Is the Commonwealth ready for an AIDS-free generation?

Prasada Rao presents on the recently published report of the Global Commission on HIV and the Law at the International AIDS Conference in July 2012.

J.V.R. Prasada Rao blogs in New Statesman (London) about the importance of law reform in successfully addressing HIV/AIDS and how the Commonwealth can lead by example and take decisive actions to address the legal and structural barriers currently impeding the global HIV response:

Last week the European Parliament agreed on a new law to provide specific assistance and protection to people who suffer crime because of their sexual orientation, gender identity or, in a first for EU law, gender expression.

Can we expect the Commonwealth to adopt such a progressive approach on HIV and human rights issues? The annual meeting of the Commonwealth Foreign Ministers, coming up soon in New York, normally attracts attention for its economic and political agenda. But among the HIV/AIDS community, populations vulnerable to the infection and human rights activists, concern is centered on the fate of certain recommendations relating to the Commonwealth’s legal reform process….

To read the complete article, please click here.

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Prasada Rao is in the UN Secretary General’s Special Envoy on AIDS in the Asia Pacific region. He is former Director General of India’s National AIDS Control Organisation (NACO) and former Regional Director of UNAIDS in Asia and the Pacific. He served as a member of the Global Commission on HIV and the Law and is a trustee of both the International HIV/AIDS Alliance and India HIV/AIDS Alliance.

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Media Advocacy for addressing MTH issues

Alliance India in Andhra Pradesh conducted a Media Advocacy Meet this week (September 17, 2012) in Hyderabad to discuss the human right issues of men who have sex with men, transgender and hijras (MTH) and the role of media in representing their issues. The meet was conducted in collaboration with Center for Advocacy and Research (CFAR) and State AIDS Control Society (APSACS). Representatives from all major national and local print and electronic media houses attended the meeting.  Community members shared their experiences of representation of their human rights violations in print and electronic media.

At the end of the discussion, the senior journalists suggested the following: (a) to create district level consortium of media and health groups working on HIV prevention, (b) to request the health department of the media houses to foreground the MTH issues, (c) to form a state level action team/committee that can respond to violation of rights of MTH populations in the media, and (d) to conduct a workshop with the management of print and electronic media entities at the state level to sensitize them to MTH media needs.

Mr. Kailashditya, Joint Director, APSACS and Dr. P. Prabhakar, Director, Alliance India in Andhra Pradesh welcomed the suggestions and proposed efforts to initiate advocacy with media in a more focused manner.

This meet received wide attention from various quarters and positive reports in the media. To read the press coverage, click here.

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The author this post, Rambabu Mudraboyina, is Advocacy Officer for Alliance India’s Pehchan Programme in Andhra Pradesh

With support from the Global Fund, Pehchan builds the capacity of 200 community-based organisations (CBOs) for men who have sex with men (MSM), transgenders and hijras in 17 states in India to be more effective partners in the government’s HIV prevention programme. By supporting the development of strong CBOs, Pehchan will address some of the capacity gaps that have often prevented CBOs from receiving government funding for much-needed HIV programming. Named Pehchan which in Hindi means ‘identity’, ‘recognition’ or ‘acknowledgement,’ this programme is implemented by India HIV/AIDS Alliance in consortium with Humsafar Trust, SAATHII, Sangama, and SIAAP and will reach 453,750 MSM, transgenders and hijras by 2015. It is the Global Fund’s largest single-country grant to date focused on the HIV response for vulnerable sexual minorities.

How integration responds to the SRHR needs of sex workers

Sex workers have the same sexual and reproductive rights as anyone else – such as to choose who to have sex with and to have sexual relations free from violence. They also share many of the same needs for SRHR information, support, commodities and services – such as advice about family planning.

However, due to many factors, sex workers often experience greater vulnerability to SRH ill health than other community members. They may experience one or all of: specific or more complex SRHR needs; additional or stronger barriers to accessing SRHR services; and weaker capacity or opportunities to demand SRHR services . These factors are further affected – sometimes complicated – by the differences between individual sex workers, such as in terms of their gender and sexual orientation (including whether they are female, a man who has sex with men (MSM) or transgender), age, legal status, HIV status, socio-economic status and whether they use drugs.

As a result, sex workers often have significant unmet needs for SRHR. These can ‘fall through the net’ of both: HIV services (often designed to address specific risk behaviors rather than the ‘whole person’); and SRHR services (often designed for the general public and focused on mainstream services, such as family planning).

This brief specifically focuses on the importance, but also challenges, of HIV/SRHR integration for sex workers. It is based on the experiences of a growing number of groups working with such communities to put integration into practice in a range of setting. These have given important insights into ‘what works’. But they also highlight that everyone is still learning and questions remain about what constitutes good practice.

This issue brief promotes integration as a desirable goal in the long-term. However, it also emphasizes that organizations must work in a way and at pace that is appropriate and feasible for them – to ensure that the joining of HIV and SRHR services and systems enhances, rather than compromises, support for sex workers.

This review was commissioned by the India HIV/AIDS Alliance with support from the European Union under the Action Project and explores experiences and lessons from around the world including Asia and the Pacific. This issue brief is part of a series of materials resulting from a review of good practice in the integration of HIV and sexual and reproductive health and rights for key populations.

Download brief from here.

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Alliance India is a state lead partner in Andhra Pradesh for implementing the Avahan India AIDS Initiative (2003-2013) which works in six states of India and is funded by the Bill & Melinda Gates Foundation. The programme aims to reduce HIV transmission and the prevalence of STIs in vulnerable high-risk populations, specifically female sex workers, MSM, and transgenders, through prevention education and services such as condom promotion, STI management, behavior change communication, community mobilization, and advocacy.

Engaging Law Enforcement Authorities for HIV Prevention: Experiences from Avahan in Andhra Pradesh

As police are the mandated protectors of the civil rights of all the citizens, they need to be aware of, and protect, the rights of sex workers and men who have sex with men (MSM). Also, police personnel themselves are vulnerable to HIV due to factors of age (25-40 years) and longtime separation from their families.

To enhance and support the functioning of the Targeted Intervention in Andhra Pradesh (AP) and to reduce vulnerability of police to HIV, India HIV/AIDS Alliance conducted police advocacy trainings in the state as part of Avahan India AIDS Initiative. To achieve this, Alliance India held consultative meetings with partners of the AP State AIDS Control Society to develop a state-level training module, and then selected state- and district-level stakeholders, including trainers, police officers, community personnel, and NGOs, to conduct advocacy trainings at the district level. Approximately 4,000 police personnel were trained as part of this initiative .

As a result of these advocacy efforts, there has been: a noticeable drop in unlawful arrest/detention of key populations, such as sex workers and MSM; a decline in police-related violence; improved safeguarding of minors to keep them out of sex work; and increased awareness and adoption of healthy sexual behavior/practices by police personnel.

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The author this post, Dr. M. Ravikanth, is Documentation and Communication Specialist, India HIV/AIDS Alliance, Andhra Pradesh.

The Avahan India AIDS Initiative (2003-2013) is funded by the Bill & Melinda Gates Foundation. The programme aims to reduce HIV transmission and the prevalence of STIs in vulnerable high-risk populations, specifically female sex workers, MSM, and transgenders, through prevention education and services such as condom promotion, STI management, behavior change communication, community mobilization, and advocacy. Avahan works in six states, and Alliance India is a state lead partner in Andhra Pradesh.

Separate hospital wards for transgenders soon to be a reality

Friendly attitudes and responsive services by hospital staff help transgenders be comfortable and open about their health concerns to care providers. Photograph shows a visit by a transgender community member to a clinic in Andhra Pradesh
(Photo © Peter Caton for India HIV/AIDS Alliance)

In India, there is documented evidence of transgenders and hijras facing repeated stigmatisation and discrimination, in violation of their dignity and basic human rights. Pehchan, as part of the programme’s advocacy efforts to raise awareness and achieve equality for these communities, organised a sensitization workshop in collaboration with its CBO partner Sakha for the staff of the government-run Capital Hospital in Odisha on the problems faced by transgender community members seeking medical treatment. Simran Shaikh, Alliance India Programme Officer for Pehchan, gave an orientation to the participants on the lives of transgendered people.

Following the training, participants noted their appreciation and increased understanding. “It was nice to know the expectations and problems transgenders are facing while seeking medical treatment,” said a nurse who joined the session. Sudahsha Dash, the Chief Medical Officer of Capital Hospital, who was the chief guest at this occasion, proposed efforts to create a separate ward for transgender patients: “We would soon request the government to form a separate ward for the transgenders and sexual minorities here.”

This workshop received wide attention from various quarters and positive reports in the media. To read the press coverage, click here.

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With support from the Global Fund, Pehchan builds the capacity of 200 community-based organisations (CBOs) for men who have sex with men (MSM), transgenders and hijras in 17 states in India to be more effective partners in the government’s HIV prevention programme. By supporting the development of strong CBOs, Pehchan will address some of the capacity gaps that have often prevented CBOs from receiving government funding for much-needed HIV programming. Named Pehchan which in Hindi means ‘identity’, ‘recognition’ or ‘acknowledgement,’ this programme is implemented by India HIV/AIDS Alliance in consortium with Humsafar Trust, SAATHII, Sangama, and SIAAP and will reach 453,750 MSM, transgenders and hijras by 2015. It is the Global Fund’s largest single-country grant to date focused on the HIV response for vulnerable sexual minorities.

HIV/SRHR Integration for MSM and Transgender People

Photograph © Prashant Panjiar for India HIV/AIDS Alliance

Men who have sex with men (MSM) and transgender people have the same sexual and reproductive rights as anyone else – such as to choose who to have sex with and to have sexual relations free from violence.They also share many of the same needs for SRHR information, support, commodities and services – such as advice about protection from sexually transmitted diseases (STIs).

However, due to many factors, MSM and transgender people often experience greater vulnerability to SRH related ill health than other community members. They may experience specific or more complex SRHR needs; additional or stronger barriers to accessing SRHR services; and weaker capacity or opportunities to demand SRHR services. These factors are further affected – sometimes complicated – by the differences between individual MSM and transgender people, such as in terms of their age, legal status, HIV status, sexual roles and whether they use drugs or are involved in sex work.

As a result, MSM and transgender people often have significant unmet needs for SRHR. These can ‘fall through the net’ of both: HIV services (often designed to address specific risk behaviors rather than the ‘whole person’); and SRHR services (often designed for the general public and focused on mainstream services, such as family planning).

This issue brief specifically focuses on the importance, but also challenges, of HIV/SRHR integration for MSM and transgender people. It is based on the experiences of a growing number of groups working with such communities to put integration into practice in a range of settings. These groups include the Badu Social Welfare Society in Bangladesh; Humsafar Trust, Family Planning Association, and SATHII in India; and Style in Cambodia. The work of these organisations offer important insights into ‘what works’. But they also highlight that everyone is still learning and questions remain about what constitutes good practice.

This issue brief promotes integration as a desirable goal in the long-term. However, it also emphasizes that organizations must work in a way and at pace that is appropriate and feasible for them – to ensure that the joining of HIV and SRHR services and systems enhances, rather than compromises, support for MSM and transgender people.

This review was commissioned by the India HIV/AIDS Alliance with support from the European Union under the Action Project and explores experiences and lessons from around the world including Asia and the Pacific. This issue brief is part of a series of materials resulting from a review of good practice in the integration of HIV and sexual and reproductive health and rights for key populations.

Download brief from here.

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In 17 states of India, Pehchān is being implemented by a consortium of India HIV/AIDS Alliance, Humsafar Trust, SAATHII, SIAAP and Sangama to build the capacity of 200 CBOs to serve as effective HIV prevention partners with the National AIDS Control Programme (NACO) . By 2015, it will reach out to more than 450,000 MSM, transgenders and hijras using a community-driven and rights-based approach. Supported by the Global Fund, Pehchān remains their largest single-country grant to date focused on the HIV response for vulnerable and underserved sexual minorities.

HIV positive women who inject drugs provided with emergency support

A nurse at a Drop In Centre medically examining female injecting drug
user in Imphal. Photographer: Prashant Panjiar

Over the last year, Chanura Kol has reached out to more than hundred women who inject drugs, many of whom are HIV positive and all of whom were in need of general and emergency care.  Chanura Kol offered the women essential care and support services. This included emergency support such as providing them with food and medication for sexually transmitted infections, which a large proportion of the women were at risk as their primary source of income was sex work. In addition to this, women were tested for HIV and Hepatitis C.

Chanura Kol also filed cases on behalf of sex workers who were the victims of violence by either their pimps, clients or police officers. Physical and sexual violence are common occurrences in the lives of these women, a number of whom are also forced to consume alcohol and drugs by their clients. In a number of cases, this marks the beginning of their downward spiral into drug addiction. With little or no support to help them out, women, who have been successful in refraining from drug use, go back to sex work where they face the added risk of relapsing into drug addiction. In addition to the women that the Chanura Kol project has reached out till now, the programme aims to provide a holistic range of services to help 550 more women who inject drugs in Manipur by the end of three years.

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The India HIV/AIDS Alliance in partnership with SASO, implements the Chanura Kol project in Manipur. Funded by the Elton John AIDS Foundation, Chanura Kol was initiated in 2010 and serves to expand interventions to reduce drug relapse among female injecting drug users. Based on a holistic and sustainable approach, Chanura Kol aims to address the root causes of vulnerability and the primary causes of relapse post-detoxification for women who inject drugs in India’s Northeastern state of Manipur, many of whom are also sex workers. Chanura Kol provides these women with long-term shelter, creates opportunities for income generation outside of sex work, and encourages the rebuilding of family relationships.