amfAR, The Foundation for AIDS Research

GRASSROOTS: The MSM Initiative Blog

amfAR's MSM Initiative supports grassroots MSM and transgender organizations responding to HIV, and advocates for effective HIV policies and increased funding for MSM/TG globally.

Belgrade, Serbia: The Pulse of Youth

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Posted by Jirair Ratevosian, February 14, 2011

“We are the pulse of the youth,” declares Isein Fetoski. He is describing SPY—Safe Pulse of Youth—a well established community-based organization in Serbia dedicated to the needs of MSM in and around Belgrade.  I spent some time this week with Fetoski and the SPY crew to learn about the outreach and research activities performed here. 

For more than five years, SPY (with support from the Global Fund) has implemented outreach services, including Internet outreach, promotion of voluntary counseling and HIV testing, and psychosocial support.


SPY staff (L to R): Loodi Nicky, Isein Fetoski, Dejan Zagrajski, Aleksandar HelterSkelter Skundric,and Ivan Ivanovic.,

Now, staff members report a disturbing trend of young MSM engaging in high-risk behavior—although “they are not lacking knowledge,” says Daniel Meskovic, co-founder of SPY.

In 2010, SPY received a community award from amfAR’s MSM Initiative to study the factors influencing HIV risk-taking behavior among MSM in Belgrade. “By understanding the patterns of HIV risk and sexual behavior and studying predictor variables such as personality and psychological factors, we are better able to meet the needs of MSM,” explained Meskovic. Until now, this type of research among MSM had not been carried out in Serbia.

While HIV prevalence among the general population in Serbia is low, as in many countries in the region, rates are notably higher among vulnerable groups; among MSM, HIV prevalence is estimated between 3.6- 6.1%. Internalized homophobia, stigma, and lack of appropriate health services are all factors fueling the spread of HIV among young Serbians.  Homophobia remains deeply engrained in the Balkan culture, evidenced by the eruption of anti-gay violence during Belgrade’s gay pride march this past October.

Serbia’s economic and social problems, deepened by the global recession, are not making things easier. In fact, SPY and other stakeholders are acutely concerned that the Serbian government will no longer be able to finance free and anonymous testing for HIV. Despite that, the important work continues. As Fetoski explains, “We are fighting to save our own lives.”

Chisinau, Moldova: Hope and Hardship

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Posted by Jirair Ratevosian, February 8, 2011

For better or for worse, the Eastern Europe and Central Asia region has attracted much attention since the release of the UNAIDS epidemic update last November. According to the report, the number of people living with HIV in the region has nearly tripled since 2000.  Even more striking, between 2000–2009 new HIV infections have increased by more than 25% in Armenia, Georgia, Kazakhstan, Kyrgyzstan, and Tajikistan—five of the seven countries worldwide with this level of increase.


Activists in Armenia with the MSM Initiative-supported group We for Civil Equality.

In a majority of these countries, rates are rising primarily among people who inject drugs, sex workers, and MSM. Although UNAIDS reports that unprotected sex between men is responsible for less than 1% of new HIV diagnoses, those on the front lines know the sobering reality: official data grossly underestimates the actual extent of infection in this highly stigmatized population.

This week in Moldova, more than 100 health and human rights activists have gathered for the closing conference of PRECIS, a widely hailed project aimed at addressing HIV/AIDS among LGBT communities in former Soviet Union countries. Since 2006, the project has partnered with eight CBOs in Armenia, Azerbaijan, Georgia, Kazakhstan, Kyrgyzstan, Moldova, and Ukraine.

Thanks to support from PRECIS, many activists have built vibrant organizations that have been able to catalyze change on a local and national level. Groups in Moldova and Georgia, for example, have recently succeeded in advancing anti-discrimination legislation at the national level.

amfAR’s MSM Initiative is also a source of support for CBOs in the region. This past year, amfAR funded Gender and Development in Baku, Azerbaijan, and is currently supporting We for Civil Equality in Yerevan, Armenia.

While there are numerous worthy achievements celebrated here this week, significant challenges remain.  In Moldova—where an LGBT activist committed suicide in December after police harassment—many are gravely concerned that the dearth of available funding for the region will undermine significant progress. Recognizing the need, the Global Fund has approved Round 10 HIV funding for Georgia and Kazakhstan to expand programming to most-at-risk-populations. 

Support from the Global Fund and amfAR are immensely valuable, but government and donor assistance remain critical in a region that is hoping that PRECIS is not the end but rather a pivotal point along the long journey to secure good health and human rights for all.

Dominican Republic: Every Scar Has a Story

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Posted by Ben Clapham, February 4, 2011


The idea of a transsexual identity did not exist in the Dominican Republic until recently. LGBT communities mainly considered a biological man dressed in woman’s clothing to be a transvestite or, worse, a drag queen.

D.R. has an overall HIV prevalence of 0.8 percent, but a recent study shows that 25 percent of female transsexual sex workers have HIV. Many have been victims of abuse from early on and have experienced sexual coercion and/or violence; very few have had access to education or prevention or treatment centers equipped to work with them. Mental health services for these vulnerable women are almost nonexistent.

Seeing the hardships facing female trans sex workers, COIN, an organization in Santo Domingo that provides sexual and reproductive health services, identified them as a priority for HIV prevention efforts and began offering them services. The program has been successful in gaining the trust of an extremely cautious and guarded community.

“I was a sex worker for a long time, but now I am a social worker,” proclaimed Nairobi, a leader in the female trans sex worker community. “I work with the girls and share my experiences so their lives can be better. One day, they won’t have to depend on sex for their survival and HIV can be less of a threat to their lives.”

Every two weeks, Nairobi and other health promoters go to the sites where the women work to notify them that COIN’s mobile clinic will be coming the following day. One woman told me, “I never miss the mobile clinic days. Even if that day is my day off, I will come.” The mobile clinic team seems to know every detail of these women’s lives. Every scar has a story to it; every wound a painful memory.

Every week at the center the women come and speak with a psychologist on subjects ranging from self-confidence to social integration at a workshop called “An Afternoon with Mama.” The women act as a family, supporting and protecting one another. For some of them, this is the only family they have.