Secret lives, other voices: study explores sexuality, gender identity and HIV transmission risk in Fiji

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Secret lives, other voices: study explores sexuality, gender identity and HIV transmission risk in Fiji

28 August 2011

Fiji's President Ratu Epeli Nailitikau reads the report Secret lives, other voices at the launch.
Credit: UNAIDS/Kim

At the 10th International Congress on AIDS in Asia and the Pacific a new study called Secret lives, other voices was launched. It explores sexuality, gender identity and HIV transmission risk in Fiji, and represents the first research of its kind to be conducted since 1998 among men who have sex with men and transgender people in the country.

The launch was attended by Fiji's President Ratu Epeli Nailitikau.

With more than 200 respondents, the research project engaged staff members and volunteers from the AIDS Task Force of Fiji's Amithi Project and the AIDS Council of New South Wales.

Conceived with the aim to inform the HIV response and the development of community-based activities, the research was conducted by members of the community.  Research staff included men who have sex with men and transgender people, from a variety of social and ethic background, who were involved in each stage of the process including planning, data collection, analysis and reporting.

The report found that men who have sex with men are at high risk of HIV in Fiji. Only 21.6% of respondents consistently used condoms during anal sex with a male or transgender partner in the previous six months. More than one in five reported never using them.

Although there are high levels of knowledge about HIV, with over 66% of respondents answering questions correctly about transmission, the knowledge is not translating to behaviour.

The study also explored transactional sex and found that two thirds of the respondents reported giving or receiving money, gifts or favours in return for sex, making this a common experience.

Of the respondents only 10% had taken an HIV test in the preceding 12 months and knew the results. Barriers to testing included confidentiality and privacy issues as well as respondents reporting judgmental attitudes by clinic staff.

With technical support from UNDP and ACON we were able to show that civil society has the capacity to complete in-depth research projects to a recognizably high standard

Niraj Singh, co-author of Secret lives, other voices

Many of the study participants had experienced some form of stigma and discrimination. About two thirds felt unsafe and uncomfortable expressing their sexuality or gender. About 57% reported experiencing verbal abuse and a third had been physically hurt in the previous six months.

The report recommends that HIV prevention and health interventions should be culturally appropriate and focused on reaching different groups within the men who have sex with men and transgender community, many of whom self identify in different ways. Access to HIV testing that is friendly should be scaled up and health care workers need training to best support the needs of men who have sex with men and transgender people, according to the authors.

In addition, the report recommends a concerted effort to challenge stigma and discrimination and increase psychosocial and support services. Men who have sex with men and transgender people are also encouraged to develop mobilizing skills to make sure their voices are heard.

"With technical support from UNDP and ACON we were able to show that civil society has the capacity to complete in-depth research projects to a recognizably high standard," said Niraj Singh, Project Manager with the AIDS Task force of Fiji and co-author of the report.

"The AIDS Task Force of Fiji has a very clear vision of the priorities leading from research to action. We now have a baseline which will help us to design and implement effective programmes to reach a diverse range of men who have sex with men and transgender people in Fiji. This study represents a valuable contribution to ongoing national and regional efforts to ensure that these communities are better served and better protected," he concluded.

The Secret lives, other voices project was funded by the United Nations Development Programme (UNDP).