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Implemention stigma reduction intervention for Key population : Experience in west Africa . Sénégal, Guinée Bissau, Guinée, Cap Vert, Mali, Burkina Faso , Niger, Gambie. KP Stigma reduction: difficult context and interventions. Despite criminalizing legal environnement
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Implemention stigma reduction intervention for Key population : Experience in west Africa Sénégal, Guinée Bissau, Guinée, Cap Vert, Mali, Burkina Faso , Niger, Gambie
KP Stigma reduction: difficult context and interventions Despitecriminalizinglegal environnement Evidences are more and more avalaible in countries High impact interventions implemented
Regionalcontext , specific country realities • Difficult social, religious and legal environment • High level of stigma and discrimination of KP • Very few local stakeholders working with KP • More data on HIV epidemic among KP and impact on stigma in reducing access to service( starting) • KP community more visible and engaged in the response to HIV and developing rights based intervention • Countries just starting meaningful programming interventions for KP (Niger, Mauritania…) Countries with more structured interventions( Senegal, Cote d’Ivoire, Nigeria, Burkina)
Current situation/INTERVENTIONS Action : Prevention Action : Advocacy Stigma/ marginalization ² ²²² Action : Improvingaccess to treatment services Health service KP competent Action :strengtheningcommunity system, leadership development
Stigma reduction interventions( 1) A- Prevention and Health Sector Interventions : • Prevention activities led by MSM/ FSW : VCT, Condom+ lube promotion, STI care, behaviors change activities • MSM and FSW Pilot project( Guinea, Gambia, Niger, cap vert) Greater or national coverage program( Senegal , Burkina Faso, Cote d’Ivoire) • Context sensitive intervention : Mobile clinic and in house activities with peer educators • Training and engaging Health care workers : stigma reduction in Health setting and adaptation of services to the need of MSM & FSW • VCT/HCT treatment and prevention services
Stigma reduction interventions( 2) B- Leadership development and community engagement • Community systems strengthening (supporting emergence of association): 25 organizations ( MSM and FSW) ( Senegal, Burkina, Guinée, Cap vert, Guinée Bissau, Mali, Niger, Gambia) • Strengthening KP leadership : ✓ MSM and FSW as program implementers ✓ Supporting meaning full participation in national political and decision making mechanism: MSM representative in the CCM in Senegal ✓ Engaging more Civil society organizations to develop interventions for KP in west Africa : 20 organizations in 8 countries
Stigma reduction interventions C- Reinforcement of social capital and economic empowerment in a context of unemployement, high school drop out and poverty : ✓ financing professional training ✓ Income generating activities ( IGA) ✓ Reinforce community cohesion with IGA
Stigma reduction interventions( 4) D- Sustained Social dialogue and anticipation strategy : ✓Setting up “Observatoire” and National MSM steering committee ( anticipation strategy, environment and rights watch ) in Senegal ✓ dialogue with religious leaders, media, parlementarians, KP communities, security forces ✓ Engaging Mass media: advocacy package, working on discourse, enrolment workshop ✓ Research , evidence and stigma reduction ✓ Involvement of KP in research ( IBSS in Gambia, Cote d’Ivoire, Burkina, Togo + qualitative assessment criminalization impact in access to care and treatment in Senegal) ✓support MSM and FSW community and CS organizations working with KP on how to use data for advocacy and stigma reduction intervention ✓ Use evidences to build progressive acceptance in general population
Funding Stigma reduction: current situation and challenges • Independently to the fundingsources, Stigma reduction interventions are implemented in most of the westafrican countries by civil society organisations • Stigma reduction interventions are mainlyfunded by foreign (international) aid ( GF+ bilateralcooperation/ aid) • Funding allocation to KP stigma intervention in HIV national responseis not proportionate to the burden of the epidemicamong KP • Questions on future direction in funding : • Given social and religiouscontext, criminalization of samesex , how to increasedomesticresourcefor intervention for KP ? • NFM new opportunity or statut quo ? • How to adress the diffusion effect/ influence of criminalizinglawpassed in certain countries of the region?