Toward gender and age-responsive HIV and AIDS programmes in the Philippines

Last Friday, 16 July 2010, I attended a whole-day, national consultation meeting upon the invitation of the National Economic and Development Authority (NEDA) in line with their project on Developing a Gender- and Age-Sensitive AIDS Response in the Philippines (see pic above). The project is jointly supported by UNDP, UNAIDS & UNICEF. The meeting, which was attended by representatives of NGOs, government agencies, and advocates from around the country aimed to 1) validate the preliminary country assessment report of the gender- and age-responsiveness of national AIDS policies and programmes, including indicators and 2) get feedback and recommendations from the national consultation participants on strengthening the gender- and age-responsiveness of the national AIDS response.

I was happy that finally this conversation has been started in HIV & AIDS circles. The preliminary assessment report for the meeting was prepared by the Health & Development Initiatives Institute in collaboration with EnGendeRights. The preliminary assessment was conducted using secondary data analysis of regional focus groups discussions (FGDs) in the National Capital Region (NCR), Cebu & Davao and interviews with key informants from different target groups including People Living with HIV (PLHIVs) and affected women, women in prostitution (WIPs), NGOs, Males who have Sex with other Males (MSMs), injecting drug users (IDUs) and overseas Filipino workers (OFWs). The feedback from the national consultation meeting would be included in the assessment report that would be given to NEDA.



The results of the assessment, which were presented to the plenary were not surprising (see pic above). HDII & EnGendeRights found that the level of gender- and age-responsiveness of HIV and AIDS programmes in the country was low. Further, they also found that mainstreaming gender issues and including age-appropriate interventions into HIV & AIDS response programmes lagged behind bio-medical interventions.



After an open forum that spilled into lunch, the participants were asked to break into various workshop groups that would give recommendations on how to include gender- and age-responsiveness into the various HIV and AIDS interventions, services and policies that are in place. I decided to join the group for MSM & TGs (see above). As expected, I was the only transperson present in the meeting, the only transperson in the workshop group and the only female.

Our workshop group was tasked to make recommendations for gender- and age-mainstreaming in various areas of interventions including: information & education campaign (IEC) materials including behavior change communication (BCC); training which covers HIV 101, peer education, life skills building & others; voluntary counseling & testing; gender-based violence & child abuse and STI services.

At the onset our group decided to make general recommendations that could not be accommodated into the matrix we needed to follow. I made it very clear to the group that for gender-mainstreaming to be fully accomplished for the transcommunity the first thing that needed to be done was to separate MSM & TG populations in HIV & AIDS response programmes in all aspects. Although STRAP does not have a programme on HIV yet, we have been having informal discussions on what a desirable programme for us would look like. We are in agreement that it should be included under a comprehensive transgender health framework that addresses access to hormones, surgeries and general well-being that does not adhere to a pathological model and has a clear component on transphobia-reduction.

I am glad that I was able to have a conversation with representatives of some of the MSM groups who joined our workshop group. I told them that our needs as transpeople especially those who are afflicted with HIV & AIDS have been invisibilized by the domination of MSMs in the discourse on HIV & AIDS in the Philippines. I have heard from positive communities that they have been accepting more and more transwomen in their support groups which clearly indicate increase in infections among tranpinays. Any intervention geared towards them should first & foremost respect their gender identity. Unfortunately, because they are subsumed under the MSM label, they are treated as men by NGO workers, health care professionals & government agencies. And because there is, as yet, no established support group for infected transpinays most of them have joined MSM support groups.

We have a long way to go before developing an intervention programme for transpinays with HIV & AIDS. In the meantime, I am starting to feel frustrated about having to attend all these HIV & AIDS meetings where I keep repeating myself. At some point, we in STRAP need to start walking the walk and doing something concrete in line with HIV & AIDS advocacy. But because we are already over-burdened by our main advocacy concerns, including HIV in our work will be spreading thinly our already limited resources & manpower. I hope our members who are studying to be or are already in the medical field will step up & decide to take on HIV & AIDS advocacy. Their biomedical knowledge will be a good foundation for social justice work in this area. This is something that we need to do and quickly at that.

Taking a stand on HIV/AIDS

In the hustle and bustle leading up to the 2009 Manila Pride March, I almost forgot that I along with two other members of the Executive Committee (ExeCom) of Task Force Pride (TFP) Philippines 2009 joined a World AIDS Day (WAD) campaign initiated by the writer and make-up artist, Anna Santos. Anna, who has taken up HIV/AIDS advocacy recently, attended the 9th International Congress on AIDS in Asia and the Pacific (ICAAP) in Bali, Indonesia in August.

It was in Bali that she thought up the idea of a "Dare to Bare" WAD campaign. The campaign was going to showcase photographs of various advocates wearing nothing but the iconic AIDS ribbon "to make a stand, and to hopefully change the way (people) look at HIV/AIDS" and would be carried by different publications including the Manila Times, Spot, Herword, WMN, UN Office for the Coordination of Humanitarian Affairs (UNOCHA)and Cosmo magazine online near or around 1 December 2009.

Anna asked the TFP ExeCom to pose as a group for the shoot (see pic below). In the end (from L to R) only me, a lesbian rights advocate under the name Queer Silver and another trasnwoman made it. The write-up on TFP for this WAD campaign, is also published in the new issue of Outrage, the only online zine for TLBG Filipinos. You can see the article here.



My personal interest in joining this campaign has to do with my growing frustration with how transgender (TG) and HIV/AIDS is framed in the Philippines. For the most part, transgender people which includes men and women have been lumped with the Males who have Sex with other Males (MSM) category in HIV/AIDS work. I have always maintained that using this framework is problematic because:
1. it disrespects trans people's identity particularly transwomen's identity because they do not see themselves as men who have sex with other men;
2. it reduces people to their sexual behavior conflating it with sexual orientation and gender identity. These concepts are not equivalent with each other.
3. it invisibilizes the particular health care needs of transgender people like access to hormones, surgeries, medical professionals who are well-versed in trans issues, etc.

Although I personally welcome the new three-year UNDP program that will provide intervention packages to vulnerable and at-risk groups including MSM and TG, I feel that the intervention packages to these two highly different groups should be separate. I hope that the NGOs working with UNDP, UNAIDS, UNFPA and other agencies working towards the Millennium Development Goal 6 of combating malaria, HIV/AIDS and other diseases will do their best to consult existing trans organizations because we can provide insight on how HIV/AIDS prevention, treatment and care intersect with and impact on our being transgender. For me, a comprehensive HIV/AIDS intervention program for the trans community is one that is cognizant of the health care needs of all transpeople not only of those who are doing sex work. Therefore, such a program should be created in collaboration with the people it aims to serve, transpeople themselves. Above all such a program should put a premium on respecting gender identity, something that is sorely missing in programs that are currently in place.

New UNDP HIV/AIDS program launch

Yesterday, May 6, I attended the launch of a new HIV/AIDS response program being co-sponsored by the Government of the Philippines (GOP) and the United Nations Development Programme (UNDP) at the Renaissance Hotel in Makati City. The new program seeks to strengthen national and local responses to HIV/AIDS and mitigate the disease's impact on human development. The GOP and UNDP have earmarked a little over a million dollars for this new three-year program and the money will be used to: a)develop an effective, sustained and comprehensive leadership program in response to HIV and AIDS; b) strengthen the capacities of government, NGOs and people living with HIV (PLHIV); c) implement HIV prevention intervention among most at-risk populations (MARPs) and identified vulnerable populations; and d) develop and disseminate information for these vulnerable groups.

According to the representative of the Philippine National AIDS Council (PNAC) at the launch, the Philippines is considered a low HIV prevalence country. In fact in 2007, the number of PLHIV in the Philippines was less than eight thousand. However, those who do HIV/AIDS work have noted an alarming trend of new infections from 20 new cases monthly in 2000 to 44 new ones per month in 2008. In January 2009, there were 65 reported new cases of HIV/AIDS infections.

The reason why we went to the launch was because the UNDP has been trying to get in touch with transgender community organizations doing HIV work. As of today, only one group for transpeople in Cebu, called the Tonette Lopez Project (TLP), is involved in HIV/AIDS work.

When I spoke to the UNDP Country Director Renaud Meyer (in the picture with us above), he asked me if any transgroup had direct involvement in their new program. The UNDP has identified the trans community as one of their MARPs and one of the components of this new program is to build the capacity of trans groups responding to HIV/AIDS. I told him that no transgroup had key role in their program but that they should get in touch with TLP if they want to target the trans population. I just emailed a Trans 101 presentation to one of the officers of TLP, Peachy Rivera, who is getting ready for a workshop designed exclusively for trans female participants next week.

I am not well-conversant in HIV/AIDS advocacy but I am aware that it uses the men- who-have-sex-with-men (MSM)framework to describe trans women. In fact the presenter from PNAC would always say MSM and TG. This is something that I feel needs to be urgently addressed by those who are involved in this kind of work because I feel that lumping female-identified trans people together with MSMs disrespects their gender identity and invisibilizes the need for a trans-specific response to HIV/AIDS prevention, treatment and care. For now, I know that there are many transgender rights activists around the world who work in MSM groups because those are the only existing HIV/AIDS organizations in their countries with access to badly needed resources. But I also know these brave trans women are beginning to interrogate within these groups the MSM label used to identify them.

Let's hope that this new UNDP program will deliver on its promise and I really hope we do not see here HIV/AIDS ravaging the trans community.