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DAY THREE Module 3 ENABLING ENVIRONMENTS

1 /3. DAY THREE Module 3 ENABLING ENVIRONMENTS. 2 /3. Overview of Module 3. 3 /3. ENABLING ENVIRONMENTS. 1 /6. This session will cover Understanding the impact of the environment on HIV prevention and care How to programme beyond the individual at risk

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DAY THREE Module 3 ENABLING ENVIRONMENTS

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  1. 1/3 DAY THREEModule 3ENABLING ENVIRONMENTS

  2. 2/3 Overview of Module 3

  3. 3/3 ENABLING ENVIRONMENTS

  4. 1/6 This session will cover • Understanding the impact of the environment on HIV prevention and care • How to programme beyond the individual at risk • Examining the opportunities and barriers that exist in the MSM and transgender environment Session 1Environments of risk, vulnerability and impact

  5. 2/6 Key Learning Points • How to ensure that people, especially young people, have the knowledge, means and power they need to respond to HIV • How to map the HIV risk, vulnerability and impact environments in which MSM and transgender people live – e.g. impact of religion, culture and tradition • Strategies for removing barriers and obstacles in the environment • The power of data to drive good programming – how the data that services and programmes generate can be fed into planning

  6. 3/6 Environmental factors What are some environmental factors affecting the ability of MSM and transgender people including YMSM and YTGP to: • Avoid HIV infection or transmission? • Access knowledge of their status? • Access HIV treatment, care and support?

  7. 4/6 HIV vulnerability HIV vulnerability depends on 3 groups of related influences • Membership in groups or populations with higher HIV prevalence • Lower quality and coverage (in total numbers and in terms of population groups covered) of services and programmes • Higher-level social/environmental influences (e.g. laws, policies, norms, and culture) which configure a hostile environment (Aggleton, 2004)

  8. 5/6 Risk Environments for MSM and Transgender People • Laws and policies reinforce stigma • Self stigma reduces access to programmes and services • MSM and transgender people have sex with women and often have children • Religion, culture and tradition can threaten MSM and transgender people Source: Adapted from APMG ProgrammeManagement Training Curriculum

  9. 6/6 Group exercise – environments • Map out an environment of risk, vulnerability and impact for an MSM or transgendersub-population • Identify the specific groups and factors that affect HIV prevention, treatment, care and support • Be specific

  10. 1/6 This session will cover • The concept of an enabling environment • Interventions that support the development of this environment Session 2Environments and interventions that support programmes and services for MSM and transgender people

  11. 2/6 Key Learning Points • Describing the elements of the enabling environment • Identifying the supportive interventions that strengthen the enabling environment • Examining examples of these strategies at work

  12. 3/6 The Comprehensive Package of MSM and TG Services Strategic Information THE COMPREHENSIVE PACKAGE  HIV Prevention  Access to HIV treatment, care and support  An enabling environment for prevention and care services  Strategic Information Structural Interventions Advocacy Community mobilization Legal Frameworks Capacity Building Policy Relationships with gatekeepers Organizational development Stigma and discrimination programmes

  13. 4/6 The Enabling Environment Harmonize HIV policies with laws that impede HIV prevention and care including age of consent laws Reduce harassment, violence, stigma Ensure continuity and consistency of programmes and services • Support MSM & transgender CBOs and NGOs Improve quality and flow of strategic information • Remove structural barriers to the use of services  An enabling environment for prevention and care services

  14. 5/6 ENABLING ENVIRONMENT

  15. 6/6 Case Studies of Supportive Interventions Present back to the group: • Why was the intervention necessary? • What did it do? • How did it help?

  16. 1/8 This session will cover • Laws and policies that impact on MSM and transgender people • Strategies for improving the policy and legal framework: advocacy, enhanced participation of MSM and transgender people, legal clinics Session 3Laws and policies that shape effectiveness for MSM and transgender programmes

  17. Key Learning Points 2/8 • Identifying the impact of laws and policies on the environment of HIV programmes for MSM and transgender people including YMSM and YTGP • Identifying strategies for reforming laws and policies that have a negative impact • Strategies for removing barriers and obstacles in the environment

  18. 3/8 Laws and policies that impact on MSM and transgender people • Sodomy and other sexual behaviour laws • Differential age of consent laws • Relationship recognition • Adoption and family law • Immigration • Public decency and nuisance laws • Pornography laws • Drug laws • Mental health law

  19. 4/8 What can we do? • Advocacy • Participation of MSM and transgender people in national bodies • Legal services and clinics

  20. 5/8 Advocacy is for everyone • Not just for affected communities and NGOs • The best results occur through dynamic tension • Need to support the advocacy efforts of other groups because … • Partnerships are powerful • Responses need to be evidence-based • The most important perspectives may be the least resourced

  21. 6/8 GROUP EXERCISE • Choose a law or policy that specifically negatively affects HIV prevention and care among MSM and transgender people – especially youth – in your country, region – or even your own service • Put together a plan to advocate for a change in that law or policy

  22. 7/8 Role of legal services • Advocacy and activism • Informed by cases, documentation of human rights violations • Documentation of stigma and discrimination – Stigma Index • Test cases and strategic litigation • Decriminalisation of homosexuality in India • Anti-discrimination in health services

  23. 8/8 Legal services support a comprehensiveHIV response Prevention is supported: • Reduce police abuses; • Increase access to condoms, e.g. prisons; and • Put in place protection orders, e.g, domestic violence. Treatment, careand support is more accessible: • Increase access to medical services, housing, welfare; and • Increase access to medicines, lower cost – challenge patent laws. Impact of HIV is reduced: • Provide redress for discrimination, human rights violations; • Allow travel rights; and • Reinstate wills, estates, and inheritance rights.

  24. 1/6 This session will cover • The relevance of human rights and social justice to HIV programmes for MSM and transgender people • The application of international human rights agreements to MSM and transgender people Session 4Human rights and social justice

  25. 2/6 Key Learning Points • The contribution of a lack of access to human rights and social justice to driving MSM and transgender HIV epidemics • “Human rights” will be sensitive in some contexts – consider “health rights” and “citizens rights” • Familiarity with documents and instruments that can assist

  26. 3/6 Looking inside key documents Universal Declaration of Human Rights: • All human beings are born free and equal in dignity and rights. They are endowed with reason and conscience and should act towards one another in a spirit of brotherhood.

  27. 4/6 Looking inside key documents Muntarbhorn V. Keynote Address, Conference on Sexualities, Genders and Rights in Asia. Bangkok, 7 July2005. Sexualities, Genders and Rights: Implications for Asia ‘… the best parts of Asian traditions, religions and philosophies preach compassion, peace and liberality of thought and action.‘

  28. 5/6 Looking inside key documents Yogyakarta Principles • All human beings are born free and equal in dignity and rights. All human rights are universal, interdependent, indivisible and interrelated. • Sexual orientationand gender identity are integral to every person’s dignity and humanity and must not be the basis for discrimination or abuse.

  29. 6/6 Looking inside key documents Sexual Orientation, Gender Identity and International Human Rights Law: Contextualising the Yogyakarta Principles. Michael O’Flaherty and John Fisher. ‘The notion that there are two and only two genders is one of the most basic ideas in our binary Western way of thinking. Transgender people challenge our very understanding of the world. And we make them pay the cost of our confusion by their suffering.’ Note: “Binary” means “composed of, or involving ONLYtwo things” (e.g., male vs. female).

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