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[email protected] www.nfi.net. Focused interventions with males who have sex with males The missing piece Arif Jafar India Naz Foundation International. [email protected] www.nfi.net. Whom are we primarily reaching right now? Kothis – feminised males who have sex with other males

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india@nfi net www nfi net

[email protected]

Focused interventions with males who have sex with males

The missing piece

Arif Jafar

India Naz Foundation International

india@nfi net www nfi net1

[email protected]

Whom are we primarily reaching right now?

Kothis – feminised males who have sex with other males

Gay population (limited numbers only)

Hijra (again limited numbers only)

india@nfi net www nfi net2

[email protected]

What is the coverage?

Total 152 organisations working on MSM and TG issues

99 are MSM community based organisations

Only 11 are exclusive Hijra programmes

india@nfi net www nfi net3

[email protected]

What is missing?

Rural MSM populations

At present the vast majority of the MSM programmes are located in urban areas with significant populations.

india@nfi net www nfi net4

[email protected]

What is missing?

Male partners of kothis / feminised / receptive MSM

Most of the programmes are designed to reach self identified kothis and a larger population of society defined“normative” males from the general male population is generally left out because they tend to be non-identified.

india@nfi net www nfi net5

[email protected]

What is missing?

MSM who are also injecting drug users

Insufficient data on male to male-to-male sexual behaviours among injecting drug users and vice versa, although anecdotal evidence does exist.

india@nfi net www nfi net6

[email protected]

What is missing?

Hijras and other transgender populations

Looking at the size of the hijra population in the country

and the risky behaviours amongst the community, 11 programmes are certainly not enough.

india@nfi net www nfi net7

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What is missing?

Self-identified adolescent MSM

Are there any programmes specifically designed to reach adolescent self-identified MSM, or those who have male-to-male sexual behaviours?

india@nfi net www nfi net8

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What is missing?

Female partners of MSM

Most of the programmes, so far, have not been able to effectively reach the female partners, including wives, of males who are have sex with males.

Possibilities of cross-infections and re-infections.

india@nfi net www nfi net9

[email protected]

What is missing?

Low coverage

In a country of over 1 billion people, 152 services organisations providing HIV services for MSM is certainly grossly inadequate

india@nfi net www nfi net10

[email protected]

What is missing?

Peer leadership

Global evidence indicates that the most effective strategy for building sustained risk reduction strategies for MSM are those that are led by MSM and are multi-leveled.

india@nfi net www nfi net11

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Other issues?

Mobility and migration

Class, poverty and education

india@nfi net www nfi net12

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Recommendations

Mobility

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