Under its Community, Rights, and Gender special initiative, The Global Fund is providing technical assistance (TA) to assist a community-based organization, LGBT Georgia, to respond to an alarming increase in HIV incidence among men who have sex with men.
According to a surveillance survey regularly performed by Curatio International Foundation, with support from The Global Fund, HIV incidence among MSM in Georgia went from 7% in 2010 to 13% in 2013. And in Tbilisi, the capital, the incidence rose to 25% in December 2015.
The request was initiated by the principal recipient for Georgia’s existing HIV grant, the National Center for Disease Control and Public Health. The TA is being provided for three months by experts from Eurasian Coalition of Male Health and the Asia-Pacific Coalition for Male Sexual Health.
The TA has three elements: (1) training community and medical personal in preventive methods; (2) conducting a needs assessment of MSM services across Georgia; and (3) undertaking organizational strengthening of LGBT Georgia.
The first element, training, has already been implemented. A training session took place on 10-11 May with the goal of sensitizing participants to the pre-exposure prophylaxis method– specifically, what is it, why it should be used, and how best to organize the provision of PrEP. On the first day, community representatives were trained; and on the second day, medical personnel. Training participants discussed various issues, including confidentiality and where the PrEP should be provided. The MSM community expressed a preference to have the service provided in a community-based setting as opposed to medical facilities.
The second element, the needs assessment, has also started. It is being done by local experts hired by ECOM. The needs assessment will explore all existing services and gaps, including PrEP. The results of the assessment will inform the pilot PrEP program that is part of the HIV grant. The program will recruit 100 participants in 2017 and another 100 persons in 2018. (The plan is to use PrEP not only for MSM, but also among sex workers and people who inject drugs, which are the populations most affected by HIV.)
The third element, organizational development, will start in the next few weeks. A strategic planning workshop will be held to identify gaps and solutions. One of the important outcomes of the workshop will be an organizational development plan for LGBT Georgia.
Capacity building of MSM organizations in Georgia is particularly important. Although the NGO sector is generally well developed, the networks of PWIDs and SWs are stronger than their MSM counterparts. MSM community-based organizations are still very new, and stigma against the MSM population is extremely high. But the legal environment is less harsh (MSM are not criminalized, for example), so there is some hope that the MSM service gap can be bridged.
The PR and National AIDS Center understand that the communities must play a central role in the delivery of PrEP. According to Nikoloz Chkhartishvili, deputy director of the National Aids Center and program manager for the HIV grant, “The role of the communities in PrEP piloting is very high, as community-based organizations are expected to mobilize and motivate participants to use the service.”