MSM project amongst refugees and surrounding host community in Cox’s Bazaar, Bangladesh
Z. Jamal1, A. Burton2, Z. Sultana3
1UNHCR, Health and Nutrition, Cox’s Bazaar, Bangladesh, 2UNHCR, Regional Office HIV, Bengkok, Thailand, 3UNHCR, Reproductive Health, Cox’s Bazaar, Bangladesh
Issues: There are 28,029 registered Rohingya refugees residing in two camps in Cox’s Bazaar, Bangladesh. Bangladesh has a low level HIV epidemic with infection risk concentrated in most-at-risk populations. The majority of men who have sex with men (MSM) in Bangladesh have limited access to critical HIV prevention, care and support services.
Description: An HIV prevention programme for MSM in refugee and surrounding communities began in 2009 and includes the following: 1. MSM and refugee peer educators provide information and facilitate access to HIV and sexually transmitted infections (STIs) prevention commodities and services including condoms, behavioural change and communication materials and appropriate referral; 2. Weekly support groups for both communities; 3. Referral in camps for HIV counseling and testing, STI management, counseling, partner tracing and treatment; 4. Provision of condoms and lubricant through peer educators, community health workers, STI clinics and two HIV resource centres; 5. General community awareness through cultural activities (e.g. street drama, folk songs and quizzes) with the aim of reducing HIV stigma and reaching MSM not reached by specific interventions.After less than one year of implementation, 79 MSM from both refugee and surrounding populations have been regularly accessing services; 9,600 condoms have been distributed to MSM compared with only 650 the previous year; 34 MSM received treatment for STIs and five have accessed voluntary counseling and testing services. This is a considerable improvement given the stigma associated with male to male sex in this particular setting.
Lessons learned: It is possible to reach MSM with HIV prevention services in refugee camp settings despite strong socio-cultural constraints. Specific services for MSM communities, including peer support, and a comprehensive package of HIV prevention services will facilitate access. In refugee settings, it is important to include MSM from surrounding host communities as their sexual networks interact.