amfAR, The Foundation for AIDS Research

GRASSROOTS: The GMT Initiative Blog

amfAR's GMT Initiative supports grassroots organizations that respond to the devastating impact of HIV/AIDS among gay men, other men who have sex with men, and transgender individuals (collectively, GMT).

Research Collaboration in Rwanda and Burundi

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Posted by Kent Klindera, April 13, 2015

LGBTI activists gather at Centre Remuruka, an LGBTI advocacy group and community center in Bujumbura, Burundi.

I recently returned from a research preparedness meeting in Kigali, Rwanda, where 25 LGBTI activists and HIV researchers from Rwanda and Burundi came together to discuss research design, questions, and priorities for health and human rights research among GMT individuals in the region. Too often, research performed among LGBTI populations is developed by researchers only. While grounded in science, they often neglect the role community should be playing in designing such studies, only seeking community involvement in the recruitment of research subjects. Due to this the lack of participation, opportunities are often lost to connect the research results with the communities’ advocacy efforts—a link that could result in a more effective HIV response among GMT populations.  

To bridge this divide, amfAR has been working with The Center for Public Health and Human Rights at the Johns Hopkins Bloomberg School of Public Health and the International AIDS Vaccine Initiative (IAVI) to connect more researchers with LGBTI community activists and vice versa. In 2011, we collectively developed a research guide called Protect, Respect, Fulfill, which offers concrete actions to overcome the gap between researchers and community leaders. We are currently adding new case studies and action checklists to the document and plan to release the updated guidance later this year. 

amfAR and IAVI have also been organizing meetings, like the one in Kigali, in several countries. Last year, we hosted a series of meetings in Kenya that resulted in the formation of a formalized LGBTI research network of both researchers and activists called the G10 that is now working to set research priorities and design studies in Kenya. This year, we have held meetings in Zambia and Rwanda and plan to support similar meetings in Belize, Paraguay, South Africa, and Tajikistan.

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Members of GMT Initiative grantee partner MOLI (Mouvement pour les Libertés Individuelles) at the organization’s offices in Bujumbura, Burundi  

One of the widest gaps between researchers and the LGBTI activists’ agendas is the fact that the activists represent a community whose ‘lived reality’ is more than just being an HIV disease vector. LGBTI people struggle with societal stigma and discrimination. Especially when living openly as LGBTI, this stigma and discrimination make it very challenging for them to receive a quality education, secure paid employment, maintain familial and romantic relationships, and access quality healthcare. However, from the HIV researchers’ perspective, it is only the health aspect that is important.

LGBTI activists often tune out if they think HIV researchers do not see them in the context of their lives, and I’ve heard them complain that the researchers seem not to care about the community. Similarly, I’ve heard researchers complain that LGBTI activists are not well organized and have unrealistic expectations. In Kigali, I was impressed at the sense of mutual admiration that the activists and researchers had for each other. As I have witnessed at every research preparedness meeting we’ve held, when both parties were brought together, camaraderie was shared, along with mutual understanding and trust.

The meetings also reveal how listening to activists is essential to designing an effective study. For example, in Kigali we discussed how using the word ‘recruit’ can be problematic and stigmatizing when performing research within LGBTI communities, as society accuses LGBTI leaders of ‘recruiting’ others into their ‘lifestyle.’ It was therefore agreed that saying ‘enroll’ or ‘engage’ research participants would be much more appropriate.

I was impressed by how truly engaged the attending activists were. I watched as they began to understand the power that solid research data can offer their advocacy efforts and the impact the community could have on shaping a future research agenda for LGBTI individuals in their area through collaboration with researchers. I was also impressed that the HIV researchers began to understand that HIV is not the most important concern of LGBTI leaders, but that the stigma and discrimination that permeate society and LGBTI individuals’ daily lives takes precedence.    

Much of the struggle we have around the HIV response among key populations is because, too often, their humanity is somehow diminished.  This may be the consequence of the irrational fear that causes societal homophobia and transphobia, or of seeing community members as data points, not vital voices in the research process. We need more gatherings and processes like this where everyone’s humanity shines through.


An amfAR Scholar Researches PEP Use Among MSM in Developing Countries

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Posted by Lucile Scott, February 26, 2015

  Johan 2Johan Hugo, an HIV clinician at the Ivan Toms Centre for Men’s Health in Cape Town, South Africa

In mid-January, four GMT scholars from Belize, China, Pakistan, and South Africa arrived in Pittsburgh to begin five months of graduate-level public health study at the Center for LGBT Health Research of the Graduate School of Public Health at the University of Pittsburgh. This is the third year amfAR has supported the scholars program, which aims to strengthen GMT community-based research and responses to HIV by offering  four researchers from low- and middle-income countries courses on LGBT health research, research methods, and grant writing. The scholarship also includes round-trip travel to the U.S., housing, and a modest stipend.

By the end of their stay, the scholars will have not only improved their research skills, but also drafted a proposal to investigate culturally appropriate strategies to improve HIV services for GMT individuals in their respective countries. As this year’s scholars began designing their own research projects, the GMT Initiative checked in with a graduate from the inaugural 2013 class of amfAR HIV Scholars, Johan Hugo, an HIV clinician at the Ivan Toms Centre for Men’s Health in Cape Town, South Africa, to see how his research was progressing. In an earlier post, we talked to another 2013 alum, Lebanon’s Johnny Tohme.

amfAR: Why did you choose to focus your research on Post-Exposure Prophylaxis (PEP) use among men who have sex with men (MSM) in South Africa?

Johan: PEP studies among MSM have been done in Amsterdam, Brazil, and San Francisco, but never before in Africa—despite the fact that in most of Africa MSM have one of the highest rates of HIV infection. I work at the Ivan Toms Centre for Men’s Health in Woodstock, Cape Town. It was one of the first men’s health clinics on the African continent to address the sexual health needs of MSM, and it currently has close to 7,500 patients. The clinic provides a platform to safely study this biomedical approach to HIV prevention in a developing world setting and determine if it will be useful. If it is, we will disseminate the knowledge throughout the developing world.

Also, South African physicians’ cultural competence and their PEP competence both urgently need addressing. I have heard many horror stories of doctors making moralistic pronouncements to MSM when they try to access PEP that make them feel like second-class citizens. Due to a lack of training and their own beliefs, many physicians feel that PEP should only be used for needle stick injuries and rape cases—and definitely not for MSM.  A lot of MSM don’t even know about PEP, and the ones who do might not go to healthcare facilities to get it because they fear facing homophobia and prejudice. Our clinic has also encountered MSM who have been prescribed dangerously outdated or contraindicated PEP regimens.

amfAR: What are the results of your research so far?

Johan: There are two components to the research. The first is a 116-question Internet survey looking at MSM’s attitudes and beliefs about PEP. It went live at the end of June 2014, and we have 326 completed surveys and 403 partially completed ones. I have some provisional data, but it is way too early to answer any of my questions.

The second component is a clinical study looking at barriers and facilitators to MSM accessing and adhering to PEP. It launched in November 2014 and will run over a 9–12 month period. Men are eligible to participate if they are older than 18 and report having had high-risk, or perceived high-risk, sexual contact with another male that resulted in requesting PEP. So far we have enrolled 12 participants. I feel it is going really well, and I am very excited to see the results.

amfAR: How did the HIV Scholars program impact your research?

Johan: My passion is sexual health, and even though it can be very challenging at times, working with the MSM population is very rewarding. My time in Pittsburgh was extremely valuable, from the coursework to the time spent with Ron Stall [chair of the Department of Behavioral and Community Health Sciences at Pitt Public Health and head of the HIV Scholars program]. It was great to be able to get to know the research language and to start speaking it. I also think I made very valuable connections for the future.


An amfAR HIV Scholar Breaks New Ground Reaching MSM Refugees in Lebanon

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Posted by Lucile Scott, January 29, 2015


Johnny-Tohme.jpgJohnny Tohme, a voluntary counseling and testing officer at the Marsa Sexual Health Center in Beirut, Lebanon, and executive director of the M-CoalitionIn mid-January, four GMT scholars from Belize, China, Pakistan, and South Africa arrived in Pittsburgh to begin five months of graduate-level public health study at the Center for LGBT Health Research of the Graduate School of Public Health at the University of Pittsburgh. This is the third year amfAR has supported the scholars program, which aims to strengthen GMT community-based research and responses to HIV by offering  four researchers from low- and middle-income countries courses on LGBT health research, research methods, and grant writing. The scholarship also includes round-trip travel to the U.S., housing, and a modest stipend.

By the end of their stay, the scholars will have not only improved their research skills, but also drafted a proposal to investigate culturally appropriate strategies to improve HIV services for GMT individuals in their country. As this year’s classes got underway, the GMT Initiative checked in with a graduate from the inaugural 2013 class of amfAR HIV Scholars, Johnny Tohme, a voluntary counseling and testing officer at the Marsa Sexual Health Center in Beirut, Lebanon, and executive director of the M-Coalition, to see how his research was progressing.

amfAR: Why did you choose to focus your research on MSM (men who have sex with men) refugees in Lebanon?

Johnny: Populations destabilized by armed conflict are at an increased risk of HIV infection, and this vulnerability is compounded among MSM refugees due to their sexual orientation, especially in a context where religious and cultural conservatism contributes to high levels of stigma and discrimination. Currently, in Lebanon we have one-and-a-half million registered Syrian refugees —plus those who are not registered, a half million Palestinian refugees, and at least 30,000 Iraqi refugees—though some speculate the number is up to 100,000.

In 2012, I was involved in a U.S. National Institutes of Health-funded behavioral study among MSM in Beirut. Of our sample of 213 MSM, 35 were refugees. Data collected from these 35 participants was not sufficient to establish trends, but judging from our field observations, it seemed they were much less likely than their Lebanese counterparts to have been exposed to sexuality education or information about HIV. We were not aware of any published studies focusing on MSM refugees, so I proposed research to assess their level of HIV risk behavior and identify both barriers to and facilitators of risk reduction and healthy sexual behaviors.

amfAR: How is the study going?

We are done with the first stage of the study, a qualitative exploration of the factors that influence MSM refugees’ sexual risk behavior and their access to HIV testing and healthcare. The data was gathered through three focus groups. In mid-September 2014, we started quantitative data collection through a 40-minute survey. This data collection is expected to be finished by mid-June.

I can’t share any specific numbers until we are done with the data collection and analysis, but general observation has shown that refugees do indeed have a different perception on sexual health than their Lebanese counterparts, especially those who arrived in Lebanon recently. It also shows that the longer they are in the country, the more they connect with Lebanese MSM and adopt their behaviors.

amfAR: How did the HIV Scholars program impact your research?

The program was a stepping stone to a new career. It wasn’t just about research methodology, but also understanding the importance of research and the whole research process— how to move from an observation to a theory to the conception and application of a study to project implementation. Knowledge about this process is much needed in my field of work and in my country and region, and I was able to convey much of what I learned to my colleagues back home.

Since finishing the program, I also helped found the M-Coalition, the first and only regional HIV/AIDS advocacy network specifically devoted to the needs of MSM in the Arab world. Due to my background in HIV research among key populations and the fact that Beirut was the safest place in the region to initiate the program, I was asked to become its executive director. We are two weeks away from celebrating our first year, and we couldn’t be prouder of the high visibility we have achieved and the support and encouragement we have received from major stakeholders in the region and internationally.

HIV Outreach and Conflict in the Congo

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Posted by Lucile Scott, December 12, 2014

Aimée Furaha (left), head of AHUSADEC’s sex worker program, and Raphael Ngeleza, director of AHUSADEC.

Eleven years ago, the Democratic Republic of the Congo (DRC) was at the center of a brutal five-year conflict known as “Africa's world war" that resulted in millions of deaths and regional instability. While a peace accord was signed in 2003, fighting and violence persist in the eastern part of the DRC, where several armed militias continue to vie for control of the country’s wealth of minerals, including cobalt, gold, diamonds, and coltan, a metallic ore used in cell phones and laptops.

East-DRC is also home to GMT Initiative grantee partner Action Humanitaire Pour la Santé et le Développement Communautaire (AHUSADEC), which provides HIV testing, counseling, and outreach services to gay men, other men who have sex with men, and transgender (GMT) individuals and to female and GMT sex workers. It is the only group in this part of the country targeting GMT individuals with HIV services.

“East-DRC is a place where there have been many conflicts, rapes, and sexual violence and many public health problems in general, but now, thanks to AHUSADEC, with amfAR’s support, GMT individuals can benefit from HIV interventions for the first time,” says Freud Muciza, who works for the DRC’s national AIDS program and was contracted by amfAR to assist AHUSADEC in further developing its organizational capacity and impact.

While the mines in the East Congo produce substantial profit, the local population receives little of the economic benefits—but bears all the costs of the endemic violence. The widespread rape of women as a tactic of war caused a senior UN official to dub DRC “the rape capital of the world” in 2010, and the violence displaced more than 100,000 people throughout the country in 2013 alone.

Bukavu, the city where AHUSADEC is based, has a large United Nations and police presence, and many refugees, usually from the rural villages near the mines, often come there, further straining the city’s already taxed housing, employment, and health infrastructure. In the midst of all this instability and flux, successfully reaching GMT individuals, a highly marginalized, stigmatized, and often hidden population, is difficult. The severe stigma around homosexuality has also prevented other groups from using their resources, which are often limited, to target them.

And while many of the international humanitarian groups in Bukavu are operated by foreigners in headquarters enclosed by protective walls, AHUSADEC is run entirely by locals out of a white stucco house with a large, welcoming front porch. The building provides a place for GMT individuals, many of whom have been kicked out of their homes or denied jobs because of their sexual orientation, to feel welcome and like they are part of a community. “They trained me as a peer educator and I felt I had a direction and purpose,” says Daniel, 19, a client who has been performing peer outreach services for one year. “I am proud to be part of this important work.”

Data about GMT individuals in the country is limited, but according to the latest UNAIDS progress report, the HIV rate among men who have sex with men (MSM) is 18%. Due to limited services targeting MSM, few are reached with HIV prevention messaging, and the report also estimates that only about 15% use condoms regularly—meaning the rate could easily rise if more men are not accessed with testing and prevention messages, like those provided by AHUSADEC. Even more challenging, almost no data exists on transgender individuals. 

AHUSADEC is also working to combat the stigma, discrimination, and violence GMT individuals encounter, both in healthcare settings and in society in general. They have a program to train police to prevent violence against GMT individuals and they also accompany clients who test positive for HIV to the hospital to prevent them from experiencing discrimination. “amfAR has helped us respond to discrimination,” says Bienfait, a nurse who performs HIV tests and counseling at AHUSADEC. “Before GMT individuals would not go to the hospital because of discrimination, and now an AHUSADEC staff member or volunteer helps them navigate the services.”

And because many GMT individuals are not aware of AHUSADEC’s services or are hesitant to seek them out at AHUSADEC’s offices, the staff makes weekly visits to bars frequented by GMT individuals to perform mobile HIV testing. During one recent mobile testing visit, Bienfait and the staff set up in a fence-in dirt yard behind the bar, which, like most establishments in Bukavu, is subject to frequent electrical brownouts. A bartender announced over a loudspeaker that free HIV tests would be offered out back, and soon the bar patrons began to line up, and Bienfait, sitting behind a small plastic table in his white lab coat, began testing them one by one.

You can view photos of AHUSADEC and its mobile testing program below.


‘My Condom, My Lube’ Video Released in Ghana

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Posted by Lucile Scott, November 7, 2014


In October, the Centre for Popular Education and Human Rights - Ghana (CEPEHRG) released a series of videos to educate gay men, other men who have sex with men (MSM), and transgender individuals (collectively, GMT) about the importance of using non-oil-based lube along with a condom every time they have sex as part of the GLAM (Global Lube Access Mobilization) project. GLAM is sponsored by amfAR, AVAC, COC Netherlands, and International Rectal Microbicide Advocates (IRMA) and funds innovative projects that promote better access to safe, affordable, condom-compatible lubricant in sub-Saharan Africa.

blog-post-IMG-20140926-WA0003.jpgA CEPEHRG peer educator performs outreach about the importance of condom-compatible lube. Using condom-compatible, water-based lubricant during anal sex prevents condom breakage and rectal inflammation that can increase risk of contracting HIV. However, despite the fact that condom-compatible lube is an essential part of safer sex, access to it remains scarce in most parts of the world. In one study conducted by researchers at John Hopkins University, only 25% of MSM surveyed in Botswana, Malawi, and Namibia used water-based lube during intercourse.

Lack of knowledge about the importance of using condom-compatible lube is one barrier to improving access to it. High cost is also a major impediment, and CEPEHRG hopes that the videos will not only increase awareness among GMT in Ghana, but also amp up advocacy efforts to improve access to free or affordable lube. The HIV rate among MSM in Ghana is approximately 17.5%, compared to 1.4% among the general population.

“Apart from CEPEHRG, most of the sexual health organizations in Ghana distribute only condoms—no lubricant, so most gay men resort to non-condom compatible, oil-based lubricants if they are out of the water-based lubricants they get from CEPEHRG and can’t afford the expensive KY jelly at the Ghanaian pharmacies,” says CEPEHRG’s Joseph Ochill.

CEPEHRG was the recipient of a 2014 GLAM grant. For more information on how to become a 2015 GLAM grantee, check in March. You can also download The GLAM Toolkit here and start advocating for increased lube access in your area today.

The Impact of Local HIV Expertise in Africa

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Posted by Lucile Scott, October 20, 2014

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The meeting attendees visit the offices of GMT Initiative grantee partner HOYMAS in Nairobi.

Despite the fact that men who have sex with men (MSM) are 19 times more likely to have HIV than members of the general population, 80–90% of gay men and other MSM in low- and middle-income countries do not have access to HIV prevention and care services, according to the World Bank. amfAR’s GMT Initiative has provided small grants to nearly 200 grassroots, GMT-led HIV organizations to help them improve and scale-up the HIV services they provide for GMT, often in countries where homosexuality is highly stigmatized or illegal. “The GMT community itself knows how to best reach other GMT,” says Kent Klindera, director of the GMT Initiative. “We are often the first donor for fledgling groups that are of the community, for the community, and by the community, and for me, success is the grantee organizations being picked up by larger donors, like PEPFAR, the Global Fund, and national governments.”

These donors generally fund large, national NGOs and securing their grants requires formalized data collection and program evaluation systems, and strong financial management and strategic planning. Many GMT Initiative grantee partners have not only successfully established HIV testing, treatment, support, and awareness services for GMT in their communities, but have also helped to build GMT advocacy movements, many of which have successfully advocated for their government to include GMT in its national HIV plan for the first time. However, most GMT Initiative grantees are community activists with little prior experience running organizations and limited knowledge about how to document their programs’ success to secure more funding.

MAAYGO’s Kennedy Otieno presents during the meeting.

To help them develop this organizational expertise, the GMT Initiative has provided grantees with technical assistance since its inception. Now, with financial support from Johnson & Johnson, the GMT Initiative is linking 10 grantees in Africa and Latin America with a local expert of their choice to work together on a more formal and ongoing basis. “Donors often have meetings to bring grantees together to build their skills, but after the three or four day training, they go home without enough knowledge to actually use the skills,” says Kent. “This model recognizes that there is expertise locally and those experts can work with grantees over an extended period.”

Recently, amfAR held a meeting in Nairobi, Kenya, for the six African grantees in the program and their mentors to discuss their progress and ongoing challenges.  In Kisumu, Kenya, Men Against AIDS Youth Group (MAAYGO) is mentored by Dancan Omiendo, who currently works at ICAP, an international NGO, and previously managed a national capacity-building program while working at LVCT Health, a PEPFAR-funded NGO in Nairobi. Originally, Duncan offered MAAYGO his professional expertise on a volunteer basis, and the amfAR funding has allowed him to work with them more closely and regularly.

Alternatives-Cameroun’s Yves Yomb (right) with John Mathenge (left), director of HOYMAS.  
Alternatives-Cameroun’s Yves Yomb (right) with John Mathenge (left), director of HOYMAS.

“When amfAR came in we had some gaps in terms of organizational systems,” says Dancan. “We didn’t have a good organizational framework or indicators to measure, and we didn’t have good data collection and reporting tools.” After two years of amfAR support, that has changed. “Now, we are able to monitor the progress of our programs,” says Kennedy Otieno, health and programs coordinator at MAAYGO. With Duncan’s guidance, they have also managed to triple their budget during that time.

Yves Yomb, the executive director of Alternatives-Cameroun, which has been receiving amfAR funding since 2008, has worked with his mentor to improve Alternatives’ monitoring and evaluations system and to develop a formalized curriculum to train GMT peer educators. Alternatives is now using their experience to support newer GMT organizations in Cameroon, where homosexuality is illegal and LGBT are regularly jailed and subjected to violence. “Alternatives-Cameroun was the first LGBT organization in Cameroon and in the French part of Africa, and we are a kind of mentor for the new groups,” says Yves. “It is because we received the support of the GMT Initiative who believed in us and our project that we have had the opportunity to help create an LGBT community in Cameroon.”

Homosexuality is also illegal in Kenya, and earlier this year MAAYGO’s offices were raided by police. When asked what motivates him to do this work despite the risk, Kennedy answered, “In 2005, 6, 7, and 8, I saw the majority of my colleagues dying because of HIV. That is when I said, ‘We need to come out and start talking openly about these issues. If we continue hiding, we are only going to be wiped out by HIV.’ I’m a gay man and I know what challenges my community has.”

Apply to Be a 2015 amfAR HIV Scholar

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Posted by Lucile Scott, September 18, 2014

For the third consecutive year the GMT Initiative is teaming up with the Center for LGBT Health Research of the Graduate School of Public Health at the University of Pittsburgh to offer scholarships for four researchers from low- and middle-income countries to learn more about HIV prevention and care programs among GMT. The four amfAR HIV scholars will undertake five months of graduate level public health study at the Pittsburgh campus. Course topics include LGBT health research, research methods, and grant writing. The scholarships include round-trip travel to the U.S., housing, and a modest stipend.

The program aims to strengthen GMT community-based research and responses to HIV, often in areas where little data about HIV among GMT currently exists and where stigma and discrimination deter many GMT from seeking HIV testing and services. By the end of their stay, scholars will have not only improved their research skills, but also drafted a proposal for researching and implementing culturally appropriate strategies to improve HIV services in their respective regions that they will present to amfAR staff for potential funding.

“The strategies that work best for addressing HIV are those developed by community-based scholars and activists, and they have to have research data or their brilliant strategies won’t get funding,” says Dr. Ron Stall, chair of the Department of Behavioral and Community Health Sciences at Pitt Public Health. “The scholars are local heroes often doing this work at great risk to themselves, and we invest in them to help them get their programs off the ground.”

amfAR’s 2014 scholars are Friedel L. Dausab from the Society for Family Health in Windhoek, Namibia;  Kiromiddin Gulov from Equal Opportunities in Dushanbe, Tajikistan; Macland Njagi from IshtarMSM in Nairobi, Kenya; and Dr. Vorapot Sapsirisavat from HIV-NAT/Thai Red Cross AIDS Research Centre in Bangkok, Thailand. With amfAR’s support, each of these scholars are now conducting GMT-specific research back home and helping expand the international health field’s understanding of HIV epidemics in those contexts. “What amfAR is doing is really important and innovative,” says Dr. Sapsirisavat. “You can’t stop HIV in the developing world without investing in community-based research.”

Find out how to apply here.

Grassroots Growth in Mexico

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Posted by Ben Clapham, September 3, 2014

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amfAR’s Ben Clapham (center) with CDIJ’s Amaranta (left) and Amaya (right).

I first visited Centro de Desarrollo e Investigación sobre Juventud, A.C. (CDIJ) in Campeche, Mexico, in mid-2012, shortly after the organization’s founding.  At the time, CDIJ consisted of a dedicated team of just three people, all under 30, who worked on a volunteer basis out of the director’s house. The grant they received from amfAR that year to support their work among Mayan GMT was their first ever outside funding, and I came to help the young organization develop strategies to increase their visibility. They were the essence of a grassroots GMT organization, and it was truly motivating to see this youth-led organization attempt to do so much with so few resources.

Due to this dedication and the effectiveness of their early efforts, CDIJ now receives funding not only from amfAR, but also from other international donors, including the Global Fund. More importantly, they are the first GMT organization in Mexico to sign a Memorandum of Understanding with the Ministry of Health. It states that the government will support and fund their work to improve GMT’s access to health services.

During a visit last week, I found myself seeing a whole new CDIJ. Upon my arrival, I was greeted at CDIJ’s new office space by a team that has more than tripled in size and that consists of a mix of paid and unpaid staff. They now have an office that looks like a gorgeous Mexican hacienda, complete with a sun-drenched terrace. When I first met the executive director, Antonio Maldonado, he was a little unsure about his new role, but he clearly possessed the motivation and desire for his work. Two years later it is as if I am meeting someone completely different. Antonio had every detail planned for my visit and he was leading his staff with confidence. “Antonio is a model for me. He has shown me that I am worth something and that I can and must help trans here in Campeche,” said Amaranta, CDIJ’s first trans staff member.

Generally, organizations focus on one population or the other, and CDIJ is one of few GMT organizations in the world that works closely with men who have sex with men and also has a strong trans-led program. The team has also established several other exciting programs. They provide HIV testing and counseling, host a support group for trans indigenous women, provide peer education and outreach to the community, and train healthcare workers at government-run facilities about how to address LGBT health needs.

I was so impressed by CDIJ’s growth in two short years. They truly represent what the GMT Initiative is all about—funding small, grassroots GMT organizations to increase their capacity so they can receive bigger grants from other international and local donors. I left Campeche feeling extremely proud to work at amfAR and be a part of a foundation where I get to experience these small but ever-so-important victories.

GMT Advocates Get Active at IAC

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Posted by Ben Clapham, August  4, 2014

Simon Cazal, executive director of SOMOSGAY, a GMT Initiative grantee partner in Paraguay, presents during the International AIDS Conference.

When I arrived in Melbourne, Australia, for the International AIDS Conference (IAC), the mood was quite somber due to the tragic downing of Malaysian Airlines flight MH17, which had delegates travelling to the conference on board. But despite the loss, the conference went on, and there was even a sense of energy and excitement among the GMT activists who were present.

At the 2012 IAC in Washington, D.C., GMT issues were not very well represented, but this year there were many more sessions addressing GMT. This inspired a sense of accomplishment among the GMT delegates, whose intense advocacy efforts helped to bring about this change.

I had the pleasure of organizing one of those GMT sessions with Michael Joyner, director of ViiV Healthcare’s Positive Action program, which funds amfAR’s Evidence in Action program. The session, "Evidence in Action: Creating Evidence-Based Programming for Men Who Have Sex with Men and Transgender People," took place in the Global Village—an area of the conference center that houses community  networking zones, booths for community organizations, and stages for fashion shows and cultural performances. Fittingly, the session attendees were mostly community activists and program implementers.

Evidence in Action was established in 2012. As part of the program, grantee organizations work with local researchers with expertise in GMT HIV programming to conduct formalized evaluations of their programs. Through this process, the grantees produce official data on the success of their programs, which can help them get increased funding and reproduce their effective strategies on a larger scale. In addition to Michael and me, our panel included representatives from participating GMT Initiative grantee partners and their evaluators from Belize, Paraguay, El Salvador, and Grenada.

This was the first time that participants in the program presented their results, and we were very curious to see how the relationships between the community implementing partners and the researchers had worked. I was very pleased to hear that the experiences had been quite positive, and that the data showed that the organizational capacity of our community partners had improved, allowing them to broaden the impact of their services.

For example, C-NET+,  an organization in Belize, presented data showing that their home care program was able to expand to provide care to more than 50 GMT living with HIV, and that the patients in the program had a 100% adherence rate to their antiretroviral therapy. Previously, it had been difficult to get GMT to allow the outreach workers into their homes due to the extremely harsh stigma and discrimination in Belize surrounding HIV and homosexuality. SOMOSGAY, in Paraguay, presented data showing that their outreach and testing services resulted in a 20% increase in the number of GMT getting tested for HIV in Asuncion.

What is most exciting is that this data was created by and for the community. Unfortunately, too often, outside researchers come into community settings to gather data about GMT that then becomes “theirs.” They do not share it with the community, and it has little impact on their lives. The unique aspect of Evidence in Action is that the communities on the ground that need the data most for their advocacy and fundraising efforts have ownership of it. The community partners who participated in the session told me that this data represents far more than just indicators and results for a project. As Eric Castellanos, executive director  of C-NET+,  said, “This data legitimizes our existence as advocates fighting for the rights and health of gay men, other men who have sex with men, and transgender people.”

Dr. Paul Semugoma Discusses His Fight for LGBT Rights in Uganda

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Posted by Lucile Scott, July 10, 2014

Dr. Paul Semugoma and Amirah Sequeira from the Student Global AIDS Campaign during amfAR’s “Making AIDS History: From Science to Solutions” event on Capitol Hill

Dr. Paul Semugoma will be honored by amfAR, the International AIDS Society and the Elizabeth Taylor AIDS Foundation with the 2014 Elizabeth Taylor Human Rights Award at the 20th International AIDS Conference in Melbourne, Australia, July 20. The award recognizes exemplary efforts to advance human rights in the field of HIV and AIDS.

Dr. Paul, as he is known to patients and friends, was among the first physicians in Uganda to provide HIV care and education for MSM. In 2009, he publicly opposed Uganda’s Anti-Homosexuality Bill after it was introduced in Parliament.  The bill, which was signed into law earlier this year, punishes same-sex sexual activity with life in prison and criminalizes the promotion of homosexuality—a category that includes providing HIV services that target LGBT. Due to his work advocating for LGBT rights, Dr. Paul was placed on a Ugandan “wanted list,” and in 2012 fear for his safety caused him to move to South Africa with his partner. This February, shortly after the Anti-Homosexuality Bill became law, he was detained at a Johannesburg airport and nearly deported back to Uganda, prompting an outpouring of support from LGBT advocates worldwide. In April, Dr. Paul spoke on a panel atMaking AIDS History: From Science to Solutions,” an amfAR-sponsored briefing on Capitol Hill. The following is excerpted from that event.

amfAR: Why did you begin addressing HIV among MSM in Uganda at a time when few other advocates or doctors were doing so?

Dr. Paul Semugona: When I started practicing medicine in Uganda, people really didn’t believe that HIV was a problem among MSM, and MSM were told that you get HIV from women, so they thought they were okay. Through a process of self-teaching, I realized that I had a big problem because I identified with a community that had no knowledge of a very big problem—HIV. So I made a program for my people in my country, Uganda.

amfAR: How has the Anti-Homosexuality Law impacted the ability of MSM to access HIV treatment and care in Uganda?

Dr. Paul: My friends are being arrested. The clinics where they go to get drugs are getting raided for promoting homosexuality. The doctors who are supposed to look after them are getting guidelines from the government that they are not supposed to promote homosexuality, so they will not tell MSM that getting HIV is a problem in the community, and they will not give them condoms or lubricant. MSM are being denied knowledge, being denied health, and being denied advocacy. But we can’t stop talking about the link between HIV and gay sexuality. Please don’t keep quiet. Silence is death. We are not promoting homosexuality. We are trying to control a disease, a virus.

amfAR: Could you describe your current work at Anova Health Institute in Johannesburg?

Dr. Paul: In South Africa, there is still a lot of stigma and discrimination towards gay men, but our patients know they can talk to their doctor about their experiences. We are given space where we can access medicines and care and protect our partners. All the advances happening in HIV in the world are accessible here at home. It gives me a belief that something like that can happen even in a country like Uganda. Uganda is not a good place to be as a gay person, but I am a gay African, and I will not let them take that identity away from me.