By Omar Banos, Sr. Technical Advisor
After walking a flight of stairs to the second floor of a rented hall in mid-December 2018, I strolled around the large room appreciating a photo-voice exhibition of photographs, each accompanied by a unique story. The photos were set on easels, spread around the room, poster size, with short statements reflecting on the emotions and experiences that each gay and bisexual men and transgender person wanted to convey. The photos told the stories of gay and bisexual men and transgender people’s experiences around barriers and entry points to sexual health services in Hanoi, Son La and other provinces of Vietnam.
I had been looking forward to this photo-voice exhibition. Lighthouse, a nonprofit organization based in Hanoi is an MPact’s Bridging the Gaps partner and had been working on this project for the past six months. They titled it Invisible (Bên trong khoảng trống) because they wanted to bring to the frontline concrete experiences that seem invisible to non-LGBTI communities.
The photo-voice exhibition reflected the every-day lives of community members who voluntarily documented their daily experiences related to stigma, discrimination, sexual health, HIV, family and friends. Each selected photo was accompanied by a written testimonial that expressed the thoughts, emotions, fear and/or endurance that the photographer related to that image. The series provided a way to capture the day to day experiences of members of this community that are rarely considered in HIV prevention programs and services.
Through these images, Lighthouse captured and documented stories that can help HIV advocates, stakeholders and policy makers understand the issues that gay and bisexual men and transgender people encounter when accessing health services, including HIV and other STI services. The stories provide nuanced experiences that can contribute to appreciate the complex sexual health needs and barriers for successful HIV interventions and overall access to healthcare services for key populations.
I could also appreciate the diversity of the photo exhibition. One photo that caught my attention depicts a bustling street crammed with motorbikes during peak traffic hour, a daily scene for most Vietnamese people going and coming to work, school, dates, or going to get tested for HIV. The caption says:
“If I have to see a doctor for STI testing, I will lie and say I have sex with women because I feel most medical staff still stigmatize gay people and actually, they don’t know anything about gay sex. So, even if I share, they may not give me the right counseling. I also don’t want them to treat me different because I am different. I don’t want to come out in the crowd.”
As a spectator, one can only imagine how stressful this situation can be for a young gay man to have to hide his sexual orientation from a healthcare provider who should be a safeguard and resource for healthcare and wellbeing.
Another image I found especially compelling portrays a close-up of the face of a gay man from the province of Hai Phong. His eyes are staring right at the camera lens, capturing an intense look. The text with this photo says
“Healthcare providers kept looking inquisitively, prying and asking questions that make some of the patients feel offended and hurt their self-respect…”
It says so much about the inquisitive looks gay men and transgender people face in spaces that should be free of stigma and judgment.
Once the viewers had walked around and contemplated the photos, one Lighthouse’s staff member invited us to sit in the middle of the room. Medical students, key stakeholders of the HIV response and community members gathered in the center of the exhibit hall to listen to three speakers. We listened in and participated in a question and answer session with a few of the photo exhibition subjects. One speaker was a transgender woman. She showed her photo and spoke about the challenging and embarrassing moments she experienced when talking to healthcare providers who are not trained to understand the sexual health needs of transgender people. Once a doctor told her to “live as a normal boy” and lectured her, questioning her how transgender women have sex. These experiences have contributed to her not seeking healthcare services when she needs them, including HIV and STI screening.
The second speaker was a young gay man who shared a positive experience at the healthcare center. He said he felt comfortable sharing with the doctor about his sexual orientation and sexual encounters with other men because he knew the clinic he was visiting had already trained and sensitized its healthcare providers on sexual orientation and gender identity.
The third speaker was a healthcare provider who shared her experience in designing services for key populations at her private clinic and coordination with Lighthouse. Students in the audience wanted to learn what needed to change to make patients feel welcome, safe and respected at the healthcare clinics. The healthcare provider spoke about the success of training healthcare providers on the needs and rights of gay and bisexual men and transgender people, including information on sexual orientation, gender identity, and key communication strategies free of stigma and discrimination. They also talked about strengthening the voice of community members to be able to voice their opinion, just like the Invisible photo voice exhibition was doing.
By the end of the discussion, I and other participants had gained new perspectives on what works and what needs to improve in order to take down barriers that hinder access to health care services for gay and bisexual men and transgender people. The photo-voice exhibition was a starting point to talk, discuss and strategize to improve the lives of gay and bisexual men and transgender people in Vietnam. The next step for Lighthouse is to bring the photo-voice exhibition to different clinics and spaces where community members, healthcare providers, stakeholders and decision makers can engage in conversations to address the issues that this key population faces.