amfAR MSM Initiative - ViiV Healthcare effect

Our Commitment, Collaboration
and Results-to-Date

The Need
Project Overview
Our Goals
What We Do
The Impact So Far
Lessons Learned

Kent Klindera, Director, MSM Initiative at amfAR

Hi, my name is Kent Klindera and I am the Director of the men who have sex with men (MSM) Initiative at amfAR, the Foundation for AIDS Research. In 2007, we launched the MSM Initiative, a global programme to combat the spread and impact of HIV among gay men, other MSM, and transgender individuals in the developing world, and have been working with Positive Action ever since. Specifically, Positive Action currently supports this programme in the Asia Pacific Region, enabling us to provide funding and support to grassroots MSM organisations. Today, I’m pleased to take you on a tour of our programme and show you how we are tackling some of the major challenges faced by gay men, other MSM and transgender individuals in this region.

The Need

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English Transcript

“You know, this region, Asia Pacific, clearly is showing an increase of HIV prevalence amongst men who have sex with men and then specifically young MSM. It’s growing exponentially. It’s very alarming, it’s very, you know, concerning and I think it reflects a lack of investment in this population. And so, I think we’re going to, in the future, see a lot more challenges in bringing the epidemic under control. You know, we supported a lot of organisations during the past in Thailand. And you know, Thailand was seen as the leader, you know, in the world, really, about how to deal with the AIDS epidemic. And now they’re seeing a resurgence amongst MSM. A population that, that in the past had been given some investment, but not a whole lot of attention, and I think we’re seeing, you know, the sex worker community is seeing a decrease in HIV incidence, but MSM are seeing an increase. And so, you know, thanks to Positive Action, amfAR is able to support organisations in this region, working to counter what the effects of the lack of investment in the past that we have been seeing.” — Kent Klindera, amfAR

Gay men, other MSM and transgender individuals who are living with HIV in the developing world suffer double discrimination, and this has a profound impact. Despite being 19 times more likely to be infected than the general population, MSM have been identified as a neglected population in low and middle-income countries. In my opinion, this has everything to do with homophobia and transphobia, compounded by a general lack of resources in these areas.

A study of 16 countries in the Asia-Pacific region revealed that no more than two per cent of MSM in those countries had access to HIV prevention programmes. So, it’s clear that stigma and discrimination against MSM can impact on an individual’s ability to access prevention and other healthcare services. What’s more, sexual orientation and HIV status can both also affect educational and career opportunities. amfAR’s programme concentrates on supporting gay men, other MSM and transgender individuals in the developing world, as there has been a lack of investment and focus on this high-risk population. As a result, we’re seeing alarming increases in HIV prevalence among MSM in many parts of Asia and the Pacific, as in other low and middle-income countries, and MSM living with HIV in these parts of the world are not getting adequate support.

Project Overview

The amfAR MSM Initiative is a small grants programme that supports community-based efforts to reduce the spread and impact of HIV/AIDS among gay men, other MSM and transgender individuals. It currently operates in five regions of the world, and supports approximately 40 community-based organisations. The projects we support have many different approaches, including:

Provision of innovative HIV/AIDS prevention and treatment services;
Research; and
Advocacy

The aim of the MSM Initiative is to be a catalyst. By giving a small investment of approximately $20,000-$30,000, amfAR can enable a community-based organisation to implement an innovative concept – thereby helping the community and raising the profile of the organisation simultaneously, so that other more sustainable donors then step in to help scale up the project even further.

Our Goals

The MSM Initiative has three main goals...

Significantly impact investment in community-based responses to HIV/AIDS among gay men, other MSM and transgender individuals.
Recognise and support key research related to gay men, other MSM, transgender individuals and HIV.
Support advocacy campaigns to breakdown policy and funding barriers for gay men, other MSM, transgender individuals and HIV.

What We Do

Each year we work through regional peer-review processes to determine which community-based organisations we will fund. We bring together 10 to 12 experts from each region, most from community-based organisations themselves, who sit on the panel and make recommendations on projects to be supported. The collaboration with Positive Action has allowed amfAR to invest in many innovative programmes; let me show you some of them:

In Southern Bangladesh last year we supported a project helping a community set up a small health clinic and gay community centre for about 200 to 250 gay men, other MSM and transgender individuals. The initial $20,000 investment meant they were able to run the office, clinic and a community centre for a whole year. The programme has provided a safe place where MSM can be themselves, as well as access services and support.

In Chiang Mai, Thailand we have been supporting a project which is researching and delivering online peer education and support for gay men, other MSM and transgender individuals. The project is evidence-based and shows that the best way to reach MSM is through websites that they already visit frequently. These websites could be related to searching for sex, searching for a boyfriend or searching for information.

We have just finished supporting a research study investigating the benefits of street-based HIV testing. The programme involved pre-test counselling sessions and the use of video messages to encourage young men to come to mobile testing units to get screened.

In Ranong, Southern Thailand we are supporting a project that is just getting off the ground. It is working with migrant MSM, a growing concern for the Thai Ministry of Health. The project has been a success, and after the initial year is over, there is already talk of scaling up the project in other parts of the town.

The Impact So Far

Within amfAR we ask our grantees to provide regular progress reports. We are tracking several indicators of the number of gay men, other MSM and transgender individuals who are reached. Throughout our entire initiative we have now reached almost a million MSM, providing support and reducing the challenges they face in their everyday lives. We’re very encouraged by the number of individuals we’ve reached thus far. We’re also very encouraged by how the projects we’ve supported are being scaled up – it means we’re having a real and sustainable impact in these communities that will continue to grow.

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English Transcript

“You know, to me, this impact that we’re having as the organisation’s strengths are growing, they are able to apply for and secure more sustainable funding. And you know, more importantly, a number of MSM are being reached, are being talked to, are given support, are finding safe spaces to be themselves, all those things. So there is some very impressive impact that I think we’re having.” — Kent Klindera, amfAR

Lessons Learned

One of the main things that’s been reinforced through this programme is that it’s absolutely critical to involve the community at every level. The individuals on the ground are the ones who know the best ways to reach MSM in their communities, the best ways to challenge homophobia and transphobia where they live, the best ways to document the issues, and what research is needed in order to successfully advocate for change. And so, to me, the lesson learned is that it’s critical to place decision making power within the community, as opposed to employing a traditional “top down” approach. The individuals on the ground are the ones who know the best ways to affect change in their own backyards.

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English Transcript

“Well, you know, on behalf of amfAR, Positive Action has been such a core supporter of our work both on the MSM Initiative and also our work amongst treatment literacy, and treatment access programmes with our TREAT Asia programme based in Bangkok. And, you know, so much of that is Positive Action’s commitment to community-led efforts. Be that, you know, our TREAT Asia programme, which is more about people living with HIV-led programmes or our MSM Initiative, which is about gay men, transgender individuals, and other MSM-leading efforts. So, I really want to thank Positive Action for having the foresight to support these community-based efforts because there is so much impact that comes from that – supporting a community-based effort, from building the capacity of activists and leaders to be managers and project managers, but as well the greater community and engaging the greater community simply by supporting a programme or supporting an NGO or a community-based organisation that puts their sign up and talks about who they are.” — Kent Klindera, amfAR

To learn more about the Positive Action programme, please click here.

Fact File

Project name:
MSM Initiative

Run by:
amfAR, the Foundation for AIDS Research

Region:
Asia Pacific

Population:
Gay men, other men who have sex with men (MSM), and transgender individuals

Challenges:
Stigma and discrimination; criminalisation; lack of access to health services

Activities:
Supporting community-based organisations; funding research; advocating for increased global attention and funding for HIV/AIDS programmes specific to MSM; supporting epidemiological, demographic and policy research to inform more effective prevention efforts in these communities.

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