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Gender Strategies in Concentrated Epidemics Case Study Series

In 2009, AIDSTAR-One developed a technical brief to explore the research and program literature on the extent to which HIV programs are addressing the unique gender-related needs of key populations in concentrated epidemics. While there is emerging literature on the gender-related needs of key populations, how programs are addressing these needs or integrating gender strategies into their activities is not well documented or disseminated. AIDSTAR-One developed nine case studies that expand on the technical brief, providing an in-depth look at HIV programs working with and for key populations in South and Southeast Asia, Eastern Europe, Latin America, and the Middle East. Finally, the project compiled a report identifying findings and recommendations across all nine case studies.

Gender Technical Brief Cover

Integrating Gender into Programs for Most-at-Risk-Populations

Gender inequity is a fundamental driver in the HIV epidemic, and integrating strategies to address gender inequity and change harmful gender norms is an increasingly important component of HIV programs. Integrating gender strategies into programs targeting key populations, which include men who have sex with men, transgender people, people who inject drugs, and male, female and transgender sex workers, whether in mixed or concentrated epidemic countries is much less prevalent. The purpose of this technical brief is to provide program managers and planners with an overview of the recent research literature on gender-related constraints effecting key populations, future program approaches, and gender-related challenges that should be considered in programs to reduce HIV risk among key populations.

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Findings Report: Integrating PEPFAR Gender Strategies into HIV Programs for Most-at-Risk Populations

While there is emerging literature on the gender-related needs of key populations, how programs are addressing these needs or integrating gender strategies into their activities is not well documented or disseminated. AIDSTAR-One developed nine case studies that expand on the Integrating Gender into Programs with Most-at-Risk Populations technical brief, providing an in-depth look at HIV programs working with and for key populations in South and Southeast Asia, Eastern Europe, Latin America, and the Middle East. AIDSTAR-One also developed a report, featured below, that includes findings and recommendations that apply across all nine case studies.

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STIGMA Foundation in Indonesia Case Study

Integrating strategies to address gender inequity and change harmful gender norms is an increasingly important component of HIV programs, including those targeting key populations. This case study (one of nine in a series) documents Indonesia’s STIGMA Foundation, which uses a peer outreach model to help men and women who inject drugs live safer, healthier, more productive lives through community organizing, advocacy, and networking.

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Outreach to Most-at-Risk Populations through SIDC in Lebanon

More than Just HIV Prevention

Successful outreach to key populations recognizes the sociocultural context and particularly the gendered norms in which key populations live. This case study (one of nine in the Gender Strategies in Concentrated Epidemics series) documents how outreach workers in Lebanon raise awareness about how gender norms can increase HIV risk; deliver basic information on HIV, hepatitis, and other STIs; offer counseling to support positive behavior change, and distribute free condoms, syringes, and lubricants.

Cover of MARPS Cambodia Case Study

PRASIT: Using Strategic Behavioral Communication to Change Gender Norms in Cambodia

Programs focused on promoting gender equity and combating detrimental gender norms play a key role in HIV prevention. This case study (one of nine in the gender concentrated epidemics series) documents how the PRASIT program in Cambodia targets entertainment workers, their mainly middle class and male clients, and males who have sex with males using strategic behavior communication. Although the programs vary in their approaches, strategies employed by PRASIT have focused on community outreach, mass media campaigns, and peer education.

SANGRAM India Case Study

SANGRAM’s Collectives in India

Integrating strategies to address gender inequity and change harmful gender norms is an increasingly important component of HIV programs. However, gender integration among programs targeting key populations is much less prevalent. This case study (one of nine in the gender strategies in concentrated epidemics series) reviews how SANGRAM, a women-led network of collective empowerment groups in India, is developing and administering projects that promote and protect the rights—and health— of key populations.

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Sex Work and Life with Dignity: Sex Work, HIV, and Human Rights Program in Peru

In Peru, where cultural norms emphasize women's subordination and the importance of masculinity, programs with a focus on gender—particularly those involving sex workers—are often underfunded and underrepresented. This case study (one of nine in the gender strategies in concentrated epidemics series) describes how three organizations focused on sex workers and transgender and transsexual people have joined together to advance the rights of sex workers. The Sex Work, HIV, and Human Rights Program uses a democratic and participatory approach in order to raise awareness of human rights and advocate for sex workers' rights on both national and local levels.

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Empowering Men Who Have Sex with Men to Live Healthy Lives in Colombia

Together, a support network plus access to legal and psychological support are essential components of HIV programming for most-at-risk populations. In Colombia, obtaining this support is difficult for many members of the lesbian, gay, bisexual, and transgender (LGBT) community due to pervasive stigma and discrimination. Bogotá's LGBT Community Center was founded in order to help fill this need and serves a clientele comprised mainly of men who have sex with men. This case study (one of nine in the gender strategies in concentrated epidemics series) examines the center's efforts to provide a social and educational base for its clients while also advocating for their rights.

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Breaking New Ground in Vietnam

Gender norms affect the behavior and life choices of both men and women. In Vietnam, these norms sometimes drive people into situations where they are at increased risk of violence, STI acquisition, and/or incarceration. This case study (one of nine in a series) examines CARE International's STEP program, which seeks to ensure that both men and women have equal access to services to prevent STIs, safeguard their health, avoid gender-based violence, and participate in income-generating activities.

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Giving Voice to Transgender Communities through ASPIDH in El Salvador

Different Needs But Equal Rights

Although transgender individuals are a highly vulnerable segment of El Salvador's population, the national political climate has only recently begun to support HIV programming that is tailored to their needs. Additionally, limited access to medical services and legal protection and considerable societal stigma and discrimination means that organizations working with transgender individuals must meet a variety of complex and varied needs. This case study, one of nine in the gender strategies in concentrated epidemics series, describes the challenges and successes of the Solidarity Association to Promote Human Development (ASPIDH), an NGO that promotes transgender rights via sensitization, education, and advocacy activities.

Russia Case Study Cover

"Follow the Voice of Life": HIV Prevention and Empowerment of MSM in Orenburg, Russia

Gender inequality is a major contributor to men who have sex with men's (MSM) vulnerability to HIV. Understanding the gender dynamics of MSM, as well as their specific sexual identity issues and concerns, is important for delivering effective HIV services. This case study (one of nine in the gender strategies in concentrated epidemics series) describes how an NGO in Russia created an MSM-supportive environment and provided free access to HIV services through its "Follow the Voice of Life" program. Developed with the active participation of MSM, this community-based program offers a range of peer services and professional psychological counseling & support.