Guidance for Applicants to the Global fund to Fight AIDS, TB and Malaria Round 8 Call for proposals 28 February 2008

Transcription

1 Guidance fr Applicants t the Glbal fund t Fight AIDS, TB and Malaria Rund 8 Call fr prpsals 28 February 2008 Sexual Minrities Backgrund: The bard f the Glbal Fund t Fight AIDS, TB and Malaria at its 16 th meeting in Kunming, China in Nvember 2007 recgnized the imprtance f addressing gender issues, with a particular fcus n the vulnerabilities f wmen and girls and sexual minrities, in the fight against the three diseases. It therefre decided that fr Prpsals fr Rund 8 t encurage applicants t submit prpsals that address gender issues, with a particular reference t the vulnerability f wmen and girls and sexual minrities. While the need t address the particular needs f vulnerable grups and mst at risk ppulatins has been part f the prpsal prcess since the utset f the Glbal Fund, this Bard decisin recgnizes the need t give additinal emphasis t this aspect f prpsal develpment. In rder t assist ptential applicants in develping their prpsals fr Rund 8, UNAIDS has develped the fllwing guidance n sexual minrities. Sexual minrities: In the cntext f HIV risk, the sexual minrities f greatest cncern are men wh have sex with men and transgender ppulatins. Men wh have sex with men include bth gay-identifying and nn gay-identifying men, and identities and scial rles vary greatly in different lcal cntexts. Transgender ppulatins als include a great variety f scial rles and identities in different lcal cntexts. Prpsal develpers and prgramme planners shuld cnsult lcally t ensure terminlgy used is understandable, inclusive and nn-stigmatizing. It may be useful fr a prpsal t use the terms men wh have sex with men r transgender fr the purpses f prpsal submissin, while, if relevant, als nting and defining the preferred terminlgy used lcally 1. Any prpsal will need t make clear the link between attentin t the identified ppulatins f cncern and the transmissin dynamics f the epidemic in the lcal cntext. 1 Further guidance n apprpriate terminlgy is given in the UNAIDS Terminlgy Guidelines available here: and in the UNESCO Guidelines n Language and Cntent in HIV- and AIDS-Related Materials URL_ID=35417&URL_DO=DO_TOPIC&URL_SECTION=201.html Uniting the wrld against AIDS 1

2 Elements t be cnsidered in the situatin analysis (bth the epidemic and respnse) Sex between men ccurs in every culture and sciety, thugh its extent and public acknwledgement vary frm place t place. There is a need t empirically assess the rle that sex between men is playing in the natinal HIV epidemic, and tailr natinal, state and lcal HIV strategies fr men having sex with men t epidemilgical and scial data, taking int accunt the diversity f men wh have sex with men and the specific scicultural circumstances and risks that they face. Additinally, transgendered peple have in many cntexts faced extreme vulnerability t HIV as a result bth f high HIV risks and severe human rights abuses and the situatin facing transgenderd peple and an empirical assessment f the rle that sex with transgendered peple is playing in the epidemic shuld be taken int accunt. Mre guidance n identifying needs fr and tailring MSM prgrammes is prvided in UNAIDS Practical Guidelines fr Intensifying HIV Preventin. The table 2.2 in page 49 summarizes the specific HIV preventin requirements and needs fr the key audiences. versal_access_en.pdf). Anther useful reference dcument is UNAIDS Plicy Brief: HIV and Sex Between Men (2006) ( en_men_sex_technical_plicies.asp), and fr thse wrking in Latin America and Caribbean als Derechs humans, salud y VIH. Guía de accines estratégicas para prevenir y cmbatir la discriminación pr rientación sexual e identidad de géner by UNAIDS, Centr Internacinal de Cperación Técnica en VIH y Sida and GCTH. ( Ratinale fr including in the prpsal actins cncerning sexual minrities under respective Service Delivery Areas Behaviural change prgrammes targeting ppulatins at especially high risk, amng them men wh have sex with men and transgendered peple, are amng the mst csteffective preventin interventins available and represent a cre cmpnent f any natinal HIV preventin prgramme. The reasns fr including MSM and transgender prgrammes in the prpsals may include: Ptential fr rapid spread within the ppulatin, if the rate f unprtected anal intercurse is high. Uniting the wrld against AIDS 2

3 High ptential HIV preventin benefit. A range f respnses aimed at reducing the risk behaviurs and vulnerability t HIV f men wh have sex with men has prved successful in a variety f settings. Ptential increase in risk behaviurs due t preventin fatigue and AIDS cmplacency. Prgrammes and services which meet the rights and needs f men wh have sex with men and transgendered peple are nt nly intrinsically valuable, they are als a critical means fr imprved health utcmes fr them and the brader cmmunity. Hw t define and quantify the target ppulatin(s) (als cnsider gender and equity issues) Sex between men ccurs in diverse circumstances and amng men whse experiences, lifestyles, behaviurs and assciated risks fr HIV vary greatly, and it encmpasses a range f sexual and gender identities amng peple in varius scicultural cntexts, that shuld be taken int cnsideratin n tailring the respnse. In lw level epidemics the UNAIDS Practical Guidelines fr Intensifying Preventin nte that the essential package f services fr men wh have sex with men shuld be available in at least all majr urban areas and accessible thrugh safe spaces. In cncentrated, generalized and hyper-endemic settings it is imprtant t ensure high cverage f men wh have sex with men everywhere. Prgrammes shuld be prmted fr men wh have sex with men and transgendered peple wh may be especially vulnerable t HIV infectin, such as sex wrkers, injecting drug users and thse in settings such as military facilities and prisns where vilence and sexual cercin may take place. A specific effrt shuld be made t meet the preventin infrmatin and service needs f transgendered persns, wh may nt identify themselves as MSM. In additin access t infrmatin and preventin and care services fr female partners f men wh have sex with men shuld be ensured. Main (imprtant) activities t be cnsidered Recgnitin f the rights f peple with different sexual identities, bth in law and practice, cmbined with sufficient, scaled-up HIV prgramming t address HIV and health needs are necessary and cmplementary cmpnents fr a successful respnse. Cuntries may chse t priritize ne r the ther cmpnent but bth are required t deal effectively with the epidemic as it relates t sex between men. Uniting the wrld against AIDS 3

4 Sme f the recmmended preventin measures fr men wh have sex with men and transgendered peple are: Guarantee f human rights; remval f legal barriers t access preventin and care, such as laws that criminalize sex between males. Cnsistent and prper use f cndms, including cnsistent access t cndms and water-based lubricants. Availability f quality treatment fr sexually transmitted infectins and referral fr HIV services. Availability f high quality HIV-related services (vluntary cunselling and testing, specialized clinics, etc.). Empwerment f gay, lesbian, bisexual and transgendered cmmunities t participate equally in scial and plitical life. Availability f safe virtual r physical spaces (fr example telephne htlines, r drp-in centres, respectively) fr men wh have sex with men t seek infrmatin and referrals fr care and supprt. Training and sensitizatin f health-care prviders t avid discriminating against men wh have sex with men. Access t medical and legal assistance fr bys and men wh experience sexual cercin r vilence. Availability f specific and targeted infrmatin n preventin and risk reductin strategies designed t appeal t and meet the needs f men wh have sex with men. Availability and prmtin f hepatitis immunizatin. Linkages between Service Delivery areas A cmprehensive respnse t the needs f men wh have sex with men and transgendered peple includes services frm numerus service delivery areas especially under preventin and supprtive envirnment. Addressing gender, human rights and equity issues Discriminatin against men wh have sex with men and transgendered peple is likely t impede scaling up f prgrammes. Legal and plicy refrms t prmte human rights and access t health services f men wh have sex with men and transgendered peple, shuld be undertaken, where barriers exist. There is need t respect, prtect Uniting the wrld against AIDS 4

5 and fulfill the rights f men wh have sex with men and transgendered peple and address stigma and discriminatin in sciety and in the wrkplace by amending laws prhibiting sexual acts between cnsenting adults in private; enfrcing antidiscriminatin; prviding legal aid services, and prmting campaigns that address hmphbia. Key implementing partners t be cnsidered Men wh have sex with men and transgendered peple, especially thse living with HIV, shuld be engaged in the design, implementatin and mnitring f prgrammes as well as in Natinal AIDS Cuncils. Nngvernmental and cmmunity-based rganizatins shuld be supprted, including rganizatins f self-identified gay men, enabling them t prmte HIV preventin and care prgrammes, and rganizatins f peple living with HIV, addressing issues related t sex between men. Alliances shuld be built between epidemilgists, scial scientists, pliticians, human rights grups, lawyers, clinicians, jurnalists, rganized grups f men wh have sex with men and transgendered peple and ther civil sciety rganizatins. Type and surces f technical assistance which might be required during implementatin The UNAIDS Technical Supprt Facilities help match cuntries technical assistance needs with slutins f the mst well suited technical assistance, and have extensive databases with quality-assured natinal and reginal cnsultants, wh can prvide the necessary supprt quickly, cmpetently and cmpetitively. Frm HIV Preventin Database f Cnsultants, an initiative by UNAIDS in cllabratin with Technical Supprt Facility (TSF) fr suthern Africa, ( yu can find tp quality cnsultants in the main fields f HIV Preventin by technical area, gegraphical area r language. Uniting the wrld against AIDS 5