Part (2) Integrating HIV & STI Programs in LGBTIQQ, MSM, WSW, Sexuality, Gender, Orientation, Health and Wellness plans (Part II)

                                                                          A 2 day Workshop

By the end of two days, participants will have:

been introduced to human rights framing their inclusion and self determination

been introduced to the concepts around acceptability of services as a key aspect of effectiveness

been introduced to health literacy

been introduced to community empowerment

been introduced to the three zero’s

been introduced to Sexuality, Gender, Orientation and health

been able to plan around all integration requirements

Human rights: 

The action points:

i. Identify protection parameters of human rights for all members of each key population.

ii. Map out legislators and other government authorities should establish and enforce anti discrimination and protective laws, derived from international human-rights standards, in order to eliminate stigma, discrimination and violence faced by key population groups and to reduce their vulnerability to HIV. 

iii. Identify various HIV & STI needs of the community.

iv. Identify access points to quality health care and provide information as a human right. It includes the right to appropriate quality health care without discrimination. 

v. Seek out mechanisms to work with health-care providers and institutions. One of the best-practice to agree upon is serving beneficiaries based on the principles of medical ethics and the right to health. Health services should be accessible to all. HIV programmes and services can be effective only when they are acceptable and high quality and widely implemented. Poor quality and restricted access to services will limit the individual benefit and public-health impact of the recommendations contained in this guidance document. 

vi. Seek out mechanisms to work with law enforcement. Access to justice is a major priority for key populations, due to high rates of contact with law enforcement services and the current illegality of their behaviours in many countries. Access to justice includes freedom from arbitrary arrest and detention, the right to a fair trial, freedom from torture and cruel, inhuman and degrading treatment and the right, including in prisons and other closed settings, to the highest attainable standard of health. 

vii. The freedom from fear is an important pillar. The protection of human rights, including the rights to employment, housing and health care, for key populations it requires collaboration between healthcare and law-enforcement agencies, including those that manage prisons and other closed institutions. Detainment in closed settings should not impede the right to maintain dignity and health.

Acceptability of services is a key aspect of effectiveness:

The action points:

1. All interventions to reduce the burden of HIV must be respectful, acceptable, appropriate and affordable to recipients in order to enlist their participation and ensure their retention in care.
2. Services delivery must often employ appropriate models of service delivery with expertise in HIV. 
3. There is a need to build service capacity on both fronts. Services that are acceptable are more likely to be used in a regular and timely way. 
4. Consultation with organizations led by and including community outreach workers in service delivery are effective ways to work towards this goal. 
5. Mechanisms of regular and ongoing feedback from beneficiaries to service-providers will help inform and improve the acceptability of services.

Health literacy:

The action points:

1. Develop readily usable health and treatment literacy materials in understandable language.
2. Provide opportunities for information to be available to influence decision-making on HIV risk behaviours and their health-seeking behaviour. 
3. Ensure health services regularly and routinely provide accurate health and treatment information. At the same time health services should strengthen providers’ ability to prevent and to Integrate service provision: Multiple co-morbidities and poor social situations for example, HIV, viral hepatitis, tuberculosis, other infectious diseases and mental health conditions are often linked to stress associated with persistent social stigma and discrimination. 
4. Integrate services to provide the opportunity for patient-centred prevention, care and treatment for the multitude of issues. In addition, integrated services facilitate better communication and care. When integration is not possible, strong links among health services should be established and maintained.

Community empowerment:

The action points:

1. Engage participants in a community empowerment session where they are supported to form enduring self help groups to address for themselves the structural constraints to health, human rights and well-being that they face, and improve their access to services to reduce the risk of acquiring HIV. 
2. Make sure that community empowerment is planned and an essential approach that underlies all the objectives. 
3. Community participation and leadership in the design, implementation, monitoring and evaluation of programmes are also essential. Participation and leadership help to build trust with those whom programmes are intended to serve, make programmes more comprehensive and more responsive to needs and create more enabling environments for HIV prevention.

Three zero’s:

The action points:

1. Key population groups should be empowered to plan activities that lead to zero deaths by HIV; zero stigma; and zero discrimination. 
2. Align downstream plans with what is taking placing at the upstream level. This is the only way realistic plans are made.

Sexuality, Gender, Orientation and health:

The action points:

1. Point out how these themes are recurring and affect the way key populations interact or seek social services in situations that are stigmatizing and discriminatory. 
2. Key populations should be empowered to examine and articulate the sexuality, gender, orientation and health needs with the goal for quality life and wellness.
3. Combine all action points into activity lists and identify required resources.