Strengthening Community Participation in China ’ s AIDS Response among MSM

1. Strengthening Community Participation in China’s AIDS Response among MSM XVII International AIDS Conference Mexico City, 3-8 August 2008 Edmund Settle HIV Programme Specialist United Nations Development Programme

2. UN Technical Working Group on MSM and HIVIncrease community based organizations participation in support of China’s national efforts to reduce HIV among MSM • Improve communication and co-ordination between MSM CBOs and between MSM CBOs and government, PLHIV, INGOs and donors • Build government capacities to involve MSM CBOs in policy-making and public service delivery • Develop the capacities of MSM community organizations and individuals to increase the coverage, sustainability and impact of community based interventions and advocacy efforts • Identify opportunities and increase involvement of Chinese MSM in global and regional advocacy initiatives • Promote leadership among MSM CBOs and individuals

3. Government Response to HIV among MSM • 1989 – First reported domestic case of HIV transmission identified through homosexual behavior (three evils) • 2005 – Identified MSM as a key population at higher risk in the Joint Assessment on AIDS in China (MOH – UN) • 2006 – Participated in national consultation sessions leading up to Risk and Responsibilities Conference; and R/R Conference • 2006 – Convened government-led national meeting on MSM and HIV; launched national MSM experts group • 2006 – PR for Global Fund 6 – MSM major focus • 2007 – Released National Framework on MSM and HIV • 2008 – Launched national programme to reduce and prevent HIV among MSM

4. Existing HIV prevalence data - MSM • 2007 - MSM account for 12.5 percent of estimated HIV cases in 2007, up from 2.5 percent in 2005 • 2003 – 2007 – prevalence rate increased from 0.6 to 10.6 (single urban area)

5. UN Technical Working Group on MSM and HIV – Activities (2006 – 2007) • Initially held bi-monthly information sharing meetings on topics identified by group members • Lead in-country national consultation process to identify major issues relating to MSM and HIV in China – related to Risk and Responsibilities (UNAIDS) • Convened national meeting on MSM/CBO’s role in increasing access to VCT services (WHO) • Supported the development of the National Framework on MSM and HIV/AIDS (UNAIDS, WHO)

6. UN Technical Working Group on MSM and HIV – Activities (2008) • Held donor and INGO meeting to identify common areas of support for MSM CBOs • Supported MSM CBO to convene national meeting on engaging owners of gay entertainment establishments (GEE) (ILO) • Supported community-led development and consultation process on National MSM Community Strategy on AIDS – included MSM CBOs, MSM PLHIV and GEE • Convened MSM Community Consultation and Action Plan Workshop • Hold national dialogue on the role of rapid testing and community based counseling in increasing access to VCT/STD services for MSM (WHO) this Fall

7. National MSM Community Strategy Development Workshop (Nanjing)Increased coverage, sustainability, impact and effective monitoring • Community facilitated • MSM CBOs, MSM PLHIV, GEE • Local partnerships (local MSM CBOs, local health departments) identified and defined • Prevention/awareness; VCT; Support/care; Advocacy and Addressing capacity needs - outcomes identified • Potential mechanism to facilitate funding to CBOs through national and local partners established • National community network on MSM dialogue initiated

8. UN Technical Working Group on MSM and HIV – Promoting Leadership • Supported MSM CBOs to develop, convene and facilitate consultations/meetings to produce community endorsed, advocacy documents and potential joint community programme proposals (UNAIDS, WHO, ILO) • Facilitated some 20 representatives from MSM CBOs, 2 government health officials and 1 academic to attend and participate in the R/R conference (UNAIDS) • Supported development of APCOM, China’s MSM CBO representative and government sector participation (UNAIDS) • Supported MSM community based organization representative to participate in regional advocacy training and attend UNGASS 2008 (UNAIDS) • Facilitated three Chinese MSM representatives to attend regional consultation of MSM outreach worker manual, and contracted to MSM CBO to adapt and translate (UNESCO)

9. Progress in Community Participation • Multiple provincial MSM working groups formed • MSM participation in policy development, programme design and implementation, and monitoring increased • MSM community involvement in regional and global MSM initiatives increased • National Community Network dialogue initiated • Advocacy documents highlighting the roles and responsibilities of MSM CBOs in China’s AIDS response produced

10. Trends Among Community Groups • Dual roles as advocates (right holders) and service delivery providers (duty bearers) • Target groups > Community response • Volunteer groups > Partners in the response • Tokenism > Community experts • Activity based funding > Output based funding • “Intense competition” > Partnership building

11. Working through partnerships… • Capacities and mandates of UN agencies • International NGOs and donors • Government and GoNGOs • Community based organizations