3rd NFI Partners Regional Consultation Meeting
5th – 7th April 2003, New Delhi, India

Living with Dignity: Social Justice for All

Summary Report

Opening Ceremony
Introduced by Arif Jafar, Director of the NFI Regional Liaison Office
in Lucknow, the opening ceremony was performed by Shri Oscar
Fernandes, Lok Sabha MP and Convenor of the All Party Parliamentary
Committee on AIDS, along with his wife. This was followed by his
speech stressing the need to address the needs of those living with
HIV/AIDS, reducing stigma and discrimination, and ensuring
appropriate methods for preventing the spread of the epidemic.
Shivananda Khan, Executive Director and founder of NFI then gave the
welcome address.

Plenary Sessions
The first plenary session on Saturday morning has the theme Living
With Dignity. The speakers were Vijay Nair, Vice-President of Udaan,
former Vice-President of INP+, and founder member of NIPSHA (a
positive support network for those kothis living with HIV/AIDS), and
Anand Grover, Project Director of the Lawyers Collective HIV/AIDS
Unit. Chairing this plenary session was Anjali Gopalan, Executive
Director of Naz Foundation India Trust.

Vijay Nair spoke on his discovery of his positive status, his fears
and concerns as a positive kothi, and the moving support of his
mother and family. His speech also addressed the needs of all the MSM
projects to develop appropriate care and support systems for their
constituents.

Anand Grover spoke on human rights and the laws affecting "sexual
minorities", and what steps are being taken to address these issues.
This included a discussion on the petition being filed in the Delhi
High Court on Section 377 of the Indian Penal Code by Naz Foundation
India Trust. This Section deals with "carnal intercourse against the
order of nature" and has been used against homosexual activity.

The second plenary session on Sunday morning had the theme,
Masculinities, Sexualities and Vulnerability. The speakers were
Aditya Bondyopadhyay, Lawyer, human rights activist and NFI
consultant, as well as founder member of Bamon Development
Consultants. With him were Ashok Row Kavi, Chairperson and founder of
Humsafar Trust and Professor Peter Aggleton, Director of the Thomas
Coram Research Unit, Institute of Education, University of London,
UK. Chairing this session was Lalitha Kumaramangalam, Executive
Director of Prakriti.

Aditya Bondyopadhyay spoke of the systematic abuse and harassment of
kothis across South Asia from early childhood, the social
construction of masculinities and how different masculinities
experience different vulnerabilities in terms of social interactions
and HIV/AIDS. Kothis and hijras experience the highest
vulnerabilities to both, each reinforcing the other. Professor Peter
Aggleton spoke of the urgent need to work with men and masculinity in
the context of HIV/AIDS prevention and care, where we need to
understand the production of masculinities, frameworks of power and
resistance to hegemonic masculinity, breaking the silence on male-to-
male sex and develop more gender/sexuality equitable programmes.
Ashok Row Kavi followed this with an interesting presentation on
Masculinities and vulnerabilities. He discussed different sexual
identities and behaviors of Indian male giving the reference of
ancient texts.

The third plenary session on Monday morning had the theme of
Supporting Marginalised Collectivities, chaired by Calle Almedal,
Senior Advisor of the Partnerships Unit of UNAIDS in Geneva. This
plenary brought together a range of donor representatives to provide
a platform for Meeting delegates to understand donor perspectives on
supporting MSM sexual health programmes in the region and to ask
specific questions of the donors. Speakers included Sri Oscar
Fernandes, Convener of the All Party Parliamentary Committee on AIDS,
Chawalit Tantinimitkul, Programme Officer, FHI Asia Regional Office,
Bethanne Moskov, USAID Mission, India, Tim Martineau, Senior Health
Advisor, DFID India and Asa Andersson, Regional HIV/AIDS Advisor to
SIDA. What was clear from this session was the increasing importance
being given to MSM sexual health issues by all donors, and the
increasing investment on MSM HIV/AIDS issues being realised in the
region. Participants deemed this the most important plenary session
of the Meeting.

Satellite sessions
Three representatives from Hijra groups were invited to attend the
meeting specifically to participate in a key satellite session on how
to provide technical support for the development of hijra focus
sexual health interventions across India. The meeting was moderated
by Shale Ahmed of Bandhu Social Welfare Society in Bangladesh, which
provides technical assistance to Shusto Jibon, a hijra sexual health
service in Dhaka, and by Vijay Nair with experience of working with
hijras in Maharashtra. Hijra representatives expressed their needs
and viewpoints.

This satellite begins a process of dialogue with hijra
representatives across India to begin the development of technical
support from NFI and its partners to assist in the development of
hijra sexual health projects. It was clear from the discussions and
previous documentation that MSM projects should not manage such
services but should assist in empowering hijras to develop their own
service provision.

A satellite meeting was supposed to be held on microbicides and
lubricants, but the Hijra technical support continued on, and so this
was cancelled.

On the Sunday, the satellite session focused on Hearing the missing
voices – empowerment and social justice for kothi-identified MSM.
This discussion explored the context of kothi lives, and included
issues of human rights abuse, social justice, and methodologies of
empowerment.

Following this, a discussion was held on a draft Meeting Charter on
Social Justice. A Working Group consisting of NFI, a number of its
partners as well as its technical advisors, had worked the on the
draft. The intention was to gain support from all the projects
present at the meeting for this Charter, and submit it to a range of
international, regional, national and state institutions. The Charter
and its contents were accepted in principle, but participants desired
that specific articles in the Charter should be linked with specific
UN conventions, guidelines or principles as already articulated in
numerous international documents signed by all UN signatories. It was
believed that this would provide a much stronger advocacy tool. It
was agreed that the draft Charter would go back to the working group
for further refinement and amendment and the final draft will be
circulated to all projects present at the meeting by end of April
2003.

Networking support
A special session was held for participants from a range of groups
from West Bengal to enhance collaboration between them, particularly
in regard to funding and service delivery so as to reduce competition
and enhance cooperation. A Calcutta Forum is to be established as an
output of this meeting.

A special session was held for delegates from south-east Asian
countries to identify This meeting was called on the request of FHI
Asia Regional Office to begin the process of identifying the needs of
the South-East Asia region in relation to MSM sexual health
programming, technical assistance, and any recommendations that
participants might have for future regional work. A brief report was
produced and forwarded onto FHI.

A session was also held to explore the development of the Indian
Network of Male Sex Workers and build links with the range of partner
agencies and other projects. Along with this an opportunity was
provided for bisexually identified persons to also meet and identify
their own needs and support mechanisms.

ARMAN Awards
This Consultation Meeting also gave the opportunity to
institutionalize a new international MSM award – The Arman Awards.
During the last Training of Trainers programme held by NFI in
September 2002 at the NFI Regional Liaison Office in Lucknow, India,
there were 15 projects from South Asia and Vietnam present. At this
course, participants agreed to form ARMAN – the Asia Regional MSM
AIDS Network that would link up all the MSM sexual health projects in
Asia as a broad network to stimulate discussion, information and
skills exchange and provide solidarity, empowerment and strength to
all MSM sexual health projects. The ARMAN Awards is an initial
attempt towards that goal.

Three awards were presented. The first award was for the person or
project that had done the most to advance the cause of ensuring
provision of appropriate services for MSM in their city, state,
country or region. The winner of this Award was Shale Ahmed,
Executive Director of Bandhu Social Welfare Society in Bangladesh,
who began BSWS in 1996 with two staff and a small drop-in in Dhaka,
and has taken BSWS since then to become the largest MSM sexual health
service provider in Asia, operating in 6 cities in Bangladesh.

The second award was deemed the ARMAN Human Rights Award, and was
given to Aditya Bondyopadhyay and Lok Prakash both of Bamon
Development Consultants and NFI consultants, for their sterling human
rights and advocacy work during the problems generated when the NFI
Regional Liaison Office Director was arrested along with his staff,
and the Regional Office closed. Their networking and advocacy skills
locally, nationally and internationally were key to ensuring their
release and the re-opening of the office.

The third award was for deemed the ARMAN Positive Award for the MSM
person who had worked extensively, both as a kothi and as a positive
person to strongly advocate on behalf of positive kothis. The award
was given to Vijay Nair, Vice President of Udaan, and founder member
of NIPSHA, a positive network for kothis.

It is intended that these Awards will be presented every two years
for these three categories, and a special Awards Committee will be
developed along with a process of selection for future Awards. The
initial choices for these Awards were made by NFI and by members of
its technical advisory network.

Workshops
Central aspects of the Meeting were the skills-building workshops.
Each was held for 3 days. NFI was fortunate enough to bring together
an extraordinary team of facilitators from a range of institutions to
provide their technical expertise for these workshops.

Voluntary Pre-and Post-Test Counselling For Self-Identified Kothis
and Other MSM
Currently the majority of the NFI MSM partner projects are not
offering this service, although it is rapidly becoming clear that the
issue of pre- and post-test counselling is becoming one of urgent
concern. However, the issues of social exclusion, marginalization,
stigmatisation, along with accessibility to appropriate treatment,
support and social services have not been adequately addressed by
VTCs or by HIV+ve groups. At the same time, partner agencies have not
adequately addressed these concerns, primarily focusing on prevention.

The workshop addressed this gap in appropriate service delivery by
taking participants through issues and needs around pre-and post-test
counselling, the actual test itself, social, psychological, physical,
and medical needs, and how these needs should be addressed to ensure
appropriateness particularly for gendered males such as kothis.

Facilitators: Dr. Bitra George, Programme Manager (Technical), FHI,
India and Neelam Dang, Coordinator, Chelsea, New Delhi, India

Self-Help, Care and Support For Self-Identified Kothis Living with
HIV/AIDS
Self-identified kothis form population groups and collectivities,
which are socially excluded, marginalised, stigmatised and
disempowered. Being HIV+ve or living with AIDS adds even further
discrimination, not only by society at large, but also by the medical
and social work professions, and very often by members of their own
collectivities. Nor can it be assumed that the fact of being HIV+ve
is enough for such persons to become an accepted part of Positive
support groups.

This workshop explored the range of issues and needs that not only
address the HIV positive status of self-identified kothis and hijras,
but also explored how their gendered identities affect these needs
and what steps need to be taken to develop self-help groups with
them, along with the necessary care and support programmes that are
appropriate to their specific needs.

Facilitators: K.K. Abraham, President, INP+, India and Geeta
Venugopal, Relationships Officer, INP+, India

Developing Operational Research Skills within MSM/Kothi Sexual Health
Projects
As more and more MSM CBO sexual health projects are developed, the
need to identify best practices, evolve appropriate strategies, as
well as to find solutions to what appear to be intractable problems
in promoting risk reduction among the different MSM frameworks
becomes an urgent necessity.

This workshop provided a skills-building programme for participants
to understand the basics of what is meant by operational research. It
explored how to identify key questions from the monitoring data that
is being collected and develop simple and easily replicable studies
to find answers and solutions to those questions that improve the
quality of service delivery as well as its capacity to reach more MSM
and build sustainable strategies of risk reduction.

Facilitators: Rajiv Dua, Senior Technical Officer, FHI, India and
Rajat Adhikari, Senior Research Officer, FHI, India

Reaching Non-Kothi MSM
The majority of the prevention and outreach work conducted by the NFI
partner agencies is with self-identified kothis, and through them,
their partners. Yet is understood that many non-kothi-identified MSM
also visit a range of sites, and that male-to-male sex goes in
neighbourhoods, hotels, as well as a range of all male institutions.

This workshop explored the range of dynamics of male-to-male sex
behaviours, what males are participating in such activities, and what
risk reduction strategies and methodologies would be possible, along
with developing a series of recommendations for action for partner
agencies to expand their MSM target populations in their service
delivery.

Facilitators: Shale Ahmed, Executive Director, Bandhu Social Welfare
Society, Bangladesh, and Deep Purkayastha, Project Director, Praajak
New Alipore Welfare Society, Calcutta, India

Advocacy and Social Justice For Kothis And Other MSM
Social justice and human rights issues for MSM are a complex matrix
of issues, concerns, and needs that reflect personal psycho-sexual
histories, economics, social-cultural polices and attitudes, as well
as legal concerns, that create a context for MSM, but particularly
for feminised males, of low-esteem, disempowerment, and
marginalisation that leads to further abuse, violence and social
exclusion.

The workshop explored these contexts, identifying issues and needs,
while developing a range of strategies that partner agencies can put
into place to respond to these concerns.

Facilitators: Elvarthi Manohar, Executive Director, Sangama,
Bangalore and Ashwini Sukthankar, activist and author

Developing a Behaviour Change Communication Strategy For Kothi/MSM
Sexual Health
Projects
The primary message given by HIV/AIDS projects, including our partner
agencies, reflects the concept of HIV/AIDS as a public health issue
and is based on disease prevention. Further these messages reflect a
construction of self as an independent individual acting in
isolation. Thus, the message is usually "use a condom and protect
yourself".
Despite the World Health Organisation defining sexual health as the
integration of the physical, emotional, intellectual and social
aspects of sexuality, the vast majority of risk reduction messages
still ignores the concept of WELL-BEING and focus on ILL-HEALTH.

The workshop explored alternate messages and communication strategies
for risk-reduction among MSM as a part of a broader concept of
wellbeing.

Facilitators: Vaishali Mahendra, Programme Office, Population Council
(Horizons Project), India, and Rajesh Jha, Vice-President, EPOS India

Masculinities, Sexualities and MSM
The primary target population which our partner agencies focus on are
self-identified kothis, and through them, their panthi partners.

A central issue of concern is how kothis identify with the feminine
as a performative role, and the conflicting situations, both
emotional and social, that such roles place them in. By linking the
kothi identify with the feminine, and then linking the feminine with
the female, kothis see themselves as NOT-MEN, while panthis are
perceived (and perceive themselves) as MEN.

This gender construct generates enormous psychological self-damage,
while at the same time increases risky behaviours with personal and
societal impacts. It further disavows other frameworks of sexualities
and behaviours, such as `bisexual behaviour', a `dubli/do-paratha'
identity, and so on.

This workshop explored the context of kothi identities within a
construct of multiple masculinities towards developing an empowering
sense of self, awareness and behaviour change.

Facilitators: Dalip Daswani, Independent Consultant, Pune, India and
Azizul Haque, Programmes Director, Bandhu Social Welfare Society,
Bangladesh

Monitoring and Evaluation
All partner agencies have monitoring mechanisms as part of the
project work. While NFI has developed a standard replicable
monitoring package, donors and government agencies often have their
own monitoring systems. At the same time, partner agencies have
experienced difficulties in understanding and implementing the use of
monitoring data for evaluation of impact and sustainability.

This workshop explored differences in monitoring systems, and how
effective evaluation methodologies can be developed, as well as
working towards developing a common system of monitoring and
evaluation for all the partner projects.

Facilitators: Dr. Ravi Verma, Programme Associate, Population Council
(Horizons Project), India, Kim Mulji, Director, UK Office, NFI

Kothi And Other MSM Sex Work, Poverty and Exclusion
Within south Asia, male sex workers operating at public sites are
primarily kothi-identified, but not exclusively so. Most are from low-
income groups where poverty and support for their families drive much
of their sex work. This is not ignore other types of male sex
workers, such as malaishias of Pakistan and the boys who operate
through massage parlours and hotels, many of whom offer their
services to both male and female clients. In other words, there
several frameworks of male sex work.

This workshop explored these frameworks, the reasons for male sex
work, the various risks and issues involved, focusing on poverty
alleviation. It will develop strategies for working with male sex
workers and reduce risks for HIV/STI infection that are based on a
framework of wellbeing.

Facilitators: Paramita Bannerji, independent consultant, Calcutta,
India and Maya Ganesh, independent consultant, New Delhi, India

Donors
The following donors supported this Meeting
DFID
Family Health International
HIVOS
International HIV/AIDS Alliance
Swedish International Development Agency
UNAIDS