Focused interventions with males who have sex with males The missing piece Arif Jafar India Naz Foundation International.

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Presentation transcript:

Focused interventions with males who have sex with males The missing piece Arif Jafar India Naz Foundation International

Whom are we primarily reaching right now?  Kothis – feminised males who have sex with other males  Gay population (limited numbers only)  Hijra (again limited numbers only)

What is the coverage?  Total 152 organisations working on MSM and TG issues  99 are MSM community based organisations  Only 11 are exclusive Hijra programmes

What is missing?  Rural MSM populations At present the vast majority of the MSM programmes are located in urban areas with significant populations.

What is missing?  Male partners of kothis / feminised / receptive MSM Most of the programmes are designed to reach self identified kothis and a larger population of society defined“normative” males from the general male population is generally left out because they tend to be non-identified.

What is missing?  MSM who are also injecting drug users Insufficient data on male to male-to-male sexual behaviours among injecting drug users and vice versa, although anecdotal evidence does exist.

What is missing?  Hijras and other transgender populations Looking at the size of the hijra population in the country and the risky behaviours amongst the community, 11 programmes are certainly not enough.

What is missing?  Self-identified adolescent MSM Are there any programmes specifically designed to reach adolescent self-identified MSM, or those who have male-to-male sexual behaviours?

What is missing?  Female partners of MSM Most of the programmes, so far, have not been able to effectively reach the female partners, including wives, of males who are have sex with males. Possibilities of cross-infections and re-infections.

What is missing?  Low coverage In a country of over 1 billion people, 152 services organisations providing HIV services for MSM is certainly grossly inadequate

What is missing?  Peer leadership Global evidence indicates that the most effective strategy for building sustained risk reduction strategies for MSM are those that are led by MSM and are multi-leveled.

Other issues?  Mobility and migration  Class, poverty and education

Recommendations  Mobility