Increasing Access to HIV/AIDS programming for MSM in the Middle East/North Africa Region

© 1999 Center for Communication Programs, Courtesy of Photoshare

By Kate Killberg, Head Of Team: US, International HIV/AIDS Alliance

Although overall HIV prevalence in the region is low, the Middle East/North Africa (MENA) region has one of the fastest growing concentrated epidemics[1] in the world. In the region, sex between men accounts for nearly one quarter of new infections – these new infections are occurring in a community made especially vulnerable by strong stigma and discrimination against men who have sex with men (MSM).

Under the USAID-funded LMG Project, MSH partners with the International HIV/AIDS Alliance to provide HIV-related services in the MENA region. This program is effectively reaching MSM in a region where such work was once thought to be near impossible. The Civil Society Organizations (CSO) with whom the project works have created linkages with local service providers to offer peer education and support, condom distribution, HIV testing and counseling, and referral for STI diagnosis and treatment for members of this key population.  They have also developed health information materials and training tools in local languages, including Arabic and French. 

The program has had, and continues to have, a significant impact on the lives of MSM in the region, as it has led to new opportunities for personal development (such as life skills and self-esteem building); access to relevant prevention, care and support services; and increased prevention-seeking behavior.

The opening of community spaces, where MSM can safely meet and exchange information, has been essential. The partners have trained teams of peer outreach educators and have developed links among communities of MSM, helping to make them more resilient to stigma and discrimination.

Thanks to the technical support provided by the LMG Project, partner CSOs have developed expertise in key population[2] programming; they have become central actors in the HIV response in their respective countries and are regularly solicited for expertise on MSM programming by other stakeholders.  Their advocacy efforts have contributed to increased awareness of the specific vulnerabilities and needs of MSM among health authorities and service providers.

The program has made an important contribution to MSM community mobilization, empowerment and involvement. It has also contributed to the empowerment of the LGBT community by providing continuous support to the only legal LGBT organization in the region, Helem in Lebanon, and by training and sustaining teams of MSM peer educators, some of whom become activists in their respective countries. Several MSM peer educators from the MENA program went on to found of the M Coalition, the first regional MSM and HIV network, in 2014.

In a region where same sex activity is illegal and/or heavily discriminated against, and where individual and organizational risk is high, by working with local partners to develop leadership in the communities, the Alliance & the LMG Project are improving access to prevention, care and treatment services for those most vulnerable to being affected by HIV.

[1] A concentrated epidemic is an epidemic in which HIV or another pathogen represents more than 5% in any sub-population at higher risk of infection—e.g., drug injectors, sex workers, and men who have sex with men.

[2] WHO describes five “key population” groups at high risk for HIV/AIDS: men who have sex with men, injecting drug users, sex workers, transgender people, and people in prisons.