ACTing Out: Cultural advocacy reduces stigma against MSM in rural south India. ACT Project - SARDM 08 Lotus Sangam, Kumbakonam Tamil Nadu, India

Transcription

1 ACTing Out: Cultural advocacy reduces stigma against MSM in rural south India ACT Project - SARDM 08 Lotus Sangam, Kumbakonam Tamil Nadu, India

2 Community-based organization Founded and run by MSM To support needs of MSM community in Kumbakonam, Tamil Nadu & surrounding rural and semi urban areas Lotus Sangam Through: Meetings, counseling, and advocacy to reduce stigma and discrimination and HIV transmission.

3 Background HIV and MSM in India 2.4 million MSM in India (NACO, 2006) 7.4% overall HIV prevalence for MSM (NACO, 2007) MSM face stigma and discrimination by family, friends and society: Isolated Abuse (verbal, physical) Blackmail (for money, sex) Self-stigma Due to societal pressure majority of MSM marry and may serve as important bridge population Very few research and interventions target rural MSM Results: Risk-taking behavior Health services (refused, reluctant) No justice Unemployment Forced marriage Runaways

4 ACT Project Objectives Improve the lives of MSM and their ability to protect themselves from S&D and HIV by: Opening up a justice channel for rural MSM through their local government (Panchayats) Reducing S&D among community and family members towards MSM Reaching out to hidden MSM in villages with support & services Building Lotus capacity to deliver programs Approach Village street theatre to educate, create empathy and motivate behavior change for stigmareduction towards MSM Non-threatening medium to broach sensitive & taboo issue Large and diverse audience; - mixed gender and age - all hear same message Live performance creates connection between audience and actors, who are MSM

5 The Play: Key Messages Messages delivered in 75 performances in 1 year, 3 districts for 270 panchayat leaders MSM are stigmatized and discriminated by: family, friends and society, and rowdies. MSM, left overpowered, often run away from villages and enter into situations of risk. Panchayat leaders could intervene to bring about justice for MSM. MSM exist in villages MSM behavior is not deviant MSM behavior is not a psychological problem that needs to be treated Forcing MSM into marriage is a detriment to women s lives Parents are not a reason for birth as MSM HIV is one of many dangers that MSM face once they leave their villages Acceptance by family and friends is extremely important MSM who are accepted by family and friends are able to live safe and healthy life

6 Baseline and endline qualitative data collection Key Informant interviews with village leaders Baseline:20 Endline:20 Focus Group discussions with MSM On issues : 5 (~50 people) Positive changes : 4 (~ 40 people) Focus group with10 theatre technical support crew (sound, light, transport providers) Case studies Village leaders-4 MSM-5 Ongoing documentation of reports by Lotus members of changes in their lives. Measurement Strategy Post-performance village leaders feedback forms. Routine monitoring data Acting in our performance group allowed us to realize how much talent we actually have. - ACT Project Actor (MSM)

7 Results - Panchayat Leaders Improved understanding of MSM issues Behavior change Improved social interaction, e.g. publicly greeting, offering tea, lifts Collaboration with Lotus Offering support, publicly speaking out against S&D, referral to Lotus Stepping in to stop harassment of MSM in the village Only after your seeing your performance, I came to know about MSM. Before that, I saw them only in television and at distance while begging in shops. Now, I have understood that I need to respect them. - Panchayat Leader

8 Results - Family & Community Village members exhibited following changes in behavior: Improved understanding of MSM Increased acceptance, respect and social interactions Reduced pressures to marry Willingness to employ MSM Public challenging of stigma and discrimination I was in the fish market, where I usually get teased and harassed. Suddenly one man, who had seen the play in his village, stood up and told the fishmongers they should stop the teasing. He explained about the play and the messages. I was so happy. - MSM Community Member

9 Results - MSM Community 147 hidden MSM self-identify themselves to Lotus team postperformance 47 MSM visited Lotus, 42 MSM counseled, and 19 MSM referred to government hospital for treatment Reduction in self-stigma Gave a reason to live Increased courage to face outside world Realized hidden talents Improved health care seeking I always think people like us should come out openly. In one performance, I openly told the audience about myself [sexuality], birth name and place where I live. I felt so happy about this. - ACT Team Member (MSM)

10 Conclusions/Recommendations S&D towards MSM can be reduced through popular rural theatre More focus needed on rural and semi-urban areas; neglected in MSM interventions I want to go to more villages and spread even more messages about our community. There is so much to share. - ACT Actor (MSM) Reducing stigma and discrimination and increasing reason to live key to successful HIV prevention for MSM

11 Next Steps Replicate and scale up in other districts, at state and national level through: Training of trainers for other MSM networks Developing a Training manual Creating a film version with discussion guide Impact evaluation of scale-up

12 Acknowledgments Special thanks to : World Bank ICRW TNSACS SIAAP NFI (India) INFOSEM UNDP INP+ SAATHII CBOs UNMAAI Consultants Not just our panchayat - you should do this drama in all panchayats. - Panchayat Leader