A survey of best practices that mitigate social discrimination against gay men and other men who have sex with men in low- and middle-income countries
M.D. Sundararaj1, R. Reynolds2, O. Banos1, P. Hebert1, K. Lauer1, G. Ayala1
1The Global Forum on MSM & HIV (MSMGF), Oakland, United States, 2International AIDS Vaccine Initiative, Amsterdam, Netherlands
Issues: Stigma, discrimination and violence against gay men and other men who have sex with men (MSM) drive negative health outcomes even in countries where the epidemic is typically characterized as generalized. In fact, MSM are 19 times more likely to be living with HIV than the general population in low- and middle-income countries. There is an urgent need for comprehensive, sustainable and targeted strategies that are robust and far-reaching to effectively mitigate these unfavorable effects.
Description: Social discrimination is defined as mean, unfair, or unequal treatment (including acts of verbal or physical violence) intended to marginalize or subordinate individuals or communities based on their real or perceived affiliation with socially constructed stigmatized attributes. The scope of need to alleviate its negative impacts is vast and further underscored by the lack of evidence-informed interventions. This presentation is a survey of current best practices targeting economically disadvantaged nations and designed to demonstrate the role of stigma reduction approaches in diverse geographies through a case-based review encompassing multiple sectors including community, health systems, workplace, religious institutions and communication media.
Lessons learned: There is a palpable lack of resources and empirical research available to disseminate strategies that diminish social discrimination universally. A main challenge is the dearth of legislative policies that foster increased access to health information, and prevention, treatment and care services in a focused and sensitive manner. The structural factors responsible for marginalization and exclusion are further compounded by stigma due to HIV infection, gender identity, drug use and sex work suggesting the need for more holistic and multi pronged approaches.
Next steps: Advocacy efforts must be scaled to include legal reform, stigma mapping, social marketing, community mobilization, social support, and information exchange. Operations and policy research is urgently needed to evaluate interventions designed to mitigate social discrimination directed towards gay men and other MSM.