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- Young men who have sex with men face a heightened risk of HIV in Kenya.
- Advocates for Youth partnered with Men Against AIDS Youth Group (MAAYGO) to implement a youth-led HIV prevention program
- Through this partnership, MAAYGO trained health care workers in working with LGBT youth, reached young people with prevention materials, and strengthened its leadership in coalitions and partnerships with other organizations which serve young people.
MAAYGO grounds its work within the “Nothing for Us without Us” framework and is a testament to the importance of centering the voices of LGBT youth within larger LGBT and public health contexts. LGBT youth are the most vulnerable to hostile political and cultural environments but are also the ones who are bravely pushing for a changing landscape that provides protection for all members of the LGBT community. MAAYGO’s work within programmatic, community mobilization and advocacy avenues aims to directly reach LGBT youth, empower and connect LGBT youth, and at the same time engage with mainstream stake holders to affect long term change. Advocates for Youth with its demonstrated commitment to centering the voices of youth has leveraged this important partnership to elevate the specific needs of LGBT youth in Kenya and more broadly in Africa to make sure that their vulnerabilities can transform into resilience and power.
Strength in Partnership : MAAYGO and Advocates for Youth
Eighty percent of new HIV cases in sub-Saharan Africa are among adolescents, and HIV prevalence among men who have sex with men (MSM) in Kenya is three times that of the general population. LGBT people face cultural and legal discrimination.
To address the lack of education and access to culturally competent HIV prevention, testing and care among LGBT youth in Kisumu County, Kenya, Advocates for Youth partnered with Men Against AIDS Youth Group (MAAYGO) to serve as a model for similar interventions in other global south communities facing similar barriers. MAAYGO is a membership organization, and its leaders and members are gay men, other men who have sex with men and transgender people (GMT) both infected and affected by HIV from the age of 18-35. The organization advocates for equitable access to effective HIV prevention, care, treatment, and support services for GMT, while promoting their sexual reproductive health and rights locally and nationally in Kenya.
Advocates for Youth was one of the first organizations to put adolescent sexual health on the agenda of the international family planning field, establishing the International Clearinghouse on Adolescent Fertility as early as 1980. In 1983, Advocates published the ground-breaking Life Planning Education (LPE) program that established sexual and reproductive health as part of life skills and youth development. LPE became a cornerstone program, used and adapted in over 35 countries, providing adolescents with information and skills on personal, family and community values, relationships, rights and responsibilities, gender equality and sexual and reproductive health. Advocates promotes youth leadership not just as a youth development strategy but as a means to achieving political and cultural change. Advocates’ Youth Activist Network stands 75,000 strong including young people from nearly 100 countries around the world and 1,000 campuses across the U.S. Advocates is also dedicated to fostering partnerships with both youth-led and youth-serving organizations, collaborating closely with at least 100 organizations domestically and 30 internationally with programming in 15 countries across Africa, Asia, and the Caribbean.
In 2015, Advocates and MAAYGO, implemented a 12 month program in Kisumu, Kenya, focused on implementing a culturally competent program for LGBT youth around accessing HIV prevention, testing and care services. MAAYGO and Advocates for Youth relied on interrelated core strategies around program implementation that included LGBT friendly services, advocacy, behavior change, communication and youth engagement at high-level convenings.
Assessing Community Need for Health Services
MAAYGO in conjunction with Advocates for Youth developed a needs assessment survey instrument to determine the barriers to access of health services for LGBT youth. The needs assessment contained 25 questions to 1) identify the sexual health concerns and needs of the LGBTQ youth in Kisumu County; 2) to gain a better understanding of the gaps in usage and access of sexual health services among LGBT youth; 3) to identify the factors that compromise sexual health of LGBT youth in Kisumu and 4) to identify existing knowledge of sexual health services amongst LGBT youth. Survey questions were around identity, education, level of being “out,” experiences around violence and rejection, knowledge around sexual health services, primary health concerns and sources of information around sexual health services including HIV prevention services.
Key findings from the survey include the following:
- All men who identified as gay reported some level of victimization from the community with the highest ones being rejected by friends followed up by rejection from family.
- Half of the transgender women had experienced physical violence.
- 60% of gay men had sex with more than one partner in the last three months but only 31 % had been tested for HIV in the last three months and 25 % had never tested at all.
- The majority of LGBT youth surveyed identified “access to health services without fear to stigma and discrimination” and access to “safer sex methods” as key concerns around sexual health
Findings demonstrated the significant need for culturally competent health care services for LGBT youth.
Training on LGBT-Friendly Youth Services
In the needs assessment, youth reported high levels of victimization and violence and identified that it is important for them to feel safe at places where they access services. In June 2015, Advocates staff to trained a cadre of 30 LGBT youth leaders with MAAYGO in Kisumu, Kenya around sexual health services and to understand the landscape of LGBT youth needs in Kisumu. Youth talked about the importance of sensitizing health care providers, the police and religious leaders; reducing stigma and discrimination from family members; and mobilizing stakeholders to affect policy change. MAAYGO conducted two workshops for health workers on the sexual health needs of LGBT youth reaching 105 health workers. MAAYGO discussed the findings from the needs assessment survey and trained providers around how to support and create a supportive environment for LGBT youth to access culturally competent services in government health facilities.
Fostering youth engagement and advocacy
MAAYGO engaged in advocacy efforts with decision makers including with Kisumu County’s Gender Technical Working group to specifically advocate for transgender visibility, young women’s involvement and LGBT-youth’s inclusion within the decision making processes of Kisumu County’s technical working groups. MAAYGO also spear headed an advocacy initiative around decriminalization of sex work and to highlight issues around violence against young women and sex workers. MAAYGO trained advocates to lead this discussion with the County Deputy of Health, Police Commandant, County Gender Technical working groups, media personnel and other civil society organizations. This advocacy work has led to increased visibility of LGBT youth in Western Kenya as well as an enabling environment to decrease the stigma and isolation. For example, MAAYGO has been building a strategic partnership with the ministry of health to strengthen the public health system and provide quality comprehensive health services to MSMs without stigma and discrimination. Through this partnership, MAAYGO has been allotted space at the Migosi Health Hospital to provide culturally competent health services to LGBT youth. MAAYGO is also now and official member of the Kisumu County’s Gender Technical Working Group.
Two lead peer educators from MAAYGO attended Advocates for Youth’s 16th Annual Youth Leadership Development Institute along with 150 other youth activists from across the United States and global south including Jamaica, Pakistan and Kyrgyzstan. The intensive five-day institute included discussions on global youth sexual and reproductive health and rights trends, LGBTQ youth health and rights, US foreign policy and UN advocacy, peer education, new media, and lobbying, among others.
The Youth Institute concluded with a Capitol Hill education day where young people meet with US policy makers to garner support for legislation around international LGBT rights. Youth met with staff from Senator Ed Markey’s office and Representative Alan Lowenthal’soffice, both co-sponsors of the International Human Rights Defense Act (a bill to make preventing and responding to discrimination and violence against the LGBT community a foreign policy priority). Youth activists met with Todd Larson, the senior Lesbian, Gay, Bisexual and Transgender (LGBT) coordinator at USAID as well as Randy Berry, U.S State Department’s first-ever Special Envoy for the Human Rights of LGBTI persons. In all of these meetings, youth from MAAYGO had an opportunity to discuss the key concerns of LGBT Youth in Kenya and how U.S foreign policy plays an important role.
Connecting LGBT youth to HIV prevention, testing, and care services
MAAYGO used the findings from the needs assessment to inform radio broadcasts to reach LGBT youth and worked with LGBT youth leaders to inform the design and content of the efforts.
MAAYGO youth decided to disseminate messaging via radio broadcasts as they are popular with youth living in both urban and rural areas of Kisumu County. The radio sessions covered issues such as the definition of key affected/LGBT population and why it is important to prioritize this population; challenges facing LGBT youth; and MAAYGO’s strategy around outreach to sensitized health providers and the impact of HIV on LGBT youth.
After each of the three radio sessions, MAAYGO invited questions via radio call-ins or SMS. The calls raised questions on issues pertaining to sexual reproductive health, STIs , HIV, unintended pregnancies, sex work, post –rape care, parent-child relationships and sexuality. During the broadcast, MAAYGO also provided its office number to encourage in person follow up with young people able to visit MAAYGO and each radio broadcast was saved for future dissemination purposes.
Four million youth and adult allies were reached by the radio broadcasts. Nearly 650 youth were reached via engagement with the radio broadcasts (375 SMS messages and 268 calls).
The outcomes of these strategies included:
administering a survey to 100 LGBT youth in Kisumu; training a cadre of 30 LGBT youth leaders; training 105 health care workers; and ultimately reaching 900 youth directly and approximately 4 million youth and adult allies indirectly through strategic media outreach efforts. Advocates’ provided critical technical expertise and capacity building support to amplify efforts to better serve LGBT youth in Kisumu County and raised the visibility of issues facing African LGBT youth, especially YMSM, demonstrated by MAAYGO’s recognition by TRUE AFRICA as one of the 100 innovators shaping Africa.
LGBT Youth Voices:
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“As a young gay person infected and affected with HIV, I have been mobilizing MSMs and other youth at-risk weekly, at MSM hot spots, clubs, social events & joint hub areas using word of mouth; visiting gay social media sites and providing health talk sessions.MAAYGO has really encouraged me to contribute my efforts to peer education programing as an effective way to increase access to prevention services.” – Brian, 24 |
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“I face the double stigma and of being gay and HIV positive. For a while, I was in a state of denial and hated myself, but four years ago I was referred by a friend to attend an event organized by MAAYGO where I met MAAYGO’s staff and started networking with them. I re-tested for HIV and then started on treatment. I am also working through self-stigma and can now feel comfortable with who I am. I now live positively through taking my treatment and continue to attend MAAYGO’s peer sessions and support group.” – Fred, 25 |
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“At first it was hard and challenging to accept that I was HIV positive but through counseling and support from the community and MAAYGO’s monthly support group forums, I can now share my HIV status with others. I have also been given trainings on adherence and this helps me to take my treatment at the right time. Through MAAYGO, I have also been trained around negotiating safer sex and self-efficacy.” – Hassan, 28 |
Conclusion
In partnering with MAAYGO, Advocates provided critical technical expertise that strengthened MAAYGO’s capacity to build youth leaders and improve health outcomes among LGBT youth in the Global South. MAAYGO was even recognized by the cutting edge media outlet TRUE Africa as one of the 100 innovators shaping Africa. By leveraging each organization’s strengths and centering the voices of LGBT young people in Kenya, Advocates and MAAYGO were able to create real and lasting change.