Access Services by Vulnerable Populations: From Criminalization to Positive Response

2. Access Services by Vulnerable Populations: From Criminalization to Positive Response Joel Gustave Nana Executive Director African Men for Sexual Health and Rights

3. Presentation Overview • Context • Mapping MSM in Africa • MSM in the African epidemics • Access to HIV services • Emerging positive response • Important Principles • Towards Universal Access to HIV PTC services

4. Mapping MSM in Africa • In this presentation, vulnerable populations refer to men who have sex with men (MSM) • MSM exist in every cultures, region and countries. • Some cultures have names for them. Eg: andli geey, dan daudu, istabane, moffie. • Male same-sex sexuality is criminalized in 38 African countries with penalties ranging from 6 months in jail (or just a fine) to death penalty. • Two countries provide protection: Seychelles and South Africa • Stigma and discrimination is the ‘norm’

5. MSM in the African HIV epidemic • Until 2004, men who have sex with men were utterly inexistent in African HIV interventions. • Endemic denial of the existence of same-sex practices on the continent has rendered them invisible and excluded them from HIV services • HIV interventions till then only targeted heterosexual persons and women specifically • A growing body of knowledge showing the high vulnerability of MSM to HIV – MSM are up to 19 times more vulnerable than the general pop.

6. HIV prevalence among MSM in Africa • .

7. Access to Services by MSM • Legal barriers • Laws criminalizing same-sex activity between consenting adults • Other laws on morality, indecency, vagrancy that are often used to criminalize consensual same-sex activity • Communicational barriers • Inadequacy of HIV prevention materials, as well as VCT protocols • Unfriendly media • Stigma and Discrimination • Insensitivity of health sector and mainstream HIV organizations to MSM • Resources • Very little or no resources available for MSM and HIV programming

8. Emerging Positive Response • Positive responses despite criminalization, discrimination and the lack of resources. • MSM have been included in about 14 national strategic plans for the fight against HIV • Countries like Senegal and South Africa have been receiving Global Fund monies and have been implementing MSM programming • An emerging movement of self-organized MSM led groups providing services to MSM and transgender persons • An increase in the number of African countries reporting on their MSM indicator at UNGASS • A growing number of mainstream HIV organizations who have included MSM populations in their programmes. • ACHPR has established a committee for the protection of MSM and other most vulnerable populations.

9. IMPORTANT PRINCIPLES • Public health • MSM are part of every society and part of the epidemic, a public health rationale requires • Men who have sex with men do not just have sex with men , some are also have one or multiple female partners. • Not addressing the MSM epidemics carries the risk of reversing gains obtained over the past 25 years. • Human rights • In international human rights law, the right to the highest attainable standard of health is a right guaranteed to every human. • The African communitarian to rights requires that the rights of individuals are fulfilled as a requirement.

10. Towards Universal Access to HIV Services • Efforts should be made by governments, inter-governmental organizations, and mainstream organizations to: • Strengthen the existing MSM programs where they exist and put in place programs where they don’t • Provide substantial resources for MSM programming on the continent • Government should repeal all laws and policies hindering access to HIV services, • IEC HIV materials should be tailored to meet the needs of MSM • Mainstream HIV NGOs and inter-governmental organizatios should sensitize their staff on the rights and health of MSM