The MSMGF Secretariat collaborates with MSMGF members around the world to bring you reports on recent developments concerning the health and human rights of MSM. The reports are meant to share insights on MSM health and rights in different regions, as well as increase awareness within our global community about who our members are and the work they do.

Thursday, October 16, 2014

Upcoming Webinar! Key Populations, Treatment Access, and the Global Fund's New Funding Model





UPCOMING WEBINAR 

Engaging Key Populations with Expertise in Treatment Access: Concept Note Development for the Global Fund New Funding Model

Wednesday, October 22
8AM-9AM PDT

The Global Forum on MSM & HIV (MSMGF) and the International Treatment Preparedness Coalition (ITPC) present a webinar on strategies to address treatment access in the context of the Global Fund New Funding Model (NFM).



Civil society is often best positioned to perform a number of vital functions for ensuring and monitoring treatment access, including: education efforts tailored to the treatment needs of key populations; community and health systems strengthening to accommodate comprehensive treatment services; and advocacy with governments, multilateral institutions, and private companies to scale-up access and meet treatment demands.

The Global Fund has historically been the largest multilateral donor to fund access to HIV treatment in most countries. However, Global Fund processes dedicated to ensuring and monitoring access to treatment have not always included civil society, often deferring instead to Ministries of Health.

This webinar will present strategies for engaging community partners with expertise in treatment access in the Global Fund country dialogue process. Featured presenters will discuss approaches for engaging community partners in the country dialogue process effectively, including: ways to identify and engage appropriate community partners; ways to access technical support for concept note development; examples of activities to be considered for a concept note; and general guidance for meeting principles of the NFM. Treatment access in the Middle East & North Africa will be presented as a case study for potential opportunities and challenges as community partners prepare to engage with the NFM in the coming period.

This webinar is free of charge and pre-registration is required to participate. You can learn more and pre-register online at https://cc.readytalk.com/cc/s/registrations/new?cid=fiu0vkrnzdmw.

Thank you very much! Any questions can be directed to MSMGF Senior Policy Advisor Nadia Rafif at nrafif@msmgf.org.

Kind regards,

The MSMGF

The MSM Implementation Tool: Operationalizing WHO's Guidelines on MSM

Dear all,

Just two months ago, WHO released new Consolidated Guidelines on HIV and STI prevention and treatment among key populations. Bringing together all existing guidance on key populations, the consolidated guidelines provide a comprehensive package of evidence-based recommendations on HIV for each key population, including MSM.

MSMGF Sr. Research and Programs Associate Keletso Makofane Presenting at the Launch of WHO's Consolidated Guidelines at AIDS 2014

Following the release of the Consolidated Guidelines, the MSMGF and UNFPA will convene a two-day consultation focused on the development of a new implementation tool to operationalize the guidelines among MSM. Called the MSM Implementation Tool (MSMIT), the tool will serve as a primary reference point for all stakeholders working to address HIV and STIs among MSM around the world, including public health officials, HIV and STI program managers, community-based organizations, and health workers.

The MSMIT will be an extremely important tool for building and implementing effective programs for MSM health and human rights, and this consultation will be essential to ensuring its success. Taking place next week in Bangkok, the consultation will bring together experts, programmers, researchers, donors, and civil society to identify good practice examples from around the world. Discussions will focus on community empowerment, addressing violence against MSM, condom and lubricant programming, community engagement, program management, and capacity building.

We are very excited for the consultation and its outcomes, and we will be posting updates from Bangkok on our Facebook and Twitter spaces early next week! Follow the discussion on Twitter at @msmgf, and use the hashtag #MSMIT to join the conversation.

As always, please don't hesitate to be in touch via Facebook, Twitter, or via email at contact@msmgf.org.

All the best,

The MSMGF

Tuesday, October 7, 2014

Good Governance and MSM Coalition Building in Africa

From our good friends at the Health Policy Project. See the original post on the Health Policy Project Blog.

Hands at the EI 6th World Congress-EI-PSI LGBT Forum


Good Governance and MSM Coalition Building in Africa

By David Mbote and Andrew Zapfel, Health Policy Project/Futures Group

"Change is the law of life and those who look only to the past or present are certain to miss the future." -John F. Kennedy

In recent years, global actors in HIV and AIDS, such as the President's Emergency Plan for AIDS Relief (PEPFAR), the World Health Organization, and the United Nations Joint Programme on HIV and AIDS, issued technical guidelines urging the removal of punitive laws that criminalize homosexuality and citing this as a critical factor to improve HIV outcomes. They have also promoted the enactment of policies to improve the accessibility of comprehensive HIV prevention services for men who have sex with men (MSM) and other key populations and that respect these populations' basic human rights.

Unfortunately, a number of African countries interpret this international standard as a sign of cultural imperialism and are moving to more vigorously enforce existing punitive laws against homosexuality. Uganda's anti-homosexuality act was declared null and void by the Ugandan Constitutional court in July, but a similarly punitive parliamentary bill in Nigeria received presidential assent and is now a law. In Gambia, Ghana, and Kenya, similar laws have been enacted or proposed by members of Parliament. Meanwhile, access to health services for sexual minorities remains inadequate across Africa. There are advocates in each of these countries working to reverse such trends, but also a need for greater financial, logistical, and capacity-building support in policy and advocacy.    
                                                                                                     
Advocacy groups often discuss the need to develop coalitions that can move legislation or policies forward. Advocacy coalitions, focusing on issues of homophobia, have developed over the recent years to bring stakeholders together in dialogue and on focused advocacy campaigns. Examples include the Men Who Have Sex With Men Global Forum on HIV, Coalition for Global Equality, and with one of the most recent being the M-Coalition, focusing on MSM health issues in Arab countries. In response to increased hostilities in Africa, a coalition of 18 MSM/Lesbian, Gay, Bisexual, Transgender and Intersex (LGBTI) organizations formed African Men for Sexual Health and Rights (AMSHeR) in 2011.Coalitions allow for dispersal of work, increased representation on the issue, and a larger number of volunteers to move a particular agenda forward. Coalition building involves developing a common vision, objectives, and action plans that assign responsibilities to each partner. Maintaining the sustainability of a coalition, particularly when the vision has not yet been achieved, is not often discussed. Times change and priorities shift for all coalitions. Therefore, refocusing the overall strategic framework may be necessary to carry through the mission and objectives of the coalition.    

AMSHeR provides a coordinated response to the grave human rights violations faced by LGBTI people throughout Africa and works to address the disproportionate effects of HIV among MSM. The coalition's goals are to identify and advocate for technical and financial resources for its members and to improve access to HIV prevention, treatment, and care services for the populations they serve. AMSHeR also seeks to facilitate the creation and dissemination of an evidence base for better human rights-based programming and policymaking in the response to HIV for MSM communities. In April and September of 2014, the USAID- and PEPFAR-funded, Health Policy Project (HPP) provided financial and technical assistance in the planning and execution of two governance meetings, enabling AMSHeR to monitor and revise its strategies and processes to maintain its focus on, "work[ing] towards a healthy, empowered life for MSM in Africa and Human Rights for All."

AMSHeR is undergoing a process of organizational growth, as all coalitions must during challenging times. Changes in donor funding of the response to HIV, regional increases in homophobic attitudes, , and even migrant labor laws restricting employment at the Secretariat for non-South Africans have affected AMSHeR's ability to implement programming where it is needed most. Change is difficult for any organization, even more so for a coalition of organizations that have historically been disenfranchised from dominant discourses about the rights of the people they serve. Therefore, HPP is supporting AMSHeR to re-establish its governance processes and develop a new framework for strategically addressing health and rights issues throughout Africa.

During the governance meetings, steering committee members reiterated their strong belief in AMSHeR's relevance in a time of increasing hostility among African countries toward MSM's human rights and health programming. Despite numerous changes at AMSHeR, including a new board structure and new executive leadership, the coalition is seen by stakeholders as more relevant now than ever before.

The governance meetings focused on coalition sustainability, and the 18-member steering committee committed to strengthen AMSHeR by increasing managerial oversight and accountability. One steering committee member noted:

"Perhaps it's  good that this [the recent governance and management challenges] has happened to AMSHeR at this point in history, when we are still a growing organization. Now we have reason to emphasize on institutions rather than an individual's good will. At this point, regardless of who will be our next ED [executive director], we shall always have to focus on professionalism and institutional strengthening."

This year's board and governance meetings set the tone for a reorganized and reinvigorated AMSHeR with a new board and stronger mandate. Coalition members are more aware of AMSHeR's strengths and relevance, and have renewed their dedication to improving its advocacy capacity. AMSHeR's experience offers lessons to all coalitions striving to achieve the shared vision of their members. Such long-term visions can only be realized by monitoring the work of the secretariat, maintaining trust among its members and stakeholders, and refocusing the organization's strategy when actions do not go according to plan.
                                                                                                             
About the Health Policy Project

The Health Policy Project (HPP) aims to strengthen policy, advocacy, governance, and finance for strategic, equitable, and sustainable health programming in developing countries. HPP is funded by the U.S. Agency for International Development and the President's Emergency Plan for AIDS Relief (PEPFAR), and implemented by Futures Group, in collaboration with Plan International USA, the Futures Institute, Partners in Population and Development, Africa Regional Office (PPD ARO), the Population Reference Bureau (PRB), RTI International, and the White Ribbon Alliance for Safe Motherhood (WRA). For more information on HPP's work on HIV, see http://www.healthpolicyproject.com/index.cfm?id=hiv.

Thursday, March 27, 2014

In Conversation with Jake Sobo from "My Life on PrEP"

This week the MSMGF Blog talks to Jake Sobo, creator of the weekly column, “My Life on PrEP.” At a time when few other channels candidly discussed the use of Truvada for HIV prevention (pre-exposure prophylaxis, or “PrEP”), Jake’s honest and sex-positive approach helped shift conversations surrounding new prevention technology in the United States. Jake discusses why he started the blog, the public’s response, and what he’s doing now.



Were you surprised by the response the series received?

When I started writing "My Life on PrEP” a year and a half ago, it was a barren landscape in terms of people talking openly and honestly about PrEP. The few people that were talking about it were desperately trying to stay "on message" and pretend like only guys with poz boyfriends or guys who also use condoms were going to be using PrEP. I knew immediately that this message was Polyanna bullshit, and so I started speaking out about my own experience. That upsets people -- we'd all rather keep our heads in the sand and pretend like gay men are all using condoms and everything is just sunshine and rainbows. The truth is that condoms are clearly failing at the community level, and we desperately need new interventions to help keep guys negative. PrEP is one intervention that could make a big difference, but we've got to speak frankly about sex -- gay sex, no less -- and that makes many people deeply uncomfortable. So I knew that I would be stirring up some intense emotions with this column -- that was my hope and intent.

What was the most surprising conversation generated by My Life on PrEP?

I think the moment I was most caught off-guard was when a reader compared me in their comment to Bobby Brown indirectly murdering Whitney Houston. I nearly died laughing! But it was a telling moment. To them, I was "promoting" unsafe sex and thereby murdering young gay men. The truth is that I don't need to promote not using condoms. The evidence is clear: many gay men are already not using them, and we need to fess up to that reality if we want to get serious about prevention.

What do you believe is the most effective way to teach people about risk? How should we shape prevention messages? 

Obviously, this is the million dollar question. For me, the three pillars of prevention have always been testing, treatment, and non-judgmental sex education. Communities have the right to decide what kinds of HIV prevention work best for them, but they obviously need to be given accurate and sex-positive information to inform those decisions. I have serious ethical questions about the continued harassment by health practitioners to clients they perceive as doing HIV prevention "wrong." People do their best, and for many people, HIV prevention just is not a top priority. If they need to have sex for money, or need to keep their partner for economic reasons, preventing infection might not be the primary motivation guiding their sexual practices. They also may just not like condoms, even though they understand them to be effective at preventing HIV. People have a right to make those choices. So I support efforts to educate and raise awareness of critical issues in public health, but the kind of shaming and strong-arming that goes on makes me and countless others at the receiving end of those efforts distrustful and hostile to future outreach efforts. That's counterproductive.

What is the relevance of My Life on PrEP in light of bigger-picture prevention work?

What I have tried to do is cut through the clinical pussyfooting that plagues HIV prevention for gay men and is largely the product of AIDS Service Organizations (ASOs) increasingly being muzzled by their funders (namely, the CDC and state health departments). If gay men can't talk about the reality of getting fucked, pleasure, or harm reduction strategies rather than complete risk elimination, then we might as well close down shop as preventionists. That's not prevention. It's propaganda that does more to serve the interests of those whose jobs are on the line than it does the communities such efforts are allegedly intended to serve. Sadly, that's what much of the work in prevention looks like these days. It's clinical, detached from the reality of our lives, and has virtually no impact on the epidemic. In many cases I actually believe that it could be doing more harm than good. Apart from treatment and testing -- which are obviously critically important, core components -- but apart from clinical care and screening, what do ASOs have to offer prevention? Increasingly, the answer is nothing. That's a tragedy that should make everyone angry. 

What’s next for Jake Sobo?

I wound down the “My Life on PrEP” series when it became clear that there were others picking up the torch and running with it. Josh Kruger started writing on PrEP, the AIDS Foundation of Chicago’s “My PrEP Experience” blog blew up, and more generally I just started seeing my arguments being taken up by other writers. That was immensely rewarding. But the time had come for me to move on from PrEP, so over the summer I launched a new column on San Francisco AIDS Foundation’s “BETA Blog” titled “Promiscuous Gay Nerd.” This new column is more broadly focused on gay sex, HIV, and stigma – all from the perspective of a research scientist and proud slut. Check it out!



Jake Sobo has worked in the world of HIV prevention for nearly a decade. He previously published a 19-part series documenting his experiences on pre-exposure prophylaxis (PrEP), “My Life on PrEP,” for Positive Frontiers magazine, which was picked up by Manhunt, translated into French, and widely read in the HIV prevention world. He has spent the better part of his adult life having as much sex as possible while trying to avoid contracting HIV. You can find Jake continuing his insightful commentary in a new column on San Francisco AIDS Foundation’s “BETA Blog” titled “Promiscuous Gay Nerd.

Friday, February 7, 2014

Donny Reyes: “Most crimes against LGBT people are lost in limbo”

As the David Kato Vision & Voice Award (DKVVA) begins to celebrate its third year, we continue to receive hundreds of nominations of phenomenal activists for lesbian, gay, bisexual, transgender and intersex (LGBTI) rights around the world. With the announcement of this 2014 winner coming up on February 14th at the renowned Teddy Awards in Berlin, we are honored to introduce you to the 5 incredible people who have been shortlisted for this year’s award.

This week we are thrilled to present prominent LGBTI activist Donny Reyes. Donny is the director of the LGBTI Rights group Asociacion Arcoiris (Rainbow Association) in Honduras. Established in 2003, the Rainbow Association trains human rights defenders and promotes HIV prevention. Despite numerous threats and targeted attacks for his advocacy, Donny Reyes continues his work to raise the voices of the LGBTI community in Honduras. The segment below is taken from an interview published in 2010 by Amnesty International.



Photo Credit: Front Line Defenders

Before the political crisis blew up in Honduras, Donny Reyes was trying to put his country on the map internationally, working to raise awareness of the abuses and discrimination suffered by lesbian, gay, bisexual, transsexual and transgender people. 

But as the Central American nation slid into political turmoil, human rights were sidelined. 
“We had started talks with the Public Prosecutor’s Office, with members of the police and some members of the government for the investigation [of crimes against the LGBT community] and access to some public services. This stopped after the coup d’etat,” Donny explained. 

According to information published by the organization Donny works for, the Rainbow Association, killings of transsexual people have also increased sharply since the coup d’etat. 

Research conducted by Rainbow found that there were 12 killings of gay, lesbian, trans sexual and transgender people in Honduras in the whole of 2008. In the four months since the coup d’etat, that figure reached 14. 

“These are the violent deaths and crimes that we have documented. It doesn't include the many others we don’t know of - the ones that are left in impunity, lost in limbo,” said Donny.

The activist – who was himself a victim of abuse at the hands of the security forces in 2007 – said the most worrying point of the crisis was during the state of emergency in the first week after the coup d’etat, when curfews were implemented in different areas of the country.

During that time, at least three members of the LGBT community were killed. Fabio Zamora was shot in the head while he was working in a market. Marion Cardenas was shot in the forehead on 29 June. Vicky Hernandez died the same way in San Pedro Sula, during the curfew on 28 June. 

“During the state of emergency you could feel a climate of fear, collective panic. Nothing could move here if it hadn’t been authorized by the armed forces, particularly the army. When the state of emergency was declared that day, everybody just ran home to hide and find refuge. What the authorities would do that night was nobody’s responsibility.”

You can access to the original article here

Since 2010, Donny has continued to combat discrimination against the LGBTI community of Honduras. Recognizing the need for a safe and secure space, Asociacion Arcoiris created “Rainbow House,” a home in Comayagüela that trains community leaders and acts as a base for HIV prevention outreach and peer support. At Rainbow House, Arcoiris conducts regular workshops to train young LGBT people and sex workers in human rights, focusing on issues such as conflict resolution, domestic violence, discrimination, and safer sex practices. Graduates go on to replicate the trainings among peer networks in Comayagüela’s LGBT and sex worker communities.

In 2013, Asociacion Arcoiris’s offices were targeted with multiple break-ins and thefts. With very little support from the police following these incidents, Asociacion Arcoiris must continue their advocacy work despite longstanding intimidation and harassment against the organization.


Thursday, January 30, 2014

Diane Rodriguez: Breaking New Ground and Making History

As the David Kato Vision & Voice Award begins to celebrate its third year, we continue to receive hundreds of nominations of phenomenal activists for LGBTI rights around the world. With the announcement of this 2014 winner coming up on February 14th at the renowned Teddy Awards in Berlin, we are honored to introduce you to the 5 incredible people who have been shortlisted for this year’s award.

This week we are thrilled to present Diane Rodriguez from Ecuador. For the past 18 years Rodriguez has fearlessly fought for LGBTI inclusion and equality in Ecuador. She has overcome stigma and discrimination to make Ecuadorian history as the first transgender person to legally change her name, setting a legal precedent. She is prepared to continue fighting for LGBTI rights until they are fully recognized in Ecuador and across the globe. 





Diane Marie Rodríguez Zambrano is one of Ecuador’s leading human rights activists. She has worked relentlessly for LGBTI rights over the past 18 years and now acts as the director of Silueta X Asociación, an advocacy group that fights for transgender rights in Ecuador. Diane Rodriguez incorporates a trans-feminist ideology into all of her work, integrating transgender discourses with feminist discourses and boldly critiquing capitalism, consumerism, and patriarchal constructs. 

In 2008 Diane Rodríguez founded Silueta X Asociación, a community-based advocacy organization that she continues to lead today. Since its inception, Silueta X has become one the most prominent organizations in Ecuador, providing a platform where Diane Rodríguez works with other community members to promote respect for transgender human rights and improve access to health services.

In 2009 Diane Rodríguez broke new ground in Ecuador after being told by her local registry office that she could not legally change her name from male to female. She sued the Civil Registry in February of that year, citing the anti-discrimination passages in Article 2 of Ecuador’s new constitution.  Diane Rodriguez took the case to the Office of the Ombudsman, which in turn took it up with the director of the National Registry Office. This resulted in Diane Rodriguez and four other members of Silueta X receiving new identity cards within a week of the appeal. Thanks to the precedent set by this case, any female or male transgender person can now legally change their name in Ecuador. Although allowed a legal name change, transgender people are still not allowed an identification card indicating their proper gender identity. Diane continues to run campaigns to fight for transgender people to legally change their gender.

In 2011 Diane Rodriguez won a “Pride and Diversity” award at the "Iberoamerican Summit of Young Leaders" in Cancun, Mexico.  In 2012, she represented Ecuador at the "Women Deliver" Satellite Session at two consecutive International AIDS Conferences in Mexico City and Washington, D.C. In 2013, Diane Rodriguez represented Ecuador at the “Conference against Homophobia,” as a prelude to the UN declaration on sexual orientation and gender identity. 

Diane Rodriguez is the first transgender person to ever enroll at the University of Guayaquil. She is currently studying psychology and is a member of the University’s Scientific Group of Faculty. She has lectured at various institutions over the years such as the San Francisco and Quito Polytechnic, University of Cuenca, Universidad Casa Grande de Guayaquil, and Guayaquil University. She emerged as an important figure in Ecuadorian politics when she made history by becoming the first transgender person to vie for a Congressional seat in the leftist Ruptura 25 party during Equador’s presidential and parliamentary elections in 2013. 

Diane Rodriguez continues her struggle for equality as outspoken activist and director of Silueta X. Her achievements are an example to admire in the international struggle for LGBTI justice and women’s rights.

You can find more information about Diane Rodriguez and her advocacy work at the following links:
www.DianeRodriguez.Net


Tuesday, January 21, 2014

Respect, Protect, and Pleasure Ms. J



There I was, a deer in the fluorescent headlights, my feet in stirrups and my undercarriage catching the freshly methylated breeze of the clinic. I had finally gone to the doctor to address a discomfort I had in my “down there” area. (I had not yet made friends with Ms. J, my bujaina. I called her “down there”, “underneath”, or when I was feeling especially cold towards her, “anus”). I had spoken to my mother about this growing discomfort underneath and she had said it might be a heamorrhoid because “you sit down a lot” – I was a student at the time and sitting down was, indeed, one of my main responsibilities. I went to the clinic to get help.

After hushed explanations to the receptionist and a few minutes of sitting down and trying to touch absolutely nothing in the waiting area, my name was called and I consulted with a nurse. She asked me to take my pants off, sit at the edge of the table and put my feet in stirrups. (I had never done it that way before, but I went with it). There were a few minutes of silent and awkward prodding and wincing. Having found no malady after rudely poking at Ms. J, she opened the door, stepped out and called in a doctor to confirm that my case was confusing.

The doctor turned out to be one I did not particularly trust. On a previous occasion, he had awkwardly taken my sexual history without making eye-contact or introducing himself. He asked me a series of strange questions including “are you an MSM?” When I asked for my medical records (curious to see what sense he could have possibly made of the inane questions and reluctant answers), he asked me if it was perhaps because I was worried about what was going on against the gay community in Kenya. We were in the US, and nothing alarming was happening in Kenya as far as I knew. He explained that the records were confidential, except if an unknown suite in my insurance company wanted to see them. I explained how far South Africa (my home country) is from Kenya, punctuating my words with severely disparaging looks.

He walked in, asked the nurse some questions, and decided that I needed to see a specialist. They Googled for one on the computer inside the consultation room. In their eagerness, they had forgotten to allow me to veil Ms. J again while calling for reinforcements and Googling for help. So I remained spread-eagled on the table in a sea of fluorescent light. It was decidedly unpornographic. Ms. J saw more action in that hour than she had in the preceding 6 months. That thought made me sad.

Nurse and Doctor Stirrups referred me to a specialist in another part of town. I was not sure exactly his specialization – I was too busy being shocked by how much money someone was going to pay for my visit (fortunately, I had health insurance). After patiently waiting for my name to come up, I was led into his office. I took a surreptitious picture of a book lying on his cluttered desk: “The Ins and Outs of Gay Sex – A Medical Handbook for Men.” He finally came in and shook my hand, a kind faced 50-something year old whose heaviness gave the reassurance of a paper weight against the wind. He sat on the other side of his desk and I explained why I was there.

Dr: When was the last time you had sex?
Dr (*laughs): On the way here?
K (*mock outrage): “Excuse me! …Uhmm, a few months ago.”
Dr: “Did you top? Did you bottom?”
K: “Yes.”
Dr: “When you bottomed, did you have any pain?”
K: “Only at first.”
Dr: “Any bleeding?”
K: “No.”

He directed me to his table where he left me behind a screen to take off my pants so that he could come back and inspect my junk. Thankfully, there were no stirrups this time. He asked some banal questions while checking the outside and inside of Ms. J., making sure to announce everything he was going to do before doing it: “Where are you from?”, “Where is your family now?”, “I am about to insert a finger”,  “What are you studying?”…  I had never thought about my family while Ms. J was being visited. It was weird and unsettling, but I knew that he was trying to put me at ease, and I really appreciated that. He showed me some paper towels to use for cleanup and invited me back to his desk when I was ready. At his desk, this doctor (who I had just decided to name my Butt-Doctor) told me what he was screening for, and he told me ways to manage my discomfort while we wait for the results.

***

In organizing a series of webinars on Anal Health for the MSMGF, I have been reflecting on these contrasting experiences with healthcare providers, which both took place in very well-resourced settings, and neither of which were homophobic in the slightest. Even though Nurse and Doctor Stirrups may not have intended to have this effect, their ill-informed exploration of Ms. J and their lack of concern for my privacy were jarring. The environment they created was not conducive to an open exchange of information that would help us figure out what was happening with my body. Having already felt an ineptitude around the discussion of sex, I would not choose to go to Nurse and Doctor Stirrups if I had STI symptoms. Because I had that negative experience with them, I would be reluctant to go there even with flu symptoms.

My Butt-Doctor, on the other hand, not only made me feel comfortable enough to talk about my sex life in some detail, he had the skills and knowledge to investigate my problem and explain what he was doing and why he was doing it. His office felt safe from the moment I walked in. Seeing the book on his desk made me think that he knew what he was doing even before I started speaking with him. He was respectful of my body and of the way I have sex. After our consult, I felt like it would be almost as easy to tell him if I had warts on my dick as it would be to tell him if I had a persistent headache.

The aim of the MSMGF webinar series on Anal Health is to equip members of our global network of lay and professional healthcare workers with a certain level of knowledge, skills, and language to deliver the care that their clients deserve. This entails not only being non-judgmental about the ways that patients live their lives, but being skilled to deliver needed care and being understanding of the fullness of their sexual lives. It means that anal sex cannot only be conceived of in terms of the risk it poses for HIV and STI transmission; it must be understood as an expression, as a pleasure, as a source of confidence or insecurity, as a source of shame or pride. Anal sex has to be understood in the multiple and complicated ways that other kinds of sex are.

We attempt to expand the way that anal sex is discussed (in the field of public health, it is often discussed as a “problem” in and of itself), by beginning with the radical assumption that anal sex causes, first and foremost, pleasure. And pleasure is a good thing. The ways in which we seek and enjoy pleasure are related, both as cause and consequence, to numerous areas of concern to public health, including mental health, drug use, HIV, and other STIs. We do not all, however, go around with the sole objective of vanquishing HIV; we go around living and loving, playing, fucking, and licking, because it feels good. And because it is good to feel good.

We open the series today with a presentation on the physiology of anal sex and how it relates to pleasure. We hope that there will be much discussion in the question and answer session immediately following the presentation, and we have opened up the MSMGF Blog to continue the discussion online. Today’s presenter, Bryan Kutner, has kindly agreed to respond to comments and questions in this Blog space that were not raised during the webinar. Please feel free to engage on this topic below, and keep an eye out for forthcoming webinars in the series.

Happy 2014!

Keletso

Keletso Makofane is a South African Fulbright Scholar and a graduate of the Columbia University Mailman School of Public Health. The first webinar in the MSMGF’s series on Anal Health took place today, January 21st, at 7AM PST - a recording of the webinar is available here. An interactive discussion with the presenter will take place here MSMGF Blog during and after the webinar.