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.
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.