Sexual Health of Males Who Have Sex With Males in South Asia

Extracted from Pukaar, the newsletter of Naz Foundation International. July 2000.

For a copy of the complete report, contact Naz Foundation International , Palingswick House, 241 King Street, London W6 9LP,UK.

Naz Foundation International is a development agency specialising in providing technical support for the promotion of sexual and reproductive health of males who have sex with males in South Asia. An external review was conducted of two Naz Foundation International partner projects; a project with the Bandhu Social Welfare Society in Dhaka, and the second with Sahodaran in Chennai. The review's purpose was to assess the relevance, quality and results of the work that Naz Foundation has facilitated in recent years. The review was undertaken by JSI(UK) on behalf of the Department for International Development.

Major findings

The initial results of the work undertaken by Naz Foundation, Bandhu and Sahodaran are very impressive. In a short space of time and in conditions which have been complex and not always encouraging:

· Theoretical analysis has been developed.

· Needs assessments have been undertaken.

· Strategies have been devised and projects designed to respond to the identified needs.

· Funding proposals have been written and project funding has been secured.

· Organisations have been established and registered.

· Initial management and administration systems have been developed.

· Staff have been recruited and trained.

· Technical support has been delivered.

· A range of sexual health services and programmes have been effectively delivered.

· A great deal of advocacy has been undertaken.

Not everything is running smoothly or as originally envisaged but this had to be considered within the context of the sensitivity of the issues involved, the inexperience of many of the individuals involved, and the limited human resources available from Naz Foundation to provide technical support.

Naz Foundation

Vision and strategy underpin the Naz Foundation programme. It is perhaps unique amongst community agencies focused on sexual health and male to male sex in South Asia that it truly has a regional perspective and dimension. It has been both responsive and proactive. It has pushed boundaries of understanding and political acceptability while remaining sensitive to local situations. It has been exploratory and flexible while proposing clear strategies and activities. It has developed and used sound theoretical and technical approaches. It has been efficiently implemented.

Bandhu and Sahodaran

They have broken new ground in their attempt to build community-based and managed organisations and responses to the sexual health needs of the least powerful and most vulnerable males who have sex with males. The projects are essentially on track and on target.

Both agencies have created 'safe spaces' in their central offices where men who are stigmatised and marginalised have an opportunity to socialise and to access a range of services openly as males who have sex with males. Very strong outreach programmes have been implemented. In Bandhu an innovative clinic service for STD diagnosis and treatment has been established. Sahodaran has contributed strongly to national advocacy and networking around policy and technical issues related to STDs, HIV and male to male sex.

Some aspects of service delivery such as phone information and counselling, need to be further strengthened. The objective of finding a way to extend services to the female partners of males who have sex with males is not yet successfully addressed. The agencies are not yet able to respond to emerging needs related to care and support for males who have sex with males who have HIV or AIDS.

Both agencies reflect a genuine concern and commitment from males who have sex with males for the health and welfare of their peers. They have to some extent demonstrated that collective action and community building have potential to be realised.

Major recommendations

1. That Naz Foundation pursue its vision and regional strategy to promote and facilitate community-based responses, using the operational framework that has underpinned its work so far, to address the sexual health needs of males who have sex with males, and their female and male partners.

2. That DFID (the UK's Department for International Development) continue its current support to Sahodaran(through Naz Foundation) and Bandhu(through CARE Bangladesh) and fund new project development in other locations.

3. That, with a view to strengthening the capacity of Naz Foundation to operate on a larger scale and address current operational weaknesses, DFID contribute funds to assist the development of the Regional Resource and Training Centre proposed by Naz Foundation.