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A Toolkit for MSM-Led HIV and AIDS Advocacy

Speaking Out is an advocacy toolkit created to address the urgent need for men who have sex with men (MSM) everywhere to engage in advocacy locally, nationally, and globally to end the HIV epidemic and promote their human rights. The toolkit equips individuals and organizations with tools and techniques that enable them to become advocates right now, whoever and wherever they happen to be.

Now, more than ever, it is important for our communities to identify our own strengths, weaknesses, and needs, advocating as individuals and collectives for our rights in ways that work for us. MSM communities live and breathe in diverse and complex ways, and we must raise our voices on our own terms, from our respective contexts. That is what this toolkit is all about: ensuring we have the tools we need to become more involved in advocating for our rights, in our homes and schools as well as in governments and international forums.

This toolkit builds on advances made in past toolkits from around the world, with some key differences: (1) it is specifically MSM-focused with exercises and ideas that serve as conduits for the energy and contributions of MSM communities; (2) it is built on the belief that organizations can start where they are, and assumes that the skill sets of individual advocates and organizational maturity of MSM groups are wide-ranging and take time to develop; and (3) it approaches HIV and AIDS from a broad human rights framework, balancing public health and human rights approaches toward addressing MSM community susceptibility to HIV.

We hope you find this toolkit useful!  Please do not hesitate to write to us with any questions or concerns at speakingout@msmgf.org.


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Weblink: http://www.msmgf.org/index.cfm/id/262









Asia Report 翻译

原文链接: http://www.msmgf.org/index.cfm/id/262

    在5月17日国际不再恐惧同志日这天,专家们在越南河内举行的研讨会上呼吁公众一同行动抵制针对性取向的歧视。"由于对同性恋缺乏认识以及社会偏见,很多同性恋者遭受家庭暴力。"越南志愿者小组ICS的联络与服务官员Huynh Minh Thao表示,她服务的志愿者小组致力于在越南社会为同性恋者塑造一个积极健康的形象。"如果大家都对同性恋有所了解,那么在父母发现自己的还是是同性恋者时,就能避免一些不必要的愤怒和困惑。"她补充道:"改变固有观念是一个任重道远的工作,但是如果我们从家庭和社区层面一步步展开倡导和宣传,最终的结果还是可以很乐观的。"

    2008年越南社会、经济与环境研究所(the Institute for Studies of Society, Economy and Environment- ISEE)对越南3000名女同性恋者和变性者进行调查。结果显示20%受访者表示他/她们曾遭其他家庭成员殴打。

    该研究所高级研究员Nguyen Thi Thu Nam表示,产生自行政管理的偏见阻碍了国际机构为越南同性恋群体提供帮助。"主要障碍来自于医护工作者,不仅是医生,就连管理和行政人员也充满偏见。"

    Nam告诉本报国际家庭健康组织(Family Health International--FHI)对胡志明市和河内市的25名医护人员开展培训,教育他/她们如何发现针对同性恋的歧视。然而,受训者反馈表示在其工作的医院和诊所歧视的案例还是屡屡发生。

    美国国际开发署,越南社会、经济与环境研究所和国际家庭健康组织联合开展的调查报告显示,医护工作者中对男男性行为者(MSM)所持的歧视最高。该报告两位作者--联合国艾滋规划署的Chris Fontaine和国际家庭健康组织的Caroline Francis在本次研讨会上陈述了这份名为《污名化和歧视如何加速HIV感染--区域和全球证据回顾》的报告。







Asia Report 翻译

组织:Family Health International (FHI)--国际家庭健康


Abuse traumatizes gay community

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On Tuesday (May 17), experts called for renewed action against sexual discrimination at a forum in Hanoi. The event coincided with the International Day Against Homophobia and Trans-phobia.

 "A significant proportion of homosexuals suffer violence in their family because of limited awareness and social prejudices," said Huynh Minh Thao, communication and service manager of ICS - a volunteer group working to foster a positive image of homosexuality in Vietnam. "If everyone was better informed, we could help avoid some of the anger and confusion that occurs when parents discover their child is homosexual."

"Changing such perceptions is a big job but it is possible if it's done step-by-step at the familial and community levels," she added.

In 2008, the Institute for Studies of Society, Economy and Environment (ISEE) surveyed 3,000 gay, lesbian and transgender Vietnamese.

Twenty percent of the respondents said they had been beaten by their family members.

Nguyen Thi Thu Nam, a senior researcher at ISEE, said that administrative prejudices have hindered international organizations from providing assistance to Vietnamese homosexuals.
"There have been major barriers from medical workers--not just doctors but administrators and other officials working at medical facilities," she said.

Nam said 25 medical workers in Ho Chi Minh City and Hanoi were trained by Family Health International (FHI) about how to detect and diffuse discrimination against homosexuals.
However, the trainees have reported that the practice continues to exist in their hospitals and clinics.

According to a joint report by the United States Agency for International Development (USAID), ISEE and FHI, discrimination against men who have sex with men (MSM) persists among medical workers.

The findings, entitled "How stigma and discrimination drive HIV: A review of the regional and global evidence" were presented at the forum by authors Chris Fontaine of the UN's AIDS-fighting agency UNAIDS and Caroline Francis of FHI.

Francis explained that such stigmas go beyond medical facilities.

"It doesn't matter where you go, this stigma exists in different forms," she told the forum.
The qualitative research was collected with help from eight participants in HCMC and nine in Hanoi.

Their findings indicate that homosexual discrimination has pushed some gays to drug use, pickpocketing, unsafe sex, fighting, suicide, stress, depression and dropping out of school.
The report also presented ample evidence that homophobic attitudes continue to exist in Vietnam's healthcare system.

"Sex between a man and a woman is normal but sex between two men or two women is not normal... I think it's something sick. Many people in society think it's not healthy; I do too," a 22-year-old officer at Hanoi Community Health Care told the researchers.

The report quotes one homosexual as saying: "My friend sought treatment for a sore anus and the doctor yelled at him: 'the anus is for bowel movements, not for having sex.'"

Vietnam is the second country in the world and the first in Asia to ratify the Convention on Child Rights, but the recent study found that 13 out of 17 participants in the research reported suffering violence from family, teachers and friends during their formative years.

Vietnam's HIV epidemic is concentrated among people who inject drugs, sex workers and the MSM. The Vietnamese Health Ministry estimates there will be around 280,000 people living with HIV by 2012, including 5,670 children.

The researchers urged Vietnamese leaders to develop and implement comprehensive communications programs that target police, education practitioners and the intimates of homosexuals to help them better understand the consequences of violence and discrimination.

They also called for the creation of psychological, health, employment, education and legal counseling services for MSM.

"Action should be taken to create a positive image of homosexuals," Buu, a gay man in HCMC, told researchers. "Society shouldn't think of a gay couple as being any different from a straight one. We wish society would recognize that true love exists between homosexuals."

Organization:Family Health International (FHI)--国际家庭健康

Weblink: http://www.thanhniennews.com/2010/Pages/20110525141452.aspx


网站: http://www.phnompenhpride.blogspot.com/

   Booklet explains unique health needs and sets forth principles of practice for doctors, nurses and other healthcare providers.


  May 17, 2011 - The Global Forum on MSM & HIV (MSMGF) has published a new primer for doctors, nurses and other healthcare providers designed to improve the quality of clinical care available to men who have sex with men (MSM) across a broad range of contexts.  Released on May 17, the International Day against Homophobia, the booklet identifies stigma and discrimination as key barriers preventing MSM from accessing vital health services.


  Entitled "Engaging with Men Who Have Sex with Men in the Clinical Setting," the primer was developed in response to the unacceptable quality of care offered to MSM at clinics around the world.  High levels of homophobia among clinic staff have led to negligent care and severe violations of patient rights, such as verbal abuse and confidentiality breeches.  In addition, clinical curricula in many low- and middle-income countries have failed to include content on MSM health, leaving healthcare professionals with no knowledge of MSM health needs or the ways to address them.  


  Such substandard care has been a primary factor in the surge of HIV among MSM around the world as well as lower health outcomes overall.  More than half of MSM globally report that it is difficult or impossible to access vital services like HIV testing and treatment, while HIV prevalence rates skyrocket above 20% in countries like Senegal, Jamaica and Thailand.  Studies indicate that MSM also experience higher rates of depression, anxiety, substance abuse and suicide due to high levels of stress and alienation from social services and support.


  The primer aims to improve the standard of clinical care for MSM by providing basic knowledge about homosexuality and MSM health needs, as well as offering a set of principles for effective engagement of MSM in a healthcare setting.  The booklet begins by dispelling common myths about homosexuality and exploring the role of service providers in meeting the needs of MSM.  These needs are then examined in greater detail, with a focus on sexual health, mental health, drug use and violence.  The primer concludes with a roadmap for healthcare providers, providing guidance on leading community-level engagement with MSM and enhancing local capacity to meet MSM needs.


 "Healthcare providers play a central part in the well-being of MSM around the world," said Dr. George Ayala, Executive Officer of the MSMGF. "We have seen how damaging it can be when they are ill-equipped to handle the needs of MSM.  But with the proper tools at their disposal, they have the potential to be an equally powerful force for good.  This primer represents a first step toward that goal."


  The primer is currently available in English and can be found on the MSMGF's website at the following link:



  Translations are forthcoming in Russian, French and Spanish.  Any questions can be directed to contact@msmgf.org.

Organization: MSMGF



"男男性行为者所面临的医疗环境"为标题,该指南针对全球MSM群体所接受的质量低下的医护服务给予回应。由于医护人员对同性恋存在高度的恐惧,导致病 患的权利遭到忽视和践踏,例如言语攻击和个人信息外泄。另外,在很多中低收入国家,医疗课程并没有包含MSM健康的相关内容,因此医疗从业人员无法了解 MSM群体的健康需求,更不用谈如何满足这些需求。

由于目前艾滋病在MSM群体中迅速传播的现实,对此类医疗标准的需求更加凸显。全球超过一半的MSM人口表示很难或根本不可能获得艾滋病毒测试和治疗,而 与此同时,泰国、牙买家和塞内加尔的艾滋流行率迅速上升20% 研究显示由于无法获得社会服务与支持,MSM人口承受了极高的压力,导致该群体高频率的抑郁、焦虑、滥用药物和自杀。

本指南以提高MSM群体医护标准为目标,为医护人员提供同性恋和MSM健康需求的基本知识,同时也提供一整套行之有效的MSM医疗环境参与准则。针对 MSM健康需求,有以下几个主要分类:性健康、心理健康、药物使用与暴力。本指南为医护人员提供如何参与社区层面的MSM治疗,以及如何提高本土医疗能力 以满足MSM群体的需求。

Asia Report 翻译




  For its 7th edition, the International Day Against Homophobia and Transphobia was celebrated on May 17th 2011 with hundreds of events taking place all around the world and on every continent.

  From important statements by international artists, organizations and institutions to mass street protests and publications of groundbreaking reports, the events around the International Day Against Homophobia and Transphobia have once again displayed the strength, the creativity, the boldness and the diversity of the global fight to end violence, discrimination and stigmatization of people on the ground of their actual or perceived sexual orientation and/or gender identity or expression.

  The IDAHO Committee, the organization promoting the International Day Against Homophobia and Transphobia worldwide, has received communications about events in over 70 countries across the world. This year, several countries saw their first 'IDAHO' celebrations, countries like Burkina Faso, Fiji or Trinidad and Tobago. The Day was also marked by a strong increase in mobilization levels in several countries, and specifically in the United States of America where many local organizations, for the first time, used the Day as an opportunity for campaigning, mobilization, outreach or lobbying. In other countries, the Day has been confirmed as a major national annual landmark with activities taking place on an ever increasing scale, often uniting hundreds of events and making it to generalized media headlines, such as in Brazil, France, the UK, Turkey, Mexico, Canada, Spain, Italy, etc...

  Across Asia and the Pacific, an increasing number of organizations saw the Day as a useful and relevant opportunity to link their local demands into a global context of mobilization for equal rights. The level of activism has kept increasing in countries like Nepal, China, Cambodia, Sri Lanka, Hong Kong, Japan, the Philippines or Thailand. Even in more hostile contexts, such as Indonesia and Bangladesh, the Day has provided space to engage in dialogue, increase awareness, develop acceptance and harness support from allies. Organizations across the region also rallied to call onto the World Health Organization to commit renewed energy to see that national health institutions implement the decision taken in 1990 to stop classifying homosexuality as a mental condition.

  2011 was a special year for Latin America, where on top of the traditional very high level of activism on the Day, the regional 'Cures that Kill' campaign, united dozens of LGBTQI organizations in 14 countries to Human Rights, Women's Rights and other social justice groups to denounce the so called 'conversion therapies' which develop across the region with the insidious proposal to 'cure' sexual orientations or gender identities that do not correspond to 'official' standards. The Cures that Kill campaign generated marches, protests, conferences, artistic events and many other events across these 14 countries.

  In Africa, activists in countries like Uganda, Kenya, Burundi, Cameroon, Nigeria, or Burkina Faso, where both authorities and the social climate are very hostile, displayed immense courage and determination to organize events that included public conferences, radio debates, artistic performances and community gatherings.
In Eastern Europe, the Day was once again marked by severe homophobic and transphobic attitudes, with attacks on activists in Montenegro and Belarus and the announcement of Moscow authorities to once again ban the Pride march.

  But this year's 'IDAHO' was also marked by increased statements of support at the highest levels, with the European Institutions and the United Nations agencies confirming their commitment to making the Day an important annual landmark. At EU level, all institutions, except the Hungarian-chaired Council of the European Union, marked the day with speeches, conferences, exhibitions, etc... The United Nations issued several high level statements, including from Michel Sidibé (UNAIDS), Rebecca Grynspan (UNAIDS) and Navanethem Pillay, the High Commissioner for Human Rights, whose office published a groundbreaking brochure which encapsulated the most significant public declarations against homophobia and Transphobia from the most senior UN officials. Thanks to the amazing work of local activists and the support from the IDAHO Committee with funds from HIVOS and the Arcus foundation, this brochure has been translated, edited and produced in many local languages to support mobilization actions on the International Day Against Homophobia and Transphobia.

  Other groundbreaking publications that were issued on the Day include the update of the ILGA world report on State-sponsored homophobia, the ILGA Europe's Rainbow Map and Index, or the report of the Trans Murder Monitoring Project.

  This year, the Day has also been characterized but a strong presence on social networks, with nearly a hundred pages, groups and events set up specifically for 'IDAHO' actions and events.
Last but not least, the global free daily paper METRO marked the Day in all its 19 national editions, distributed to 17 million people, with a full two-pages on Human rights and LGBT people, an initiative that was part of a much noticed special edition edited by pop star Lady Gaga. Many other international artists tweeted or mentioned the Day on their Facebook pages, or participated in specific IDAHO events, concerts, video projects, fundraising initiatives, etc... Some specific artistic projects, like the 'Walk with Pride' global exhibition were developed, signaling a potential future development of such international initiatives, for which the Day provides a particularly good opportunity.

  With reports from media coverage coming in from 50 countries, the IDAHO Committee estimates that the Day has provided the opportunity to reach out to close to 50 million people worldwide.

  Information and contacts on all the above initiatives, and many more, can be found at www.dayagainsthomophobia.org

Weblink: http://www.msmgf.org/index.cfm/id/11/aid/3685/lang_id/1

Organization: the International Day Against Homophobia and Transphobia

TREAT Asia Symposium Gathers Global and Regional Experts

  Confronting the increasing burden of cancer among people living with HIV/AIDS in Asia, TREAT Asia co-sponsored a two-day symposium in November bringing together regional and global experts with the aim of deepening understanding of cancer and its relationship to HIV.

  "People with HIV are living longer because of highly active antiretroviral treatment [HAART], but because they have a higher risk of developing certain cancers associated with other viral infections, they can still die younger," said TREAT Asia Director Annette Sohn, M.D. "The situation is amplified in Asia and other resource-limited regions where cancer is hard to diagnose and treat since medical resources are not usually available."

  Because of the strong association of human papillomavirus (HPV) with anal and cervical cancers, a number of presentations addressed current research into these two illnesses. Studies have shown that HIV-positive women and men who have sex with men (MSM) are much more likely to have HPV-associated cancers. In the US, HPV is now preventable through a childhood vaccine, but the cost is prohibitive in Asia. "We don't have the infrastructure in Asia for cervical cancer screening in the general population, but it's desperately needed among women with HIV given the much higher risk," said Liesl Messerschmidt, TREAT Asia's director of research.

  High rates of HPV-related anal dysplasia have been identified by the Thai Red Cross AIDS Research Centre in Bangkok via a screening program supported by TREAT Asia through a grant from the US National Institutes of Health's IeDEA (International Epidemiologic Databases to Evaluate AIDS) program.

  The Thai study has raised significant concerns about the extent of anal cancer risk among MSM, according to principal investigator Nittaya Phanuphak, M.D. The study is now looking at proteins associated with anal cancer in order to determine if men who are more likely to progress to cancer can be more accurately identified. The Thai Red Cross's research is rapidly advancing the understanding of anal cancer risk, progress that is leading to opportunities to collaborate with other US and Australian investigators.

  Another area of growing interest in Asia is liver cancer associated with viral hepatitis infection. Many of the local HIV epidemics in the region are connected with injection drug use and studies show that upwards of 90 percent of IDUs in Asia can also be infected with hepatitis C, which puts them at risk for liver cancer; this risk is even greater in the context of HIV infection. But because the costs of treating hepatitis B and C are prohibitively high, local clinicians lack the tools to help patients who may have more problems with liver disease than with their HIV infection.

  The symposium, which was supported by the IeDEA program, brought together 61 participants from nine countries to hear presentations from the World Health Organization's International Agency for Research on Cancer; the US National Institutes of Health's National Cancer Institute; regional medical centers and universities; and Australia's National Centre in HIV Epidemiology and Clinical Research, which co-sponsored the symposium.

Weblink: http://www.amfar.org/world/treatasia/article.aspx?id=9682&tr=y&auid=8379954

Organization: TREAT Asia

TREAT Asia研讨会集结地区和全球专家

     在亚洲,由于越来越多的艾滋病患者面临癌症的威胁,TREAT Asia于去年11月召开了一个为期两日的研讨会,召集区域和全球专家共同商讨如何加深我们对艾滋与癌症之间的关系的理解。

     "由于接受高效抗逆转录病毒治疗(HAART),艾滋病患可以存活更久,但由于他/她们患癌症或其它病毒感染的风险更高,较早期死亡仍有可能发生。" TREAT Asia主任、医学博士Annette Sohn表示:"在亚洲以及其它一些资源有限的地区,由于通常情况下很难获得医疗资源,所以很难对癌症进行诊断和治疗。"


   因为通常情况下人类乳头瘤病毒(HPV)与肛门癌、宫颈癌共生,本次研讨会上有很多针对这两种疾病的研究陈述。研究显示携带艾滋病毒的妇女与男男性行为者(MSM)更容易患与HPV相关的癌症。目前在美国HPV可以通过在孩童时期注射疫苗来预防,但在亚洲来说这种疫苗的价格过于高昂。TREAT Asia研究总管Liesl Messerschmidt 表示:"在亚洲我们并缺乏对公众进行宫颈癌普查的基础医疗设施。但由于感染艾滋的妇女患病风险较高,我们对这种检测的需求极为迫切。"

     TREAT Asia通过美国国家健康研究所的国际艾滋评估流行病学数据库(IeDEA)项目资金支持位于曼谷的泰国红十字会艾滋研究中心开展研究,结果显示与HPV相关的肛门癌发生比率相当高。

  该研究的首席研究人员、医学博士Nittaya Phanuphak表示,该研究引起了相关人士对MSM群体患肛门癌的风险程度的高度关注。这项研究目前正在观察与肛门癌相关的蛋白值,以便确定能否更加准确地鉴别患癌症可能性较大的男性。泰国红十字会所开展的研究迅速的提高了人们对肛门癌风险的认识,这一进步将吸引来自美国和澳大利亚的研究人员共同开展合作研究。





Asia Report 翻译


机构: TREAT Asia




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