Tools and Guidelines

The training presented in this manual has been developed to help operationalise the UNAIDS MENA regional publication HIV and outreach programs with men who have sex with men (MSM) in the Middle East and North Africa (MENA): from a process of raising awareness to a process of commitment. It provides technical information and practical tools for peer educators to use as part of MSM outreach programmes in the Middle East and North Africa. These programmes aim to reduce the spread of HIV and other sexually transmitted infections (STIs) among MSM within a framework and context where their privacy, confidentiality and rights are respected.

Women affected by HIV in Nepal have reported violations of their rights, particularly in health care settings, being subject to forced and coerced sterilization or abortions, or denied access to sexual and reproductive health services. Yet, according to a UNDP Report released in 2013, not a single case was officially filed claiming discrimination or abuses in a health care setting. This is why this toolkit is needed and why it is vital for Nepal's fight against HIV. This training manual, Positive Protection: Empowering Women Affected by HIV to Protect their Rights at Healthcare Settings, will help ensure no one is left behind or overlooked in our work to achieve the Sustainable Development Goals (SDGs). This manual is aimed at empowering women with HIV to know and protect their rights, and to gain access to justice in cases where those rights have been violated.

Positive Protection is a training manual to empower civil society organizations to protect the rights of women affected by HIV at health care settings in Nepal. It was developed by the United Nations Development Programme (UNDP), the Asia Pacific Network of People living with HIV (APN+) and the National Federation of Women Living with HIV and AIDS in Nepal, in partnership with UNAIDS. The training manual was developed based on consultations with a wide range of national civil society groups in Nepal, including a two-day consultative workshop in November 2014 in Kathmandu to agree on the main areas to be included in the manual, and a two-day meeting in August 2015 in Nepal to agree on and validate the final draft of the manual.

As a network that focuses on male and transgender sexual health issues, one of ISEAN vision is to make societies within ISEAN are more accepting of sexual orientation and gender identity within the context human rights. ISEAN realizes that disseminating comprehensive information about sexual orientation and gender identity and expression (SOGIE) to our community is the most important and urgent thing that must be done prior to implementing the next program. The SOGIE Training Manual can be used as a guide in organizing capacity building on the basic knowledge of SOGIE. This manual consists of five modules that discuss the terms related to gender and sexuality; introduction to gender and sexuality; the process of identity formation and its challenges; stigma and discrimination, including homophobia and transphobia; and psychological issues related to gender and sexuality.

ISEAN has developed sexual orientation and gender identity and expression (SOGIE) package that can be applied by organizations that focus on the issue of sexuality and sexual health as well as by other organizations that consider this issue is important to be institutionalized in their organizations. The first document of this SOGIE Package is the SOGIE Assessment Tool that is used to measure the sensitivity level of an organization and its personnel to the issue of SOGIE. This tool can be used as a database for organizations that want to mainstream SOGIE issue in organization’s activities.

There were an estimated 17.8 million women aged 15 and older living with HIV in 2015, constituting 51% of all adults living with HIV. Adolescent girls and young women are particularly affected; in 2015 they constituted 60% of young people aged 15–24 years who were living with HIV, and they also accounted for 58% of newly acquired HIV infections among young persons in that age group. In many countries, women living with HIV do not have equitable access to good-quality health services and are also faced with multiple and intersecting forms of stigma and discrimination. Furthermore, women living with HIV are disproportionately vulnerable to violence, including violations of their sexual and reproductive rights. This guideline is meant to help countries to more effectively and efficiently plan, develop and monitor programmes and services that promote gender equality and human rights and hence are more acceptable and appropriate for women living with HIV, taking into account the national and local epidemiological context. It discusses implementation issues that health interventions and service delivery must address to achieve gender equality and support human rights.

Previously published United Nations (UN) guidance documents describe the content of effective HIV and HCV prevention interventions for people who inject drugs, in the context of harm reduction and HIV prevention for key populations. UN guidance is also grounded in an approach expressed in the critical enablers described in Table 2—strategies, activities and approaches to increase the accessibility, acceptability, coverage, quality and uptake of interventions and services for key populations. This tool offers practical advice on how to implement these programmes and these approaches for and with people who inject drugs, across the full continuum of HIV and HCV prevention, diagnosis, treatment and care, aligned with UN guidance. It contains examples of good practice from around the world that may support efforts in planning programmes and services, and describes issues that should be considered and how to overcome challenges. This tool does not seek to ignore the complex policy and legislative environment around drugs and injecting drug use in most countries, nor the need for advocacy to confront the stigma, discrimination and human-rights violations faced by people who inject drugs.

This Operational Manual has been prepared for easy reference of the staff at sentinel sites and provides the guidance on operational as well as technical aspects, for efficient implementation of HIV Sentinel Surveillance (HSS). It details the roles and responsibilities of the staff, recruitment process, and documentation, including instructions on filling of data forms and blood specimen management. The site in-charge should be aware of the entire set of functions and responsibilities of all the designated staff involved in surveillance activities at the sentinel site. This ensures better coordination and uninterrupted implementation of surveillance activities at the sentinel site.

This manual is in series of rounds of operational manual that is related before each round of surveillance with an objective to simplify the processes and to make them user-friendly. The manual, published separately for (antenatal clinic sites) ANC and (high-risk groups) HRG & bridge population sites, describes the eligibility criteria and sampling process to be followed for surveillance among respective groups. The steps and precautions to be taken while collecting, drying, packing and transporting the specimens are also outlined in this manual and explained with the help of graphics wherever necessary.

A gender analysis can be used to increase the effectiveness of HIV prevention, care, and treatment activities for key populations by identifying the specific gender issues in a given context, describing how they could affect a program’s goals, and identifying ways to work around or transform gender-related barriers and leverage gender-related opportunities. For USAID-funded projects, USAID requires that a gender analysis be conducted during the project design phase to inform a project’s design and implementation; it is the first step in the gender integration process. The toolkit contains all the information needed to conduct a comprehensive gender analysis. However, in recognition that programs may want to conduct a more streamlined analysis, key steps can be found on pages 7-16. Each step can be streamlined based on time, resources, and information available for a gender analysis.