Overview of current advocacy and community mobilisation strategies in Africa Brian, Kadiri and Morenike

Brian Kanyemba Research Assistant/AVAC Fellow/IRMA Advocate 2 nd December 2011 Advocacy Community Mobilization

Community Perspectives and Policy- post iPrEX 21 Community Discussions 521 Participants Cape Town, Johannesburg, Pretoria, Pietermaritzburg, Durban

Community Perspectives and Policy- post iPrEX Massive Stakeholders Responses on ANAL SEX. Need to collaborate with broader MSM community and address homo-negativity and stigma.

Community Perspectives and Policy- post iPrEX Dispelling the Myths of anal sex by including men and women and other stakeholders. Promoting Anal health as a drive to end HIV Pandemic. Train and sensitize health personnel on AI

MSM Training Manual Very Important Tool which includes: Background and Introduction on MSM and HIV in Sub Saharan Africa Human Sexuality (other than Hetero-normative) Anal Sex, STIs and HIV (relation to Anal Sex) Condom and Lubricants Mental Health and Stigma Risk Reduction Counselling with MSM

MSM Sensitivity Training 583 Health Care workers trained February September 2011 Trainees included Healthcare workers from: South African NGOs Government Facilities Structure included: group work Lecture Interactive discussions Interactive activities

MSM Sensitivity Training (Sample Example) Sensitive awareness on sexual stimulation areas on the human body Body Mapping Exercise Exercise that changed perspectives on AIs to most trainees.

MSM Symposium, Cape Town Developing Rectal Microbicides Poster. Advocacy Video (Fiona Pop Council). Discussions on Anal Sex with other Participants

MTN 017 Consultation Meeting, Cape Town

RM : A Civil Society Update and Consultation Provided key feedback on earlydraft of MTN-017 Key Civil society Reps. Advocates from HIV and MSM organizations in South Africa. 12

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South African Rectal Stars

IRMA, Nigeria Advocacy Efforts Case study of Advocacy, Education and HIV Prevention Activities

Involving community stakeholders IRMA Nigeria advocacy efforts is geared towards mobilising communities of stakeholders to make demands on their government for investment in Microbicide research and development. Nigeria has a history of engagement in past microbicide research. NHVMAS has commenced community mobilisation efforts. IRMA just built on the existing efforts to further its work with respect to rectal microbicide advocacy.

Community stakeholder engagement Communities mobilised CBOs Community heads Youth leaders Market women Artisans and craftmen Health workers xxx

Tools for community mobilisation Campaigns Sensitisation programs Trainings Talks Music events Drama

Messages during programmes Capacity building efforts for peer educators Basic facts about HIV Known HIV prevention tools Other biomedical HIV prevention research Research literacy Faciliating peer mobilisation

Messages during programmes - 2 Musical outreaches Basic facts about HIV HIV infection control Non-stigmatisation of PLWAs The future of HIV control

Messages during programmes - 3 Campaigns and sensitisation programmes Basic facts about HIV STIs management and prevention New HIV prevention tools

Messages during programmes - 4 Drama Skills building for peer education Skills building for safer sex negotiation

Population reached Sex workers Youths MSMs Health workers Market women General population Religious leaders Politicians

Geographical emphasis Lagos State Amuwo Odofin Local Government area – made possible by a member of IRMA in political office

Lessons learnt on the field Information on new biomedical HIV prevention technology has to be tucked within the context of HIV prevention messages. Education builds capacity of communities to advocate for themselves and demand for political changes. The Nigeria environment is changing with respect to knowledge and community awareness about NPTs. More active actors are emerging in the field – NHVMAS, IRMA, S4M, Safehaven, Good to Neighbours, NYNETHA

Result of advocacy efforts Inclusion of NPT issues in National documents ef HIV policy, National strategic framework and national HIV research policy. Discussion of NPTs in public discourse – national conferences, Ethics committees, HIV prevention meetings, seminars, newspapers. Increasing number of NGOs including information on NPTs in their HIV prevention messages.

Lessons learned from related areas of work

Overview of rectal microbicide advocacy Started discussion on rectal microbicide as way back as 2006 along with NPT information sharing. Recognised the risk of anal infection as MSM were engaged in early NHVMAS advocates efforts. Also made effort to discuss rectal microbicide as a complement for preventing HIV via sex. Message simply promoted as anal sex protection with little emphasis on sexual orientation related issue.

Experience with discussion on MSM Engaged with sexual diversity trainings in 2009 and 2010 made it quite clear the sentiments people have about MSM. Growing hostile environment also makes open, short term logical discussions about sexual diversity difficult. Successes ONLY achieved following 3 days training. Shorter term training achieve nothing significant.

Rectal microbicide Conducted first formal evaluation on any of our public education on rectal microbicides in days training session for teachers was held in November Training included group work and plenary discussion on rectal microbicide. Session was the ‘stormiest’. Very similar to experience with sexual diversity trainings.

Result of test analysis Evidence through pre and post test analysis showed significant change in knowledge about NPT. Many scored 100% on some of the 8 test questions. Most significant improvement observed with HIV Vaccine. No change observed with rectal microbicide despite it being the only NPT session that had a dedicated group discussion.

Lesson learnt NHVMAS had underestimated negative public sentiment about MSM as resistance expressed about rectal microbicide was linked to MSM issue. Silence on MSM even when discussing rectal microbicide may not have been the best strategic approach by NHVMAS. There may be the need to redress strategies for rectal microbicide campaign within the Nigerian public.

Way Forward Continuation of Advocacy and community awareness raising on rectal microbicide Set another stage for M2012 DTHF conducting MTN 017 and others Looking forward Project Arm Video Developing strategic ways of discussing rectal microbicide within an MSM context

Acknowledgements Ben Brown Jim Picket Zoe Duby Andrew Scheibe Project Arm/Irma Morenike Kadiri Marc-Andre Paul Semugoma All the advocates Sidaction IRMA Lagos State Agency for the control of AIDS

Thank You!