Posted by: drollason | 08/13/2009

IDU and MSM at ICAAP

GHC Legislative and Outreach Coordinator Duncan Rollason will be blogging all week from the (ICAAP) in Bali, Indonesia. Here is his fourth report:

BALI, Indonesia — Although my site visits to the methadone clinic and voluntary counseling and testing site were cancelled today I was still able to gain a better sense of the Indonesian context of HIV/AIDS and even parts of the wider Asian context. Immediately following notification that my site visits had been cancelled, I arranged to meet with two board members of JANGKAR, The Indonesian Harm Reduction Network.

We talked at length about the political and legal challenges they faced in their work and their efforts to make needle exchange and rehabilitation centers more accessible while maintaining the rights and integrity of injection drug users (IDU). Their advocacy on the national level has been very successful, but they said the provincial level was a completely different story while some provinces accept the work that they are doing while others do not.  Regardless of the challenges though, they do have a stable relationship with the Indonesian National AIDS Commisson and are undoubtedly making an impact.

JANGKAR often holds trainings for the Indonesian Police, educating them to best handle their encounters with injection drug users. This quickly brought us to our next topic of conversation; decriminalization and needle exchange. They were very eager to discuss the possible lifting of the US ban on federal funding of needle exchange programs as it would have incredibly important impact on their work. Regardless of US legislation, Indonesia is still having it’s own moral battle about decriminalization and some have sincere concerns that decriminalization and needle exchange will lead to wide spread drug use.

Later in the afternoon I met with two men from the Asia Pacific Network of People Living with AIDS: Men who have Sex with Men working group (APN + MSM) to discuss issues specific to men who have sex with men (MSM) in Asia and the Pacific. Right away they told me that nearly 30 % of MSM in Asia are living with HIV. They went on to say that more than 90 % of men who have sex with men in the region are left without any access to HIV prevention and care. In some instances services just don’t exist while in others MSM is criminalized or so heavily stigmatized that men fear that accessing services will lead to involuntary disclosure.

To combat the legal barriers and gain equality for men who have sex with men, APN + MSM has developed it’s network of 32 members in 15 countries to increase the visibility of MSM participation in the response to HIV. APN + MSM utilizes research and evidence-based programs to advocate for the rights of positive MSM to have equitable access to MSM friendly prevention, care, treatment and support services. With continued and dedicated advocacy they are hopeful that they will continue to see repeals of criminalization of homosexuality as we recently saw in India across all of Asia.

For both groups though, it will continue to be a challenging battle, and the members I spoke to recognize that. There are still 22 countries in Asia and the Pacific that criminalize homosexuality and APN + MSM is working to overcome the devastating effects that this legislation has HIV among MSM. Mandates to make arrests and seize drug contraband often overshadow the work of groups like JANGKAR, but like APN + MSM they will undoubtedly continue their efforts through civil society networks and governments.

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