From the Frontline of Community Action: A Compendium of Six Successful Community Based HIV Interventions That Have Worked for MSM- TG-Hijras in India30 Apr 2011
The report critically assesses six community-based organizations working with men-who-have-sex-with-men and transgenders from different parts of the country. It details key interventions implemented by them, partnerships with other community members, lessons learnt and replicable models for further interventions.
Men who have sex with men (MSM) and male-to-female transgenders (TGs) form an important ‘high risk group’ for HIV prevention efforts in India. The HIV prevalence in these groups has been relatively high (>5%) in many of the surveillance reports.
Thus, interventions in these groups have been an important thrust area for the National AIDS Control Organization (NACO), India. Unlike, some other high risk groups (such as patients attending sexually transmitted infections [STI] clinics) these groups usually have strong community ties; thus, many interventions in these groups are community driven and often through community based organisations (CBOs). Indeed, successful interventions in these ‘core groups’ in some of the high prevalence states are because of active community participation though CBOs.
A total of six CBOs working with MSM and TGs (from different regions of the country) who had previously scored highly on intervention implementation were critically assessed. Relevant literature and annual reports of these organisations were scanned. This was followed by site visits to each of these organisations. During these visits, in-depth interviews were conducted with a range of individuals, starting from grass-root level workers of these organisations such peers, outreach workers (ORWs), community mobilisers to more senior level members including managers and board members. Furthermore, discussions were also conducted with their collaborators, partners, and State AIDS Control Societies.
This report presents the details of this assessment. For each of the six organisations, the discussion starts with a profile. The discussion later proceeds to the key interventions implemented by them, their partnerships with other members of the society (such as health, law enforcement agencies, funders etc.) if any, and some of the key outcomes of these interventions. Furthermore, some of the lessons learnt and replicable models that can be used for further interventions have been highlighted.
It was found that that some of these organisations based their community work on different aspects of community needs, for example health was an important focus and basis of community interventions at the Humsafar Trust from Mumbai, whereas Sangma - Samara from Bengaluru had a more human rights and legal approach towards dealing with the community. Nonetheless, despite these different approaches the overall aim of these various organisations was community driven sustainable interventions for HIV prevention and care, and general health and well being of MSM and TGs.
Given the geographic and cultural differences in different parts of the country, it was but natural that there would be variations in approach to community issues in these regions. However, these differences also provide an opportunity to understand the successful models in various regions, and their replicability (even though not in their entirety) to communities and CBOs situated in other parts of the country. Some of the interventions/programmes by these organisations are beyond the mandate required by the national programme; thus these key interventions are important to be highlighted and understood by others working in the field. In addition, lessons learnt from this exercise are potentially useful in the creation of new organisations under an enhanced HIV Prevention Program.
Finally, the role of India Network for Sexual Minorities (INFOSEM) as an umbrella organisation for developing and streamlining community related activities in the country has been highlighted. All these six organisations are a part of INFOSEM; thus, their experiences can be shared on a common platform. This platform, in turn, provides inputs on needs and strategies for community led interventions in the country, thus making the relationship between the CBOs and INFOSEM a multidirectional association.