Stigma within healthcare facilities blocks access to services for MSM and TGs

Shobha Shukla – CNS
Born in 1948 in India, Shivananda Duncan Khan migrated to the UK when he was ten years old. In 1988 he founded an organization for South Asian LGBTs in London called Shakti, followed by health support groups for MSMs across India, Bangladesh and other South Asian countries. After losing a close gay Muslim friend to AIDS in the early 1990s, Mr Khan became active in the AIDS response and founded the Naz Foundation International based in London and Lucknow.

Mr Khan campaigned to bring greater attention to the challenges and strategies needed to address HIV among men who have sex with men and transgender people. Mr Khan was the central figure in the development of the Asia Pacific Coalition on Male Sexual Health (APCOM), serving as its Chair from 2009–2012. In recognition of Mr Khan’s work with men who have sex with men and transgender people in Asia and globally, he was awarded the Order of the British Empire in 2005.This committed, passionate, inspiring and visionary activist passed away on Monday, 20th May 2013.

Following are excerpts from an interview he gave at the previous ICAAP in 2011:
“Stigma within health care settings blocks access of men who have sex with men (MSM) and transgender populations to existing services to an alarming level. The Asia Pacific Coalition on Male Sexual Health (APCOM) has been looking at this issue of stigma within health care settings, which prevents people from accessing services and in fact kills people if nothing else. So NFI and APCOM are engaging more with the UN, the WHO, and other stakeholders to improve quality of education for the health sector, to engage in issues around health sector reforms and to improve services at grassroots level."
“Mental health issues arise because of significant levels of stigma and discrimination. Depression, harassment, relationship problems, loneliness and social isolation, are among the few pressing mental health concerns that challenge MSM and transgender populations in particular. HIV and sexually transmitted infections (STI) counselling is more concerned with sexual and reproductive health, and doesn't adequately address mental health concerns beyond HIV prevention and to some extent care and support issues.”

"Medical curricula need to be re-evaluated to address the health needs of all marginalized communities including MSM and transgenders. If you look at the treatment of STIs there is no training in the curricula that is appropriate to the needs of MSM and transgender populations. If you look at the mental health curricula there is no training around addressing stigma and discrimination as a key element in addressing mental health problem. There is no education for the families arising from having gay sons and [lesbian] daughters."

"Human beings irrespective of their sexual identities should be treated with dignity. Families, medical fraternity, police, bureaucrats, politicians, it is the whole of society which you must engage in improving health responses for MSM and transgender populations."

"My message for the conference is that the key vulnerable communities in Asia and the Pacific to HIV are MSM and transgender populations. Unless there is clear recognition from all governments that these populations are engaged in designing, developing and providing services, HIV is never going to be resolved in terms of reducing the level of HIV in our parts of world."

Shobha Shukla, Citizen News Service – CNS
November 2013

Note: This article was first published in 11th ICAAP INSIGHT, the official daily conference newspaper of 11th International Congress on AIDS in Asia and the Pacific (11th ICAAP) in Bangkok, Thailand. This newspaper was managed by Inis Communication and CNS.