Negotiating Religious Barriers to Mobilizing and Building Capacity of Key populations (KP) for HIV Prevention in Sub-Saharan Africa Facilitator: Justus Aungo, PhD. Co-Facilitators: Zebedee Mkala and Carlos Laudari Pathfinder International WEWS10

SESSION 1: INTRODUCTION a.General information b.Background to the Workshop c.Objectives of the workshop d.Method and scope of workshop e.Key concepts in the workshop f.Expectation from the workshop Session Facilitator: JB Aungo.

Reality of HIV and KP in SSA High incidence of HIV and AIDS in SSA Widespread effect of HIV and AIDS in SSA Key drivers of HIV and AIDS in SSA Extreme poverty Extreme gender and rights inequalities Low health literacy and access Key Populations (KP): MSMS, SWs and PWUD/PWID) are excluded, marginalized and violated- at individual, social and structural level.

General information The Organizers work for Pathfinder International (PI) in Kenya Pathfinder International is a global leader in reproductive Health Facilitators: – Lead Facilitator: Justus Aungo, PhD- M&E /Gender and Rights Technical Advisor, PI Kenya. A Sociologist and Anthropologist with over ten years working in HIV Prevention among Key populations in Kenya. – Co-Facilitator: Zebedee Mkalla, Senior Technical Advisor, Community and outreach programs, PI Kenya – Contributor: Carlos Laudari Senior Technical Advisor, HIV Prevention, PI

Background to the Workshop High incidence of HIV infection among KP in Kenya: between % above the national average Stigma against KP in national prevention intervention Overt and covert structural, social and individual barriers to access and utilization of health services by KP Continued marginalization of KP participation in interventions Increasing participation of conservative, neigh extreme religious groups in reproductive health and HIV prevention – Catholic opposition to condom promotion and use – Christian and Muslim opposition to sex education – Christian and Muslim opposition to constitutional recognition of LGBT, sex work e.t.c.

Findings from Studies In sub-Saharan Africa, male and transgender sex workers (MTSW) are often engaged in sex work for financial reasons and are at a high risk of HIV Transmission. Criminalisation of homosexuality drives male sex work underground, making it extremely difficult for MTSWs to access HIV prevention initiatives. In cases where programmes have recognized KP needs, capacity to participate is hindered. See more at: Source: hivaids.htm#sthash.E0xBMvCM.dpuf

Fact or Fiction: Key populations groups often engage in behaviors that are (or may be interpreted to be) at odds with traditional religious teachings (Source: Bergmann and Saleh-Ramírez, 2011 ) Religious groups use this as basis of avoiding, shunning or targeting them for inclusion or exclusion, depending on their motivation- evangelizing or condemnation.

Premise of the Workshop Religion is a complex socio-structural determinant of health and health seeking behaviour; When combined, religious and cultural morality practices can create unfriendly environments rife with stigma, intolerance and violence against key population (KP) groups, increasing their vulnerability to HIV infection. The Environment within which KP live determines their access and utilization of health services and capacity to prevent infection Access to health service is a right- it is about justice.

Objectives of the Workshop The Workshop aims to facilitate participants to : Increase their knowledge and skills necessary to address religious and associated socio-cultural barriers to HIV prevention facing key populations by: highlighting the challenges in the KP, religion, and HIV nexus. sharing experiences, lessons and innovations from Africa and elsewhere. – Increase awareness, knowledge and information on the range of risks and vulnerabilities of KP; – Enhance capacity to assess and identify contextual religion- driven social, cultural and political barriers to prevention among KPs.

Scope and Issues The workshop is at an intermediate level with modest scope: – Generate discussion on the ‘other side’ of religion in context of HIV. – Share the experience we have had in Kenya – Takes a purely programmatic approach without getting into issues of religious dogma, ideology or belief systems; – Focus is on the socio-structural level barriers to prevention – KP is used loosely as a composite term referring to MSM, SW and PWUD/PWID

Key Concepts Religious Barriers: A series of actions, practices and views based on adherence or following of a belief system that do, can or may behaviourally socially or/and structurally prevent or hinder access and utilization of services by a particular population group or category; especially those socially defined or identified. Key populations (also referred to as most-at-risk populations) who are disproportionately infected or prone to infection with HIV compared to the general population. The core key populations are people who use/inject drugs (PWU/ID), gay men and other men who have sex with men (MSM), transgender persons and sex workers (SW). Prevention: the whole array of intervention aimed at reducing risk, susceptibility and vulnerability to infection and re-infection with HIV, including behavioral, social and structural intervention as well as adherence to care and treatment.

Expectations of Workshop More networking and collaboration? A research/ technical working group on Religious barriers to prevention? Concerted documentation and sharing of experiences and successes?

Methodology Participatory Reflexive Discussion