have not been seriously using the ideas and human resources available on the ground as part and parcel on these programs and strategies. Many persons who have been trained for peer to peer work etc are hardly utilized to carry out specific responsibilities on a volunteer basis for short periods in an effort for continuity of said interventions. MSMs are not readily visible and many who are already HIV+ do not necessarily access public health care readily and usually wait until they are at a crisis stage before doing do so they wont be reached by any direct interventions soon. The intricate network on event planners and social cell groups around are fertile ground for this kind splintered intervention that may well come together after some time.
One hardly hears of any regularly planned or occurring focus or support groups for HIV positive MSMs while done in a social setting or via private cell groups at all. The idea was reestablished under the former Jamaica AIDS Support for Life’s GLABCOM’s Steering Committee (Gay Lesbian Bisexual Community Outreach under the aegis of the Targeted Interventions Dept. drawn from the GLBTQ communities) of which I was a member, where it was agreed and formulated that selected committee members themselves would have identified their own peers and gone in to enact the Targeted Interventions initiatives at the time, it was beginning to bear fruit as all participating members had to report at every meeting what was accomplished or discussed at the cell group level this in turn was to be fed into a larger monthly and then annually published document but as we saw the GLABCOM program was closed in Kingston and the regularly held general populations meetings would have acted as a conduit if the ideas were allowed to flourish. There was some concerns raised at the Board level of JASL that the GLAB Steering Committee ought to concern itself with policy development at the Management level and not in direct activities as a committee to which I strongly disagree, we are also a part of the community and hence we must not only be developers but direct participants in order to engage others.
The apparent lack of autonomy as well at the GLABCOM Steering Committee level to function was another hindrance as at that time we had to operate in the purview of the T.I’s goals and objectives so many other social support ideas that were not adopted or carried out by JFLAG were left on paper because they couldn’t be supported by the structure.
It is only recently we have seen some presence of Peer Influentials (P.I) at a few events and they only seem to just operate at a basic level that of a condom station and very little interactions with the patrons present. The identification of willing volunteers is a critical first step then the planning and roll out of very simple yet effective initiatives ideas of which reside in the very communities that are to be reached, volunteers must feel a sense of worth in participating where their ideas, plans and objectives form part of the solutions (GLABCOM or similarly typed semi-autonomous structure).
The other communities have very little direct interventions to tackle HIV/AIDS issues save and except for the heterosexual designed messages from the national programs. There is very little exposure to GLBTQ messaging via US cable television and the internet but that will not and has not sufficed to make a meaningful impact as I feel persons feel removed from their cultural differences.
Please download the PDF version of the report from MSMGF and peruse it carefully.
Recommendations welcomed also no matter how simple, sometimes it’s those that work.
Peace and tolerance.
H
my rants and rave:
No comments:
Post a Comment