Download - Where there is a will !
Where there is a will !
MSM and Transgender persons in Mumbai : Creating
Friendly environments for access to health care
Vivek Anand : CEO -The Humsafar Trust, Mumbai ,India
26th July 2012 : XIX International AIDS Conference : Washington DC
Background
In India Section 377 of the Indian Penal Code
criminalized same sex behaviour
Section 377 is an archaic British law made in 1865 and
passed on to an independent India.
New Beginnings
In 1990 India’s first registered LGBT magazine
Bombay Dost was launched
New Beginnings
In 1994 the board of Bombay Dost came together to set up “The Humsafar Trust” (Companions on a
journey) India’s first community based organisation for Gay men / Kothis / MSM / and LBT
communities in Mumbai
Strategic Decisions
• To work with Local and National Government
• To work within Public health care settings in Mumbai and not replicate services
• To create friendly environments for MSM and TG to access health care services
Sensitization and Negotiations
• In 1996 Sensitization and negotiation with LTMG - a medical teaching college and public Hospital in Central Mumbai began
• Student interns were invited to attend community meetings• LTMG started posting students train them on issues of MSM and
Transgenders and provide services• DHS sensitization resulted in MSM and TG site mapping and
MDACS commissioned pilot prevention programme
Integrated Counseling and Testing Center & STI clinic
• In 1999 ICTC and a STI clinic was set up by NACO within CBO to provide treatment for STIs and HIV testing
• Student interns from LTMG managed the clinic• Community Health worker was posted at LTMG to provide support
Integrated Counseling and Testing Center & STI clinic
• HIV positive were referred to LTMG for treatment of OIs and future follow up.
• 5 ART centers started in 2003• MSM/TG/ MSW living with HIV started registering at the LTMG -
ART center
Prevention/Care Support and Treatment Services
• The Humsafar Trust outreach programme reaches out more than 13,500 MSM and TG distributing free condoms and provide information on safer sex.
• Provides STI services and free HIV testing to 8000 MSM and TG every year.
• Nearly 1000 MSM and TG are registered for ART services at the 3 ART centres for care, support and treatment services
• Humsafar – LTMG model is considered a good practise model of public private partnership
The Humsafar Outreach Team
HIV Support Group
• Support group for HIV positive MSM and TG was established in 2003
• Safe space for positive men to meet and discuss their issues
• Initiate activities for getting family and community support
HIV Support Group
• Professional mental health support• Treatment of Opportunistic Infections (OIs) and enrollment in
accessing ART• Nutrition counseling and nutritive supplement support• Health workers became the linkage between Humsafar and Public
health systems• The model was replicated in three other public hospitals
Research Support • Set up in 2004• IRB registered with NIH and FWA certification• The Research Unit aims at community based research
and concentrates on studies that strengthen its services to the community and act as evidence for the national programme.
• Regular dissemination in public health care settings in an ongoing effort to create friendly services to MSM/TG and MSW communities
Research Support • Ongoing baseline studies• Mental health issues of MSM• Married MSM and their vulnerability to HIV • HPV prevalence among MSM and TG• Impact of stigma and depression on sexual risk behaviour of MSM
and TG• Advancing HIV trial preparedness among MSM in India• ISHKonnect : Internet based HIV prevention for MSM in India• SHAKTI : Stigma reduction, health care providers, awareness and
knowledge enhancement on Transgender issues in India.
Learning
A clear sense of purpose with active involvement of the community and ongoing sensitization and negotiation
with public health delivery systems helped create friendly services for MSM and TG in Mumbai despite laws
criminalizing same sex behaviour
Finally….
• NACO scaled up Targeted Interventions with MSM and TG from 32 TIs to around 300 TIs by the end of March 2012 in NACP III
• Consenting same sex between adults (above 18 years)was decriminalised and Section 377 was read down by Delhi High Court on 2nd July 2009. NACO provided support affidavit.
Finally….• The Delhi High Court
judgement was challenged by 16 opponents in the Supreme Court of the country
• The hearings in Supreme Court ended in March 2012
• The judgement and fate of millions of LGBT is AWAITED from the apex court of the country.
GratitudeNACO – MDACS
UNDP - UNAIDS
USAID – FHI
USAID – AVERT
BMGF – FHI
EU-HIVOS
SIDA -RFSU
GFATM Round 9 - India HIV AIDS Alliance
Fenway Community Health
University of Minnesota
Baldwin Wallace College-Ohio
CIHR-University of Toronto
UCSF
NIH – ICMR
MCC-CMC
NARI – TISS - MGM
ICRW
LSHTM – Welcome Trust
Friends of Humsafar
Thanks for your patience...