J. Robertson1, M.-D. Cobbinah2, F. Wosornu3
1John Snow, Inc. (JSI), Boston, MA, United States, 2Center for Popular Education and Human Rights, Ghana (CEPEHRG), Accra, Ghana, 3Maritime Life Precious Foundation, Takoradi, Ghana
Issues: MSM have been neglected in HIV programming in sub-Saharan Africa, frequently ignored in national strategies and hidden in the face of intolerance, stigmatization and punitive laws. Recent research shows HIV prevalence of 25% among Ghanaian MSM.
Description: In Ghana, community-based organizations (CBOs) have been at the forefront of HIV programming for MSM. With PEPFAR support, CEPEHRG and Maritime have been part of efforts to reach MSM with prevention messages, condoms, and lubricant and to increase their uptake of HIV/STI services using cell phones. Building on its rights advocacy experience, CEPEHRG helped develop pioneering interventions for MSM. Working previously only in seafaring communities, Maritime expanded its capacity to serve MSM. Both organizations used research and tools from AED’s SHARP project. To stimulate usage of clinical services, both also supported SHARP’s “Text Me! Flash Me!” Helpline. Consequently, the number of MSM receiving STI testing at CEPEHRG’s drop-in center increased sixfold.
Lessons learned: CBOs advocating for the rights of sexual minorities are essential partners in efforts to develop HIV services for MSM, however capacity to serve this population can be developed in organizations with different core missions. Governments should support such programming, using donor funding if necessary. Research on MSM should be undertaken to define programmatic and resource priorities. Experimentation is vital to success; as cell phones became commonplace, outreach successfully leveraged this technology. Training healthcare workers to provide responsive care to MSM improves services and reduces discriminatory attitudes. Criminalization of homosexual behavior continues to impede and undermine progress.
Next steps: Interventions for MSM and other high-risk groups are appropriate in all epidemic types, including generalized ones. Even using conservative estimates, MSM in Ghana remain underserved. The vulnerability of MSM to HIV must be acknowledged as an urgent priority?in Ghana and elsewhere?by all stakeholders with the responsibility to act, including governments, donors, and civil society.
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