AIDSTAR-One Empowering Men Who Have Sex with Men to Live Healthy Lives in Colombia

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Together, a support network plus access to legal and psychological support are essential components of HIV programming for most-at-risk populations. In Colombia, obtaining this support is difficult …

Together, a support network plus access to legal and psychological support are essential components of HIV programming for most-at-risk populations. In Colombia, obtaining this support is difficult for many members of the lesbian, gay, bisexual, and transgender (LGBT) community due to pervasive stigma and discrimination. Bogotá's LGBT Community Center was founded in order to help fill this need and serves a clientele comprised mainly of men who have sex with men. This case study (one of nine in a series) examines the center's efforts to provide a social and educational base for its clients while also advocating for their rights.

www.aidstar-one.com/focus_areas/gender/resources/case_study_series/colombia_lgbt

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  • 1. AIDSTAR-One | CASE STUDY SERIES September 2011Empowering Men Who Have Sexwith Men to Live Healthy LivesIntegrated Services at Bogotá’s Lesbian, Gay, Bisexual,and Transgender Community Center I n a small two-story house in an upper middle class neighborhood in Bogotá, some 20 men, ranging in age from the late teens to the mid-50s, sit in a crowded circle in a tiny room. Group participants come from all over Colombia, and even include an expatriate from abroad. But they all share two things: they all identify as men who have sex with men (MSM), and they are all looking for a place where they can speak freely about their sexual orientation. In Colombia’s highly homophobic society, such a setting is not commonplace. This week’s discussion topic centers on preparation for Colombia’s gay pride parade; this year, the theme is “Neither ill, nor antisocial—proudly LGBT.” Later, a psychologist will talk to the men about common mental health issues among MSM, Myra Betron particularly those who are still coming to terms with their sexual orientation.Entrance to the LGBT CommunityCenter. This is a typical evening at Colombia’s Lesbian, Gay, Bisexual, and Transgender Community Center (LGBT CC), housed in the barrio (neighborhood) of Chapinero, the location of many bars where Bogotá’s LGBT population commonly meets. The LGBT CC gives the community an alternative to the bars, a safe space where MSM feel no pressure to engage in risky behavior, and where they can developBy Myra Betron supportive social networks, which—importantly in Colombia—can also reduce their risk of contracting HIV.AIDSTAR-OneJohn Snow, Inc.1616 North Ft. Myer Drive, 11th Floor This publication was produced by the AIDS Support and Technical Assistance ResourcesArlington, VA 22209 USA (AIDSTAR-One) Project, Sector 1, Task Order 1.Tel.: +1 703-528-7474 USAID Contract # GHH-I-00-07-00059-00, funded January 31, 2008.Fax: +1 703-528-7480 Disclaimer: The author’s views expressed in this publication do not necessarily reflect the views of the United Stateswww.aidstar-one.com Agency for International Development or the United States Government.
  • 2. AIDSTAR-One | CASE STUDY SERIESGender, Men Who Have orientation, but these protections often fail. There is a strong fear and aversion among politicians to be seenSex with Men, and HIV in as investing in MSM and prostitutes, though they areColombia the groups that are most vulnerable to HIV infection. Indeed, the MSM population in Colombia is highlyAlthough Colombia’s national HIV prevalence is low stigmatized and discriminated against for their(roughly 0.6 percent; Joint U.N. Programme on HIV/ sexual orientation and gender identity. This leads toAIDS [UNAIDS] 2006), the number of people living with increased HIV risk in various ways. Violence againstHIV (PLHIV) in Colombia is one of the highest in Latin MSM is said to be common, and many have beenAmerica—estimated at 170,000 to 200,000 (UNAIDS murdered, under the guise of “social cleansing,”2006). MSM (along with sex workers) are among by paramilitary groups and death squads (Humanpopulations most-at-risk for HIV infection. Although Rights Watch 1994). As a result, MSM deny theirdata on HIV indicators among MSM are scarce, small- identity and likewise, their HIV risk (Saewyc et al.scale studies indicate the prevalence of HIV among 2006 in Spratt 2010). In addition, MSM may alsoMSM to be anywhere from 10 to 18 percent (Liga hide their sexuality, which, as studies have shown,Colombiana de Lucha Contra el SIDA 2000). Yet there can prevent them from receiving information aboutis little public investment in HIV prevention. HIV transmission and prevention or adequate health services (Morrison 2006). Staff and users ofUnlike other countries in the region, Colombia has the LGBT CC said that health care providers hadno nationally-funded HIV program, though there denied them services based on either HIV status oris a National Plan to Respond to HIV and AIDS perceived sexual orientation or gender identity.2008–2011. Comprehensive operational guidelinesfor the plan include a programming framework for Over the last decade, however, rights organizationsMSM, national campaigns, educational projects on for LGBT individuals have sought to combat stigmaHIV and other sexually transmitted infections (STIs) and discrimination through advocacy for legaltargeted at MSM and providers, and informational rights and protection. As a result of many years ofprojects on rights and access to services. However, advocacy, in particular by the nongovernmentalimplementation of the plan is very limited. The national organization (NGO) Colombia Diversa (DiverseHIV plan is coordinated and monitored by the Ministry Colombia), landmark legal reform has takenof Social Protection but is not centrally funded. Under place, making Colombia one of the world’s mostColombia’s decentralized public health system, progressive countries with respect to rights for LGBT.provincial ministries can decide whether or not to Perhaps most notably, individuals in same-sexinvest funds to execute the activities recommended partnerships now have the right to access health andin the national plan. As a result, levels of effort to social security benefits of their partners.address HIV vary throughout the country. In Bogotá,one of the more progressive districts, there is a Luis Eduardo Garzón, mayor of Bogotá from 2004nascent initiative to develop a public policy on HIV to 2007, passed a decree that defines the principles,by the Secretary of Health, but in other sectors, a objectives, strategic processes, and components ofresponse to HIV is practically non-existent. public policy for LGBT in Bogotá. The resulting policy framework created and designated the SubsecretariatA number of local and national laws assert for Women, Gender and Sexual Diversity withinequal rights for same-sex couples and prohibit the Planning Secretariat to formulate, monitor, anddiscrimination and mistreatment based on sexual evaluate activities under the LGBT policy framework.2 AIDSTAR-One | September 2011
  • 3. AIDSTAR-One | CASE STUDY SERIESThe decree also established an LGBT Advisory Council, which is madeup of delegates from the LGBT community, to provide input into the work PEPFAR GENDERof the Office of Sexual Diversity within the Subsecretariat. The most STRATEGIESvisible work is currently being done by the District Institute for Community ADDRESSED BY THEParticipation and Action (IDPAC), which strengthens LGBT organizations LGBT CCto meet its objectives of increased citizen participation of these groups.IDPAC also oversees and funds the work of the LGBT CC and has • Increasing gender equity in HIVmanaged the community center since 2009. programs and services • Addressing harmful genderHowever, these advances in LGBT inclusion occurred in isolation from norms and behaviorsthe work being done to address HIV and required much advocacyby champions of the sexual diversity agenda within the government. • Increasing legal protection.Moreover, the MSM community has not been active in advocating forincreased attention to the problem of HIV. Pervasive attitudes—includinga public perception that all MSM are infected with HIV and a strong taboo,even among MSM, to discuss HIV openly—render such advocacy verydifficult, make PLHIV unwilling to come forward, and constitute a majorlost opportunity to mitigate the HIV crisis. As a result, efforts to create agroup representing the interests of PLHIV have been unsuccessful.Program ObjectivesThe LGBT CC was established in 2006 with the overall goal ofincreasing citizen participation and advancing the rights of the LGBTpopulation of Bogotá. The community center seeks to empowerLGBT individuals and groups to reach their fullest potential—includingacceptance with individual sexual orientation, helping families andcommunities to understand the rights of LGBT individuals to choosea gender identity and have loving relationships, and support collectiveaction by LGBT groups and organizations to defend and demand theirrights at the local and national levels. LGBT individuals can meet atthe community center to organize political actions, conduct advocacy,provide emotional support to one another, participate in cultural and I now feel happy to have found a space in which I need not hide or disguise, a place of open doors and hearts, a place [in] which I do not have to shut up or conceal my desires. —Clara, a transgender woman Empowering Men Who Have Sex with Men to Live Healthy Lives: Integrated Services at Bogotá’s LGBT Community Center 3
  • 4. AIDSTAR-One | CASE STUDY SERIES educational activities, and receive legal or psychological services for BOX.1 PROFAMILIA personal problems resulting from stigma and discrimination based on COLOMBIA their sexual orientation and gender identity. Although it is open to all of the LGBT community and their friends and families, the majority PROFAMILIA is a private NGO of users—some 43 percent—identify themselves as MSM (Centro that has promoted and provided Comunitario LGBT 2009). sexual and reproductive health services in Colombia for the The concept for the LGBT CC was born in 2005, under the leadership and past 45 years. The organization direction of civil society with the support of Mayor Luis Eduardo Garzón. has 33 clinics with over 1,700 The leader of the Chapinero neighborhood consulted with LGBT groups staff in 29 cities throughout the to identify what they considered to be priority issues and needs in the country. For the past 19 years— community. LGBT groups, led by Colombia Diversa, proposed the idea of PROFAMILIA has worked in the LGBT CC. Subsequently, Colombia Diversa called upon PROFAMILIA the area of gender—beginning because they are the strongest Colombian NGO working on sexual first with youth and in recent and reproductive health, a major NGO health service provider, and a years with the general public. leading proponent of HIV prevention, as well as for its expertise in project PROFAMILIA has also been execution and service provision (see Box 1). Fundación Arcoiris (Rainbow working in the area of HIV Foundation), the philanthropic arm of Theatrón, Bogotá’s largest LGBT club, from a health perspective over was enlisted to help with fundraising. The mayor’s office would support the the last 15 years. In 2003, the idea as a pilot project initially, which in effect meant only partial funding. organization fortified its HIV prevention work with MSM. Recognizing that stigma and Collectively, Colombia Diversa, PROFAMILIA, and Fundación Arcoiris— discrimination is a major factor in referred to as the Temporary Union—designed and managed a pilot the spread of HIV in Colombia, project lasting from October 2006 to January 2009. During the first PROFAMILIA has also focused phase of the project, the mayor’s office provided 60 percent of the costs on reducing HIV-related to run the LGBT CC; the Temporary Union had to raise the rest of the stigma and discrimination. funds through events and in-kind donations, including volunteer human For PROFAMILIA, this means resources. The Temporary Union worked closely with the municipal increased respect for sexual government to conceptualize and design the LGBT CC, but even in diversity, which it sees as critical the pilot phase the NGOs had to justify the center’s value by regularly to the concept of sexual rights. presenting service statistics and audits to members of the municipal To that end, PROFAMILIA government who questioned the need for and integrity of the program. developed a virtual training course on sexual diversity for staff in all of their clinics, both Lesbian, Gay, Bisexual, and Transgender administrative and clinical. Community Center Services The original vision of the LGBT CC did not include service provision; those provisions were added during the pilot to meet demands from users. PROFAMILIA designed the health and psychological service components and ensured quality of services, while Colombia Diversa designed legal components.4 AIDSTAR-One | September 2011
  • 5. AIDSTAR-One | CASE STUDY SERIES BOX 2. CLARA’S STORY The availability of a safe space to share experiences can be transformative. One exemplary case is Clara, a transgender woman. She came to the center, with great trepidation, seeking psychological support for her lifestyle. The acceptance she found at the center first calmed Myra Betron her fears and finally exceeded her expectations. Users of the LGBT CC get ready to march in Bogotá’s LGBT “With the passage of time and pride march. the consultations I realized thatSexual and reproductive health and HIV: HIV was not what I felt was not deviance, thatthe main focus of the LGBT CC during its formation. However, the I was not a pervert or somethinginvolvement and experience of PROFAMILIA, combined with the many like that. After my first time atrequests from users, led the center management to incorporate a the LGBT Community Center, Isexual and reproductive health component, including HIV, within the could assume my identity as apilot project. Activities such as game nights, movie nights, and eight woman. It was wonderful—for“Sexual and Reproductive Health Days” were initiated by activists and the first time I felt accepted andvolunteers and supported by the director of PROFAMILIA’s gender a part of something…I now feeland sexual diversity program. All of these activities incorporated happy to have found a spacediscussions about sexuality, sexual and reproductive health, STIs, in which I need not hide orcondom use and negotiation, and safer sex. During some chats, La disguise, a place of open doorsRed Colombiana de Personas Viviendo con VIH (The Colombian and hearts, a place which I doNetwork of People Living with HIV) and Liga Colombiana de Lucha not have to shut up or concealContra el SIDA (Colombian network responding to AIDS) provided my desires.”their expertise on HIV prevention, care, and support. Center staff Eventually, Clara became andistributed condoms, supplied by PROFAMILIA, during various events, important fixture of the center,and referred users to PROFAMILIA for special sexual and reproductive giving art classes as a volunteer.health needs such as voluntary counseling and HIV testing services. In the end, Clara was able to beDuring World AIDS Day 2008, the LGBT CC also conducted a public open with her gender identity,campaign to raise awareness about HIV. proud of who she was and her talents, and much more engagedServices to increase legal rights and protection: Legal services with her community.that have been provided at the LBGT CC address same-sex partner rightsto health and pension benefits, workplace discrimination, harassment basedon sexual orientation, and violence against LGBT. For transgender people,legal interventions have included development of processes to changetheir names and sex on official documentation. The community center has Empowering Men Who Have Sex with Men to Live Healthy Lives: Integrated Services at Bogotá’s LGBT Community Center 5
  • 6. AIDSTAR-One | CASE STUDY SERIEShelped a number of PLHIV in the community to file through its activities or services—demonstrateddiscrimination suits against health services that have that the pilot program had been a success. Basedrefused to attend to them, or employers who have on these results, starting in 2009, the mayor’sdismissed them, because of their HIV status. office agreed to completely fund the community center as part of the district’s development plan.Psychological services: The psychological After the end of the pilot phase, a new mayor,services that have been provided at the LGBT CC, Samuel Moreno, took leadership of Bogotá’sand are in very high demand, are for LGBT individuals government and supported the policy frameworkwho have experienced discrimination, violence, put into place by Garzón. Although Moreno is notand rejection based on their sexual orientation by seen as a strong supporter of LGBT rights, thefamilies or friends (see Box 2). The psychologist policy framework already put in place by Garzónworks with families and friends of LGBT individuals, committed the government to continuing to addressor the individuals themselves, to help them accept LGBT issues; the high visibility and demand forthe idea of sexual choices outside the social norms; services of the LGBT CC would make it politicallythe psychologist also addresses a few cases of MSM risky not to continue funding it. Moreover, supportliving with HIV who experience discrimination in the for the community center continued in the Office ofhealth care setting or in the workplace. Sexual Diversity and other government offices. The center continues to operate as a government entitySocial work: Social work that has been provided managed by IDPAC.consists of helping organize specific political interestand support groups promoting a range of issues ofinterest to LGBT individuals. These groups and theiractivities are the foundation and center point for What Worked Wellthe theory of personal and collective empowermentbehind the LGBT CC. All of these groups seek a The LGBT CC has not been formally evaluated.“safe” space—MSM, for example, want to socialize However, LGBT CC staff collect and monitorand interact in non-sexual ways, and parents’ groups service statistics routinely, which are then reportedseek to better understand and accept the sexual to IDPAC. Also, the coordinator of the LGBT CCorientation and gender identity of their children. pilot project developed a summary of the lessons learned during the pilot. Based on those data andCurrently, a multi-sectoral team, made up of a interviews with key informants and focus groupslawyer, two psychologists, a social worker, a with users, the following are lessons learned andcoordinator, and administrative staff, work to provide successes of the project.the services described previously. In addition, thecommunity center relies on various volunteers and Filling a service gap for LGBT individualsinterns, particularly for the counseling work provided in Bogotá: Since its inception, LGBT CC staffby the psychologists, which is in high demand. The noted a very strong, sometimes overwhelming,LGBT CC also provides cultural and entertainment demand for services. In focus group discussions,activities; training for health center staff, schools, users of the community center noted that theygovernment entities, and police; and referrals to appreciate having access to a place where theyother organizations and services. know they will be understood and accepted by staff, as opposed to legal and psychological services forHigh demand for services and high attendance—in the general public where LGBT individuals must2009 alone, the center served over 14,000 people explain their gender identity. Both staff and users of6 AIDSTAR-One | September 2011
  • 7. AIDSTAR-One | CASE STUDY SERIESthe community center emphasized the value that the environment provided at the LGBT CC are muchpsychological services alone provide to community safer in terms of HIV risk. The value of the spacecenter users; MSM said that the center has helped and support that the community center offers forthem to accept their sexual orientation and gender reflection, organizing, and empowerment cannotidentity, and to understand and defend their rights be overestimated in terms of its contribution to HIVas MSM. The community center added more space prevention and mitigation.in response. As a result of the first LGBT CC’ssuccessful establishment, there is the possibility ofopening similar community centers in other cities Challengessuch as Medellín. This would be an importantachievement given the very conservative political After the pilot phase, LGBT CC was converted intoenvironment at the national level. a government-run and -funded institution that is supported by IDPAC, which focuses mainly on citizenHIV prevention through social and participation. A number of challenges and lessonspolitical action: HIV experts and researchers emerged through this process.argue that by encouraging at-risk groups to seeksupport for the internal and external stigma they Loss of expertise with new management:face, either because of their identity as sex workers The transfer of management from the Temporaryor MSM, or their HIV status, individuals may Union (PROFAMILIA, Fundación Arcoiris, andbe more likely to engage in protective behavior, Colombia Diversa) led to a significant loss insuch as condom use and seeking life-saving expertise and lessons learned. For example, whilesupport, including HIV services (see, for example, the LGBT CC developed a directory of referralInternational Center for Research on Women 2009; services during the pilot years, the current staffMartinez 2004; Pronyk et al. 2008). Participants stated that they were developing their own referraland program staff felt that the main benefit of the system and seemed unaware of the referral directoryLGBT CC was the space it provided to socialize by the previous LGBT CC staff. Moreover, the roleand network with others of the same gender identity of the LGBT CC in training and sensitizing otheroutside a bar or sauna setting, where casual institutions and service providers on LGBT rights hassexual encounters are common. The activities and been transferred to the Office of Sexual Diversity. This approach loses the special perspective of the LGBT CC, which works more directly with the I took a risk and entered (the center). community and has a stronger understanding of LGBT concerns. I found that there was a place where one can express himself, where Lack of integration of sexual and one can share; not only are there reproductive health issues: Likewise, because the community center’s main goals discotheques, bars, saunas, but there currently fall under objectives related to increasing also exists a real place where one citizen participation in Bogotá’s development plan, can relate with others and where they and because PROFAMILIA is no longer involved, HIV and health issues do not play a role in the give cultural and educational talks. community center’s current activities and services. –MSM participant The new team does not seek to link PLHIV with HIV service organizations, even though several users Empowering Men Who Have Sex with Men to Live Healthy Lives: Integrated Services at Bogotá’s LGBT Community Center 7
  • 8. AIDSTAR-One | CASE STUDY SERIEShave sought help of this kind. There are ad hoc largely to socialize and seek support from peers,efforts to address HIV, such as discussions about the for psychosocial services, and to a lesser extent,myths related to HIV, and there is a move to organize for legal services. These services are still importanta PLHIV support group. However, these efforts are strategies for reducing HIV risk.still in the initial stages of planning.Other key barriers to incorporating HIV preventionand care into the LGBT CC include the following: Recommendations Draw on the strengths of various sectors• Weak external partnerships and networks with well- to develop integrated services: The established and experienced HIV organizations, development of the LGBT CC was a completely and lack of expertise in health and HIV among the new effort for any one group in Colombia. Thus, center’s present management and staff—even to Colombia Diversa, when initially approached by the orient and refer users who come to the center with mayor’s office, was wise to bring in the expertise specific health issues is a key challenge. of other organizations. Colombia Diversa brought• The continuing widespread belief that all MSM its expertise in human rights, advocacy, and legal have HIV may increase the stigma directed at services; PROFAMILIA brought its expertise as a community center staff and users by those within sexual and reproductive health service provider; and outside the LGBT community. and Fundación Arcoiris brought its experience in fundraising. PROFAMILIA’s experience and• Overall weak leadership on the issue of HIV reputation also reassured the government and public on the part of the government. As discussed that the funds were being managed and invested previously, both at the national and municipal in worthwhile activities, and counteracted the levels, HIV has not been prioritized. apprehension that public funds were being spent on “gay” activities. Finally, the municipal government’sBarriers in government: Under its new leadership in financing, coordinating, and politicallyleadership, the community center conducts less supporting the creation and existence of the LGBToutreach than it did previously on the rights of CC was essential to its sustainability.LGBT, despite the desires of center staff and users,who would like further public promotion of LGBT The importance of this multi-sectoral approachrights, including a curriculum on LGBT rights within is underscored in the current status of the LGBTprofessional and academic training programs. CC. Despite the government’s important role inHowever, government bureaucracy can potentially sustaining the work of the LGBT CC, they lackdecelerate the progress of campaigns to counter the specific expertise in legal, health, and generaldiscrimination. For example, under the present service provision, as well as experience in workingarrangement, all messages released by the LGBT through networks. Thus, while the current LGBTCC must be reviewed and approved by the municipal CC is relatively stronger as a space for political andgovernment’s Secretary of Communication, which social activity for LGBT, it is less able to meet thiscan delay or derail advocacy efforts. Moreover, community’s continuing demand for health, legal, andsince staff are government employees, there may psychological services. Similar efforts to establishbe more reticence to confront government on a center that provides multi-sectoral services maygaps in laws and policies. To be sure, users of the require either a longer transition period from civilLGBT CC currently do conduct advocacy activities. society to government, wherein both co-manageHowever, the users go to the community center the program to allow for transfer of knowledge and8 AIDSTAR-One | September 2011
  • 9. AIDSTAR-One | CASE STUDY SERIESresources. Alternatively, the program should be work needs to be done to tackle the stigma, whichadministered and coordinated by a unit in the higher undermines the potential for a more comprehensivereaches of government, such as the mayor’s office, approach to HIV prevention.which can coordinate various government agenciesinvolved, such as health, social services, and the Involve appropriate and representativedepartment of justice. groups to represent LGBT populations: Overall, the LGBT CC can be replicated in settingsAssess community needs in advance of with a strong health and legal framework in place. Indesigning programs: Although this may seem Colombia, for example, years of effort by Colombialike an obvious point, it should still be underscored. Diversa, PROFAMILIA, and other advocacy andDuring the pilot phase, the staff of the LGBT CC service groups, combined with a relatively favorablewere initially unprepared for the deluge of clients policy environment, enabled the creation andfor services, especially psychological services. success of the LGBT CC, first as a service providerEven after they hired the relevant staff, they were and later as a center for political and communityoften understaffed and unable to meet demand. participation. In other settings—for example,Moreover, while current political objectives by where the LGBT community is persecuted for evenmunicipal leadership dictate the LGBT CC focus identifying as outside the social norm—establishingon citizen participation, there is clearly a need an LGBT center could endanger those attending orfor comprehensive services. Understanding and prevent their attendance entirely.prioritizing those needs is essential to improve thewell-being of the LGBT community. Where the political environment is favorable enough, the government may in fact be a keySecure internal expertise and leadership collaborator. However, groups that adequatelyto maintain the focus on HIV: Because the represent LGBT interests and concerns mustLGBT CC’s current funding stream is tied to line always be part of the process to maximize theitems related to citizen participation in Bogota’s benefit of their experience. As initial lessons fromdevelopment plan, and because PROFAMILIA is this experience in Colombia have shown, this mayno longer involved, HIV and health issues no longer require a longer process for civil society experts toplay a role in the center’s activities and services. work alongside government.However, program statistics and focus groupdiscussions with program participants demonstrate Rigorous monitoring and evaluation isstrong uptake of and interest in support groups and essential: The effects of the LGBT CC on HIVservices related to HIV. PROFAMILIA’s experience prevention were not evaluated following the pilotshows that there must be a champion to lead the phase. Still, the literature indicates that a rights-effort of integrating such a specialized topic into a based approach to HIV prevention that addressesbroader program. issues of discrimination and violence, as the LGBT CC’s services do, can be more effective thanCombat HIV-related stigma as well as strictly focusing on sexual risk behavior of MSM. Itstigma based on gender identity: In is not clear, with its current structure, whether thesettings with highly concentrated epidemics, HIV is LGBT CC would benefit its users by adding HIVextremely stigmatized and information about HIV services or whether this would diminish the qualityis extremely distorted. In Colombia, this stigma of existing services by stretching limited resources.has steered the LGBT movement away from Given that there are already other organizationsinvolvement with the HIV movement. Clearly, much that can provide expertise in HIV, it may be better Empowering Men Who Have Sex with Men to Live Healthy Lives: Integrated Services at Bogotá’s LGBT Community Center 9
  • 10. AIDSTAR-One | CASE STUDY SERIESfor the center to take advantage of these existing Human Rights Watch. 1994. Generation Underservices and its wide accessibility to MSM to raise Fire: Children and Violence in Colombia. Availableawareness about HIV risk or refer MSM to HIV at www.hrw.org/reports/1994/colombia/gener1.htmservices at other organizations. (accessed August 2010) International Center for Research on Women (ICRW). 2009. Sex, Rights and the Law in a WorldFuture Directions with AIDS: Meeting Report and Recommendations. Washington, DC: ICRW.Under the city’s development plan, the program“Bogotá Respects Diversity” includes plans to Joint U.N. Programme on HIV/AIDS. 2006.open three more community centers in the city, Prevalencia de Infección por VIH en HSH de Bogotá.one of which is a mobile center that is already Informe final (Preventing HIV Infection in MSM infunctioning. This mobile center does not provide Bogota: Final Report). Colombia: UNAIDS.services; instead, it refers individuals to servicesas needed. The main focus of the mobile center, Liga Colombiana de Lucha contra el SIDA (LCLS).as with the first LGBT CC, is to promote political 2000. Estudio de Prevalencia al VIH con HSH enand community participation by LGBT to advance Bogotá (HIV Prevention Study with MSM in Bogotá).the objectives of increased equity and recognition Colombia: LCLS, SDS (Secretaria Distrital de Saludof sexual diversity. The others have yet to open. de Bogotá), and UNAIDS.According to representatives of the mayor’s office,the main barrier is a lack of funding because the Martinez, A. 2004. “Social Capital: Convergencescenters were not well budgeted for when they were and Divergences Between Sociology and Publicinitially proposed. Health Research.” Paper presented at the annual meeting of the American Sociological Association,In addition, the health sector is developing San Francisco, August 14.protocols to attend to LGBT in the health caresetting, an effort being led by the Hospital of Morrison, K. 2006. Breaking the Cycle: Stigma,Chapinero. There are also efforts to reduce Discrimination, Internal Stigma and HIV. Washington,discrimination in schools, as well as cultural DC: U.S. Agency for International Developmentactivities in the community to raise awareness Policy Project.about LGBT rights. To that end, the Office of Pronyk, P. M., T. Harpham, L. A. Morison, et al.Sexual Diversity will be carrying out trainings for 2008. Is Social Capital Associated with HIV Riskteachers, health providers, and other government in Rural South Africa? Social Science & Medicineservice providers on LGBT rights. n 66(9):1999–2010. Saewyc, E., C. Skay, K. Richens, et al. 2006. SexualREFERENCES Orientation, Sexual Abuse, and HIV-Risk Behaviors Among Adolescents in the Pacific Northwest.Centro Comunitario LGBT. 2009. Un Lugar de American Journal of Public Health 96(6):1104–10.Encuentro y Convivencia con la Diversidad: InformeFinal de Gestión (A Meeting Place and Living with Spratt, Kai. 2010. Technical Brief: Integrating GenderDiversity: Final Management Report). Colombia: into Programs with Most-at-Risk Populations.PROFAMILIA). Arlington, VA: USAID’s AIDS Support and Technical10 AIDSTAR-One | September 2011
  • 11. AIDSTAR-One | CASE STUDY SERIESAssistance Resources, AIDSTAR-One, Task Order helping to document focus group discussions with1. Available at www.aidstar-one.com/focus_areas/ LGBT CC participants. Thanks also to the PEPFARgender/resources/technical_briefs/gender_MARPs Gender Technical Working Group for their support(accessed August 2011) and careful review of this case study.ACKNOWLEDGMENTS RECOMMENDED CITATIONThe author greatly appreciates the former and Betron, Myra. 2011. Empowering Men Who Havecurrent staff and users of the LGBT CC, as well as Sex with Men to Live Healthy Lives: Integratedrepresentatives of civil society and government who Services at Bogotá’s Lesbian, Gay, Bisexual, andtook the time to discuss the LGBT CC, the LGBT Transgender Community Center. Case Study Series.movement, and HIV in Colombia. Special thanks Arlington, VA: USAID’s AIDS Support and Technicalgoes to Elizabeth Castillo Vargas of PROFAMILIA Assistance Resources, AIDSTAR-One, Task Order 1.for the time and effort she took to accompany theauthor throughout the case study data collection visit Please visit www.AIDSTAR-One.com forand provide useful insights into the establishment of additional AIDSTAR-One case studies and otherthe LGBT CC. The author thanks Maritza Ochoa for HIV- and AIDS-related resources. Empowering Men Who Have Sex with Men to Live Healthy Lives: Integrated Services at Bogotá’s LGBT Community Center 11
  • 12. AIDSTAR-One’s Case Studies provide insight into innovative HIV programs and approachesaround the world. These engaging case studies are designed for HIV program planners andimplementers, documenting the steps from idea to intervention and from research to practice.Please sign up at www.AIDSTAR-One.com to receive notification of HIV-related resources,including additional case studies focused on emerging issues in HIV prevention, treatment,testing and counseling, care and support, gender integration and more.