From personal survival to public health: community leadership by men who have sex with men in the response to HIV

Abstract

Community leadership and participation by gay men and men who have sex with men (MSM) have been central to the response to HIV since the beginning of the epidemic. Through a wide array of actions, engagement of MSM has been important in the protection of communities. The connection between personal and community health as drivers of health advocacy continue to be a powerful element. The passion and urgency brought by MSM communities have led to the targeting and expansion of HIV and AIDS research and programming, and have improved the synergy of health and human rights, sustainability, accountability, and health outcomes for all people affected by HIV. MSM are, however, frequently excluded from the evidence-based services that they helped to develop, despite them generally being the most effective actors in challenging environments. Without MSM community involvement, government-run health programmes might have little chance of effectively reaching communities or scaling up interventions to lessen, and ultimately end, the HIV pandemic.

Figure 1. 1986 poster adopted by the AIDS Coalition to Unleash Power

The text at the bottom reads “Why is Reagan silent about AIDS? What is really going on at the CDC, the FDA, and the Vatican? Gays and lesbians are not expendable… Use your power… Vote… Boycott… Defend yourselves… Turn anger, fear, grief into action”. Image provided by Avram Finkelstein and reproduced by permission of the Silence=Death Project. CDC=Centers for Disease Control and Prevention. FDA=Food and Drug Administration.

Figure 2. South African activist, Simon Tseko Nkoli

Simon Tseko Nkoli typified the social movement that fought to end apartheid in South Africa and to increase the rights and recognition of gay men and other MSM in South Africa. As one of the first openly HIV-positive African gay men, he supported the decriminalisation of same-sex practices in South Africa and the creation of targeted HIV services for MSM. Reproduced by permission of Braxton University, Pretoria, South Africa. MSM=men who have sex with men.

Figure 3. Centro de Orientación e Investigación Integral workers with transgender individuals in the Dominican Republic

As a provider of HIV services, Centro de Orientación e Investigación Integral provides HIV prevention, care, and testing services to transgender individuals through a mobile clinic. Reproduced by permission of ProActividad/amfAR, The Foundation for AIDS Research.

Figure 4. Increased awareness of gay and MSM groups can raise the risk of reprisal

Image shows an article from a short-lived Ugandan tabloid newspaper of Nov 15, 2010.